Nokea
The nurse educator is presenting an in-service on seizures. Which disease process is the leading cause of seizures in the elderly?
- A. Alzheimer’s disease.
- B. Parkinson’s disease (PD).
- C. Cerebral Vascular Accident (CVA, stroke).
- D. Brain atrophy due to aging.
Correct Answer: C
Rationale: Stroke (CVA, C) is the leading cause of seizures in the elderly due to brain tissue damage. Alzheimer’s (A) and Parkinson’s (B) may cause seizures but are less common, and brain atrophy (D) is not a primary cause.
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The nurse is administering mannitol IV to decrease the client’s ICP following a craniotomy. Which laboratory test result should the nurse monitor during the client’s treatment with mannitol?
- A. Serum osmolarity
- B. White blood cell count
- C. Serum cholesterol
- D. Erythrocyte sedimentation rate (ESR)
Correct Answer: A
Rationale: Mannitol (Osmitrol), an osmotic diuretic, increases the serum osmolarity and pulls fluid from the tissues, thus decreasing cerebral edema postoperatively. Serum osmolarity levels should be assessed as a parameter to determine proper dosage. The WBC count is not affected by mannitol. Serum cholesterol is not affected by mannitol. ESR is not affected by mannitol.
The nurse is assessing the client diagnosed with meningococcal meningitis. Which assessment data would warrant notifying the HCP?
- A. Purpuric lesions on the face.
- B. Complaints of light hurting the eyes.
- C. Dull, aching, frontal headache.
- D. Not remembering the day of the week.
Correct Answer: A
Rationale: Purpuric lesions (A) indicate possible meningococcemia, a life-threatening complication requiring immediate HCP notification. Photophobia (B), headache (C), and confusion (D) are expected but less urgent.
The nurse is caring for a client diagnosed with encephalitis. Which is an expected outcome for the client?
- A. The client will regain as much neurological function as possible.
- B. The client will have no short-term memory loss.
- C. The client will have improved renal function.
- D. The client will apply hydrocortisone cream daily.
Correct Answer: A
Rationale: The goal for encephalitis is to maximize neurological recovery (A), as inflammation may cause deficits. No memory loss (B) is unrealistic, renal function (C) is unrelated, and hydrocortisone cream (D) is not indicated.
The nurse is assessing the client with a tentative diagnosis of meningitis. Which findings should the nurse associate with meningitis? Select all that apply.
- A. Nuchal rigidity
- B. Severe headache
- C. Pill-rolling tremor
- D. Photophobia
- E. Lethargy
Correct Answer: A,B,D,E
Rationale: Irritation of the meninges causes nuchal rigidity (stiff neck). Irritation of the meninges causes severe headache. Pill-rolling tremors are associated with PD. Irritation of the meninges causes photophobia (light irritates the eyes). Lethargy, pathological state of sleepiness or unresponsiveness, indicates a decreased level of consciousness which is associated with meningitis.
The nurse is caring for the client with an SCI at the level of the sixth cervical vertebra. Which findings support the nurse’s conclusion that the client may be experiencing autonomic dysreflexia? Select all that apply.
- A. Blurred vision
- B. BP 198/102 mm Hg
- C. Heart rate 150 bpm
- D. Extreme headache
- E. Sweaty face and arms
Correct Answer: A,B,D,E
Rationale: Blurred vision results from the hypertension occurring with autonomic dysreflexia. Hypertension is a symptom of autonomic dysreflexia from overstimulation of the sympathetic nervous system (SNS). Bradycardia (not tachycardia) results from autonomic dysreflexia; the parasympathetic nervous system attempts to maintain homeostasis by slowing down the HR. Headache results from the hypertension occurring with autonomic dysreflexia. Sweating results from the sympathetic stimulation above the level of injury.