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Which goal is most realistic for a client diagnosed with Parkinson's disease?
- A. To reverse the symptoms and cure the disease
- B. To remove the symptoms of the disease process
- C. To maintain optimal muscle and motor function
- D. To prepare for a progressive terminal disease
Correct Answer: C
Rationale: Maintaining optimal muscle and motor function is realistic, as Parkinson's is progressive but manageable with treatment.
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The client has been diagnosed with a cerebrovascular accident (stroke). The client's wife is concerned about her husband's generalized weakness. Which home modification should the nurse suggest to the wife prior to discharge?
- A. Obtain a rubber mat to place under the dinner plate.
- B. Purchase a long-handled bath sponge for showering.
- C. Purchase clothes with Velcro closure devices.
- D. Obtain a raised toilet seat for the client's bathroom.
Correct Answer: B,C,D
Rationale: Generalized weakness post-stroke affects mobility and self-care. A long-handled bath sponge (B) aids bathing, Velcro clothes (C) simplify dressing, and a raised toilet seat (D) facilitates safe toileting. A rubber mat (A) is less relevant to generalized weakness.
The 34-year-old male client with an SCI is sharing with the nurse that he is worried about finding employment after being discharged from the rehabilitation unit. Which intervention should the nurse implement?
- A. Refer the client to the American Spinal Cord Injury Association (ASIA).
- B. Refer the client to the state rehabilitation commission.
- C. Ask the social worker (SW) about applying for disability.
- D. Suggest that the client talk with his significant other about this concern.
Correct Answer: B
Rationale: The state rehabilitation commission (B) provides vocational training and job placement services for individuals with disabilities like SCI. ASIA (A) focuses on research and advocacy, disability application (C) may not address employment goals, and talking with a significant other (D) is not a direct intervention.
A hospitalized client diagnosed with seizures has a vagus nerve stimulation (VNS) device implanted. The nurse determines that the VNS is working properly when making which observation?
- A. It stimulated a heartbeat when bradycardia occurred during a seizure.
- B. It defibrillated a lethal rhythm that occurred during the client’s seizure.
- C. The client activates the VNS device to stop a seizure from occurring.
- D. The client activates the device at seizure onset to prevent aspiration.
Correct Answer: C
Rationale: A VNS device does not stimulate the heart to beat as a pacemaker. A VNS device does not defibrillate the heart as an implantable cardioverter/defibrillator does. A VNS is a medical device that is implanted in the chest and stimulates the vagus nerve to control seizures unresponsive to medical treatment. Clients who experience auras before a seizure use a magnet to activate the VNS to stop the seizure. The device does not have an effect on the airway or secretions.
The 29-year-old client is admitted to the medical floor diagnosed with meningitis. Which assessment by the nurse has priority?
- A. Assess lung sounds.
- B. Assess the six cardinal fields of gaze.
- C. Assess apical pulse.
- D. Assess level of consciousness.
Correct Answer: D
Rationale: Level of consciousness (D) is the priority assessment in meningitis, as it indicates neurological status and potential complications like increased ICP. Lung sounds (A), eye movements (B), and pulse (C) are secondary.
When the nurse performs a physical assessment, which finding is most indicative of the client's disorder?
- A. Quivering eye movement
- B. Muscle spasms in the lower extremities
- C. Loss of motor function on the affected side
- D. Unilateral facial paralysis
Correct Answer: D
Rationale: Unilateral facial paralysis is the hallmark sign of Bell's palsy, caused by inflammation of cranial nerve VII.