Nokea
You are caring for a patient who has just had open carpal tunnel release surgery. The surgeon has requested that the patient's hand and arm remain elevated above the level of the heart after the surgery. This is to
- A. Reduce lymphatic drainage.
- B. Reduce postoperative swelling.
- C. Restrict hand movements.
- D. Decrease possibility of nosocomial infection.
Correct Answer: B
Rationale: Elevation reduces swelling by improving venous and lymphatic return.
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A neurologist asks a patient to stick out the tongue. Which cranial nerve (CN) is being tested?
- A. VII (facial)
- B. I (olfactory)
- C. IV (trochlear)
- D. XII (hypoglossal)
Correct Answer: D
Rationale: Cranial nerve XII (hypoglossal) controls tongue movement and is tested when a patient is asked to stick out the tongue. Cranial nerves I, IV, and VII are involved in smell, eye movement, and facial expression, respectively. Assessing CN XII is important for evaluating motor function of the tongue.
The ________ ________ consists of glands that secrete hormones:
- A. nervous system
- B. immune system
- C. endocrine system
- D. cerebral cortex
Correct Answer: C
Rationale: The endocrine system consists of glands that secrete hormones into the bloodstream to regulate various bodily functions, such as metabolism, growth, and reproduction. Key glands include the pituitary, thyroid, and adrenal glands. Hormones act as chemical messengers, influencing target organs and tissues to maintain homeostasis. The endocrine system works closely with the nervous system to coordinate the body's responses to internal and external changes.
Which patient should the nurse assess first after change-of-shift report?
- A. A 42-year-old patient with carpal tunnel syndrome complaining of pain.
- B. A 64-year-old patient with osteoporosis who is waiting for discharge.
- C. A 28-year-old patient with fracture complaining that the cast is tight.
- D. A 56-year-old patient with left leg amputation complaining of phantom pain.
Correct Answer: C
Rationale: A tight cast can lead to compartment syndrome, which is a medical emergency.
The nurse will document which reflex is present when there is dorsiflexion of the great toe with fanning of other toes?
- A. Brudzinski
- B. Babinski (damage to the corticospinal tracts)
- C. Trousseaus
- D. Kernigs
Correct Answer: B
Rationale: The Babinski reflex, characterized by dorsiflexion of the great toe and fanning of the other toes, is abnormal in adults and indicates damage to the corticospinal tract. This reflex is normal in infants but disappears as the nervous system matures. Its presence in adults suggests neurological pathology.
When assessing a patient's level of consciousness, the nurse should:
- A. Evaluate the patient's response to verbal and physical stimuli.
- B. Measure the patient's blood pressure.
- C. Inspect the patient's skin color.
- D. Assess the patient's respiratory rate.
Correct Answer: A
Rationale: Evaluating a patient's response to verbal and physical stimuli is essential for assessing their level of consciousness. Blood pressure, skin color, and respiratory rate are important but do not directly measure consciousness.