NUR424 Chapter 70 Prep-U

A nurse is caring for a client who underwent a lumbar laminectomy 2 days ago. Which finding requires immediate intervention?

Urine retention or incontinence may indicate cauda equina syndrome, which requires immediate surgery. An increase in back pain is more common because on the second postoperative day the long-acting local anesthetic, which may have been injected during surgery, will wear off. Although paresthesia is common after surgery, progressive weakness or paralysis may indicate spinal nerve compression.

A health care provider needs help in identifying the precise location of a brain tumor. To measure brain activity, as well as to determine structure, the nurse expects the health care provider to order which of the following tests?

A PET scan is most diagnostic for brain activity, as well as for assessment of tumor size. It can also be useful in differentiating a tumor from scar tissue or radiation necrosis.

The nurse teaches the patient that corticosteroids will be used to treat his brain tumor for which reason?

Corticosteroids may be used before and after treatment to reduce cerebral edema and promote a smoother, more rapid recovery.

The nurse is performing an assessment for a patient in the clinic with Parkinson's disease. The nurse determines that the patient's voice has changed since the last visit and is now more difficult to understand. How should the nurse document this finding?

Dysphonia (voice impairment or altered voice production) may occur as a result of weakness and incoordination of the muscles responsible for speech.

Which of the following medications is the most effective agent in the treatment of Parkinson's disease (PD)?

Levodopa (Larodopa) is the most effective agent and the mainstay of treatment for Parkinson's disease. Cogentin, Symmetrel, and Parlodel are utilized in the treatment of PD but are not the most effective.

Which of the following terms is used to describe edema of the optic nerve?

Papilledema is edema of the optic nerve. Scotoma is a defect in vision in a specific area in one or both eyes. Lymphedema is the chronic swelling of an extremity due to interrupted lymphatic circulation, typically from an axillary dissection.

Which of the following statements reflect nursing interventions of a patient with post-polio syndrome?

Providing care aimed at slowing the loss of strength and maintaining the physical, psychological and social well being of the patient.

The nurse identifies a nursing diagnosis of self-care deficit, bathing related to motor impairment and decreased cognitive function for a client with cerebral metastasis. Which outcome would the nurse most likely identify on this client's plan of care?

The client has a self-care deficit related to bathing. Therefore, an appropriate outcome would address the client's participation in daily hygiene measures.

A patient with postpolio syndrome displays fatigue and decreased muscle strength. What is the best statement for the nurse to make to the patient?

There is no specific treatment for postpolio syndrome; however, the infusion of IV immunoglobulin has been shown to help with the physical pain and weakness.

In which location are most brain angiomas located?

Brain angiomas occur most often in the cerebellum. Most brain angiomas do not occur in the hypothalamus, thalamus, or brainstem (midbrain, pons, medulla).

A nurse assesses a patient who has been diagnosed with having a pituitary adenoma that is pressing on the third ventricle. The nurse looks for the associated sign/symptom. What is that sign/symptom?

All the choices are signs and symptoms that can occur with an adenoma, depending on whether the pressure is exerted on the hypothalamus, the third ventricle, or the optic nerves, chiasm, or tracts. Increased intracranial pressure occurs when the third ventricle is affected.

Which of the following terms is used to describe rapid, jerky, involuntary, and purposeless movements of the extremities?

Choreiform movements, such as grimacing, may also be observed in the face. Bradykinesia refers to very slow voluntary movements and speech. Dyskinesia refers to impaired ability to execute voluntary movements.

A nurse is working on a surgical floor. The nurse must logroll a client following a:

The client who has had spinal surgery, such as laminectomy, must be logrolled to keep the spinal column straight when turning. The client who has had a thoracotomy or cystectomy may turn himself or may be assisted into a comfortable position.

A client has a herniated disk in the region of the third and fourth lumbar vertebrae. Which nursing assessment finding most supports this diagnosis?

The most common finding in a client with a herniated lumbar disk is severe lower back pain, which radiates to the buttocks, legs, and feet — usually unilaterally. A herniated disk also may cause sensory and motor loss (such as footdrop) in the area innervated by the compressed spinal nerve root.