A nurse is assessing a client who has a spinal cord injury. Which of the following assessment findings should the nurse expect with neurogenic shock? (Select all that apply.)
(Select All that Apply.)

Temperature 36.3° C (97.4° F)

Respirations 12/min

Blood pressure 184/88 mm Hg

Heart rate 54/min

Calcium level 7.0 mg/dL

Answer and Explanation

Correct Answer : A,D

Choice A Reason:

Temperature 36.3°C (97.4°F) is correct. Hypothermia is a characteristic finding in neurogenic shock due to the loss of sympathetic control over temperature regulation and peripheral vasodilation. This can lead to heat loss from the skin surface and a decrease in core body temperature.

Choice B Reason:

Respirations 12/min is incorrect. Respiratory rate is usually not significantly affected in neurogenic shock. However, individuals with high cervical or upper thoracic spinal cord injuries may experience respiratory compromise due to paralysis of respiratory muscles, but this is not a typical feature of neurogenic shock.

Choice C Reason:

Incorrect: Neurogenic shock typically results in hypotension (low blood pressure) due to vasodilation. The given blood pressure reading is elevated, which is not consistent with neurogenic shock.

Choice D Reason:

Heart rate 54/min is correct. Bradycardia is a common finding in neurogenic shock due to unopposed parasympathetic activity resulting from the loss of sympathetic tone. The heart rate may be slow and may decrease further over time.

Choice E Reason:

Calcium level 7.0 mg/dL is incorrect, Calcium levels are not directly related to neurogenic shock. Neurogenic shock primarily involves the loss of sympathetic tone and the resulting hemodynamic changes, rather than alterations in calcium metabolism.

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Correct Answer is D

Explanation

Choice A Reason:

Bronchopneumonia is incorrect. Bronchopneumonia is characterized by patchy areas of consolidation involving multiple lobules scattered throughout the lungs. It typically results from bronchial obstruction and aspiration of infected material into the smaller airways and alveoli.

Choice B Reason:

Severe pneumonia is incorrect. "Severe pneumonia" is a broad term that can refer to pneumonia with various degrees of severity. It does not specifically describe the pattern of consolidation involving the entire lobe of the lung.

Choice C Reason:

Empyema is incorrect. Empyema refers to the accumulation of pus in the pleural cavity, often as a complication of pneumonia. It does not describe the pattern of consolidation within the lung tissue.

Choice D Reason:

Lobar pneumonia is correct. Lobar pneumonia is characterized by consolidation involving an entire lobe or lobes of the lung. It typically results from infection by a single pathogen, such as Streptococcus pneumoniae, which leads to inflammation and consolidation of an entire lobe of the lung.

A. Take small bites of food. B. Liquids should be thickened. C. Eat sitting slightly forward. D. Chew food thoroughly before swallowing. E. Avoid having conversations while eating. F. Avoid fiber in the diet.

Correct Answer is ["A","C","D"]

Explanation

Choice A Reason:

Take small bites of food is correct. Taking small bites of food can help prevent choking and aspiration, particularly during mealtime. It is a recommended practice for individuals with epilepsy to reduce the risk of aspiration if a seizure were to occur during eating.

Choice B Reason:

Liquids should be thickened is incorrect. Thickened liquids are typically recommended for individuals with swallowing difficulties (dysphagia) to help prevent aspiration. However, thickened liquids may not be necessary for all individuals with epilepsy unless specifically indicated based on their swallowing function assessment.

Choice C Reason:

Eat sitting slightly forward correct.: Eating while sitting slightly forward can help prevent aspiration in case of a seizure during meals. This position allows gravity to assist in preventing food or liquid from entering the airway.

Choice D Reason:

Chew food thoroughly before swallowing is correct. Thoroughly chewing food before swallowing is important for proper digestion and to reduce the risk of choking or aspiration, especially for individuals with epilepsy who may be at increased risk of aspiration during a seizure.

Choice E Reason:

Avoid having conversations while eating is incorrect. Avoiding conversations while eating is not directly related to epilepsy management. However, focusing on eating and taking appropriate precautions, such as sitting upright and chewing food thoroughly, can help reduce the risk of aspiration during meals.

Choice F Reason:

Avoid fiber in the diet is incorrect.: There is no specific recommendation to avoid fiber in the diet for individuals with epilepsy. In fact, a balanced diet that includes fiber-rich foods can promote overall health and well-being, which is important for individuals with epilepsy as well.

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A nurse is assessing a client who has a spinal cord injury. Which of the following assessment findings should the nurse expect with neurogenic shock? (Select all that apply.) (Select All that Apply.)

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is ["A","C","D"]

Explanation

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A nurse is assessing a client who has a spinal cord injury. Which of the following assessment findings should the nurse expect with neurogenic shock? (Select all that apply.) (Select All that Apply.)

A nurse is assessing a client who has a spinal cord injury. Which of the following assessment findings should the nurse expect with neurogenic shock? (Select all that apply.)
(Select All that Apply.)