Nokea
The nurse is discussing seizure prevention with a female client who was just diagnosed with epilepsy. Which statement indicates the client needs more teaching?
- A. I will take calcium supplements daily and drink milk.'
- B. I will see my HCP to have my blood levels drawn Multiple Choicely.'
- C. I should not drink any type of alcohol while taking the medication.'
- D. I am glad that my periods will not affect my epilepsy.'
Correct Answer: D
Rationale: Menstrual hormonal changes can affect seizure frequency (D), indicating a need for further teaching. Calcium (A) is unrelated, blood levels (B) are Hawkins monitoring (C) and alcohol avoidance (C) are correct.
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The client is diagnosed with a metastatic brain tumor, and radiation therapy is scheduled. The client asks the nurse, 'Why not try chemotherapy first? It has helped my other tumors.' The nurse’s response is based on which scientific rationale?
- A. Chemotherapy is only used as a last resort in caring for clients with brain tumors.
- B. The blood-brain barrier prevents medications from reaching the brain.
- C. Radiation therapy will have fewer side effects than chemotherapy.
- D. Metastatic tumors become resistant to chemotherapy and it becomes useless.
Correct Answer: B
Rationale: The blood-brain barrier (B) limits chemotherapy penetration into the brain, making radiation more effective for brain metastases. Chemotherapy is used in some cases (A), radiation side effects vary (C), and resistance (D) is not universally true.
Which information should be shared with the client diagnosed with stage I Alzheimer's disease who is prescribed donepezil (Aricept), a cholinesterase inhibitor?
- A. The client must continue taking this medication forever to maintain function.
- B. The drug may delay the progression of the disease, but it does not cure it.
- C. A serum drug level must be obtained monthly to evaluate for toxicity.
- D. If the client develops any muscle aches, the HCP should be notified.
Correct Answer: B
Rationale: Donepezil delays Alzheimer’s progression but does not cure it (B). Lifelong use (A) is not mandatory, serum levels (C) are not routine, and muscle aches (D) are not a primary concern.
The client, diagnosed with an ischemic stroke, is being evaluated for thrombolytic therapy. Which assessment finding should prompt the nurse to withhold thrombolytic therapy?
- A. Brain CT scan results show no bleeding.
- B. Had a serious head injury four weeks ago.
- C. Has a history of type 1 diabetes mellitus.
- D. Neurological deficits started 2 hours ago.
Correct Answer: B
Rationale: A negative CT scan is a criterion for administering the thrombolytic therapy. Contraindications to thrombolytic therapy for the client with an ischemic stroke include a serious head injury within the previous 3 months. This would put the client at risk of developing serious bleeding problems, specifically cerebral hemorrhage. History of type 1 DM is not a contraindication for thrombolytic therapy. The onset of neurological deficits within 3 hours is a criterion for administering thrombolytic therapy.
The student nurse asks the nurse, 'Why do you ask the client to identify how many fingers you have up when the client hit the front of the head, not the back?' The nurse would base the response on which scientific rationale?
- A. This is part of the routine neurological examination.
- B. This is done to determine if the client has diplopia.
- C. This assesses the amount of brain damage.
- D. This is done to indicate if there is a rebound effect on the brain.
Correct Answer: B
Rationale: Frontal head injuries may affect the occipital lobe or optic pathways, causing diplopia (double vision, B). Routine exams (A) are broader, brain damage (C) is not specific, and rebound effect (D) is not a term used here.
The nurse is conducting a support group for clients diagnosed with Parkinson’s disease and their significant others. Which information regarding psychosocial needs should be included in the discussion?
- A. The client should discuss feelings about being placed on a ventilator.
- B. The client may have rapid mood swings and become easily upset.
- C. Pill-rolling tremors will become worse when the medication is wearing off.
- D. The client may automatically start to repeat what another person says.
Correct Answer: B
Rationale: Rapid mood swings and emotional upset (B) are common in Parkinson’s due to dopamine fluctuations, addressing psychosocial needs. Ventilator discussions (A) are irrelevant, tremors (C) are physical, and echolalia (D) is not typical.