Know what the left temporal lobe of brain affects as far as the senses
1. 1. A nurse prepares to teach a client who has experienced damage to the
left temporal lobe of the brain. Which action should the nurse take when
...
Know what the left temporal lobe of brain affects as far as the senses
1. 1. A nurse prepares to teach a client who has experienced damage to the
left temporal lobe of the brain. Which action should the nurse take when
providing education about newly prescribed medications to this client?
a. Help the client identify each medication by its color.
b. Provide written materials with large print size.
c. Sit on the clients right side and speak into the right ear.
d. Allow the client to use a white board to ask questions.
ANS: C
The temporal lobe contains the auditory center for sound interpretation.
The clients hearing will be impaired in the left ear. The nurse should sit on
the clients right side and speak into the right ear. The other interventions
do not address the clients left temporal lobe damage.
Know what hypoactive deep tendon reflexes affect
2. A nurse plans care for a client who has a hypoactive response to a test of
deep tendon reflexes. Which intervention should the nurse include in this clients
plan of care?
a. Check bath water temperature with a thermometer.
b. Provide the client with assistance when ambulating.
c. Place elastic support hose on the clients legs.
d. Assess the clients feet for wounds each shift.
ANS: B
Hypoactive deep tendon reflexes and loss of vibration sense can impair balance
and coordination, predisposing the client to falls. The nurse should plan to
provide the client with ambulation assistance to prevent injury. The other
interventions do not address the clients problem.
Know what things can interfere with MRI scans
10. A nurse obtains a focused health history for a client who is scheduled for
magnetic resonance imaging (MRI). Which condition should alert the nurse to
contact the provider and cancel the procedure?
a. Creatine phosphokinase (CPK) of 100 IU/L
b. Atrioventricular graft
c. Blood urea nitrogen (BUN) of 50 mg/dL
d. Internal insulin pump
ANS: D
Metal devices such as internal pumps, pacemakers, and prostheses interfere
with the accuracy of the image and can become displaced by the magnetic force
generated by an MRI procedure. An atrioventricular graft does not contain any
metal. CPK and BUN levels have no impact on an MRI procedure.
14. After teaching a client who is scheduled for magnetic resonance imaging
(MRI), the nurse assesses the clients understanding. Which client statement
indicates a correct understanding of the teaching?
a. I must increase my fluids because of the dye used for the MRI.
b. My urine will be radioactive so I should not share a bathroom.
c. I can return to my usual activities immediately after the MRI.
d. My gag reflex will be tested before I can eat or drink anything.
ANS: C
No postprocedure restrictions are imposed after MRI. The client can return to
normal activities after the test is complete. There are no dyes or radioactive
materials used for the MRI; therefore, increased fluids are not needed and the
clients urine would not be radioactive. The procedure does not impact the
clients gag reflex.
Know what a single-photon emission computed tomography (SPECT) scan is
and if there is any care required afterwards
20. A nurse cares for a client who is recovering from a single-photon emission
computed tomography (SPECT) with a radiopharmaceutical agent. Which
statement should the nurse include when discussing the plan of care with this
client?
a. You may return to your previous activity level immediately.
b. You are radioactive and must use a private bathroom.
c. Frequent assessments of the injection site will be completed.
d. We will be monitoring your renal functions closely.
ANS: A
The client may return to his or her previous activity level immediately.
Radioisotopes will be eliminated in the urine after SPECT, but no monitoring or
special precautions are required. The injection site will not need to be assessed
after the procedure is complete.
Know what imitrex is and any side effects associated with it
3. A nurse obtains a health history on a client prior to administering prescribed
sumatriptan succinate (Imitrex) for migraine headaches. Which condition should
alert the nurse to hold the medication and contact the health care provider?
a. Bronchial asthma
b. Prinzmetals angina
c. Diabetes mellitus
d. Chronic kidney disease
ANS: B
Sumatriptan succinate effectively reduces pain and other associated symptoms
of migraine headache by binding to serotonin receptors and triggering cranial
vasoconstriction. Vasoconstrictive effects are not confined to the cranium and
can cause coronary vasospasm in clients with Prinzmetals angina. The other
conditions would not affect the clients treatment.
What is bacterial meningitis and how is it contracted?
9. A nurse obtains a focused health history for a client who is suspected of
having bacterial meningitis. Which question should the nurse ask?
a. Do you live in a crowded residence?
b. When was your last tetanus vaccination?
c. Have you had any viral infections recently?
d. Have you traveled out of the country in the last month?
ANS: A
Meningococcal meningitis tends to occur in multiple outbreaks. It is most likely
to occur in areas of high-density population, such as college dormitories,
prisons, and military barracks. A tetanus vaccination would not place the client
at increased risk for meningitis or protect the client from meningitis. A viral
infection would not lead to bacterial meningitis but could lead to viral
meningitis. Simply knowing if the client traveled out of the country does not
provide enough information. The nurse should ask about travel to specific
countries in which the disease is common, for example, sub-Saharan Africa.
What are clinical manifestations of Parkinson’s?
10. After teaching the wife of a client who has Parkinson disease, the nurse
assesses the wifes understanding. Which statement by the clients wife indicates
she correctly understands changes associated with this disease?
a. His masklike face makes it difficult to communicate, so I will use a white
board.
b. He should not socialize outside of the house due to uncontrollable drooling.
c. This disease is associated with anxiety causing increased perspiration.
d. He may have trouble chewing, so I will offer bite-sized portions.
ANS: D
Because chewing and swallowing can be problematic, small frequent meals and
a supplement are better for meeting the clients nutritional needs. A masklike
face and drooling are common in clients with Parkinson disease. The client
should be encouraged to continue to socialize and communicate as normally as
possible. The wife should understand that the clients masklike face can be
misinterpreted and additional time may be needed for the client to
communicate with her or others. Excessive perspiration is also common in
clients with Parkinson disease and is associated with the autonomic nervous
systems response.
11. A nurse plans care for a client with Parkinson disease. Which intervention
should the nurse include in this clients plan of care?
a. Ambulate the client in the hallway twice a day.
b. Ensure a fluid intake of at least 3 liters per day.
c. Teach the client pursed-lip breathing techniques.
d. Keep the head of the bed at 30 degrees or greater.
ANS: D
Elevation of the head of the bed will help prevent aspiration. The other options
will not prevent aspiration, which is the greatest respiratory complication of
Parkinson disease, nor do these interventions address any of the complications
of Parkinson disease. Ambulation in the hallway is usually implemented to
prevent venous thrombosis. Increased fluid intake flushes out toxins from the
clients blood. Pursed-lip breathing increases exhalation of carbon dioxide.
Know patient/family teaching for Alzheimer’s and what the medications do
12. A nurse is teaching the daughter of a client who has Alzheimers disease. The
daughter asks, Will the medication my mother is taking improve her dementia?
How should the nurse respond?
a. It will allow your mother to live independently for several more years.
b. It is used to halt the advancement of Alzheimers disease but will not cure it.
c. It will not improve her dementia but can help control emotional responses.
d. It is used to improve short-term memory but will not improve problem solving.
ANS: C
Drug therapy is not effective for treating dementia or halting the advancement
of Alzheimers disease. However, certain drugs may help suppress emotional
disturbances and psychiatric manifestations. Medication therapy may not allow
the client to safely live independently.
13. A nurse assesses a client with Alzheimers disease who is recently admitted
to the hospital. Which psychosocial assessment should the nurse complete?
a. Assess religious and spiritual needs while in the hospital.
b. Identify the clients ability to perform self-care activities.
c. Evaluate the clients reaction to a change of environment.
d. Ask the client about relationships with family members.
ANS: C
As Alzheimers disease progresses, the c
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