Nokea
The client is diagnosed with Creutzfeldt-Jakob disease. Which referral would be the most appropriate?
- A. Alzheimer's Association.
- B. Creutzfeldt-Jakob Disease Foundation.
- C. Hospice care.
- D. A neurosurgeon.
Correct Answer: B
Rationale: The Creutzfeldt-Jakob Disease Foundation (B) provides specialized support and resources. Alzheimer’s Association (A) is unrelated, hospice (C) may be premature, and neurosurgery (D) is not typically indicated.
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Which intervention is most appropriate for a client with multiple sclerosis experiencing fatigue?
- A. Schedule activities in the late afternoon.
- B. Encourage short, frequent rest periods.
- C. Administer caffeine supplements.
- D. Increase physical therapy sessions.
Correct Answer: B
Rationale: Short, frequent rest periods help manage fatigue in multiple sclerosis by conserving energy.
The nurse is assessing the client diagnosed with bacterial meningitis. Which clinical manifestations would support the diagnosis of bacterial meningitis?
- A. Positive Babinski’s sign and peripheral paresthesia.
- B. Negative Chvostek’s sign and facial tingling.
- C. Positive Kernig’s sign and nuchal rigidity.
- D. Negative Trousseau’s sign and nystagmus.
Correct Answer: C
Rationale: Kernig’s sign (pain with leg extension) and nuchal rigidity (C) are hallmark signs of bacterial meningitis due to meningeal irritation. Other options include unrelated or less specific findings.
The client underwent a lumbar laminectomy with spinal fusion 12 hours earlier. Which nursing assessment finding indicates that the client has a leakage of CSF?
- A. Backache not relieved by narcotic analgesics
- B. 50 mL of serosanguineous fluid in the bulb drain
- C. Clear fluid drainage noted on the surgical dressing
- D. Sudden spike in temperature to 101.3°F (38.5°C)
Correct Answer: C
Rationale: Unrelieved back pain may be associated with another complication, not CSF leakage. A severe headache, rather than back pain, may be associated with CSF leakage. 50 mL of serosanguineous fluid in the bulb drain is a normal finding. Clear drainage on the surgical dressing is indicative of a CSF leak. The temperature elevation could indicate an infection.
When the client asks why fluids are being restricted, which explanation by the nurse is best?
- A. Large amounts of fluid may contribute to vomiting.'
- B. The kidneys need to conserve fluid output.'
- C. Fluid restriction reduces the volume in the cranium.'
- D. The prescribed volume is sufficient for relieving thirst.'
Correct Answer: C
Rationale: Fluid restriction reduces intracranial volume, minimizing the risk of increased intracranial pressure post-craniotomy.
The public health department nurse is preparing a lecture on prevention of West Nile virus. Which information should the nurse include?
- A. Change water daily in pet dishes and birdbaths.
- B. Wear thick, dark clothing when outside to avoid bites.
- C. Apply insect repellent over face and arms only.
- D. Explain that mosquitoes are more prevalent in the morning.
Correct Answer: A
Rationale: Changing water daily in pet dishes and birdbaths (A) prevents mosquito breeding, reducing West Nile virus risk. Thick clothing (B) should be light-colored, repellent (C) should cover all exposed areas, and mosquitoes are more active at dusk (D).