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The client with PD has a new surgically implanted DBS. After the stimulator is operational, which criterion should the nurse use to evaluate that the DBS is effective?
- A. The client has cogwheel rigidity when moving the upper extremities.
- B. The client has a decrease in the frequency and severity of tremors.
- C. The client has less facial pain and converses with more facial expression.
- D. The client no longer experiences auras or a severe frontal headache.
Correct Answer: B
Rationale: Cogwheel rigidity, a symptom of PD, is interrupted muscular movement and is not treated with the DBS. DBS is a treatment used for intractable tremors associated with PD. The electrical current interferes with the brain cells initiating the tremors. Severe facial pain is associated with trigeminal neuralgia, not PD rau. The DBS will not affect facial expression. Auras are unusual sensations experienced before a seizure occurs and are not associated with PD.
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Which activity should the nurse encourage for a client with early Parkinson's disease to improve mobility?
- A. High-intensity aerobic exercise
- B. Daily stretching and balance exercises
- C. Weightlifting three times weekly
- D. Complete bed rest during tremors
Correct Answer: B
Rationale: Stretching and balance exercises improve mobility and reduce fall risk in early Parkinson's disease.
The client is brought to the emergency department by the police for public disorderliness. The client reports feeling no pain and is unconcerned that the police have arrested him. The nurse notes the client has epistaxis and nasal congestion. Which substance should the nurse suspect the client has abused?
- A. Marijuana.
- B. Heroin.
- C. Ecstasy.
- D. Cocaine.
Correct Answer: D
Rationale: Cocaine (D) causes epistaxis, nasal congestion, and euphoria with pain insensitivity. Marijuana (A), heroin (B), and ecstasy (C) do not typically cause these nasal symptoms.
Which intervention should the nurse implement to decrease increased intracranial pressure (ICP) for a client on a ventilator? Select all that apply.
- A. Position the client with the head of the bed up 30 degrees.
- B. Cluster activities of care.
- C. Suction the client every three (3) hours.
- D. Administer soapsuds enemas until clear.
- E. Place the client in Trendelenburg position.
Correct Answer: A
Rationale: HOB at 30 degrees (A) promotes venous drainage, reducing ICP. Clustering activities (B) increases ICP, suctioning every 3 hours (C) is excessive, enemas (D) are irrelevant, and Trendelenburg (E) worsens ICP.
The wife of the client diagnosed with septic meningitis asks the nurse, 'I am so scared. What is meningitis?' Which statement would be the most appropriate response by the nurse?
- A. There is bleeding into his brain causing irritation of the meninges.'
- B. A virus has infected the brain and meninges, causing inflammation.'
- C. It is a bacterial infection of the tissues that cover the brain and spinal cord.'
- D. It is an inflammation of the brain parenchyma caused by a mosquito bite.'
Correct Answer: C
Rationale: Septic meningitis is a bacterial infection of the meninges (C). Bleeding (A) describes subarachnoid hemorrhage, viral meningitis (B) is aseptic, and mosquito-related inflammation (D) refers to encephalitis.
The client is admitted to the medical floor with a diagnosis of closed head injury. Which nursing intervention has priority?
- A. Assess neurological status.
- B. Monitor pulse, respiration, and blood pressure.
- C. Initiate an intravenous access.
- D. Maintain an adequate airway.
Correct Answer: D
Rationale: Airway maintenance (D) is the highest priority in any critically ill patient, including those with head injuries, to ensure oxygenation. Neurological assessment (A), vital signs (B), and IV access (C) follow after securing the airway.