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The client, undergoing testing for a possible brain tumor, asks the nurse about treatment options. The nurse’s response should be based on knowing that treatment of a brain tumor depends on which factors? Select all that apply.
- A. How rapidly the tumor is growing
- B. Whether the tumor is malignant or benign
- C. Cell type from which the tumor originates
- D. Where the tumor is located within the brain
- E. The client’s age and type of insurance
Correct Answer: A,B,C,D
Rationale: Surgery, radiation therapy, and/or chemotherapy may be used to treat a slowly or rapidly growing tumor. Surgery, radiation therapy, and/or chemotherapy may be used to treat a benign or malignant tumor. Surgery, radiation therapy, and/or chemotherapy may be used to treat tumors of different cell types. The tumor’s location in the brain may affect whether surgery is an option or whether the surgical approach with radiation therapy and/or chemotherapy is used to treat the tumor. Comorbid conditions, not age, may be determining factors in treatment options. The type of insurance is irrelevant to treatment unless treatment is experimental.
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The nurse is caring for the client who is having difficulty walking. Which procedure should the nurse perform to test the cerebellar function of the client?
- A. With the client’s eyes shut, ask whether the touch with a cotton applicator is sharp or dull.
- B. Ask the client to close the eyes, then hold hands with palms up perpendicular to the body.
- C. Ask the client to grasp and squeeze, with each hand at the same time, the hands of the nurse.
- D. Have the client place the hands on the thighs, then quickly turn the palms up and then down.
Correct Answer: D
Rationale: Detecting sharp or dull touch is a test for peripheral nerve function. Assessing for pronator drift is a test for muscle weakness due to cerebral or brainstem dysfunction. Assessment of hand grasps compares equality of muscle strength bilaterally. Repetitive alternating motion tests the client’s coordination, an indicator of cerebellar function.
The nurse caring for a client diagnosed with Parkinson’s disease writes a problem of 'impaired nutrition.' Which nursing intervention would be included in the plan of care?
- A. Consult the occupational therapist for adaptive appliances for eating.
- B. Request a low-fat, low-sodium diet from the dietary department.
- C. Provide three (3) meals per day that include nuts and whole-grain breads.
- D. Offer six (6) meals per day with a soft consistency.
Correct Answer: A
Rationale: PD can impair fine motor skills, making eating difficult. Consulting an occupational therapist (A) for adaptive appliances supports nutritional intake. Low-fat diets (B) are not specific, nuts/breads (C) may be hard to chew, and six soft meals (D) may not address motor issues.
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.
The rehabilitation nurse caring for the client with an Lumbar SCI is developing the nursing care plan. Which intervention should the nurse implement?
- A. Keep oxygen via nasal cannula on at all times.
- B. Administer low-dose subcutaneous anticoagulants.
- C. Perform active lower extremity ROM exercises.
- D. Refer to a speech therapist for ventilator-assisted speech.
Correct Answer: B
Rationale: Lumbar SCI affects lower extremities, increasing DVT risk. Low-dose anticoagulants (B) prevent thromboembolism. Oxygen (A) is unnecessary without respiratory issues, active ROM (C) is not feasible due to paralysis, and speech therapy (D) is irrelevant.
Which home care suggestion is best for promoting the mobility of the client with a spinal cord injury?
- A. Rent or buy a conventional hospital bed.
- B. Build a wheelchair ramp to the door.
- C. Apply for a handicapped parking sticker.
- D. Provide a raised toilet seat with grab bars.
Correct Answer: B
Rationale: A wheelchair ramp enhances home accessibility, significantly improving mobility for a client with a spinal cord injury.