ATI RN
Health Assessment Neurological System NCLEX Questions Quizlet Questions
Question 1 of 5
The health care provider has ordered IV dopamine (Intropin) for a patient in the emergency department with a spinal cord injury. The nurse determines that the drug is having the desired effect when what is observed in patient assessment?
Correct Answer: C
Rationale: In this scenario, the correct answer is option C) Blood pressure of 106/82 mm Hg. IV dopamine is commonly used in cases of spinal cord injury to help maintain blood pressure and cardiac output. Dopamine acts on adrenergic receptors to increase heart rate and contractility, leading to increased cardiac output and subsequently improving blood pressure. Option A) Heart rate of 68 bpm, may not necessarily indicate the desired effect of dopamine, as dopamine is expected to increase heart rate. Option B) Respiratory rate of 24, is not directly affected by dopamine and is not a specific indicator of the drug's effectiveness in this context. Option D) Temperature of 96.8°F (36.0°C), is not a parameter typically influenced by dopamine administration in the context of a spinal cord injury. Educationally, understanding the effects and indications of IV dopamine is crucial for nurses caring for patients with spinal cord injuries or other conditions requiring hemodynamic support. This question helps reinforce the importance of monitoring vital signs and recognizing the appropriate responses to medications used in emergency situations. It also highlights the significance of maintaining blood pressure in patients with spinal cord injuries to prevent complications like neurogenic shock.
Question 2 of 5
A 72-year-old man tells the nurse that he cannot perform most of the physical activities he could do 5 years ago because of overall joint aches and pains. What can the nurse do to assist the patient to prevent further deconditioning and decrease the risk for developing musculoskeletal problems?
Correct Answer: D
Rationale: The correct answer is D: Discuss use of over-the-counter (OTC) medications to decrease inflammation and pain so that exercise can be maintained. Rationale: - OTC medications can help manage pain and inflammation, allowing the patient to continue exercising and prevent deconditioning. - A) Limiting weight-bearing exercise is not recommended as it can lead to further deconditioning and increase the risk of musculoskeletal problems. - B) Advising against the use of canes and walkers can compromise the patient's safety and independence, leading to increased risk of falls and injuries. - C) Increasing activity by climbing stairs may exacerbate joint pain and worsen the patient's condition rather than preventing deconditioning. Educational context: Encouraging the appropriate use of OTC medications can help patients manage pain effectively, maintain their mobility, and prevent further decline in physical function. It is essential for nurses to educate patients on safe and effective strategies to manage musculoskeletal issues while promoting overall health and well-being.
Question 3 of 5
Before feeding a patient four days following a stroke, what should the nurse do first?
Correct Answer: A
Rationale: In this scenario, the correct answer is A) Check the patient's gag reflex. This is the priority action before feeding a patient four days following a stroke because assessing the patient's ability to protect their airway is crucial to prevent aspiration, especially in the acute phase post-stroke when swallowing reflexes may be impaired. Option B) Order a soft diet for the patient is incorrect because before diet modifications can be made, assessing the patient's gag reflex and ability to swallow safely is essential. Option C) Raise the head of the bed to a sitting position is not the first action because it does not directly address the risk of aspiration when feeding a stroke patient. Option D) Evaluate the patient's ability to swallow small amounts of crushed ice or ice water is not the initial step as assessing the gag reflex is more comprehensive and directly related to the patient's safety during feeding. In an educational context, understanding the importance of assessing the gag reflex in stroke patients is crucial for nurses in providing safe and effective care. This knowledge helps prevent complications such as aspiration pneumonia, which can have serious consequences for patients. Nurses must prioritize airway protection and swallowing function assessments in stroke patients to ensure their well-being and recovery.
Question 4 of 5
When teaching a patient with a seizure disorder about the medication regimen, what is it most important for the nurse to emphasize?
Correct Answer: C
Rationale: In the context of teaching a patient with a seizure disorder about their medication regimen, emphasizing the importance of not stopping the medication abruptly (Option C) is crucial. This is because suddenly discontinuing antiseizure medications can lead to withdrawal symptoms, increased seizure intensity, and a higher frequency of seizures. Educating patients about the potential risks of abrupt cessation empowers them to adhere to their prescribed treatment plan. Option A is incorrect because adjusting medication dosage without medical advice can be dangerous and should not be done based solely on stress levels. Option B is incorrect because not all over-the-counter and prescription drugs are safe to take with antiseizure medications as they can interact and affect the effectiveness of the antiseizure drugs. In an educational context, it is vital for nurses to ensure that patients understand the significance of medication adherence in managing chronic conditions like seizure disorders. Providing clear and accurate information about the risks of non-adherence can help patients make informed decisions regarding their health and treatment plan.
Question 5 of 5
One of the most distressing problems experienced by the patient with ALS is
Correct Answer: B
Rationale: The correct answer to the question regarding the distressing problem experienced by a patient with ALS being the retention of cognitive function with total degeneration of motor function (Option B) is due to the nature of ALS, also known as Amyotrophic Lateral Sclerosis or Lou Gehrig's disease. ALS is a progressive neurodegenerative disease that primarily affects the motor neurons in the brain and spinal cord, leading to the loss of voluntary muscle control. In ALS, the cognitive function of the patient remains intact while the motor function deteriorates over time. This creates a distressing situation for the patient as they are fully aware of their physical decline and loss of independence, which can be emotionally challenging and frustrating. Option A, painful spasticity of the face and extremities, is not the most distressing problem in ALS, as pain is a symptom that can be managed with medications and therapies. Option C, uncontrollable writhing and twisting movements of the face and limbs, is more characteristic of conditions like Huntington's disease, not ALS. Educationally, understanding the specific challenges and symptoms associated with ALS is crucial for healthcare providers to provide appropriate care and support for patients with this condition. Recognizing the unique emotional and physical struggles faced by ALS patients can guide healthcare professionals in developing comprehensive care plans to improve the quality of life for these individuals.