Nokea
The client newly diagnosed with Parkinson’s Disease (PD) asks the nurse, 'Why can’t I control these tremors?' Which is the nurse’s best response?
- A. You can control the tremors when you learn to concentrate and focus on the cause.'
- B. The tremors are caused by a lack of the chemical dopamine in the brain; medication may help.'
- C. You have too much acetylcholine in your brain causing the tremors but they will get better with time.'
- D. You are concerned about the tremors? If you want to talk I would like to hear how you feel.'
Correct Answer: B
Rationale: Parkinson’s tremors result from dopamine deficiency (B), and medications like levodopa help. Concentration (A) doesn’t control tremors, acetylcholine imbalance (C) is partial and not time-resolving, and reflection (D) doesn’t answer the question.
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The nurse enters the room as the client is beginning to have a tonic-clonic seizure. What action should the nurse implement first?
- A. Note the first thing the client does in the seizure.
- B. Assess the size of the client’s pupils.
- C. Determine if the client is incontinent of urine or stool.
- D. Provide the client with privacy during the seizure.
Correct Answer: A
Rationale: Noting the first action (A) helps identify the seizure type and focus, aiding diagnosis and treatment. Pupil size (B), incontinence (C), and privacy (D) are secondary to ensuring safety and documenting the event.
The nurse is working with clients and their families regarding substance abuse. Which statement is the scientific rationale for teaching the children new coping mechanisms?
- A. The child needs to realize that the parent will be changing behaviors.
- B. The child will need to point out to the parent when the parent is not coping.
- C. Children tend to mimic behaviors of parents when faced with similar situations.
- D. Children need to feel like they are a part of the parent’s recovery.
Correct Answer: C
Rationale: Children often mimic parental behaviors (C), including unhealthy coping mechanisms. Teaching new strategies helps break this cycle. Other options misrepresent the child’s role or focus.
Which nursing action is best for controlling the symptoms of the client diagnosed with myasthenia gravis?
- A. Ensure that the client has regular bowel and bladder elimination.
- B. Administer each dose of medication at the precise scheduled time.
- C. Encourage the client to exercise twice daily for 30 minutes.
- D. Monitor the client's blood pressure every 4 hours.
Correct Answer: B
Rationale: Precise timing of pyridostigmine administration ensures consistent symptom control in myasthenia gravis by maintaining acetylcholine levels.
The nurse is caring for the client with a leaking cerebral aneurysm. What is the earliest sign that would indicate to the nurse that increased ICP may be developing?
- A. Change in pupil size and reaction
- B. Sudden drop in the blood pressure
- C. Experiencing diminished sensation
- D. Change in the level of consciousness
Correct Answer: D
Rationale: Pupillary changes may occur with ICP as it progresses, but they are not an early sign of developing ICP. A drop in BP is not directly associated with neurological deterioration. A BP with a wide pulse pressure is a late sign of increased ICP. Diminished sensation may occur with increased ICP, but it is not the earliest sign. A change in the level of consciousness is the first sign of neurological deterioration and is often associated with the development of increased ICP.
The husband of a client who is an alcoholic tells the nurse, 'I don’t know what to do. I don’t know how to deal with my wife’s problem.' Which response would be most appropriate by the nurse?
- A. It must be difficult. Maybe you should think about leaving.'
- B. I think you should attend Alcoholics Anonymous.'
- C. I think that Alanon might be very helpful for you.'
- D. You should not enable your wife’s alcoholism.'
Correct Answer: C
Rationale: Alanon (C) supports families of alcoholics, offering coping strategies. Suggesting leaving (A) is judgmental, AA (B) is for alcoholics, and accusing enabling (D) may alienate.