Practice Questions ~ Fundamentals
The nurse assesses that the client has sensory impairment from longterm furosemide (Lasix) use. Which of the following actions will the nurse implement? a) When communicating with the client, use a lower tone of voice. b) Provide enlarged print for reading. c) Encourage the client to participate in exercise classes. d) Protect the client's skin from temperature extremes.
When communicating with the client, use a lower tone of voice.
A school-aged child is attentive to following the rules at school, respects his teachers, and views justice as a means of fair play. These are characteristics of which type of development typical of this age group? a) Moral development b) Spiritual development c) Physiologic development d) Psychosocial development
a
Which of the following nursing activities is the most significant in assisting with transitioning from the adolescent to the young adult age group? a) Facilitating healthy family relationships b) Encouraging safety when participating in sports c) Teaching information on chronic illnesses d) Promoting safe sexual activities for both sexes
a
Which of the following actions should a nurse take in order to apply theories of development into nursing care? a) Maintain separation between clients with widely varying developmental stages b) Choose outcomes that are reflective of clients' developmental stages c) Consistently ask clients what developmental stage they are currently experiencing d) Grant autonomy to clients who are in later developmental stages but make decisions for those in earlier stages
b
A pediatric nurse practitioner is assessing the development of a child. The nurse's assessment of development will focus on which of the following? a) Increases in the child's body size b) A static process that occurs during childhood c) Changes in thoughts, feelings, and behaviors d) Changes in the body's cell structure, function, and complexity
changes in thoughts, feelings, and behaviors Explanation: Development is an orderly pattern of change in structure, thoughts, feelings, or behaviors resulting from maturation, experiences, and learning. Development is a dynamic and continuous process as one proceeds through life, characterized by a series of ascents, plateaus, and declines. Growth, on the other hand, is an increase in body size, or changes in body cell structure, function, and complexity
A nursing student is studying the normal physiologic changes of older adults. The faculty member knows that the student comprehends the information when she says which of the following? Select all that apply. a) "Fluids and electrolytes remain within normal ranges." b) "The senses of taste and smell are decreased, sour taste diminishes first." c) "Height may decrease 1-3 inches." d) "Rate of reflex responses increase." e) "There is an increased sensitivity to glare."
• "Height may decrease 1-3 inches." • "There is an increased sensitivity to glare." • "Fluids and electrolytes remain within normal ranges."
A nurse working in a community clinic assists middle adult patients to follow guidelines for health-related screenings and immunizations. What preventive measures would the nurse recommend for this population? (Select all that apply.) a) A physical exam every year from age 40 on b) Zoster vaccine, live (Zostavax) for adults 50 years and older c) Prostate-specific antigen (PSA) test every year for men d) Clinical skin examination every 3 years e) Pelvic examination and Pap exam at least every 3 years for women f) Breast self-examination every month for women
• A physical exam every year from age 40 on • Prostate-specific antigen (PSA) test every year for men • Pelvic examination and Pap exam at least every 3 years for women • Breast self-examination every month for women Correct Explanation: The nurse would recommend several different preventive measure that are listed. The nurse would recommend that the client have a physical exam every year from age 40 on. The nurse would recommend that the female client do a breast self-examination every month. The nurse would recommend a pelvic examination and Pap exam at least every 3 years for women. The nurse would recommend a prostate-specific antigen (PSA) test every year for men. The nurse would recommend a clinical skin examination every year. Zoster vaccine, live (Zostavax) would be recommended for adults 60 years and older.
A nurse is promoting body movements for a patient during range-of-motion exercises. Which movements provide for flexion? (Select all that apply.) a) Curling the toes downward and then straightening them out b) Extending the leg and lifting it upward, then returning the leg to the original position c) Bending the leg and bringing the heel toward the back of the leg and then returning the leg to the straight position. d) Turning the sole of the foot toward the midline, then turning the sole of the foot outward e) Moving the head from side to side, then bringing the chin toward each shoulder f) Bending the hand or foot backward and forward
• Bending the hand or foot backward and forward • Bending the leg and bringing the heel toward the back of the leg and then returning the leg to the straight position. • Moving the head from side to side, then bringing the chin toward each shoulder Explanation: Flexion is the state of being bent. Bending the hand or foot backward and forward would be an example of flexion. Bending the leg and bringing the heel toward the back of the leg and then returning the leg to the straight position would be an example of flexion. Moving the head from side to side, then bringing the chin toward each shoulder would include the movement of flexion. (less)
For which conditions would the nurse assess to determine if a patient is suffering from sensory deprivation or overload? (Select all that apply.) a) Decreased sleeping b) Boredom c) Thought disorganization d) Anxiety e) Dreamless sleep f) Quickness of thought
• Boredom • Thought disorganization • Anxiety
Nurses use medical asepsis, or clean technique, in practice to reduce the number and transfer of pathogens. Which of the following are principles of this practice? Select all that apply. a) Place soiled bed linen or any other items on the floor, instead of the bed or furniture. b) Carry soiled items close to the body to prevent transfer of pathogens into the environment. c) Clean the least soiled areas first and then move to the more soiled ones. d) Shake out linens and patient clothing before placing them back on the bed. e) Use personal grooming habits, such as shampooing hair often, to prevent spreading microorganisms. f) Move equipment close to you when brushing, dusting, or scrubbing articles.
• Clean the least soiled areas first and then move to the more soiled ones. • Use personal grooming habits, such as shampooing hair often, to prevent spreading microorganisms. Correct
The nurse is caring for a client with a North America Diagnosis Association-International (NANDA-I) diagnosis of Imbalanced nutrition: Less than body requirements, related to difficulty breathing. The nurse would implement which measures to maintain an adequate nutritional status for this client? Select all that apply. a) Distribute six small meals over the course of the day. b) Encourage client to decrease protein, but increase calcium intake. c) Encourage client to eat 1 to 2 hours before breathing treatments and exercises. d) Provide frequent oral hygiene especially before meals. e) Encourage client to eat alone for privacy during mealtime.
• Distribute six small meals over the course of the day. • Provide frequent oral hygiene especially before meals.
A nurse is caring for patients with alterations in mobility. Which nursing interventions are recommended for these patients? (Select all that apply.) a) For ineffective breathing patterns, encourage shallow breathing and coughing. b) For impaired skin integrity, reposition the patient in correct alignment at least every 1 to 2 hours. c) For constipation, increase fluid intake and roughage. d) For increased cardiac workload, instruct the patient to lie in the prone position. e) For orthostatic hypotension, have the patient sleep sitting up or in an elevated position. f) For impaired physical mobility, perform ROM exercises every 2 hours.
• For orthostatic hypotension, have the patient sleep sitting up or in an elevated position. • For constipation, increase fluid intake and roughage. • For impaired skin integrity, reposition the patient in correct alignment at least every 1 to 2 hours.
A nurse is teaching a patient how to walk with crutches. Which teaching points are recommended guidelines for this activity? (Select all that apply.) a) When climbing stairs, advance the unaffected leg past the crutches, then place weight on the crutches, then advance the affected leg and then the crutches. b) Use the two-point gait for patients who may not bear weight on either foot. c) Prevent crutches from getting closer than 3 inches to the feet. d) Use the swing-to gait for patients who may bear weight on one foot. e) Use the four-point gait for patients who may bear weight on both feet. f) Keep elbows close to sides.
• Keep elbows close to sides. • Prevent crutches from getting closer than 3 inches to the feet. • Use the four-point gait for patients who may bear weight on both feet. Explanation: The client should keep the elbows close to their sides. The crutches should not be any closer than 12 inches from the feet. The client should use the four-point gait if they can bear weight on both feet. When climbing stairs, the client should advance the unaffected leg past the crutches, then place weight on the unaffected leg. Then the client should advance the affected leg and then the crutches to the step. The swing-to gait is for individuals who can bear weight on both feet. This technique cannot be used with individuals who can bear weight on only one foot. The two-point gait is used with individuals who can bear weight on both feet.
A home care nurse is visiting one of her elderly clients. Which of the following does the nurse do to screen for chronic illnesses common to the elderly? Select all that apply. a) Assess joint mobility and presence of pain b) Perform blood glucose monitoring c) Assess visual acuity d) Monitor blood pressure e) Assess skin turgor
• Monitor blood pressure • Perform blood glucose monitoring • Assess joint mobility and presence of pain Explanation: In the older adult, the most commonly encountered chronic disorders are hypertension (monitor blood pressure), arthritis (assess joint mobility and presence of pain), heart disease, cancer, diabetes (perform blood glucose monitoring), and sinusitis. Assessing skin turgor and visual acuity, which often decrease in the older adult, does not provide information about these chronic conditions.
The nurse is caring for a male client 17 years of age who was admitted to the intensive care unit with a gunshot wound to his head. He and his 17-year-old girlfriend had carried out a suicide pact. She died at the scene and Brett survived. The nurse recalls what she has read about the nation's teenagers and suicide. Which of the following are correct? Choose all that apply. a) Rate of teenage suicides is decreasing b) More prevalent in teenagers than other age groups c) Males succeed at suicide more often d) Third leading cause of death in ages 15 to 24 e) Females attempt suicide more often
• More prevalent in teenagers than other age groups • Males succeed at suicide more often • Third leading cause of death in ages 15 to 24 • Females attempt suicide more often
A nurse is caring for a homeless toddler in a community free health clinic. When developing a plan of care for the child, which of the following factors that affect growth and development should be considered? (Select all that apply.) a) Climate b) Nutrition c) Caregivers d) Social Skills e) Poverty
• Nutrition • Caregivers • Poverty • Climate Nutrition, caregivers, poverty, and climate are all factors that affect growth and development with regard to the toddler's homeless situation. As this child is a toddler, social skill is not a factor to be considered at this time and does not affect the growth and development of this child
Which actions are performed according to guidelines for caring for visually impaired patients? (Select all that apply.) a) Orient the person to the arrangement of the room and its furnishings. b) Sit in the person's field of vision if he or she has partial or reduced peripheral vision. c) Explain the reason for touching the person after doing so. d) Speak in a normal tone of voice. e) Wait for the person to sense your presence in the room before identifying yourself. f) Assist with ambulation by walking slightly behind the person.
• Orient the person to the arrangement of the room and its furnishings. • Sit in the person's field of vision if he or she has partial or reduced peripheral vision. • Speak in a normal tone of voice.
Which statements accurately describe the body's defense mechanisms against stressors? (Select all that apply.) a) Displacement occurs when a person refuses to acknowledge the presence of a condition that is disturbing. b) Projection occurs when a person's thoughts or impulses are attributed to another person. c) Repression occurs when a person voluntarily excludes an anxiety-producing event from conscious awareness. d) Defense mechanisms are conscious reactions to stressors. e) Withdrawal behavior involves physical withdrawal from the threat or emotional reactions such as admitting defeat, becoming apathetic, or feeling guilty and isolated. f) Reaction formation occurs when a person tries to give questionable behavior a logical or socially acceptable explanation.
• Projection occurs when a person's thoughts or impulses are attributed to another person. • Repression occurs when a person voluntarily excludes an anxiety-producing event from conscious awareness. Explanation: Defense mechanisms are unconscious reactions to stressors and protect one's self-esteem and are useful in mild to moderate anxiety; however, if they are used too much they can distort reality and lead to problems with relationships. Projection occurs when a person's thoughts or impulses are attributed to another person. Repression occurs when a person voluntarily excludes an anxiety-producing event from conscious awareness. Withdrawal is considered a coping mechanism. Displacement occurs when a person transfers (displaces) an emotional reaction from one object or person to another object or person. Reaction formations occurs when a person develops conscious attitudes and behavior patterns that are opposite to what he or she would really like to do.
A nurse is caring for a client who cannot swallow or expectorate. What interventions to keep the mouth and throat free of accumulating secretions should the nurse perform when caring for this client? Select all that apply. a) Apply mineral oil to the lips. b) Provide frequent mouth care. c) Assist the client to a lateral position. d) Arrange for suctioning to remove mucus. e) Change the client's position every two hours.
• Provide frequent mouth care. • Arrange for suctioning to remove mucus. • Assist the client to a lateral position.
A nurse is performing health promotion activities for patients at a local health care clinic. Which nursing actions exemplify the focus of secondary preventive care? (Select all that apply.) a) Screening patients for hypertension b) Scheduling a mammogram for a patient c) Performing range-of-motion exercises on a patient d) Scheduling immunizations for a child e) Referring a patient to family counseling f) Teaching parents about child safety in the home
• Screening patients for hypertension • Scheduling a mammogram for a patient • Referring a patient to family counseling
The nurse is planning strategies to increase sensory stimulation for patients in isolation. Which considerations should the nurse keep in mind? (Select all that apply.) a) It is recommended that medically fragile infants have greater light and visual and vestibular stimulation. b) The amount of stimuli different individuals consider optimal is constant. c) An individual's culture may dictate the amount of sensory stimulation considered normal. d) Sensory functioning is established at birth and is independent of stimulation received during childhood. e) Different personality types demand different levels of stimulation. f) Sensory functioning tends to decline progressively throughout adulthood.
• Sensory functioning tends to decline progressively throughout adulthood. • An individual's culture may dictate the amount of sensory stimulation considered normal. • Different personality types demand different levels of stimulation.
You are preparing to perform oral care for a patient who has full dentures. Which of the following actions should you take? Select all that apply. a) Use a toothbrush and paste and gently brush all surfaces. b) Rinse the dentures with normal saline if the patient is dehydrated. c) After cleaning, insert the lower denture followed by the upper denture. d) Use a sterile 4 × 4 gauze to remove debris from the gums and mucous membranes. e) Provide privacy while the patient removes dentures from the mouth. f) Place paper towels or a washcloth in the sink to prevent damage if the dentures are dropped during cleaning.
• Use a toothbrush and paste and gently brush all surfaces. • Provide privacy while the patient removes dentures from the mouth. • Place paper towels or a washcloth in the sink to prevent damage if the dentures are dropped during cleaning.
The client who has cancer has adapted to her diagnosis and has recently returned to work. When first diagnosed she was depressed and told everyone how sick she was. Since undergoing the chemotherapy she states that she now feels better than ever. The nurse recognizes that which of the following models of health promotion is most appropriate for this client? a) The Health-Illness Continuum Model b) The Health Promotion Model c) The Health Belief Model d) The Agent-Host-Environment Model
A
A nursing instructor is preparing a class presentation about sensory perception across the lifespan. At which developmental stage would the instructor describe sensory perception as at its peak? a) Preschooler b) Young adult c) Older adult d) Adolescent
B
A patient in a long-term care facility cannot control the direction of thought content, has a decreased attention span, and cannot concentrate. Which of the following effects of sensory deprivation might the patient be experiencing? a) Perceptual response b) Cognitive response c) Emotional response d) Physical response
B
The neonatal intensive care unit (NICU) nurse is reviewing sensory development in the neonate. Which of the following statements indicates to the preceptor that the nurse knows how to provide stimulation for these neonates? a) "Medically fragile infants need constant light and visual stimulation." b) "The use of mobiles will stimulate visual sensation." c) "Rocking and changes of body postion will help to stimulate visual sensations." d) "Stimulation is not needed as the neural pathways are mature in the newborn."
B
A healthy 52-year-old client asks the nurse what she can do to maintain her health. Which of the following does the nurse recommend? a) Perform self-examination of the skin every month b) Have a colonoscopy every 10 years c) Obtain the zoster vaccine d) Have a physical examination every 3 years
a
A nurse is educating a client about how the general adaptation syndrome theory works in the human body. She realizes the client will need more teaching when the client states which of the following? (Select all that apply.) a) "The alarm reaction alerts my family that I need to slow down." b) "The fight-or-flight reaction is initiated by growth hormone released in my brain." c) "I often get exhausted when I do too much yard work." d) "Physical activity can help me cope with the challenges of my deadlines at work."
• "The alarm reaction alerts my family that I need to slow down." • "I often get exhausted when I do too much yard work." • "The fight-or-flight reaction is initiated by growth hormone released in my brain."
A school nurse is assessing school-aged children for developmental milestones. Which students would be a concern for the nurse? (Select all that apply.) a) A 12-year-old student who still has baby teeth b) An 8-year-old student whose height hasn't changed since preschool c) A 9-year-old student who has not developed a set of values d) An 11-year-old student who is not developing skills for physical games e) A 10-year-old student who has not begun puberty f) An 8-year-old student who is not writing with a pencil
• An 8-year-old student who is not writing with a pencil • A 12-year-old student who still has baby teeth • An 8-year-old student whose height hasn't changed since preschool • An 11-year-old student who is not developing skills for physical games
The oncology nurse is caring for a client receiving chemotherapy. Which of the following statements would be a priority assessment for the nurse? a) "Have you been experiencing any strange tastes or aftertastes lately?" b) "Close your eyes and tell me when you feel something." c) "Repeat the words that I will softly speak close to each ear." d) "Please read my name tag."
"Have you been experiencing any strange tastes or aftertastes lately?" Clients receiving chemotherapy may have altered gustatory or olfactory sensations. Asking about taste would be an assessment for this condition
The acute care nurse is talking with an older client who had a complete bed bath earlier in the day. The client states, "I like to be scrubbed clean during my bath and the person who bathed me today didn't even use soap and water, and barely rubbed my skin to dry it." Which of the following responses by the nurse is most appropriate? a) "Can you tell me the name of the person who bathed you this morning? I will review proper bathing procedures with this person." b) "It sounds like you are not happy with the care you are receiving. Would you like me to bathe you again?" c) "When you feel well enough to bathe yourself we can give you your favorite soap and a big thick towel." d) "That person probably used special bathing products and deliberately avoided scrubbing to help keep your skin intact."
"That person probably used special bathing products and deliberately avoided scrubbing to help keep your skin intact." Explanation: Nurses should examine bathing practices and consider the effect on the client's skin in regard to routine and frequent bathing practices.
The nursing student is studying the reticular activating system (RAS). Which of the following statements indicates to the professor that the student has mastered the information? a) "To receive stimuli and respond appropriately, the brain can be in any state of arousal." b) "The RAS allows all impulses to reach the cerebral cortex and to be perceived." c) "The RAS is a well-defined network that extends from the hypothalamus to the medulla." d) "The RAS serves to monitor and regulate incoming sensory stimuli."
"The RAS serves to monitor and regulate incoming sensory stimuli."
A nurse at health care facility uses a mask to prevent spread of microorganisms by droplet or airborne transmission. What care should the nurse take when using masks? Select all that apply. a) Position the mask so that it covers the nose and mouth b) Avoid touching the mask once it is in place c) Change the mask every 20 or 30 minutes d) Touch only the strings of the mask during removal e) Discard used marks into a regular waste basket
.Position the mask so that it covers the nose and mouth • Avoid touching the mask once it is in place • Change the mask every 20 or 30 minutes • Touch only the strings of the mask during removal
The nurse is educating a client with diabetes, who is frequently admitted to the hospital due to elevated blood sugars, on how to better control blood sugar levels and recognize the symptoms associated with both hyperglycemia and hypoglycemia. This education is an example of which level of health promotion? a) Secondary b) Tertiary c) Chronic d) Primary
B
The health belief model is useful when teaching individuals about health and illness. Why would this be? a) It fosters dependency. b) It promotes interactions with patients focused on the cause of a disability. c) It allows you to assess the patient's beliefs and structure goals so he or she can meet health needs. d) It encourages the provision of care that is based on a disability
C
When the older adult faces illness, the greatest threat to health is: a) developing depression to a life-threatening situation with no desire to fight. b) increased complications with decreased ability to participate in recovery activities. c) loss of physiologic reserve of the organ systems. d) inability to respond to any stress and quickly deteriorating.
C
A nurse is providing discharge instructions to an elderly client and his daughter. The daughter asks for suggestions to help keep her father healthy. Which of the following could the nurse suggest? a) The client should limit carbohydrates in his diet. b) The daughter can talk to the client's physician about taking a vitamin B supplement. c) The client should have his eyes examined every year for glaucoma. d) The client should have a physical examination every 3 years.
C The nurse should teach the patient and his family general health-promotion activities, including having his vision checked yearly, which includes checking for glaucoma; for those over 40 years of age, an annual physical examination; eating a diet that includes all food groups and is low in fat, saturated fat, and cholesterol; and discussing with the physician whether to include vitamin D supplementation
The elderly client, who lives alone, has been admitted to the intensive care unit (ICU) following a stroke. She is now agitated and complaining about the noise. Which of the following will the nurse add to her care plan? a) Instruct the client in self-stimulation methods such as singing b) Provide pet therapy c) Offer frequent backrubs d) Provide a consistent, predictable pattern of stimulation
D
Which is an example of the sociocultural dimension influencing a person's health-illness status? a) A family lives in a city environment where the air pollution levels are high. b) A father who is a practicing Jehovah's Witness refuses a blood transfusion for his son. c) A teenager who was in an automobile accident worries that his scars will cause him to lose friends. d) A single mother of two applies for food stamps in order to feed her family.
D
You are assessing a middle-aged adult age 48 years in the clinic. You recall the changes that occur in middle age as you complete your physical and cognitive examination. Changes that occur include what? a) Low-pitched sounds are more difficult. b) Loss of fatty tissue c) Visual acuity changes with myopia. d) Cardiac output decreases.
D
A nurse is developing a plan of care for a client who recently lost his spouse. Which of the following would be most appropriate for the nurse to suggest to help the client cope with his loss? a) maintaining nutritional intake b) validating his needs c) remaining active in the community d) seeking support from his faith
D Seeking support from the client's faith is an adaptive means of coping with loss. Social support and therapy are other methods of adaptive coping. Although remaining active in the community fosters social connection, the client may find it difficult to do so. Remaining active does aid in addressing loneliness. Maintaining nutrition promotes the health of the older adult but does not affect coping. Validating his needs is a treatment strategy used with clients experiencing dementia.
The physician tells the nurse that the elderly client has presbycusis. Which of the following interventions will the nurse place in the client's care plan? a) Clearly communicate that the client is expected to perform all the self-care activities he or she can. b) Perform routine oral hygiene. c) Decrease background noises, as much as possible, before speaking. d) Clear pathways for walking in the room and do not rearrange furniture.
Decrease background noises, as much as possible, before speaking
A cycling accident has resulted in a head injury to a male client and he has been admitted to the intensive care unit for the treatment of increased intracranial pressure. Consequently, he has been placed in a private room with low light and his care has been organized to minimize disturbances. What nursing diagnosis is this client at risk of? a) Disturbed Sensory Perception: Sensory Overload b) Disturbed Sensory Perception: Sensory Deprivation c) Chronic Confusion d) Acute Confusion
Disturbed Sensory Perception: Sensory Deprivation
A group of nursing students is reviewing information about the older adult and mobility. The students demonstrate a need for additional study when they identify which statement as accurate? a) Older adults are faced with challenges related to the fear of falling and striving for independence. b) Falls are the leading cause of death due to injury in individuals who are over the age of 75 years. c) Medications in the older adult play a major contributing role to the risk for falling. d) An older adult experiences numerous factors that increase the risk for falls
Falls are the leading cause of death due to injury in individuals who are over the age of 75 years.
A neonatal intensive care nurse is caring for an infant born prematurely. How will the nurse manage the infant's environment to best support his sensory needs? a) Encourage frequent visitors and tactile stimulation at least hourly b) Provide an active, stimulating environment c) Limit lighting, visual, and vestibular stimulation d) Provide changing patterns of light and shade, and the use of bright objects
Limit lighting, visual, and vestibular stimulation
Which of the following is an important role for the nurse when incorporating principles and theories of growth and development? a) Initiate interventions to meet specific outcomes of care. b) Provide developmentally challenging environments and experiences. c) Provide physical care to meet comfort needs of children. d) Initiate activities that involve passive interactions with others.
Provide developmentally challenging environments and experiences. Explanation: When incorporating principles and theories of growth and development, the nurse has a responsibility to provide environments and experiences that are developmentally challenging. Although nurses provide interventions to meet outcomes of care, this choice is the most important in terms of growth and development
A client has a nursing diagnosis of self care deficit: bathing. What would an appropriate related/to (r/t) statement include? a) R/t impaired mobility b) R/t the inability to perform bathing independently c) R/t right-sided weakness d) R/t the inability to recognize the need to urinate or defecate
R/t right-sided weakness Explanation: Self-care deficit: Bathing is related to lack of motor skills, coordination, mental status and endurance when performing bathing activities. Right-sided weakness is an appropriate statement about why this problem exists. A person's inability to perform bathing independently is more of a sign or symptom in the as manifested by statement of a nursing diagnosis. Related to impaired mobility is a nursing diagnosis and cannot be used as a related/to statement.
While assessing a patient's neurological status, Janet Wilkes, RN, asks the patient to close his eyes and identify the object Janet places in his hand (a pencil). Janet explains that this lets her know if the patient is able to identity the solidity, size, shape, and texture of the object. Janet documents this as which of the following? a) Kinesthesia b) Sensory perception c) Proprioception d) Stereognosis
Stereognosis
The nurse is caring for Kristin Brook, a 53-year-old patient who suffered a traumatic brain injury in a skiing accident. Kristin breathes on her own, is very drowsy, but can be aroused by extreme or repeated stimuli. The nurse documents that Kristin's level of consciousness is which of the following? a) Stupor b) Coma c) Somnolence d) Asleep
Stupor Explanation: When a person is asleep he/she can be aroused by normal stimuli (light touch, sound, etc.). When someone is stuporous, he/she can be aroused by extreme and/or repeated stimuli. A person in a coma cannot be aroused and does not respond to stimuli. Someone who somnolent is extremely drowsy, but will respond normally to stimuli.
