A client with a history of seizures is being admitted to the emergency room after experiencing a partial seizure. Which question would be most appropriate for the nurse to ask the client?
“Were you feeling jittery or irritable prior to the seizure?”
“Are you feeling sleepy or very tired at this time?”
“When did you last take your seizure medication?”
“Do you know if you lost consciousness during the seizure?”
The Correct Answer is C
Choice A rationale:
While inquiring about pre-seizure symptoms can be informative, it's not the most crucial question at this point. The priority is to gather information about medication adherence to assess potential causes for the breakthrough seizure.
Choice B rationale:
Assessing for post-ictal fatigue is important, but it's not the most pressing question in the immediate aftermath of a seizure. Determining medication adherence takes precedence.
Choice D rationale:
Establishing whether consciousness was lost can aid in classifying seizure type, but it's not as critical as understanding medication adherence in the initial assessment.
Choice C rationale:
This question directly addresses a potential cause of the seizure. Understanding when the client last took their medication can help determine if missed or delayed doses contributed to the seizure, guide medication adjustments, and inform further seizure prevention strategies.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale:
Pain management: Rheumatoid arthritis (RA) is a chronic inflammatory disease that causes pain, stiffness, swelling, and fatigue in the joints. Pain is often the most debilitating symptom of RA, and it can significantly impact a person's quality of life.
Therefore, the nurse's primary consideration is to ensure the client's comfort by effectively managing their pain. This may involve using a variety of interventions, such as:
Administering pain medications as prescribed Applying heat or cold therapy
Using assistive devices to reduce joint strain
Teaching the client about pain management techniques, such as relaxation exercises and pacing activities
Promoting rest and sleep: Rest and sleep are essential for healing and reducing inflammation. The nurse can encourage the client to rest during the day and to get enough sleep at night.
Creating a comfortable environment: The nurse can help to create a comfortable environment for the client by adjusting the room temperature, providing soft bedding and pillows, and reducing noise and distractions.
Providing emotional support: RA can be a challenging disease to live with, and it can take a toll on a person's emotional well- being. The nurse can provide emotional support by listening to the client's concerns, offering reassurance, and encouraging them to express their feelings.
Choice B rationale:
Motivation is important: While motivation is important for self-management of RA, it is not the primary consideration for the nurse. The nurse's focus is on providing comfort and addressing the client's immediate needs. Once the client's pain and other symptoms are managed, the nurse can then work with the client to develop a plan for managing their RA long-term. This may include providing education about the disease, teaching self-care strategies, and encouraging the client to participate in activities that promote physical and emotional well-being.
Choice C rationale:
Surgery may be an option: Surgery may be an option for some clients with RA, but it is not the primary consideration for the nurse. Surgery is typically considered only after other treatment options have failed to control the client's symptoms.
Choice D rationale:
Education is important: Education is an important part of managing RA, but it is not the primary consideration for the nurse. The nurse's focus is on providing comfort and addressing the client's immediate needs. Once the client's pain and other symptoms are managed, the nurse can then provide education about the disease and its management.
Correct Answer is B
Explanation
Choice A rationale:
Delivering meal trays to clients in their rooms is a simple task that does not require any specialized skills or knowledge. Volunteers can be safely assigned this task, as it does not involve any direct patient care or decision-making.
Choice B rationale:
Observing postoperative clients who are confused requires a higher level of skill and knowledge than delivering meal trays. Volunteers are not typically trained to assess and monitor patients for changes in their condition, and they may not be able to recognize and respond to potential emergencies. This task is best assigned to a licensed nurse or other qualified healthcare professional.
Choice C rationale:
Assisting ambulatory clients with meals is another task that can be safely assigned to volunteers. This task involves helping patients with simple activities such as opening food containers and cutting food. Volunteers can be trained to perform these tasks safely and effectively.
Choice D rationale:
Delivering mail is a simple task that does not require any specialized skills or knowledge. Volunteers can be safely assigned this task, as it does not involve any direct patient care or decision-making.
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