Nokea
The nurse is assessing a client receiving prescribed donepezil. Throughout the duration of therapy, the nurse should monitor the client's
- A. Pulse
- B. Fasting blood glucose
- C. Total cholesterol
- D. Pulse oximetry
Correct Answer: A
Rationale: Donepezil, a cholinesterase inhibitor for Alzheimer's, can cause bradycardia due to increased vagal tone. Monitoring pulse is essential. Blood glucose, cholesterol, and pulse oximetry are not typically affected.
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The nurse is performing a physical assessment on a client. Which of the following findings would indicate a positive result for clonus?
- A. Rubor of the feet and ankles when the leg is in the dependent position
- B. Rapid, rhythmic muscle contractions
- C. Popping or clicking of the knee joint with movement
- D. Audible cracking and palpable grating with movement of the joints
Correct Answer: B
Rationale: Clonus is characterized by rapid, rhythmic muscle contractions, often seen in neurological disorders.
A 28-year-old woman presents to the trauma bay after being shot in the upper back. She can move the left side of her body but cannot move the right. However, she cannot feel any pain in her left. The nurse knows these symptoms suggest which type of spinal cord injury?
- A. Incomplete spinal cord injury, central cord syndrome
- B. Incomplete spinal cord injury, Brown-Sequard syndrome
- C. Complete spinal cord injury, paraplegia
- D. Incomplete spinal cord injury, anterior cord syndrome
Correct Answer: B
Rationale: Brown-Sequard syndrome involves ipsilateral motor loss and contralateral sensory loss.
The nurse is teaching a client with Parkinson's disease about dietary considerations. The nurse understands that this client is at highest risk for
- A. Constipation and drooling
- B. Drooling and a loss of appetite
- C. Loose stools and choking
- D. Dysphagia and aspiration
Correct Answer: D
Rationale: Parkinson's disease increases risk for dysphagia and aspiration due to impaired swallowing.
The following scenario applies to the next 6 items
The nurse in the emergency department (ED) is caring for a 20-year-old female client
Item 3 of 6
ED Triage Note
History And Physical
0912: Client was brought to the ED by her two college roommates 'because she was not acting right.' The roommate reports that she went to bed the night before reporting stiffness in her neck and a headache. She attributed it to being under pressure with final exams and having poor sleep the previous several days. The client apparently took non-prescribed lorazepam from another roommate to assist her with sleep. The roommate reported recently having influenza and is unsure if she became infected. It is reported that she declined the influenza vaccination when it was offered on campus. The roommate reports waking her with physical stimuli and found her diaphoretic, hot to touch, and mumbling, saying she did not feel well.
Vital signs: T 103.4° F (39.7° C), P 112, RR 12, BP 116/86, pulse oximetry 95% on room air.
The client is at highest risk for developing …………………..
- A. Bacterial meningitis
- B. Influenza
- C. Benzodiazepine toxicity
Correct Answer: A
Rationale: Symptoms (fever, neck stiffness, altered mental status) strongly suggest bacterial meningitis.
The nurse is planning a staff education program about seizures. It would be correct for the nurse to characterize complex partial seizures as
- A. A seizure that may cause syncope lasting for 1 to 3 minutes.
- B. A seizure where the individual remains conscious throughout the episode.
- C. A sudden loss of muscle tone, lasting for seconds, followed by postictal confusion.
- D. A brief jerking or stiffening of the extremities that may occur singly or in groups.
Correct Answer: B
Rationale: Complex partial seizures involve impaired consciousness, not full consciousness.