Exam 2 Term 4

What nursing assessment is done before starting a patient on a beta adrenergic blocking agent? A. Complete blood count (CBC) and sedimentation rate B. Liver enzymes C. Blood pressure and heart rate D. Blood urea nitrogen (BUN) and creatinine levels

C. Blood pressure and heart rate

The nurse is aware that the drug t-PA (Activase), a tissue plasminogen activator, must be given in____hours of the onset of symptoms to have maximum benefit. a. 3 hours b. 4 hours c. 6 hours d. 8 hours

a. 3 hours

In assessing a patient with suspected Bell's palsy, what clinical manifestations might be present? a. Inability to wrinkle forehead and pucker lips b. Inability to touch nose with finger with eyes closed c. Symmetric facial expressions d. Excruciating lightninglike shock in lips

a. Inability to wrinkle forehead and pucker lips

The nurse is caring for a patient recovering from a hip replacement and is providing education regarding exercises in physical therapy. What type of therapy should the nurse call these exercises? a. Alternative therapies b. Complementary therapies c. Comfort therapies d. Body therapies

b. Complementary therapies

What does the nurse know about the stroke patient who has expressive aphasia? a. Has difficulty comprehending spoken and written communication b. Cannot make any vocal sounds c. Has total loss and comprehension of language d. Can understand the spoken word, but cannot speak

d. Can understand the spoken word, but cannot speak

Why are the drugs neostigmine (Prostigmin) and pyridostigmine (Mestinon) helpful to the person with myasthenia gravis? a. Improves speech b. Improves visual disturbances c. Reduces pain d. Promotes nerve impulse transmission

d. Promotes nerve impulse transmission

The nurse recognizes that the rehabilitation process involves the efforts of various disciplines whose focus is to build on a person's: a. losses. b. long-term plans. c. drives. d. abilities.

d. abilities.

The nurse takes special care to be gentle in caring for patients with spinal cord injuries to avoid stimulating the autonomic nervous system and triggering an episode of: a. paresis. b. heterotopic ossification. c. postural hypotension. d. autonomic dysreflexia.

d. autonomic dysreflexia.

When do we call MD after a seizure? Check what?

After the seizure is finished. Check neuro status.

Which beta stimulant is used for bronchodilation and to stop premature labor? A. Metaproterenol (Alupent) B. Albuterol (Proventil) Incorrect C. Phenylephrine (Neo Synephrine) D. Terbutaline (Brethine)

D. Terbutaline (Brethine)

A pt is ice skating and falls. What is immediate concern?

Falling (yes) Lost consciousness (yes) Arrived on spinal board (no) Pain 5/10 (yes) Alert and oriented x2 (yes) PERRLA (no) GSC of 15 (no) (determine vitals)

Signs and symptoms of a concussion?

Memory loss Nausea Headache Light sensitivity

What do we do during 23-hour observation?

Monitor level of consciousness or changes in neuro status

Which symptoms are associated with Parkinson disease? Select all that apply

Rigidity, Tremors, and Bradykinesia

The nurse is providing information to a patient recently prescribed entacapone. Which statement is correct? a. This medication is not to be taken with carbidopa levodopa. b. Dosage is adjusted according to the patient's response. c. There will be fewer incidences of dopaminergic effects, such as confusion. d. This medication increases the production of dopamine in the brain

b. Dosage is adjusted according to the patient's response.

A frantic family member is distressed about the flaccid paralysis of her son following a spinal cord injury several hours ago. What does the nurse know about this condition? a. It is an ominous indicator of permanent paralysis. b. It is possibly a temporary condition and will clear. c. It degenerates into a spastic paralysis. d. It will progress up the cord to cause seizures.

b. It is possibly a temporary condition and will clear.

When caring for a 32-year-old Hispanic male who has become disabled, the rehabilitation team will set the priority of treatment goals based on the: a. difficulty of the language barrier. b. cultural significance of the disability. c. depth of the patient's support system. d. attitude toward rehabilitation.

b. cultural significance of the disability.

To decrease the potential for a deep vein thrombosis (DVT) in a patient who is a paraplegic from a spinal cord injury, the nurse will: a. massage the patient's legs daily. b. perform passive range-of-motion exercises. c. encourage frequent warm baths. d. allow the patient's legs to dangle for a period of 10 minutes several times a day.

b. perform passive range-of-motion exercises.

The nurse explains that the main goal of gerontological rehabilitation nurses (GRNs) is to provide rehabilitative care, and also to teach: a. restoration. b. prevention. c. adaptive skills. d. positive reinforcement.

b. prevention.

A patient with quadriplegia resulting from a spinal cord injury says to the rehabilitation nurse, "I'm sick of this interdisciplinary stuff! What is an occupational therapist going to do for me? Can she give me an "occupation?" The most helpful response the nurse could make is: a. "No, but the occupational therapist can show you how to enjoy some recreational activities." b. "Yes, in a way. The occupational therapist provides training that strengthens muscles you can still control." c. "Maybe. The occupational therapist recommends adaptive equipment that will make you more independent." d. "No, the voc-rehab counselor helps with employment. The occupational therapist helps train you for improved communication skills."

c. "Maybe. The occupational therapist recommends adaptive equipment that will make you more independent."

When assessing a patient with a cervical spinal injury (CSI), the rehabilitation nurse notes paralysis of the lower extremities as well as bladder and bowel incontinence. The nurse recognizes the injury as most likely occurring at the vertebral level of: a. C1 to C2. b. C3 to C4. c. C2 to C7. d. C4 to C7.

c. C2 to C7.

The newly admitted patient to the emergency room after a motorcycle accident has serosanguineous drainage coming from the nose. What is the most appropriate nursing response to this assessment? a. Cleanse nose with a soft cotton-tipped swab b. Gently suction the nasal cavity c. Gently wipe nose with absorbent gauze d. Ask patient to blow his nose

c. Gently wipe nose with absorbent gauze

What is the basic problem that prompts most of the early signs of Alzheimer disease? a. Changes in mood b. Misplacing things c. Memory loss that disrupts daily life d. Problems with words in speaking

c. Memory loss that disrupts daily life

What is the pharmacologic action of entacapone, a potent catechol O methyl transferase (COMT) inhibitor? a. Slows the deterioration of dopaminergic nerve cells. b. Inhibits the relative excess of dopaminergic activity. c. Reduces the destruction of dopamine in peripheral tissues. d. Enhances the cholinergic symptoms of Parkinson's disease

c. Reduces the destruction of dopamine in peripheral tissues.

Which cholinergic symptoms of Parkinson's disease are reduced with anticholinergic drugs? a. Cognitive impairments b. Rigidity c. Tremors and drooling d. Postural abnormalities

c. Tremors and drooling

The rehabilitation nurse prepares the family for when the patient with a brain injury begins to regain memory. The nurse explains that the patient will most likely become more: a. combative. b. angry. c. depressed. d. retiring.

c. depressed.

When changing the position of a patient with a spinal cord injury at T4, the nurse observes the first indication of an episode of autonomic dysreflexia, which is: a. nausea. b. pallor c. goose bumps. d. dizziness.

c. goose bumps.

The nurse who helps a family and a patient with a disability rejoice in the acquisition of the smallest new skill is following the rehabilitation philosophy of: a. resolving impairments. b. removing disabilities. c. increasing quality of life. d. returning to the community.

c. increasing quality of life.

To reduce the incidence of postural hypotension in a patient with a spinal cord injury, the nurse should: a. monitor diastolic blood pressure closely. b. encourage the patient to sit in wheelchair in upright position. c. raise the head of the bed 45 degrees before transfer to a wheelchair. d. encourage adequate intake of fluids to expand fluid volume.

c. raise the head of the bed 45 degrees before transfer to a wheelchair.

The nurse who is part of a team focused on restoring an individual to the fullest physical, mental, social, vocational, and economic capacity is practicing: a. holistic nursing. b. conscientious nursing. c. rehabilitation nursing. d. comprehensive nursing.

c. rehabilitation nursing.

When the seriousness of craniocerebral trauma is assessed, it is important to remember that a. heavy scalp bleeding indicates serious trauma. b. open injuries are always more serious than closed injuries. c. signs and symptoms may not occur until several days after the trauma. d. trauma to the frontal lobe is more significant than to any other area.

c. signs and symptoms may not occur until several days after the trauma.

The rehabilitation nurse explains that the difference between multidisciplinary and interdisciplinary is that in an interdisciplinary approach: a. each discipline makes its own goals for the patient. b. the entire team collaborates on the goals for the patient. c. the team is led by several members from different disciplines. d. cross-trained people are utilized who have functional ability in two or more disciplines.

c. the team is led by several members from different disciplines.

The rehabilitation nurse can use basic rehabilitation skills regardless of the origin of the disability. An example of an intervention that would be effective for a person with arthritis, a person with a brain injury, or a person with a spinal cord injury is: a. encouraging large fluid intake. b. seeking spiritual support from a higher being. c. using the spouse as a support system. d. positioning to maintain alignment.

d. positioning to maintain alignment.

When the nurse observes a patient experiencing a severe episode of autonomic dysreflexia, the initial intervention is to: a. locate the cause of irritation. b. assess the blood pressure. c. cover the patient with several blankets d. raise the head of the bed to a high Fowler's position.

d. raise the head of the bed to a high Fowler's position.