CNS BN 19 21 78 80 PN 12 TO 18

The nurse is caring for a client with head trauma who has increased intracranial pressure (ICP). Which ICP is normal? Select one: A. 2 to 10 mm Hg B. 5 to 15 mm Hg C. 6 to 18 mm Hg D. 4 to 13 mm Hg

4 to 13 mm Hg ntracranial pressure (ICP) is the pressure that the brain, blood, and CSF exert inside the cerebrospinal cavity. Normally, ICP is 4 to 13 mm Hg. If one of the normal contents of the cranial or spinal cavity (e.g., brain tissue, blood, or CSF) increases in size, volume, or shape, pressure increases. This increase in pressure can cause the delicate structures to be moved, damaged, or destroyed.

Which client should the nurse monitor for tactile sense disorders? Select one: A. A client with rheumatoid arthritis B. A client with renal failure C. A client who has uncontrolled diabetes D. A client after a myocardial infarction

: A client who has uncontrolled diabetes A tactile sense disorder often results from a neurologic disorder. Persons with spinal cord injuries, nerve transmission deficits, or disorders in the brain's sensory area may be unable to feel or interpret pain. Diabetes mellitus causes peripheral neuropathy with subsequent loss of sensation, especially in the extremities.

A nurse is assisting a healthcare provider during a refractive error examination. Which intervention should the nurse implement during the procedure? Select one: A. Place the phoropter at the sides of the client's eyes. B. Position the client 20 ft from the phoropter. C. Place the phoropter in front of the client's eyes. D. Position the client 10 ft from the phoropter

: Place the phoropter in front of the client's eyes. When performing a refractive examination for a client, the nurse should place the phoropter in front of the client's eyes. Light from the examiner' s retinoscope is streaked across the eye, while the lenses from the phoropter are adjusted until the light streak is neutralized. The phoropter is held close to the client's eyes, not 10 or 20 ft from the client. Placing the phoropter at the sides of the client's eyes will not neutralize the light streak and will not allow for accurate testing.

The nurse is providing genetic counseling to a young couple hoping to start a family. The husband has the Huntington's disease (HD) gene and does not want to pass the disease on to his children. Which of the following teaching points should the nurse include in a teaching plan for this couple? Select one: A. A child with a parent who has HD has a 50-50 chance of inheriting the gene. B. Of the children who inherit the gene, 50% will develop the disease. C. Symptoms of HD generally appear before the age of 12. D. A child with a parent who does not inherit the HD gene may still develop the disease.

A child with a parent who has HD has a 50-50 chance of inheriting the gene. A child with a parent who has the HD gene has a 50-50 chance of inheriting the gene. Only children who inherit the gene will develop the disease. Only children who inherit the gene can pass on the gene to the next generation. All children who inherit the gene eventually will develop HD. The age of onset varies, although symptoms generally do not appear until the person is older than 30 years.

The nurse is aware that clients with tactile difficulties may be in danger because they cannot react appropriately to external injuries or internal disorders. Which of the following clients should the nurse monitor for tactile sense disorders? Select one: A. A client with rheumatoid arthritis B. A client after a myocardial infarction C. A client with renal failure D. A client who has uncontrolled diabetes

A client who has uncontrolled diabetes

The nurse is preparing a client who manifests with the signs and symptoms of status epilepticus for a test to diagnose seizure activity. Which of the following would be the best test to diagnose this condition? Select one: A. Electroencephalography B. Lumbar puncture C. Angiography D. Myelography

A. Electroencephalography

A nurse is assisting the anesthetist in performing a lumbar puncture on a client who is about to undergo a cesarean section under spinal anesthesia. What important factor should the nurse document before and after the procedure? Select one: A. Muscle tone and strength B. Direction of the eye movements C. Function of the cranial nerves D. Ability to move all extremities

Ability to move all extremities The nurse should document the client's ability to move all extremities before and after the lumbar puncture. There may be damage to the spinal cord if the spinal catheter goes too far, resulting in a mobility disorder. Assessing and documenting the muscle tone and strength, function of cranial nerves, and direction of the eye movements are key components of neurologic assessment and are not documented during lumbar puncture.

Which type of medication would be used to dilate the pupils before an eye examination? Select one or more: A. Osmotics B. Coritcosteroid C. Beta adrenergic agent D. Adrenergic agent

Adrenergic agent

PN12 Which patients would the nurse expect an anticholinergic agent to be ordered? SATA a. pt with hypertension # beta-adrenergic blocker b. pt with nocturnal enuresis c. pt with tachycardia d. pt with Parkinson's disease e. pt who needs an endotracheal tube

Anticholinergic agents are used clinically in the treatment of Parkinson's disease and genitourinary disorders like nocturnal enuresis. Anticholinergic agents are used to prevent vagal stimulation from skeletal muscle relaxants or placement of an endotracheal tube. Anticholinergic agents are used clinically in the treatment of bradycardia, not tachycardia.

A nurse is caring for a client with a sty on his left upper eyelid. Which measure should the nurse employ when caring for this client? Select one: A. Administer miotic drops, as ordered. B. Apply pressure patching for 24 to 48 hours. C. Compress the sty to prevent spread of infection. D. Apply warm, moist compresses over the eyelid.

Apply warm, moist compresses over the eyelid. The nurse should apply warm, moist compresses over the eyelid to help localize the infection. The nurse should caution the client not to squeeze or compress a sty, which could spread the infection. The nurse should apply pressure patching for 24 to 48 hours in case of corneal injuries and not when treating a sty. Miotic drops are administered when treating acute angle glaucoma, not for treating a sty.

What teaching should the nurse provide for a client diagnosed with myasthenia gravis? Select one: A. Wear Medic-Alert tag whenever out alone. B. Avoid any form of exercise or activity to conserve energy. C. Avoid exposure to temperature extremes and infections. D. Have regular eye examinations to check intraocular pressure.

Avoid exposure to temperature extremes and infections. The nurse should instruct the client with myasthenia gravis to avoid exposure to temperature extremes and infections because these may trigger myasthenic crisis, leading to respiratory distress, muscular weakness, dysphagia, fever, and general malaise. The nurse should instruct the client to wear a Medic-Alert tag at all times, not only when going out alone. Regular eye examinations to check intraocular pressure are important in clients with Parkinson disease and not myasthenia gravis. The nurse should instruct the client to maintain as regular a passive and active exercise regimen as possible to develop muscle strength and prevent contractures, muscle atrophy, and other disuse deformities. A regular exercise schedule must be maintained and energy conserved for essential activities.

Which intervention is most critical when monitoring the client's intracranial pressure (ICP)? Select one: A. Stop immediately if there is a break in the ICP monitoring system. B. Monitor and document the client's vital and neurologic signs. C. Observe the client's general appearance as well as mobility level. D. Avoid moving the client's head up or down without physician orders.

Avoid moving the client's head up or down without physician orders. The nurse should take care not to move the client's head up or down without specific orders from the physician. Monitoring and documenting the client's vital signs and neurologic signs are specifically important when assisting during a lumbar puncture; they are not specific measures during ICP monitoring. The nurse should report any break in an ICP monitoring system to the neurosurgeon immediately and not stop it on their own. Observing the client's general appearance and mobility level are important during neurologic nursing assessment, but not specific to ICP monitoring.

The nurse is preparing a client for an ophthalmic examination. Which action occurs when the nurse instills eye drops to produce mydriasis? Select one or more: A. Paralysis of the ciliary muscle B. Extreme dilation of the pupil C. Drying of tears in the eyes D. Opening of the canal of Schlemm

B. Extreme dilation of the pupil

A nurse is caring for a client who experiences cluster headaches. The nurse knows that cluster headaches result from a vascular disturbance leading to vasodilation. What symptoms and signs of vasodilation should the nurse look for in the client? Select one: A. Shrunken eyes B. Tears forming C. Reduced respiratory rate D. Generalized shivering

B. Tears forming The nurse should look for tear formation (lacrimation) when looking for symptoms of vasodilation in clients with cluster headaches. Other symptoms of vasodilation seen in clients with cluster headaches include runny nose, sweating, and bulged eyes. Reduced respiratory rate, generalized shivering, and shrunken eyes are not symptoms of vasodilation.

An older adult is diagnosed with the condition known as presbyopia, and is experiencing errors in far and near vision. Which of the following is the most common treatment option for this client? Select one: A. Bifocals B. Hard contact lenses C. Eye surgery D. Lens implants

Bifocals Eyeglasses (spectacles) are prescribed to correct the refractive errors of myopia, hyperopia, astigmatism, and presbyopia and for some low-vision ("legally blind") individuals. Bifocals, two lenses in one, may be prescribed to correct the problem of presbyopia. Each eyeglass lens has two parts: one part corrects the defect in near vision; the other corrects the defect in far vision.

PN12 Which nursing assessment is done before starting a patient on a beta-adrenergic blocking agent? a. Complete blood count (CBC) and sedimentation rate b. BP & HR c. Liver enzymes d. Blood urea nitrogen BUN & creatinine levels

Blood pressure and heart rate A baseline level of blood pressure and heart rate should be obtained because beta-adrenergic blocking agents affect both of these functions. Beta-adrenergic blocking agents do not affect CBC and sedimentation rate, liver enzymes, or BUN and creatinine levels.

PN 12A patient taking labetalol Normodyne has also been prescribed procainamide Procanbid. Which symptom does the nurse monitor for in this patient? a. Increased BP b. Tachycardia c. Bradycardia d.Seizures resulting from decreased sodium & potassium

Bradycardia This combination of medications may significantly decrease the patient's heart rate.

When obtaining a health history from a patient with a neurological problem, the nurse is likely to elicit the most valid response from the patient with which question?

Can you describe the sensations you are having in your head?

The nurse is caring for clients with neurologic deficits. Which of the following would the nurse describe as the most common complaint of these clients? Select one: A. Cephalgia B. Respiratory distress C. Gastrointestinal disorders D. Back pain

Cephalgia Cephalgia (headache) is one of the most common symptoms of a neurologic disorder. It is also associated with many other diseases and disorders. Headache is not a disease in itself, but rather it is a symptom of an underlying disorder.

An elderly client is diagnosed with cataracts. The client complains of double vision and says he sees halos around lights. What should the nurse expect to find in the client's eyes during the nursing assessment? Select one: A. Dilation of the pupils B. Redness of lid margins C. Cloudiness of the lens D. Drooping of the eyeli

Cloudiness of the lens The nurse should look for cloudiness of the lens in clients suspected to have cataracts. Blepharitis, not cataracts, is usually characterized by red lid margins. Drooping of the eyelid is seen in clients with ptosis and not cataracts. Cataracts are characterized by narrowing of the pupils, not dilation of the pupils.

The nurse is caring for a client who is having a myasthenic crisis. What are manifestations of this emergency situation? Select all that apply. Select one or more: A. Diplopia B. Ptosis C. Dysphagia D. Cardiac arrest E. Seizures F. Dysphasia

Dysphagia, Dysphasia, Ptosis, Diplopia A myasthenic crisis occurs rapidly and is considered an emergency situation. Dysphagia, dysphasia (difficulty in speaking), ptosis, diplopia (double vision), and respiratory distress are the usual manifestations. Maintaining an open (patent) airway can be lifesaving.

The nurse caring for a client following eye surgery reports to the surgeon that the client is showing signs of ptosis (drooping eyelid). What might this finding indicate? Select one: A. Hemorrhage B. Dehydration C. Paralysis D. Edema

Edema The nurse should report any paralysis of the face or on the operative side or ptosis (drooping eyelid) immediately. These findings may indicate damage to the facial nerve or the presence of edema.

Which diagnostic test is used to detect seizure activity in the brain? Select one: A. Myelography B. Electroencephalography C. Angiography D. Lumbar puncture

Electroencephalography Electroencephalography (EEG) records the brain's electrical impulses as a graph. This test is used frequently in the diagnosis of seizure disorders, brain tumors, blood clots, infections, and sleep disorders. The lumbar puncture (LP, spinal tap) involves the insertion of a hollow needle with a stylet (guide) into the subarachnoid space of the lumbar region of the spinal canal. In some cases, a myelogram is performed to visualize the spinal cord. An angiogram is an x-ray study of any blood vessel.

Which neurologic condition is directly associated with lead poisoning? Select one: A. Encephalitis B. Meningitis C. Acute Transverse Myelitis D. Guillain-Barré syndrome

Encephalitis Encephalitis is an inflammation of the white and gray matter of the brain. It may be associated with meningitis. Encephalitis is caused by a virus, bacteria, or chemicals (e.g., as in lead poisoning). Encephalitis can attack suddenly, causing violent headache, fever, nausea, vomiting, and drowsiness. The person may show muscular weakness, tremors, or visual disturbances. Guillain-Barré syndrome is an autoimmune disorder of the peripheral nervous system. Acute transverse myelitis is an inflammatory condition affecting the spinal cord.

A nurse is caring for a client with paraplegia. Which of the following important measures should the nurse follow when providing care for this client? Select one: A. Use trochanter rolls to assist the client when changing positions. B. Use a trapeze bar to help in maintaining proper body alignment. C. Encourage the use of high-top sneakers to prevent footdrop. D. Ask the client to avoid breathing deeply because it may lead to exertion.

Encourage the use of high-top sneakers to prevent footdrop. The nurse should encourage the use of high-top sneakers to prevent footdrop by maintaining normal anatomic alignment of the joints. A trapeze bar is used to assist the client when changing positions and does not assist in maintaining proper body alignment. A trochanter roll helps to maintain proper body alignment and does not assist the client with position changes. The nurse should encourage the client to breathe deeply or cough to prevent pulmonary complications.

The nurse is caring for a hospitalized client with Guillain-Barré syndrome. Which of the following is a nursing consideration for this client? Select one: A. The client will be on bed rest and muscles will be rested until the disease resolves. B. Recovery is fast; nursing implications focus on physical rather than emotional aspects. C. Excellent nursing care is necessary to prevent permanent damage. D. The nurse will start steroid therapy as the drug of choice.

Excellent nursing care is necessary to prevent permanent damage. The nurse must keep in mind that this client has an excellent chance of total or nearly total recovery. Therefore, excellent nursing care is necessary to prevent permanent damage. Steroid therapy is controversial because, although it may reduce symptoms, it may be deleterious to the client's recovery. Maintenance of muscle function is required to prevent atrophy and skeletal deformities. Nursing interventions, such as providing passive range of motion and working with physical therapy, are very important from the very beginning of the diagnosis. Recovery is usually slow, lasting weeks, months, or years, depending on the severity of symptoms and emotional support is essential.

A nurse is caring for a client who is diagnosed with Ménière disease. Which measure should the nurse take when caring for this client? Select one: A. Explain all actions to the client ahead of time. B. Elevate the head of the bed to about 45 degrees. C. Provide the client a diet rich in sodium. D. Encourage the client to take in more fluids.

Explain all actions to the client ahead of time. When caring for a client with Ménière disease, the nurse should explain all actions ahead of time because sudden actions may precipitate an attack. The nurse should encourage the client to take fluids in small amounts because the nauseated client is better able to tolerate small amounts. The nurse should keep the bed in a low position at all times to protect against dangerous falls. The client should be given a low-sodium diet and not a diet rich in sodium, in order to decrease edema and pressure on the inner ear.

A nurse is caring for a client who is diagnosed with Ménière's disease. Which of the following measures should the nurse take when caring for this client? Select one: A. Elevate the head of the bed to about 45 degrees. B. Explain all actions to the client ahead of time. C. Provide the client a diet rich in sodium. D. Encourage the client to take in more fluids.

Explain all actions to the client ahead of time. When caring for a client with Ménière's disease, the nurse should explain all actions ahead of time because sudden actions may precipitate an attack. The nurse should encourage the client to take fluids in small amounts because the nauseated client is better able to tolerate small amounts. The nurse should keep the bed in a low position at all times to protect against dangerous falls. The client should be given a low-sodium diet and not a diet rich in sodium, in order to decrease edema and pressure on the inner ear.

BN80 Is the following statement true or false? For a client with conjunctivitis, rubbing the infected eye gently helps relieve pain and itching.

False A nurse must teach the client not to rub the eyes, which can lead to corneal scarring. If eye drops are used, teach the client not to touch the eye with the dropper which will contaminate the solution. Discard unused or partially used eye drops because the solution can become contaminated.

BN 80 Is the following statement true or false? The client with one eye patched is allowed to drive.

False If one eye is patched, the client will have a loss of depth perception and peripheral vision. The client should not drive or perform duties that could be unsafe to the individual or to others. Individuals commonly become confused or disoriented when one or both eyes are patched.

BN80 Meniere disease Is the following statement true or false? The symptoms of Ménière disease are not treatable.

False Ménière disease causes significant vertigo, nausea, vomiting, and tinnitus. The symptoms of the disorder typically are treatable with palliative medications.

A nurse is caring for a client with a contusion injury to his right eye. Which of the following signs would alert the nurse to a detached retina in this client? Select one: A. Flashes of light B. Immediate loss of vision C. Wavy lines D. Severe eye pain

Flashes of light Signs and symptoms of a detached retina may occur suddenly or gradually. If a large part of the central retina is affected, vision loss is greater than if the outer edges are destroyed. The person may see flashes of light (flashers) or moving spots (floaters). Vision may be blurry, or it may seem as though a shade has been pulled over part of the vision. Usually no pain occurs with a detached retina.

The nurse is entering the hospital room of a client who has a severe hearing deficit. Which nursing considerations would be appropriate for this client? Select all that apply. Select one or more: A. Face the client on the same level. B. Repeat specific words rather than entire phrases. C. Speak slowly and clearly. D. Get the client's attention before speaking. E. Use hand motions to facilitate the conversation.

Get the client's attention before speaking., Face the client on the same level., Speak slowly and clearly., Use hand motions to facilitate the conversation. The nurse should face the client on the same level, speak slowly and clearly, and verify that the client understood the conversation. The nurse should also get the client's attention before speaking, repeat entire phrases rather than specific words, and use contextual clues, such as objects, persons, and hand motions, to facilitate the conversation.

PN12 Which information does the nurse teach a patient about taking a beta-adrenergic blocking agent? a. if the medication is stopped abruptly, it may cause an exacerbation of anginal symptoms. b. The drug may be taken with cimetidine without any adverse reactions. c. The drug may be stopped when the patient begins to have better blood pressure readings. d. The medication must be taken with meals.

If the medication is stopped abruptly, it may cause an exacerbation of anginal symptoms. Stopping beta-adrenergic blocking agents may exacerbate anginal symptoms and lead to myocardial infarction. Individuals who are placed on beta-adrenergic blocking agents should not discontinue them without consulting a healthcare professional. Beta-adrenergic blocking agents are not required to be taken with meals. Taking a beta-adrenergic blocking agent with cimetidine may require the beta blocker dosage to be higher because the cimetidine may interfere with the medication's metabolism.

The nurse is assisting with a caloric test to determine if an alteration exists in the vestibular origin of the acoustic nerve. Which intervention will the nurse implement during this procedure to support the desired results? Select one: A. Replace water with hot air for a client with a punctured eardrum. B. Place the client in a prone position to perform the examination. C. Instill cold and/or warm water into the external ear canal. D. Test the affected side after testing the normal side

Instill cold and/or warm water into the external ear canal. During this procedure, the client is either seated or supine, and water is instilled into the external ear canal. Sometimes, warm and cold water are alternated. The affected side is tested first because less of a reaction is expected to occur there. The normal response to this test is nystagmus (rapid, rhythmic eye movements), nausea, vomiting, vertigo (a feeling of spinning), and a feeling of falling. Decreased or absence of these responses within 3 minutes indicates an abnormality. Water cannot be used for this test if the client's eardrum is punctured. Cold air may be substituted.

he nurse monitors an 80-year-old client's blood urea nitrogen (BUN) and creatinine before and after positron emission tomography. The dye used in the test increases the client's risk for which side effect? Select one: A. Hypernatremia B. Cardiac dysrhythmias C. Respiratory distress D. Kidney damage

Kidney damage The nurse should monitor the older adult client's blood urea nitrogen (BUN) and creatinine before and after any procedure that uses dye. The aging population is at increased risk for kidney damage, and the nurse should promptly report any elevations in BUN and creatinine values. The dye is not known to be associated with the other options.

The nurse is caring for a patient in the hospital who is visually impaired. Which of the following nursing considerations would be appropriate for this client? Select all that apply. Select one or more: A. Lightly push the client from behind when helping the client to ambulate. B. Let the client know when you are leaving the room. C. Speak in a louder tone to compensate for loss of vision. D. Identify self when entering the room.

Let the client know when you are leaving the room., Identify self when entering the room. When caring for a visually impaired client, the nurse should let the client know when entering or leaving the room, place the client's food in the same "clock position" for every meal, and identify each food. The nurse should speak in a normal tone, speak to the clients before touching them so as not to frighten them, and when ambulating, walk slowly and allow the person to take the nurse's arm.

The nurse is caring for a client who is diagnosed with a brain abscess. If left untreated, what condition may develop as a result of a brain abscess? Select one: A. Acute Transverse Myelitis B. Guillain-Barré syndrome C. Shingles D. Meningitis

Meningitis Brain abscess is a collection of pus that may result from an infection of the ears, mastoid, sinus, or skull. It can also directly result from a brain surgery. If left untreated, the encapsulated pus pocket eventually ruptures and spreads, causing further abscesses and meningitis, infection of the meninges. Guillain-Barré syndrome is an autoimmune disorder of the peripheral nervous system. Acute transverse myelitis is an inflammatory condition affecting the spinal cord. Shingles, or herpes zoster, is an acute viral inflammation of a nerve caused by the varicella-zoster virus, which results from reactivation of latent virus cells residing in dorsal root or cranial nerve ganglion cells

The nurse is caring for a client who is having a migraine headache. Which are signs or symptoms of this condition? Select all that apply. Select one or more: A. Premonition the headache will occur B. Mood changes C. Respiratory alterations D. Numbness of a body part E. Nausea and vomiting

Mood changes, Numbness of a body part, Premonition the headache will occur, Nausea and vomiting The person may have sensory warnings or premonitions (aura) that a headache will occur. Various auras include mood changes, anorexia, numbness of a body part, or visual symptoms, such as flashing lights or floating spots. Later, the person will experience unilateral throbbing or steady pain, sometimes accompanied by nausea and vomiting.

A nurse is assisting with a cerebral arteriography for a client with a head injury. What is the nurse's role when assisting with this procedure? Select one: A. Check the insertion site every hour for signs of bleeding. B. Restrict excess fluid intake during the arteriography procedure. C. Obtain a baseline neurologic assessment before the procedure. D. Apply a pressure device after the procedure to prevent scarring.

Obtain a baseline neurologic assessment before the procedure. The nurse should obtain a baseline neurologic assessment before the procedure because there is a possibility that a thrombus can become dislodged, causing an embolus to travel to the brain, leading to neurologic impairment. The nurse should encourage large amounts of fluids, unless contraindicated, because of the radiopaque dye used. The nurse should apply a pressure device to the insertion site to reduce edema, bleeding, and hematoma formation and not to prevent scarring. The insertion site should be checked for bleeding every 15 to 30 minutes for several hours, and not at the end of every hour.

Several specialists are involved in the treatment of the eye. Who would be licensed to perform cataract surgery? Select one: A. Optometrist B. Ophthalmologist C. Optician D. Ophthalmic technician

Ophthalmologist ophthalmologist has received a Doctor of Medicine (MD) degree and has completed at least 3 years of postgraduate training in diseases and surgeries of the eye. This healthcare provider is licensed to diagnose and treat eye disorders, prescribe medications, perform surgery, and fit glasses or contact lenses. An optometrist has received a Doctor of Optometry (OD) # licensed to examine eyes, prescribe eyeglasses or contact lenses, and, in many states, treat some eye diseases with medication. An optician is responsible for grinding lenses and fitting spectacles as specified by either an ophthalmologist or an optometrist. Ophthalmic technicians are certified by the Joint Commission to assist the ophthalmologist in performing tests on clients.

A client is diagnosed with conductive hearing loss. What are common causes of this condition? Select all that apply. Select one or more: A. Viral infections B. Foreign bodies obstruction C. Perforated eardrum D. Excessive cerumen E. Otitis media F. Excessive noise

Otitis media, Excessive cerumen, Perforated eardrum, Foreign bodies obstruction Causes of conductive hearing loss include otitis media, perforated eardrum, and obstruction of external auditory canal (e.g., foreign body or cerumen). Excessive noise, tumors, and viral infections may cause sensorineural losses.

Which measures should the nurse implement when caring for a client in an active seizure? Select one: A. Elevate the head of the bed to 45 degrees. B. Observe for a flushing of the skin. C. Place a soft pad beneath the client's head. D. Put something in the mouth to keep it open.

Place a soft pad beneath the client's head. The nurse should place a small soft pad beneath the client's head to protect the head from injury. The nurse should avoid putting anything in the client's mouth during a seizure. Doing so can cause the client's teeth to break because of the force. During a seizure, the nurse should observe the client for respiratory depression and not increased respiratory rate. Elevating the head of the bed to 45 degrees is not necessary during a seizure.

A patient has a head injury and is presenting with signs and symptoms of increased intracranial pressure. Which nursing intervention would be helpful in reducing this pressure?

Place the neck in a neutral position to promote venous drainage. ...

PN12 Which medications that may inhibit therapeutic activity for a patient receiving adrenergic agents? SATA a. Bretylium tosylate (Bretylate) b. Aspirin c. Diphenhydramine (Benadryl) d. Omeprazole (Prilosec) e. Propranolol (Inderal)

Propranolol (Inderal) + bretylium tosylate or beta-adrenergic blocking agents, such as propranolol, with adrenergic agents is not recommended because these drugs can inhibit the therapeutic activity of adrenergic agents. Omeprazole, diphenhydramine, and aspirin are not known to inhibit the therapeutic activity of adrenergic agents.

PN12 Which effect may occur with medications that stimulate the beta-2 receptors? a. brochoconstriction b. relaxation of uterus c. Vasoconstriction of peripheral blood vessels d. Increase in HR

Relaxation of the uterus Stimulation of beta-2 receptors causes relaxation of smooth muscle in the uterus, as well as in the smooth muscle in the bronchi , muscle in the peripheral arterial blood vessels (vasodilation). Stimulation of beta-1 receptors causes an increase in the heart rate.

Which body system would the nurse choose to closely monitor in a patient diagnosed with Guillain-Barré syndrome?

Respiratory

A nurse is caring for a client with autonomic dysreflexia. The nurse has been ordered to monitor the client's blood pressure regularly because it is dangerously elevated. The nurse should be aware that a sudden onset of hypertension can result in which of the following? Select one: A. Visual disturbances B. Chills and severe headache C. Respiratory distress D. Seizures and strokes

Seizures and strokes The nurse should be aware that the sudden onset of hypertension in clients with autonomic dysreflexia causes seizures or strokes. Autonomic dysreflexia is characterized by a sudden and dangerous elevation of blood pressure owing to autonomic response to various stimuli. A sudden onset of hypertension may not result in chills and severe headache, respiratory distress, or visual disturbances.

PN 12 A patient taking albuterol Proventil has also started taking an over-the-counter OTC cold medication. Which symptom does the nurse monitor for in this patient? a. Increased fluid retention b. Tachycardia c. Bradycardia d.increased occurrence of bronchospasms

Tachycardia The concurrent use of albuterol and OTC cold medications may have an additive effect and cause tachycardia as well as chest pain. The OTC medication will not have an effect on the bronchi. The concurrent use of albuterol and OTC cold medication will not decrease heart rate or increase fluid retention.

The nurse is working with a client that is hearing-impaired. Which is the best method for the nurse to use to communicate? 1 Write out all communication. 2 Shout into the good ear. 3 Speak directly to the client, facing the client. 4 Talk directly into the impaired ear.

Speak directly to the client, facing the client. Explanation: Facing the client and speaking directly to the client is the best way to communicate with clients who have a hearing impairment. It is best to speak into the non-impaired ear. It is best to speak first directly and clearly then write all communication if the person does not understand. Shouting may cause distortion and maybe too loud for the client with sensorineural damage.absence

The nurse is entering the hospital room of a client who has a severe hearing deficit. Which nursing considerations would be appropriate for this client?Select all that apply. Select one or more: A. Verify that the person understood the conversation. B. Repeat specific words rather than entire phrases. C. Speak slowly and clearly. D. Speak first and then get the client's attention.

Speak slowly and clearly., Verify that the person understood the conversation. The nurse should face the client on the same level, speak slowly and clearly, and verify that the client understood the conversation. The nurse should also get the client's attention before speaking, repeat entire phrases rather than specific words, and use contextual clues, such as objects, persons, and hand motions, to facilitate the conversation.

The nurse is counseling a 30-year-old paraplegic client. Which information would the nurse include in a teaching plan concerning female health related issues? Select one: A. Menses usually resume within 1 year following the injury. B. Tampons are not recommended for use and can be dangerous. C. The use of birth control pills is recommended. D. Labor and childbirth are easier and safer because of the paralysis.

Tampons are not recommended for use and can be dangerous. The use of tampons is dangerous because the woman may forget that a tampon is in place because she has no sensation. The use of birth control pills is not recommended because they can lead to thrombus formation, particularly if the client is not exercising or is immobile. Menses usually resume within 3 months following the injury. Labor and childbirth may be dangerous. The woman may not be aware of the onset of labor. The likelihood of a cesarean birth is increased because the woman may not be able to assist with the delivery and the uterus may not have adequate muscle tone. In addition, labor and delivery may serve as a trigger for autonomic dysreflexia.

The nurse is providing teaching for a 7-year-old child who is having polyethylene (PE) tubes inserted because of recurrent inner ear infections. Which teaching point should the nurse provide this client and family? Select one: A. The child's ear should be plugged with cotton. B. The child will be on antibiotics for the first month. C. The child should be trained to lip read. D. The child should not use a shower or swim.

The child should not use a shower or swim. Polyethylene (PE) tubes are often inserted through an eardrum incision into the middle ear. This procedure is most commonly done in children with recurrent ear infections. PE tubes allow continuous drainage from the middle ear. In this case, the client must use caution to prevent water from entering the ear. Swimming and showering are contraindicated. The other answer options are not related to PE tubes.

A nurse is caring for a client with trigeminal neuralgia. The client is advised by the healthcare provider to undergo partial surgical removal of the trigeminal (5th cranial) nerve root. Of what should the nurse be aware regarding the characteristic of pain in the client?

The pain may be triggered by the slightest touch of the trigger zone.

The nurse caring for clients with spinal cord injuries explains the physiology of the spinal cord to the student nurse. Which of the following accurately describes this organ? Select one: A. If the spinal cord is severed, the brain takes over communication to the body. B. The spinal cord is the communication system between the brain and body. C. The brain sends a signal to the spinal cord to initiate the reflex arc. D. The spinal cord is a tight cluster of white matter surrounded by gray matter.

The spinal cord is the communication system between the brain and body. The spinal cord is the communication system between the brain and the periphery of the body. It is composed of a tight cluster of nerve cell bodies (gray matter), surrounded by the ascending (sensory) and descending (motor) tracts (white matter). If the spinal cord is severed or compressed, communication between the brain and the rest of the body is literally cut off. The spinal cord is also responsible for the reflex arc.

The nurse performing a physical assessment of an 80-year-old client documents the structural disorder known as entropion. What occurs in this condition? Select one: A. There is drooping of the upper eyelid owing to muscle weakness or nerve damage. B. There is an outward turning of the eyelid caused by the aging process. C. There is increased fluid pressure within the eye. D. There is an inward turning of the lid margin common in older adultscluster headache

There is an inward turning of the lid margin common in older adults With entropion, an inward turning of the lid margin occurs in which the lower lashes turn inward and irritate the conjunctiva and cornea. An outward turning of the eyelid is known as ectropion, drooping of the eyelid is called ptosis, and increased eye pressure is known as glaucoma.

The nurse is assisting a client with paraplegia into a special "neuro chair." What are the advantages/disadvantages of using these devices?

They adjust to various positions.

PN12 Which conditions are potentially more sensitive to the effects of adrenergic agents? SATA a. Hypotension b. Thyroid disease c. Impaired hepatic function d. Lung disease e. Heart disease

Thyroid disease + Impaired hepatic function + Heart disease + hypertension Patients who are potentially more sensitive to adrenergic agents include those with impaired hepatic function, thyroid disease, and heart disease. Patients with lung disease are not known to be more sensitive to the effects of adrenergic agents. Patients with hypertension, not hypotension, are known to be more sensitive to the effects of adrenergic agents.

The nurse is assisting an ophthalmologist with a test to measure the pressure in the eyes of a client to detect glaucoma. Which test is being performed? Select one: A. Refractive Examination B. Tonometry C. Ophthalmoscopic examination D. Slit lamp examination

Tonometry An instrument called a tonometer can indirectly measure intraocular pressure (IOP), the pressure within the eye. The slit lamp is a special type of microscope that directs a beam of light onto or through the cornea to view the eye's anterior structures. The ophthalmoscope is an instrument used by the examiner to look through the pupil to see the retina and other interior structures. The refractive examination is used to identify the degree of refractive error and determine the type of lens necessary to correct a visual defect.

The nurse is caring for a client diagnosed with a subdural hematoma. Which of the following is the usual cause of this condition? Select one: A. An accumulation of blood between the dura and skull B. Hemorrhage and edema from bleeding in the skull C. A penetrating head injury D. Torn vein on the brain's surface

Torn vein on the brain's surface A subdural (below the dura) hematoma is typically slow forming. It is caused by an accumulation of blood, usually from a torn vein on the brain's surface. An intracranial (intracerebral) hematoma is caused by hemorrhage and edema that results from bleeding within the skull. An epidural hematoma is an accumulation of blood, usually from the temporal artery, between the dura and the skull. In a penetrating head injury, the degree of damage depends on the penetrating object's velocity and location. A high-velocity object, such as a bullet, typically causes more damage than a low-velocity object, such as a stab wound.

For which condition may cabamazepine (Tegretol) be used? Select one or more: A. tardive dyskinesia B. Trigeminal neuralgia pain C. Sedation D. Psychotic episodes

Trigeminal neuralgia pain

BN80 Is the following statement true or false? Extreme caution is necessary when instilling any type of medication into the eye.

True Containers of eye medications are similar to bottles for other solutions. For example, some non-eye solutions come in small bottles with droppers e.g., guaiac solutions used to test for occult blood. These solutions can be extremely caustic and can cause blindness.

The ophthalmologist examining a client's eyes documents that the client has astigmatism. Which of the following describes this condition? Select one: A. Elongation of the eyeball B. Unequal curvature in shape of the lens C. Shorter than normal eyeball D. Loss of elasticity of the lens

Unequal curvature in shape of the lens Astigmatism is an unequal curvature in shape of the lens or cornea, myopia is elongation of the eyeball, hyperopia is a shorter than normal eyeball, and presbyopia is loss of elasticity of the lens or poor accommodation.

PN12 Which common adverse effects might a patient experience when taking an anticholinergic agent? SATA a. Urinary retention b. diarrhea c. chills d. Dryness of mouth e. Blurred vision

Urinary retention + Blurred vision ++ dryness + Constipation Blurred vision may occur with the use of anticholinergic agents, and appropriate suggestions should be made for the patient's safety. If the patient develops urinary hesitancy with the use of anticholinergic agents, he or she should be assessed for bladder distention and the healthcare provider contacted for further evaluation. Mucosa dryness may occur with the use of anticholinergic agents, and may be alleviated by sucking hard candy or ice chips or by chewing gum. Constipation, not diarrhea, is a common adverse effect of anticholinergic agents. Chills are not a common adverse effect of anticholinergic agents.

The nurse is providing client education for a client whose healthcare provider ordered a brain scan. Which conditions might the nurse mention are diagnosed by a brain scan? Select all answers that apply. Select one or more: A. Vascular lesions B. Increased intracranial pressure C. Cerebrovascular ischemia D. Abscesses E. Neoplasms

Vascular lesions, Neoplasms, Abscesses, Cerebrovascular ischemia

A brain scan is used during the diagnosing process for which conditions? Select all that apply. Select one or more: A. Vascular lesions B. Cerebrovascular ischemia C. Abscesses D. Infection of the meninges E. Increased intracranial pressure F. Neoplasms

Vascular lesions, Neoplasms, Abscesses, Cerebrovascular ischemia A brain scan is used to evaluate vascular lesions, neoplasms, abscesses, and areas of cerebrovascular ischemia. The rationale for this procedure is that the radioisotope will accumulate in a greater amount at a site of pathology than at normal brain tissue. A lumber puncture may be performed to measure pressure of cerebrospinal fluid (CSF) and obtain a sample of CSF for culture and sensitivity.

A nurse is irrigating the ear of a client to clear an external auditory canal obstruction. Which of the following measures should the nurse employ when caring for this client? Select one: A. Warm the irrigating solution to body temperature. B. Straighten the client's ear canal down and back. C. Place the syringe at the tip of the external auditory meatus. D. Keep the ear canal wet to promote client comfort.

Warm the irrigating solution to body temperature When performing ear irrigation, the nurse should warm the irrigating solution to body temperature because hot or cold solutions can stimulate the inner ear and cause nausea or dizziness. When irrigating the ear for an adult, the nurse should straighten the ear canal up and back; however, when irrigating the ear for a child, straighten the ear canal down and back to provide better access to the ear canal. The nurse should insert the syringe into the meatus only as far as can be seen, to prevent injury to the canal. The nurse should keep the client's ear dry, not wet, to promote client comfort.

A client has an eye patch to allow the eye to rest following an injury playing soccer. Which of the following is a teaching point for a client with one eye patch? Select one: A. Tell the client to report any changes in depth perception. B. Tell the client to remove the patch at night. C. Tell the client to report any changes in peripheral vision. D. Warn the client not to drive a car or other machinery.

Warn the client not to drive a car or other machinery. If one eye is patched, the client will have a loss of depth perception and peripheral vision. The client should not drive or perform duties that could be unsafe to the individual or to others. The patch is generally not removed at night.

The nurse is providing preoperative teaching for a client undergoing eye surgery. What are accurate teaching points to prepare this client following the surgery? Select all that apply. Select one or more: A. Remove the dressings when alert. B. Do not lift more that 20-30 pounds for about a week. C. Sleep on the non-operative side for at least one week. D. Wear a metal shield, if prescribed, for up to 4 weeks. E. On the second postoperative day, clean the eye with moist cotton balls. F. Avoid sudden movements and straining at stool.

Wear a metal shield, if prescribed, for up to 4 weeks., Sleep on the non-operative side for at least one week., On the second postoperative day, clean the eye with moist cotton balls., Avoid sudden movements and straining at stool. Following surgery, the client should wear a metal shield, if prescribed, while sleeping or napping for up to 4 weeks to protect the eye from accidental bumping. On the second postoperative day, the client can clean the eye gently to remove mucus, using cotton balls or tissues moistened with tap water. The client should avoid sudden movements and straining at stool. The client should not remove the dressings, should not sleep on the operative side for at least a week, and should not lift more than 10 to 30 pounds for about a week.

PN 12 A patient who has recently experienced a heart attack is prescribed a beta-adrenergic blocking agent. Which symptom of this therapy would be of concern to the nurse? a) Decrease in heart rate from 88/min to 46/min b) Decrease in blood pressure from 146 mm Hg systolic to 110 mm Hg systolic c) Decrease in temperature from 37.6º C to 37.2º C d) Decrease in respirations from 26/min to 20/min

a) Decrease in heart rate from 88/min to 46/min Beta-Adrenergic Blocking Agents Benefits include treatment for Hypertension + Angina pectoris + Cardiac dysrhythmias + Hyperthyroidism

The nurse is preparing a 25-year-old male client for a resting electroencephalogram (EEG). Which of the following accurately describes a nursing consideration for this client?

a) Tell the client that he will be asked to watch a pattern on a TV monitor.

C78 The nurse is reinforcing education for a female client paralyzed from a spinal cord injury SCI. What statement made by the client demonstrates understanding of the education? a. "I may begin to menstruate within 3 months following my injury." b. "I should use birth control pills as a means of contraception." c. "It is just as safe for me to become pregnant as a woman without an SCI." d. "I should use a tampon instead of a feminine pad when I am menstruating."

a. "I may begin to menstruate within 3 months following my injury." Explanation: Menses usually resume within 3 months following the injury. It takes time for the body to adjust to the injury. The use of birth control pills is not recommended. They can lead to thrombus formation, particularly if the client is not exercising or is immobile. Effectiveness often decreases because of interactions with other medications. Labor and childbirth may be dangerous. The woman may not be aware of the onset of labor. The likelihood of a cesarean birth is increased because the woman may not be able to assist with the delivery and the uterus may not have adequate muscle tone. In addition, labor and delivery may serve as a trigger for autonomic dysreflexia. The use of tampons is not recommended because the woman may forget that a tampon is in place because she has no sensation.

The nurse is caring for a client with amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease. Which of the following is a characteristic of this disease? Select one: A. ALS always progresses to respiratory dysfunction and death. B. There are new therapies that will lessen or halt the progress of ALS. C. There are periods of remission with ALS when no symptoms occur. D. Clients with ALS experience intellectual and sensory deficits near

a. ALS always progresses to respiratory dysfunction and death The course of the ALS is consistent, with no remissions. ALS always progresses to respiratory dysfunction and death, generally within 5 years after onset, although the course of the disease may vary. No cure or therapy will lessen the progress of, or reverse, the disorder. The individual with ALS retains intellectual and sensory function throughout the course of the disease.

BN80 The nurse is caring for a client who was hit in the left eye with a softball. The eye is edematous and painful to touch. What is the priority intervention by the nurse? a. Apply a cold pack. b. Apply a warm compress. c. Have the client lay flat for 12 hours to decrease swelling. d. Place drops in the eye to decrease pain.

a. Apply a cold pack. Explanation: The initial intervention by the nurse should be to apply a cold pack or compress to the eye to minimize pain and edema. A warm compress should be applied after 24 to 48 hours. Lying flat will not decrease the swelling and is not a necessary intervention. Drops are not necessary for trauma to the eye.

BN80 When caring for a client who is experiencing a hearing impairment, what must a nurse do? a. Face the client on the same level. b. Speak to the client gently, in a quiet and darkened room. c. Do not use hand motions that may offend the client. d. Repeat the same words to support understanding. e. Wait for the client to notice, rather than getting the client's attention, as this might startle the client

a. Face the client on the same level. The nurse should also - Get the client's attention before beginning to speak. - Ensure sufficient light for the client to see the speaker's mouth clearly. - Decrease background noises; do not chew, smoke, put objects in the mouth, or cover it while talking. - Speak slowly and clearly, repeat entire phrases, restate the conversation with different words, use contextual clues. Verify the client has understood.

What is the physiologic cause of termors in patients with Parkinson's disease? a. Increase in the amount of acetylcholine in the brain b Increase in the amount of dopamine produced in the substantia nigra c. overgrowth of the substantia nigra in the brain d. lack of oxygne to brain during respiratory

a. Increase in the amount of acetylcholine in the brain Rationale The symptoms associated with parkinsonism are caused by a deterioration of the dopaminergic neurons in the substantia nigra, resulting in a depletion of dopamine in the autonomic ganglia, basal ganglia, and spinal cord causing progressive neurologic deficits. These areas of the brain are responsible for maintaining posture & muscle tone & regulating voluntary smooth muscle activity as well as other nonmotor activities. Normally a balance exists between dopamine, an inhibitory neurotransmitter, and acetylcholine, an excitatory neurotransmtter. With a deficiency of dopamine, a relative increae in acetylchoine activity occurs, causing the symptoms of parkinsonism. About 80% of the dopamine in the neurons of the substantia nigra og the brain must be depleted for symptoms of develop.

BN80 The nurse is assisting a visually impaired client with meals. What nursing interventions will assist the client with maintaining independence and dignity? Select all that apply. a. Place food in the same "clock position" on the plate. b. Tell the client what is being served. c. Feed the client so food will not spill. d. Tell the client where food is located. e. Prepare finger foods so the client will not have to use utensils.

a. Place food in the same "clock position" on the plate. b. Tell the client what is being served. d. Tell the client where food is located. Explanation: When assisting a visually impaired client with meals, it is important to maintain the client's independence and dignity. Place the food in the same clock position on the plate, tell the client what is being served so he/she can choose to eat it or not, and indicate where the food is located on the plate so the client can eat independently. The client should be able to eat anything according to the assigned diet and not only finger foods. Do not feed clients but allow them to feed themselves.

C78 The nurse is caring for a client with herpes zoster. What priority measures to avoid cross-contamination should the nurse provide? a. Use transmission-based precautions. b. Administer antiviral medications as ordered. # reduces symptoms, NOT prevent the risk of transmission c. Apply antihistamine cream to the lesions. # do not prevent transmission d. Have the client wear gloves. # NURSE must wear gloves, not necessary for pt

a. Use transmission-based precautions. EXPLANATION a. to prevent from develop chickenpox from contact with someone with shingles, herpes zoster can e.g All healthcare providers should avoid touching the lesions directly & wear gloves

Which nursing intervention is best for pt with Parkinson's disease? a. provide six small meals per day rather than three large ones. a. provid for alll of the pt's basic needs like dressing, feeding, and bathing. c. schedule all acitivities in the morning after breakfast & bthing. d provid environmental stimulation with music, TV, and activities

a. provide six small meals per day rather than three large ones. Rationale The pt with Parkinson's disease often has difficulty chewing & swallowing because of muscle weakness & fatigue. Frequent small meals also allow the pt to have a more balanced diet. Swallowing techniques must be taught to prevent aspiration.

method of reducing a person's risk of becoming infected with the West Nile virus would be to

apply insect repellent that contains DEET

PN 12 A patient with chronic obstructive pulmonary disease (COPD) reports having insomnia and a racing heart after starting terbutaline therapy. Which explanation by the nurse is most accurate? a. "The symptoms are typical and indicate that the medication is at a therapeutic level." b. "The symptoms will tend to resolve with continued therapy." c. "The symptoms are unusual and need to be reported to the healthcare provider immediately." d. "The symptoms are indicative of toxicity

b "The symptoms will tend to resolve with continued therapy."

C78 A client with a T6 injury reports a pounding headache, blurred vision, and nasal congestion. The nurse observes profuse sweating above the level of injury. What is the priority action by the nurse? a. Irrigate the client's indwelling catheter. b. Elevate the client's head. c. Place the client in Trendelenburg position. d. Obtain the client's temperature.

b. Elevate the client's head. Explanation: Autonomic dysreflexia is a medical emergency that requires prompt treatment with SS 1 Sudden, significant increase in blood pressure (systolic and diastolic) of 20 to 40 mm Hg above baseline 2 sudden onset of a pounding headache, bradycardia, arrhythmias, profuse sweating # diaphoresis, goose bumps # piloerection, and flushing above the level of injury, blurred vision, or spots in the visual field, nasal congestion, apprehension, anxiety are all symptoms of autonomic dysreflexia.

What is the action of carbidopa/levodopa Sinemet? a. Decreases the plasma level of acetylcholine b. Provides increased amounts of dopamine to the brain

b. Provides increased amounts of dopamine to the brain Rationale Sinemet is a combination product of carbidopa & levodopa used for treating the symptoms of Parkinson' disease. Cabidopa is an enzyme inhibitor that reduces the metabolism of levodopa, allowing a greater portion of the administered levodopa to reach the desired receptor sites in the basal ganglia. Carbidopa has no effect when used alone; it must be used combination with levodopa. The primary therapeutic outcome sought from Sinemet is to establish a balance of dopamine and acetylcholine in the basal ganglia of the brain by enhancing delivery of dopamine to brain cells. It doesn't change the amount of acetylcholine, which is excitatory, but increases the amount of dopamine, which is inhibitory.

C78 1) The nurse witnesses a client having a tonic-clonic seizure in the bed. What is the priority action by the nurse? a. Insert a tongue blade between the client's teeth. b. Place the client in the prone position. c. Turn the head to the side. d. Insert an indwelling catheter.

c . Turn the head to the side. to avoid aspiration Explanation: a. Insert a tongue blade between the client's teeth. CAUSE DAMAGE the oral mucosa and break teeth, splinter & be ASPIRATED. b. prone position can NOT PROCTED the airway d. It is unnecessary to insert a catheter into the client for urinary drainage even if the client voids incontinently during the seizure.

PN 12 Which term describes the collective symptoms of blurred vision; constipation; urinary retention; and dry nose, mouth, and throat? a) Dehydration b) Toxic effects c) Anticholinergic effects d) Cholinergic action

c) Anticholinergic effects Common SE Blurred vision; constipation; urinary retention; dryness of the mucosa of the mouth, nose, and throat

PN 12 Adrenergic drugs are known to cause what common adverse effect? a) Drowsiness b) Cardiac dysrhythmias c) Tremors d) Bradycardia

c) Tremors Since Adrenergic Agents stimulate SYMPATHETIC ANS, so Common adverse effects are Palpitations, tachycardia, skin flushing, dizziness, tremors, orthostatic hypotension

PN12 A patient with Parkinson's disease asks the nurse why anticholinergics are used in the treatment. Which response by the nurse is most accurate? a. "These drugs help you urinate." b. "These drugs will decrease your eye pressure." c. "These drugs inhibit the action of acetylcholine." d. "These drugs will assist in lowering your heart rate."

c. "These drugs inhibit the action of acetylcholine."

PN12 A patient with Parkinson's disease asks the nurse why anticholinergics are used in thetreatment. Which response by the nurse is most accurate? a. "These drugs help you urinate." b. "These drugs will decrease your eye pressure." c. "These drugs inhibit the action of acetylcholine." d. "These drugs will assist in lowering your heart rate."

c. "These drugs inhibit the action of acetylcholine."

BN80 The nurse is reinforcing education regarding the use of eye drops during treatment for a client who has been diagnosed with conjunctivitis. What is a priority for the nurse to include? a. Warm the solution briefly in the microwave prior to use. b. Save the unused solution for use if the infection returns. c. Be sure not to touch the eye with the dropper. d. Use the drops for the other member of the family who has conjunctivitis.

c. Be sure not to touch the eye with the dropper. Explanation: The solution is not required to be warmed and a microwave causes "hot spots" in the solution that may cause burns. The solution should be discarded after the completed course of medication due to the possibility of contamination of the solution. The dropper should not touch the eye because it may cause contamination of the dropper and reinfect the eye. The client should not share the solution because cross-contamination may occur.

What is the therapeutic outcome of antiparkinson medication therapy? a. Cure the disease b. Prevent the symptoms of the disease c. Decrease the symptoms of the disease d stop the progession of the disease

c. Decrease the symptoms of the disease Rationale There is known cure for Parkinson's disease. Medication therapy will decrease but not prevent the symptoms of the disease. High doses of drugs may increase the very symptoms that are being treated. The goal of treatment is to relieve symptoms & restore dopaminergic acitvity & neurotransmitter function to as close to normal as possible.

PN 12 Which condition would alert the nurse of the need to use beta-adrenergic blockers cautiously? a. Hypertension b. Raynaud's phenomenon c. Emphysema d. Cardiac dysrhythmias

c. Emphysema

BN80 A client is being considered as a candidate for a cochlear implant. What data gathered by the nurse would support the client's candidacy? a. The client has mild mental retardation. b. The client has a history of schizophrenia. c. The client is unable to recognize words spoken. d. The client expects hearing will resume normally after surgery.

c. The client is unable to recognize words spoken. Explanation: The potential candidate for cochlear implant must be an otherwise healthy individual with no evidence of mental retardation or psychological disorder. The client must be unable to recognize words spoken away from the line of vision and be realistic and optimistic about the results.

PN 12 A patient has been prescribed an anticholinergic drug for irritable bowel syndrome (IBS). For which adverse effect must the nurse teach the patient to be aware when beginning this drug? a) Rhinitis (runny nose) b) Drowsiness c) Diarrhea d) Orthostatic hypotension

d) Orthostatic hypotension Serious adverse effects Confusion, depression, hallucinations, nightmares, glaucoma, palpitations, dysrhythmias, Orthostatic hypotension

PN12 Before the initiation of anticholinergic medications, it is important for the nurse toscreen patients for which condition? a. Hypertension b. Infectious diseases c. Diabetes d. Closed-angle glaucoma

d. Closed-angle glaucoma

C78 The nurse is requested to place an ice pack on the eyelid for 2 minutes for a client suspected of having myasthenia gravis MG with diplopia. What outcome does the nurse anticipate if the diagnosis is confirmed? a. The client will have an improvement in respiratory status. b. The client will have blindness. c. The client will have a grave prognosis. d. The client will have a temporary improvement in eye symptoms.

d. The client will have a temporary improvement in eye symptoms. Explanation: An ice pack test is a noninvasive method of testing for MG. If the client has diplopia, an ice pack over the eyelid for 2 minutes will result in improvement of eye symptoms. The ice pack will not improve respiratory status. It is not an indication that the client will experience blindness or that the prognosis is grave.

BN80 The primary care provider orders ear irrigation for a client. What situation requires the nurse to question this order? a. The client has a scratch on the external canal. b. The client has a foreign body in the ear. c. The ear canal has impacted cerumen. d. The eardrum may be punctured.

d. The eardrum may be punctured. Explanation: An ear irrigation may be performed to rinse drainage or medication from the ears and to remove wax or foreign bodies. It is done only with a physician's order. Do not irrigate the ear if the client's eardrum is punctured. This will cause damage to the ear and hearing. A scratch on the external canal is not a contraindication for ear irrigation. A foreign body may be flushed out with a gentle irrigation. Impacted cerumen is an indication for irrigation of the ear canal to remove impacted wax.

The name of this area of the brain means "bridge." It is the origin of cranial nerves V through VIII and is responsible for sending impulses to the structures inferior and superior to it. It also contains a respiratory center that complements the part of the brain stem located inferior to it. It is called the

medulla oblongata.

PN 12Which condition is dopamine commonly used to treat? SATA a. stroke b. hemmorhage c shock d. hypertension e. asthma

shock & hypertension Dopamine, an adrenergic agent, is commonly used to treat shock as well as hypertension. Adrenergic agents albuterol Proventil and terbutaline Brethine are commonly used to treat asthma. Adrenergic agents are not used to treat stroke.

BN80 Meniere disease The nurse is gathering data from a client with Meniere disease. Which symptom does the nurse relate to the disease process? epistaxis facial pain ptosis tinnitus

tinnitus Explanation: Tinnitus, dizziness, and vertigo occur in Meniere disease. Facial pain may occur with trigeminal neuralgia. Ptosis occurs with a variety of conditions, including myasthenia gravis. Epistaxis may occur with a variety of blood dyscrasias or local lesions.

The cranial nerve that supplies most of the organs in the thoracic and abdominal cavities and also carries motor fibers to glands that produce digestive juices and other secretions is the

vagus nerve.