Nokea
Which rationale explains the transmission of the West Nile virus?
- A. Transmission occurs through exchange of body fluids when sneezing and coughing.
- B. Transmission occurs only through mosquito bites and not between humans.
- C. Transmission can occur from human to human in blood products and breast milk.
- D. Transmission occurs with direct contact from the maculopapular rash drainage.
Correct Answer: B
Rationale: West Nile virus is primarily transmitted via mosquito bites (B), not human-to-human contact, body fluids (A), blood/breast milk (C), or rash drainage (D).
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The client is diagnosed with ALS. As the disease progresses, which intervention should the nurse implement?
- A. Discuss the need to be placed in a long-term care facility.
- B. Explain how to care for a sigmoid colostomy.
- C. Assist the client to prepare an advance directive.
- D. Teach the client how to use a motorized wheelchair.
Correct Answer: C
Rationale: ALS progression leads to significant disability, making advance directives (C) critical to ensure the client’s wishes are respected. Long-term care (A) is premature, colostomy (B) is unrelated, and wheelchair use (D) is secondary.
Which client should the nurse assess first after receiving the shift report?
- A. The client diagnosed with a stroke who has right-sided paralysis.
- B. The client diagnosed with meningitis who complains of photosensitivity.
- C. The client with a brain tumor who has projectile vomiting.
- D. The client with epilepsy who complains of tender gums.
Correct Answer: C
Rationale: Projectile vomiting (C) in a brain tumor suggests increased ICP, a life-threatening condition requiring immediate assessment. Paralysis (A), photosensitivity (B), and tender gums (D) are less urgent.
The client is diagnosed with a pituitary tumor and is scheduled for a transsphenoidal hypophysectomy. Which preoperative instruction is important for the nurse to teach?
- A. There will be a large turban dressing around the skull after surgery.
- B. The client will not be able to eat for four (4) or five (5) days postop.
- C. The client should not blow the nose for two (2) weeks after surgery.
- D. The client will have to lie flat for 24 hours following the surgery.
Correct Answer: C
Rationale: Blowing the nose (C) risks disrupting the surgical site and causing CSF leaks after transsphenoidal surgery. Turban dressings (A) are not used, eating resumes sooner (B), and flat positioning (D) is not required.
The nurse is caring for clients on a medical unit. Which client would be most at risk for experiencing a stroke?
- A. A 92-year-old client who is an alcoholic.
- B. A 54-year-old client diagnosed with hepatitis.
- C. A 60-year-old client who has a Greenfield filter.
- D. A 68-year-old client with chronic atrial fibrillation.
Correct Answer: D
Rationale: Atrial fibrillation (D) increases stroke risk due to clot formation. Age (A) is a factor but less specific, hepatitis (B) is unrelated, and Greenfield filters (C) prevent pulmonary embolism, not stroke.
Which environmental modifications should the nurse implement? Select all that apply.
- A. Keep the room dark and quiet.
- B. Lower the bed to the lowest position.
- C. Keep the side rails up and padded.
- D. Provide soft, soothing music.
- E. Ensure a warm, well-lit room.
- F. Make sure suction equipment is available.
Correct Answer: B,C,F
Rationale: Lowering the bed, padding side rails, and ensuring suction equipment availability reduce injury risk and manage complications during a seizure.