Nokea
Which of the following would not be included in the nursing care plan for a client with Parkinson's disease?
- A. Restricting his intake of oral fluids
- B. Range of motion exercises
- C. Allowing him to carry out activities of daily living by himself even though he is very slow
- D. Providing him with diversionary tasks that require motor coordination of hands
Correct Answer: A
Rationale: Fluids should be encouraged to prevent dehydration and manage drooling in Parkinson's disease, making restriction inappropriate.
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A 27-year-old woman is admitted to the hospital complaining of numbness in both legs, difficulty walking, and double vision of one week in duration. Multiple sclerosis is suspected. Orders include bed rest with bathroom privileges, brain scan, EEG, lumbar puncture, adrenocorticotropic hormone (ACTH) 40 units intramuscularly (IM) bid x 3 days, then 30 units IM bid x 3 days, then 20 units IM bid x 3 days; and passive range of motion (ROM) progressing to active ROM as tolerated. In planning care for this client, which activity is most important to include?
- A. Encouraging her to perform all care activities for herself
- B. Frequent ambulation to retain joint mobility
- C. Scheduling frequent rest periods between physical activity
- D. Feeding the client to reduce energy needs
Correct Answer: C
Rationale: Frequent rest periods are essential to manage fatigue, a common symptom in multiple sclerosis, while supporting activity as tolerated.
The client asks the nurse about symptoms associated with retinal detachment. Which symptoms should the nurse identify? Select all that apply.
- A. Seeing bright flashes of light
- B. Shooting, throbbing eye pain
- C. Severe frontal headache
- D. Diminished visual acuity
- E. Seeing floating dark spots in the vision field
Correct Answer: A,D,E
Rationale: As the choroid and retina partially separate, the client notices flashes of light, decreased vision, and floating dark spots. Pain is not associated with retinal detachment due to few pain fibers in the retina. Headache is not associated with retinal detachment.
Which situation makes the nurse suspect the client has glaucoma?
- A. An automobile accident because the client did not see the car in the next lane.
- B. The cake tasted funny because the client could not read the recipe.
- C. The client has been wearing mismatched clothes and socks.
- D. The client ran a stoplight and hit a pedestrian walking in the crosswalk.
Correct Answer: A
Rationale: Not seeing a car in the next lane suggests peripheral vision loss, a hallmark of glaucoma. Taste, color perception, and stoplight issues are unrelated.
The client tells the nurse, 'I have something under my upper eyelid and don't recall how it happened.' The client has no eye redness or pain and no changes in vision. Which intervention should the nurse implement?
- A. Notify the client's health care provider for guidance.
- B. Flush the client's eye with sterile saline for 10 minutes.
- C. Evert the upper lid with a cotton-tipped applicator for examination.
- D. Place an eye patch, taping from the outside of the eye to the inside.
Correct Answer: C
Rationale: Since the client has no pain or vision changes, the nurse should assess by everting the upper eyelid with a cotton-tipped applicator to visualize the issue. Contacting the HCP, flushing, or patching should follow assessment.
The client recovering at home following a stapedectomy for otosclerosis reports having dizziness. To decrease symptoms, which interventions should the nurse recommend? Select all that apply.
- A. Refrain from sudden movements.
- B. Avoid chewing on the affected side.
- C. Avoid lifting objects that are heavy.
- D. Minimize bending over at the waist.
- E. Restrict the intake of oral fluids.
Correct Answer: A,C,D
Rationale: Refraining from sudden movements, avoiding heavy lifting, and minimizing bending decrease dizziness by reducing fluid shifts in the inner ear. Chewing and fluid restriction do not affect dizziness.