Nokea
The nurse is caring for a patient diagnosed with a cerebral tumor. For which function should the nurse expect to assess an abnormality?
- A. Reflex movement
- B. Movement and speech
- C. Coordination and posture
- D. Heart rate and respiratory rate
Correct Answer: B
Rationale: A cerebral tumor in the frontal lobe may affect movement and speech, as this area contains the motor cortex and Broca's area. Reflex movements are controlled by the spinal cord, coordination by the cerebellum, and heart rate by the medulla. Assessing movement and speech is critical for localizing the tumor's effects.
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A laminectomy and spinal fusion are performed on a patient with a herniated lumbar intervertebral disc. During the postoperative period, which finding is of most concern to the nurse?
- A. Paralytic ileus
- B. Urinary incontinence
- C. Greater pain at the graft site than at the lumbar incision site
- D. Leg and arm movement and sensation unchanged from preoperative status
Correct Answer: B
Rationale: Urinary incontinence may indicate nerve damage.
Application of RICE (rest, ice, compression, and elevation) is indicated for initial management of which type of injury?
- A. Muscle spasms
- B. Sprains and strains
- C. Repetitive strain injury
- D. Dislocations and subluxations
Correct Answer: B
Rationale: RICE is effective for managing acute soft tissue injuries like sprains and strains.
What measures can help control the client's body temperature related to brain infection?
- A. Administering prescribed antipyretics.
- B. Reducing body hydration.
- C. Applying ice packs.
- D. Keeping the room temperature warm.
Correct Answer: A
Rationale: Antipyretics directly address fever, reducing cerebral irritation.
A patient diagnosed with depersonalization disorder tells the nurse, It's starting again. I feel as though I'm going to float away. The nurse should help the patient by:
- A. encouraging meditation.
- B. administering an anxiolytic medication.
- C. helping the patient visualize a pleasant scene.
- D. helping the patient focus on the here and now.
Correct Answer: D
Rationale: The correct answer is D: helping the patient focus on the here and now. This is appropriate for depersonalization disorder as it helps the patient ground themselves in reality and reduce dissociative symptoms. Encouraging meditation (A) may exacerbate dissociation by further disconnecting the patient from reality. Administering an anxiolytic medication (B) may provide temporary relief but does not address the underlying issue. Helping the patient visualize a pleasant scene (C) may be soothing but may not be effective in addressing the dissociative symptoms.
A 25 year-old housewife presents to the urgent care clinic for evaluation of paralysis in her face on the right side. She has a history of an upper respiratory infection 2 weeks before the onset of symptoms. She states that her face on the right is drooping and she is not able to close the right eye. On physical examination, you note that her forehead is smooth on the right, the left palpebral fissure appears wider than the right, and her nasolabial fold on the right is flattened and she is drooling. Based on this information, what is the most likely diagnosis?
- A. Cortical stroke
- B. Bell's palsy
- C. Horner's syndrome
- D. Stress reaction
Correct Answer: B
Rationale: Bell's palsy is a condition characterized by sudden, unilateral facial paralysis due to inflammation or compression of the facial nerve (CN VII). It often follows a viral infection and presents with drooping of the face, inability to close the eye, and flattening of the nasolabial fold. A cortical stroke typically spares the forehead, and Horner's syndrome involves ptosis and miosis.