ATI RN
Health Assessment Neurological System NCLEX Questions Quizlet Questions
Question 1 of 5
What surgical treatment will the nurse prepare the patient for in the presence of compartment syndrome?
Correct Answer: A
Rationale: In the presence of compartment syndrome, the correct surgical treatment that the nurse should prepare the patient for is option A) Fasciotomy. Compartment syndrome is a serious condition that occurs when increased pressure within a muscle compartment compromises blood flow and can lead to tissue damage and necrosis. A fasciotomy involves making an incision through the fascia to relieve the pressure within the compartment, allowing for improved blood flow and preventing further tissue damage. Option B) Amputation is not the primary surgical treatment for compartment syndrome. Amputation is usually considered as a last resort when tissue damage is extensive and irreversible. Option C) Internal fixation is a surgical procedure used to stabilize fractured bones with hardware such as screws, plates, or rods. While internal fixation may be needed for fractures, it is not the primary treatment for compartment syndrome. Option D) Release of tendons is not the appropriate surgical treatment for compartment syndrome. Tendons are not the primary issue in compartment syndrome; it is the increased pressure within the muscle compartment that needs to be addressed. In an educational context, understanding the appropriate interventions for compartment syndrome is crucial for nurses and healthcare providers working in acute care settings. Prompt recognition of compartment syndrome and knowledge of the appropriate interventions are essential to prevent further tissue damage and preserve limb function. This question reinforces the importance of surgical interventions in managing compartment syndrome and highlights the critical role of nurses in preparing patients for such procedures to optimize outcomes and prevent complications.
Question 2 of 5
During a follow-up visit to a patient with acute osteomyelitis treated with IV antibiotics, the home health nurse is told by the patient's wife that she can hardly get the patient to eat because his mouth is so sore. In assessing the patient's mouth, what should the nurse expect to find?
Correct Answer: B
Rationale: The correct answer is B) White, curdlike membranous lesions of the mucosa. These lesions are characteristic of oral candidiasis, a common fungal infection seen in patients receiving prolonged antibiotic therapy, like the IV antibiotics the patient is on for osteomyelitis. These lesions may cause pain and discomfort in the mouth, leading to decreased appetite. Option A) A dry, cracked tongue with a central furrow is indicative of dehydration and not specifically related to the patient's situation with soreness in the mouth. Option C) Ulcers of the mouth and lips surrounded by a reddened base are more indicative of conditions like herpes simplex virus or aphthous ulcers rather than the fungal infection seen in the patient. Option D) Single or clustered vesicles on the tongue and buccal mucosa are more characteristic of viral infections like herpes simplex or varicella-zoster rather than the fungal infection seen in this case. Educationally, understanding the oral manifestations of common infections in patients on specific treatments is crucial for nurses to provide appropriate care and support. Recognizing these signs aids in timely intervention and symptom management, ultimately improving patient outcomes.
Question 3 of 5
To preserve function and the ability to perform activities of daily living (ADLs), what should the nurse teach the patient with OA?
Correct Answer: B
Rationale: The correct answer is B) Plan and organize task performance to be less stressful to joints. This approach is crucial for managing osteoarthritis (OA) effectively. By planning and organizing tasks, patients can reduce strain on affected joints, preserve function, and maintain independence in performing activities of daily living (ADLs). Option A) Avoid exercise that involves the affected joints is incorrect because regular, low-impact exercise is actually beneficial for OA patients to strengthen muscles around the joints, improve flexibility, and reduce pain. Complete avoidance can lead to muscle weakness and decreased joint mobility. Option C) Maintain normal activities during an acute episode to prevent loss of function is incorrect because during an acute flare-up of OA, it is essential to rest the affected joint to reduce inflammation and prevent further damage. Overusing the joint during an acute episode can exacerbate pain and lead to increased functional impairment. Option D) Use mild analgesics to control symptoms when performing tasks that cause pain is incorrect as it only addresses symptom management temporarily. While pain relief is important, it is equally important to focus on long-term strategies like joint protection techniques, exercise, and proper task planning to maintain function and quality of life in OA patients. In an educational context, teaching patients with OA about effective joint protection strategies, task modification, and exercise programs tailored to their needs are essential components of nursing care. Empowering patients with knowledge and skills to manage their condition can significantly improve their outcomes and quality of life.
Question 4 of 5
The nurse teaches the patient with RA that which exercise is one of the most effective methods of aerobic exercise?
Correct Answer: C
Rationale: The correct answer is C) Aquatic exercises. In patients with Rheumatoid Arthritis (RA), aquatic exercises are one of the most effective methods of aerobic exercise due to the buoyancy of water reducing stress on the joints. This low-impact environment allows for increased range of motion and improved flexibility without causing excessive strain on the joints affected by RA. Option A) Ballet dancing is high-impact and can put significant stress on the joints, potentially worsening RA symptoms. Option B) Casual walking, while generally a good form of exercise, may not provide the same benefits for RA patients as aquatic exercises due to the impact on weight-bearing joints. Option D) Low-impact aerobic exercises are beneficial, but aquatic exercises offer the added advantage of decreased joint stress due to the water's buoyancy. Educationally, it's important for healthcare providers to understand the specific needs of patients with RA when recommending exercise. By selecting aquatic exercises as the most effective method of aerobic exercise for RA patients, it demonstrates a tailored approach to promoting physical activity while considering the limitations imposed by the condition. This rationale reinforces the importance of individualized care in managing RA and promoting overall health and well-being.
Question 5 of 5
During assessment of the patient diagnosed with fibromyalgia, what should the nurse expect the patient to report?
Correct Answer: B
Rationale: In assessing a patient diagnosed with fibromyalgia, the nurse should expect the patient to report nonrestorative sleep with resulting fatigue. This is the correct answer because one of the hallmark symptoms of fibromyalgia is chronic widespread pain accompanied by fatigue and sleep disturbances. Patients with fibromyalgia often experience difficulty falling asleep, staying asleep, and feeling refreshed upon waking, leading to daytime fatigue and lethargy. Option A, generalized muscle twitching and spasms, is incorrect because these symptoms are not typically associated with fibromyalgia. Option C, profound and progressive muscle weakness that limits ADLs, is also incorrect as fibromyalgia does not cause muscle weakness but rather widespread pain and fatigue. Option D, widespread musculoskeletal pain accompanied by inflammation and fever, is incorrect because fibromyalgia does not involve inflammation or fever, distinguishing it from conditions like rheumatoid arthritis. Educationally, understanding the characteristic symptoms of fibromyalgia is crucial for nurses to provide appropriate care and support to patients. By recognizing the key features of fibromyalgia, nurses can effectively assess, educate, and implement interventions to help manage the chronic pain, fatigue, and sleep disturbances experienced by patients with this condition.