Nokea
When Mr. Jones develops an attack of autonomic dysreflexia, it is initially most important to
- A. elevate the head of his bed
- B. monitor his blood pressure closely
- C. assess for bowel and bladder distention
- D. encourage him to ventilate his concerns
Correct Answer: C
Rationale: Assessing for bowel and bladder distention is critical as these can trigger autonomic dysreflexia.
You may also like to solve these questions
Which of the following nursing interventions may reduce hemostasis and decrease the potential for thrombophlebitis for a client with neurologic disorder?
- A. Remove and reapply elastic stockings
- B. Change the client's position
- C. Keep extremities at neutral position
- D. Use a flotation mattress
Correct Answer: B
Rationale: Changing position promotes circulation and reduces clot formation.
When is a fat embolism most likely to occur?
- A. 24 to 48 hours following a fractured tibia
- B. 36 to 72 hours following a skull fracture
- C. 4 to 5 days following a fractured femur
- D. 5 to 6 days following a pelvic fracture
Correct Answer: A
Rationale: Fat embolism is most common after tibial fractures within 24-48 hours.
Which patient should be assigned to the traveling nurse, new to neurologic nursing care, who has been on the neurologic unit for 1 week?
- A. A 34-year-old patient newly diagnosed with multiple sclerosis (MS)
- B. A 68-year-old patient with chronic amyotrophic lateral sclerosis (ALS)
- C. A 56-year-old patient with Guillain-Barré syndrome (GBS) in respiratory distress
- D. A 25-year-old patient admitted with C4 level spinal cord injury (SCI)
Correct Answer: A
Rationale: A newly diagnosed MS patient would likely have stable conditions and be appropriate for a less experienced nurse.
For a patient with a stroke and right-sided hemiplegia, what should the nurse teach the family?
- A. Ignore undesirable behaviors manifested by the patient.
- B. Provide directions to the patient verbally in small steps.
- C. Distract the patient from inappropriate emotional responses.
- D. Supervise all activities before allowing the patient to pursue them independently.
Correct Answer: B
Rationale: Small verbal instructions help the patient understand and follow through with tasks
There are ________ layers of meninges around the brain and spinal cord.
- A. one
- B. two
- C. three
- D. four
Correct Answer: C
Rationale: The brain and spinal cord are protected by three layers of meninges: the dura mater, arachnoid mater, and pia mater. These layers provide structural support, cushioning, and protection against physical injury. The dura mater is the outermost layer, the arachnoid mater is the middle layer, and the pia mater is the innermost layer. Therefore, three is the correct answer as it accurately describes the number of meningeal layers.