Nokea
Which assessment data should the nurse expect to observe for the client diagnosed with Parkinson's disease?
- A. Ascending paralysis and pain.
- B. Masklike facies and pill rolling.
- C. Diplopia and ptosis.
- D. Dysphagia and dysarthria.
Correct Answer: B
Rationale: Masklike facies and pill-rolling tremors (B) are hallmark Parkinson’s signs due to dopamine deficiency. Paralysis/pain (A) suggest Guillain-Barré, diplopia/ptosis (C) indicate myasthenia gravis, and dysphagia/dysarthria (D) are later symptoms.
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The client admitted to the hospital to rule out encephalitis is being prepared for a lumbar puncture. Which instructions should the nurse teach the client regarding care postprocedure?
- A. Instruct that all invasive procedures require a written permission.
- B. Explain that this allows analysis of a sample of the cerebrospinal fluid.
- C. Tell the client to increase fluid intake to 300 mL for the next 48 hours.
- D. Discuss that lying supine with the head flat will prevent all hematomas.
Correct Answer: C
Rationale: Post-lumbar puncture, increasing fluid intake (C) helps replace CSF and prevent headaches. Consent (A) is preoperative, CSF analysis (B) explains purpose, and lying flat (D) prevents headaches, not hematomas.
Which client statement indicates a need for further teaching about post-craniotomy care?
- A. I'll avoid coughing forcefully.'
- B. I'll sleep with my head elevated.'
- C. I can lift heavy objects after a week.'
- D. I'll report severe headaches immediately.'
Correct Answer: C
Rationale: Lifting heavy objects post-craniotomy can increase intracranial pressure; clients should avoid this for several weeks.
When the medical history is reviewed, which finding is most likely related to the client's diagnosis?
- A. The client had an influenza immunization in the past week.
- B. The client was bitten by a spider several days ago.
- C. The client drinks fresh, unpasteurized milk daily.
- D. The client sprayed the garden with insecticide yesterday.
Correct Answer: A
Rationale: Guillain-Barré syndrome is often preceded by a viral infection or immunization, such as an influenza vaccine, which can trigger an autoimmune response.
When assisting the client with activities of daily living (ADLs), which approach is best?
- A. Limit the time for performing ADLs to 30 minutes.
- B. Eliminate whatever tasks the client cannot perform.
- C. Let the client rest between activities.
- D. Perform all of the client's ADLs at this time.
Correct Answer: C
Rationale: Allowing rest between activities conserves energy and supports the client's independence during an MS exacerbation.
The nurse is caring for the client who has severe craniocerebral trauma. Which finding indicates that the client is developing DI?
- A. Blood glucose level at 230 mg/dL
- B. Urinary output 1500 mL over 4 hours
- C. Urine specific gravity at 1.042
- D. Somnolent when previously alert
Correct Answer: B
Rationale: Elevated glucose levels are not associated with DI. The lack of ADH that occurs in DI results in excreting a large amount of pale, dilute urine. The urine of clients with DI is very dilute and therefore has a very low, not high, specific gravity. Decrease in level of consciousness is not directly associated with DI but rather with craniocerebral swelling or bleeding from the trauma.