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The nurse is caring for a patient newly diagnosed with a primary brain tumor. The patient asks the nurse where his tumor came from. What would be the nurses best response?
- A. Your tumor originated from somewhere outside the CNS.
- B. Your tumor likely started out in one of your glands.
- C. Your tumor originated from cells within your brain itself.
- D. Your tumor is from nerve tissue somewhere in your body.
Correct Answer: C
Rationale: Primary brain tumors arise from brain cells, unlike secondary tumors from outside the CNS. Glandular or nerve tissue origins are less specific.
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While assessing the patient at the beginning of the shift, the nurse inspects a surgical dressing covering the operative site after the patients cervical diskectomy. The nurse notes that the drainage is 75% saturated with serosanguineous discharge. What is the nurses most appropriate action?
- A. Page the physician and report this sign of infection.
- B. Reinforce the dressing and reassess in 1 to 2 hours.
- C. Reposition the patient to prevent further hemorrhage.
- D. Inform the surgeon of the possibility of a dural leak.
Correct Answer: D
Rationale: Serosanguineous drainage suggests a dural leak, a serious complication requiring surgical notification. It is not a direct sign of infection, and repositioning or reinforcing the dressing delays critical intervention.
The nurse is caring for a boy who has muscular dystrophy. When planning assistance with the patients ADLs, what goal should the nurse prioritize?
- A. Promoting the patients recovery from the disease
- B. Maximizing the patients level of function
- C. Ensuring the patients adherence to treatment
- D. Fostering the familys participation in care
Correct Answer: B
Rationale: Muscular dystrophy is incurable, so maximizing function through ADLs is the priority. Family participation and adherence support this goal but are secondary.
A 37-year-old man is brought to the clinic by his wife because he is experiencing loss of motor function and sensation. The physician suspects the patient has a spinal cord tumor and hospitalizes him for diagnostic testing. In light of the need to diagnose spinal cord compression from a tumor, the nurse will most likely prepare the patient for what test?
- A. Anterior-posterior x-ray
- B. Ultrasound
- C. Lumbar puncture
- D. MRI
Correct Answer: D
Rationale: MRI is the most sensitive test for detecting spinal cord compression from tumors. X-rays, ultrasound, and lumbar puncture are less effective for this diagnosis.
A male patient with a metastatic brain tumor is having a generalized seizure and begins vomiting. What should the nurse do first?
- A. Perform oral suctioning.
- B. Page the physician.
- C. Insert a tongue depressor into the patients mouth.
- D. Turn the patient on his side.
Correct Answer: D
Rationale: Turning the patient on their side prevents aspiration of vomit during a seizure. Tongue depressors are contraindicated, and suctioning or paging the physician are secondary actions.
The nurse is writing a care plan for a patient with brain metastases. The nurse decides that an appropriate nursing diagnosis is anxiety related to lack of control over the health circumstances. In establishing this plan of care for the patient, the nurse should include what intervention?
- A. The patient will receive antianxiety medications every 4 hours.
- B. The patients family will be instructed on planning the patients care.
- C. The patient will be encouraged to verbalize concerns related to the disease and its treatment.
- D. The patient will begin intensive therapy with the goal of distraction.
Correct Answer: C
Rationale: Encouraging verbalization helps the patient gain control over anxiety by understanding the disease and treatment. Routine medications or distraction do not address the root cause, and family planning does not empower the patient.