A client arrived by EMS after a bar fight. He is disoriented with a Glasgow coma scale of 10.

What additional finding indicates that he has suffered a basilar skull fracture?

bruising over the cheek

missing teeth

discoloration behind the left ear

Bleeding from the nose

Answer and Explanation

The Correct Answer is C

Bruising over the cheek is a sign of facial trauma, not basilar skull fracture.

Missing teeth is a sign of dental injury, not basilar skull fracture.

Discoloration behind the left ear, also known as Battle's sign, is a sign of basilar skull fracture, as blood accumulates in the mastoid process due to a fracture in the temporal bone.

Bleeding from the nose is a sign of nasal trauma, not basilar skull fracture.

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Correct Answer is B

Explanation

A. "Wear an eye patch on the right eye at all times."
An eye patch may be recommended alternating between eyes for short periods to relieve diplopia, but wearing it continuously on one eye can lead to eye strain and decreased depth perception.

B. "Implement a schedule to include periods of rest."
Fatigue is a common and debilitating symptom in clients with MS. Scheduling regular rest periods helps prevent overexertion, which can worsen symptoms and increase the risk of relapse.

C. "Engage in a vigorous exercise program."
Vigorous exercise may exacerbate MS symptoms, particularly fatigue and heat sensitivity. Instead, a moderate, low-impact exercise program (e.g., swimming, yoga) is more appropriate.

D. "Plan to relax in a hot tub spa each day."
Heat can worsen MS symptoms (a phenomenon known as Uhthoff’s sign). Hot environments, such as hot tubs or spas, should be avoided to prevent symptom exacerbation.

A. The client opens his eyes when spoken to B. The client can follow simple motor commands C. The client is unconscious D. The client is unable to make vocal sound.

Correct Answer is A

Explanation

A. A GCS score of 3 for eye opening indicates that the client opens their eyes in response to speech. This accurately reflects the client's level of responsiveness.

B. A GCS score of 5 for motor response indicates that the client localizes pain or can follow simple motor commands. However, this does not fully encapsulate the most appropriate conclusion, given the specific GCS score for eye opening.

C. A total GCS score of 13 (3 for eye opening, 5 for verbal response, and 5 for motor response) suggests mild impairment, not unconsciousness. Unconsciousness is typically indicated by a GCS score of 8 or below.

D. A GCS score of 5 for verbal response indicates the client is oriented and can respond verbally, so they are capable of making vocal sounds.

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A client arrived by EMS after a bar fight. He is disoriented with a Glasgow coma scale of 10. What additional finding indicates that he has suffered a basilar skull fracture?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is presenting discharge instructions to a client who has multiple sclerosis (MS). The client reports symptoms of diplopia, dysmetria, and sensory change. Which of the following nursing statements are appropriate?

Correct Answer is B

Explanation

A nurse is receiving a transfer report for a client who has a head injury. The client has a Glasgow Coma Scale (GCS) score of 3 for eye opening, 5 for best verbal response, and 5 for best motor response. Which of the following is an appropriate conclusion based on this data?

Correct Answer is A

Explanation

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A client arrived by EMS after a bar fight. He is disoriented with a Glasgow coma scale of 10.

What additional finding indicates that he has suffered a basilar skull fracture?