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Which diagnostic test is used to confirm the diagnosis of Amyotrophic Lateral Sclerosis (ALS)?
- A. Electromyogram (EMG).
- B. Muscle biopsy.
- C. Serum creatine kinase (CK).
- D. Pulmonary function test.
Correct Answer: A
Rationale: EMG (A) detects abnormal muscle electrical activity characteristic of ALS, confirming the diagnosis. Muscle biopsy (B) is less specific, CK (C) may be elevated but isn’t diagnostic, and pulmonary tests (D) assess complications, not diagnosis.
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The intensive care nurse is caring for a client with a T1 SCI. When the nurse elevates the head of the bed 30 degrees, the client complains of light-headedness and dizziness. The client's vital signs are T 99.2°F, P 98, R 24, and BP 84/40. Which action should the nurse implement?
- A. Notify the health-care provider as soon as possible (ASAP).
- B. Calm the client down by talking therapeutically.
- C. Increase the IV rate by 50 mL/hour.
- D. Lower the head of the bed immediately.
Correct Answer: D
Rationale: Light-headedness and low BP (84/40) in T1 SCI suggest orthostatic hypotension or neurogenic shock. Lowering the HOB (D) restores cerebral perfusion. Notifying the provider (A) or increasing IV rate (C) follows, and talking therapeutically (B) does not address the urgent issue.
The home health nurse is caring for a 28-year-old client with a T10 SCI who says, 'I can’t do anything. Why am I so worthless?' Which statement by the nurse would be most therapeutic?
- A. This must be very hard for you. You’re feeling worthless?'
- B. You shouldn’t feel worthless—you are still alive.'
- C. Why do you feel worthless? You still have the use of your arms.'
- D. If you attended a work rehab program you wouldn’t feel worthless.'
Correct Answer: A
Rationale: Reflecting the client’s feelings (A) validates their emotions and encourages further discussion, promoting therapeutic communication. Other options dismiss feelings (B), challenge the client inappropriately (C), or assume solutions (D).
The client diagnosed with Parkinson’s disease (PD) is being admitted with a fever and patchy infiltrates in the lung fields on the chest x-ray. Which clinical manifestations of PD would explain these assessment data?
- A. Masklike facies and shuffling gait.
- B. Difficulty swallowing and immobility.
- C. Pill rolling of fingers and flat affect.
- D. Lack of arm swing and bradykinesia.
Correct Answer: B
Rationale: Difficulty swallowing and immobility (B) in PD increase aspiration risk, leading to pneumonia, which presents as fever and lung infiltrates. Other manifestations are less directly related to pulmonary complications.
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.
Which type of precautions should the nurse implement for the client diagnosed with septic meningitis?
- A. Standard Precautions.
- B. Airborne Precautions.
- C. Contact Precautions.
- D. Droplet Precautions.
Correct Answer: D
Rationale: Meningococcal meningitis is transmitted via respiratory droplets, requiring Droplet Precautions (D) in addition to Standard Precautions. Airborne (B) and Contact (C) are not indicated.