Nokea
The newly admitted patient to the emergency room after a motorcycle accident has serosanguineous drainage coming from the nose. Which is the appropriate nursing response to this finding?
- A. Cleanse nose with a soft cotton-tipped swab.
- B. Gently suction the nasal cavity.
- C. Gently wipe nose with absorbent gauze.
- D. Ask patient to blow his nose.
Correct Answer: C
Rationale: The patient's ear and nose are checked carefully for signs of blood and serous drainage, which indicate that the meninges are torn and spinal fluid is escaping. No attempt should be made to clean out the orifice or to blow the nose. The drainage can be wiped away. The drainage can be tested for the presence of glucose, which would confirm that the fluid is spinal fluid and not mucus.
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The nurse is aware that the drug t-PA a tissue plasminogen activator, must be given within how many hours of the onset of symptoms to have maximum benefit?
- A. 3 hours
- B. 4 hours
- C. 6 hours
- D. 8 hours
Correct Answer: A
Rationale: t-PA must be given within 3 hours of the onset of symptoms to be beneficial.
Which sign is the first sign of Bell's palsy?
- A. Inability to wrinkle forehead and pucker lips on affected side
- B. Sudden pain in nostril on affected side
- C. Excessive salivation on the affected side
- D. Excessive mucus running from nostril on affected side
Correct Answer: A
Rationale: Unilateral weakness of the facial muscles usually occurs, resulting in a flaccidity of the affected side of the face with inability to wrinkle the forehead, close the eyelid, pucker the lips, smile, frown, whistle, or retract the mouth on that side. The face appears asymmetric.
What are surgical navigational systems?
- A. Computerized devices that guide the surgeon
- B. A set of detailed anatomic maps pinpointing specific areas of the brain
- C. A written set of progressive processes for the resection of small brain tumors
- D. The use of radioactive materials to pinpoint small tumors of the brain
Correct Answer: A
Rationale: Surgical navigational systems are computerized devices that guide the surgeon and make possible the resection of tumors that were once thought to be inoperable.
Which divisions are the two divisions of the nervous system?
- A. Somatic and the autonomic
- B. Cerebellum and the brainstem
- C. Medulla oblongata and the diencephalon
- D. Central and the peripheral
Correct Answer: D
Rationale: The central and the peripheral are the two divisions of the nervous system. The autonomic and the somatic are the division of the peripheral nervous system.
Which benefit do the drugs neostigmine and pyridostigmine have for the person with myasthenia gravis?
- A. Improves speech.
- B. Improves visual disturbances.
- C. Reduces pain.
- D. Promotes nerve impulse transmission.
Correct Answer: D
Rationale: Prostigmine and Mestinon improve the nerve impulses and alleviate the symptoms.