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A 68-year-old male presents to the emergency department with sudden onset of right-sided weakness and difficulty speaking. The symptoms resolved after 20 minutes. Which of the following are appropriate actions and considerations for this patient who has experienced a transient ischemic attack (TIA)?
(Select All that Apply.)

Assume the episode was a migraine and schedule a neurology follow-up for a later date.

Discharge the patient immediately since the symptoms resolved.

Initiate antiplatelet therapy, such as aspirin, to reduce the risk of future strokes.

Order a CT scan of the head to rule out intracranial hemorrhage.

Start anticoagulation therapy immediately without further evaluation.

Conduct a carotid ultrasound to assess for stenosis.

Refer the patient for lifestyle modifications, including smoking cessation and diet changes.

Answer and Explanation

Correct Answer : C,D,F,G

A.   Assuming the episode was a migraine and scheduling a follow-up is not appropriate. TIAs are serious warning signs of potential future strokes and require immediate attention and evaluation.
B.   Discharging the patient immediately after symptoms resolve is not appropriate. Even though symptoms resolve, TIAs are medical emergencies, and further evaluation is necessary to reduce the risk of a full-blown stroke.
C.   Initiating antiplatelet therapy, such as aspirin, is an appropriate action to reduce the risk of future strokes in patients who have had a TIA.
D.   Ordering a CT scan of the head is appropriate to rule out an intracranial hemorrhage and other causes of the symptoms.

E.   Starting anticoagulation therapy immediately without further evaluation is not recommended. The patient must be properly assessed before starting anticoagulation to determine the cause of the TIA and if anticoagulation is appropriate.
F.   Conducting a carotid ultrasound is appropriate to assess for stenosis, which could be contributing to the TIA.
G.   Referring the patient for lifestyle modifications, including smoking cessation and diet changes, is crucial to reduce future stroke risk. These interventions help prevent the recurrence of TIAs and strokes.

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Correct Answer is B

Explanation

A. Staring spells with a brief loss of awareness are characteristic of absence seizures, not myoclonic seizures.
B. Myoclonic seizures involve sudden, brief, involuntary muscle jerks that typically occur on both sides of the body, which is the key characteristic for this type of seizure.
C. Loss of consciousness followed by confusion is characteristic of tonic-clonic or focal seizures, not myoclonic seizures.
D. Prolonged muscle contractions lasting several minutes describe a tonic seizure, which is distinct from myoclonic seizures.

A. Recommending high-intensity wrist exercises to strengthen wrist muscles B. Nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce inflammation and pain C. Ergonomic adjustments to the patient's work area to minimize wrist strain D. Wrist splinting, especially at night, to keep the wrist in a neutral position E. Encouraging the use of a vibrating hand massager to alleviate symptoms F. Applying heat packs to the wrist to improve circulation and relieve symptoms G. Corticosteroid injections to decrease inflammation and swelling around the median nerve

Correct Answer is ["B","C","D","G"]

Explanation

A. High-intensity wrist exercises may aggravate symptoms and should generally be avoided in carpal tunnel syndrome.
B. NSAIDs are helpful in reducing inflammation and pain, providing symptomatic relief for carpal tunnel syndrome.
C. Ergonomic adjustments to the patient’s work area, such as adjusting chair height and keyboard
positioning, can help reduce strain on the wrist.
D. Wrist splinting, especially at night, keeps the wrist in a neutral position, reducing pressure on the median nerve.
E. A vibrating hand massager could increase irritation to the median nerve and is not recommended.
F. Heat packs are not effective in treating carpal tunnel syndrome; cold therapy may help reduce inflammation.
G. Corticosteroid injections can help decrease inflammation and swelling around the median nerve, providing symptom relief.

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Naxlex Comprehensive Predictor Exams

A 23-year-old patient is diagnosed with myoclonic seizures. Which of the following characteristics is most indicative of this type of seizure?

Correct Answer is B

Explanation

A nurse is educating a patient diagnosed with carpal tunnel syndrome about non-surgical management options. Which of the following interventions are appropriate to include in the patient's care plan? (Select All that Apply.)

Correct Answer is ["B","C","D","G"]

Explanation

A 25-year-old patient with a history of epilepsy is brought to the emergency department after experiencing a generalized tonic-clonic seizure. Which of the following is the most appropriate initial action by the nurse?

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