Nokea
Which clinical manifestation is the educator most likely to include as the initial sign of Parkinson's disease?
- A. Muscle rigidity
- B. Muscle tremors
- C. Muscle weakness
- D. Muscle deterioration
Correct Answer: B
Rationale: Muscle tremors, particularly resting tremors, are often the initial sign of Parkinson's disease.
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Which signs and symptoms will the nurse detect with this disorder? Select all that apply.
- A. Speech by the client to consume a high-fiber diet
- B. Rapid heart rate
- C. Pounding headache
- D. Pale skin
- E. Blurred vision
- F. Nasal stuffiness
Correct Answer: C,E,F
Rationale: Autonomic dysreflexia presents with a pounding headache, blurred vision, and nasal stuffiness due to unopposed sympathetic activity.
The home health nurse evaluates the foot care of the dark-skinned African client who has peripheral neuropathy. Which client actions in providing foot care are appropriate? Select all that apply.
- A. Uses a mirror and visually inspects the feet on a daily basis
- B. Lotions the feet and legs daily, avoiding between the toes
- C. Goes barefoot when indoors to help dry and air out the feet
- D. Wears warm socks and boots when outside in cold weather
- E. Trims toenails weekly so they have a rounded contour
- F. Inspects the feet for redness and other signs of inflammation
Correct Answer: A,B,D
Rationale: Using a mirror allows for visual inspection of the bottom of the feet and between the toes for areas of skin breakdown. Keeping the skin adequately lubricated with lotion prevents drying and cracking. Lotion should not be applied between the toes because it increases moisture and the risk for infection. Clients should avoid going barefoot because this increases the risk for foot injury. Wearing appropriate clothing protects the skin from injury because sensation is diminished with peripheral neuropathy. Toenails should be trimmed straight across to avoid damaging the tissue, which is slow to heal in the presence of peripheral neuropathy. In a dark-skinned client, areas of inflammation may appear purplish-blue or violet rather than appearing reddened (erythematous).
The nurse arrives at the site of a one-car motor-vehicle accident and stops to render aid. The driver of the car is unconscious. After stabilizing the client's cervical spine, which action should the nurse take next?
- A. Carefully remove the driver from the car.
- B. Assess the client's pupils for reaction.
- C. Assess the client's airway.
- D. Attempt to wake the client up by shaking him.
Correct Answer: C
Rationale: After cervical spine stabilization, ensuring a patent airway (C) is the next priority to support oxygenation. Removing the driver (A) risks further injury, pupil assessment (B) is secondary, and shaking (D) could worsen spinal injury.
The nurse is admitting a client with the diagnosis of Parkinson’s disease. Which assessment data support this diagnosis?
- A. Crackles in the upper lung fields and jugular vein distention.
- B. Muscle weakness in the upper extremities and ptosis.
- C. Exaggerated arm swinging and scanning speech.
- D. Masklike facies and a shuffling gait.
Correct Answer: D
Rationale: Masklike facies and shuffling gait (D) are hallmark signs of Parkinson’s due to bradykinesia and rigidity. Crackles and JVD (A) suggest heart failure, weakness and ptosis (B) indicate myasthenia gravis, and exaggerated arm swinging (C) is opposite to Parkinson’s.
The client has undergone a craniotomy for a brain tumor. Which data indicate a complication of this surgery?
- A. The client complains of a headache at '3' to '4' on a 1-to-10 scale.
- B. The client has an intake of 1,000 mL and an output of 3,500 mL.
- C. The client complains of a raspy, sore throat.
- D. The client experiences dizziness when trying to get up too quickly.
Correct Answer: B
Rationale: Significant output (3,500 mL) compared to intake (1,000 mL, B) suggests diabetes insipidus, a complication of craniotomy due to pituitary dysfunction. Mild headache (A), sore throat (C), and orthostatic dizziness (D) are less concerning.