Study Guide Quiz 5 Medical Surgical ll

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A nurse assesses the patient's level of consciousness using the Glasgow Coma Scale. What score indicates severe impairment of neurologic function?

3

A nurse is caring for four patients. Which patient is at a greater risk for the development of blindness?

A 58-year-old Caucasian female with macular degeneration

An increased risk of falls is dangerous for any patient. What of the following patients would be at an increased risk of falls?

A patient with vertigo

A client is color blind. The nurse understands that this client has a problem with:

Cones

The nursing instructor is discussing increased intracranial pressure (ICP) with the nursing students. What would the instructor be correct in telling the students is an early clinical manifestation of ICP?

Disorientation and restlessness

A client experiences loss of consciousness, tongue biting, and incontinence, along with tonic and clonic phases of seizure activity. The nurse should document this episode as which type of seizure?

Generalized

A patient with a seizure disorder is presenting having a generalized seizure. An appropriate nursing intervention during the seizure would include what?

Loosen the patient's restrictive clothing

The nurse is reviewing the medical record of a client with glaucoma. Which of the following would alert the nurse to suspect that the client was at increased risk for this disorder?

Prolonged use of corticosteroids

The registered nurse is taking shift report and finds that one of her assigned patients is blind. The nurse recalls that the best way to approach a patient who is blind is to what?

State your name and role after entering the patient's room.

A client who comes to the ambulatory care facility states, " It feels like things are moving or spinning around me." The nurse interprets this as indicating which of the following?

Vertigo


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