A nurse in an emergency department is caring for a client who became unresponsive after stating she had a sudden, severe headache with vomiting and then seizure activity. The client's vital signs are as follows: blood pressure of 198/110 mm Hg pulse of 82 bpm, respirations of 24/min, and a temperature of 100.8 F (38.2° C). Which neurologic disorder would the nurse suspect?

Thrombotic stroke

Embolic stroke

Hemorrhagic stroke

Transient ischemic attack (TIA)

Answer and Explanation

The Correct Answer is C

A. Thrombotic stroke. A thrombotic stroke develops more gradually and is not typically associated with such sudden and severe symptoms.

B. Embolic stroke. An embolic stroke is often associated with a known embolic source, such as a clot from the heart, and can present more suddenly, but without all the symptoms seen here.

C. Hemorrhagic stroke: Hemorrhagic strokes often present with a sudden, severe headache, vomiting, seizure activity, and high blood pressure. A fever may also develop due to increased intracranial pressure.

D. Transient ischemic attack (TIA). TIAs are brief and resolve within minutes to hours and do not typically cause seizures.

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Correct Answer is ["D","E","F","G"]

Explanation

A. Morphine is typically used for pain relief, but it is not used to reduce cerebral edema.

B. Lactated Ringers is a balanced electrolyte solution, but it does not address the need for reducing cerebral edema.

D. Dexamethasone is a corticosteroid used to reduce inflammation and cerebral edema in cases of brain injury.

E. Mannitol is an osmotic diuretic used to reduce cerebral edema by drawing fluid out of the brain and into the bloodstream.

F. Hypertonic saline is used to increase serum osmolality, helping to pull water out of the brain and reduce edema.

G. Furosemide is a loop diuretic that can also help reduce cerebral edema by promoting diuresis.

A. Troponin B. Alkaline phosphatase C. Creatine kinase D. Myoglobin

Correct Answer is A

Explanation

A. Troponin: Troponin is the most specific and reliable biomarker for myocardial injury. Levels rise within 3-6 hours and remain elevated for days, providing diagnostic and prognostic information.

B. Alkaline phosphatase: This is related to liver and bone disorders, not cardiac events.

C. Creatine kinase (CK): While CK-MB is specific to cardiac tissue, it is less specific and remains elevated for a shorter period compared to troponin.

D. Myoglobin: Myoglobin is an early but nonspecific marker of muscle damage and is not as reliable for diagnosing myocardial injury.

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a client who was admitted 24 hours ago with a traumatic brain injury. Which medications would the nurse anticipate being prescribed to reduce cerebral edema and prevent a secondary brain injury? Select All That Apply

Correct Answer is ["D","E","F","G"]

Explanation

The nurse is caring for a client who is newly admitted with severe chest pain and suspected myocardial infarction. Which diagnostic blood test would be considered the most reliable and critical indicator of myocardial injury?

Correct Answer is A

Explanation

The charge nurse observes a new graduate nurse who is caring for a client who has a severe head injury. Which action by the new graduate nurse requires the charge nurse to intervene?

A nurse is caring for an alert client who reports heart palpitations, nausea, and dizziness. An electrocardiogram (EKG) confirms the client is experiencing vector tachycardia (VT). The nurse should anticipate which action?

A 55-year-old client who is diagnosed with an evolving myocardial infarction (MI) insists on going home. The nurse encourages the client to be admitted because he knows that within the first 24 hours of a MI, there is a high risk for which of the following?

The nurse is caring for a client who reports persistent, crushing chest pain. What additional signs or symptoms would make a nurse suspect that the client is experiencing a myocardial infarction?

The nurse is teaching a class to a group of staff nurses about traumatic brain injury which condition would the nurse identify as having the highest risk of a fatal outcome within the first 24 hours post-injury?

A nurse is caring for a client who had a stroke involving the right cerebral hemisphere. The nurse should monitor the client for which finding?

The nurse is caring for a client who suffered a hemorrhagic stroke. In order to prevent increased intracranial pressure, the client should be placed in which position for the first 72 hours after the onset of a stroke?