A nurse is caring for a client who had a traumatic brain injury (TBI). Which of the following manifestations indicate a mild TBI?

Persistent headache and aggression

Headache and confusion

Loss of vision and depression

Seizures and extremity weakness

Answer and Explanation

The Correct Answer is B

A. Persistent headache and aggression: While persistent headache and aggression can occur following a traumatic brain injury (TBI), these symptoms are not specific to mild TBI. Aggression is more commonly associated with severe TBI, and persistent headache can occur across the spectrum of TBI severity.

B. Headache and confusion: Headache and confusion are common manifestations of mild TBI. Following a mild TBI, individuals often experience headache, which may be mild to moderate in intensity. Confusion, disorientation, and difficulty concentrating are also typical symptoms of mild TBI due to the transient disruption of cognitive function.

C. Loss of vision and depression: Loss of vision and depression are less commonly associated with mild TBI. These manifestations may occur in more severe cases of TBI or with specific types of brain injury affecting visual pathways. However, they are not typically indicative of mild TBI.

D. Seizures and extremity weakness: Seizures and extremity weakness are more indicative of moderate to severe TBI rather than mild TBI. While mild TBI may result in brief loss of consciousness, seizures and significant extremity weakness are less characteristic of mild TBI and are more commonly observed with more severe brain injuries.

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Correct Answer is C

Explanation

A) Computed tomography (CT) scan: A CT scan may provide detailed images of the heart and surrounding structures, but it is not typically the initial diagnostic test used to assess for cardiac tamponade. CT scans are often used in conjunction with other diagnostic tests but are not the first-line investigation for suspected tamponade.

B) Chest x-ray: While a chest x-ray may show signs of cardiac tamponade, such as an enlarged cardiac silhouette or evidence of fluid accumulation around the heart, it is not as sensitive or specific as other diagnostic tests, particularly in the acute setting. Chest x-rays may be obtained as part of the diagnostic workup, but they are not the first-line test for suspected tamponade.

C) Echocardiogram: An echocardiogram is the most appropriate initial diagnostic test for suspected cardiac tamponade. It provides real-time imaging of the heart and can detect pericardial effusion, collapse of the right atrium and ventricle during diastole (diastolic collapse), and signs of hemodynamic compromise. Echocardiography allows for rapid assessment at the bedside and can guide immediate management decisions.

D) Electrocardiogram (ECG): While an electrocardiogram may show nonspecific changes in cardiac tamponade, such as low-voltage QRS complexes or electrical alternans, it is not as sensitive or specific as an echocardiogram for diagnosing tamponade. ECG findings may support the diagnosis but are not typically the first-line test for suspected tamponade.

A. The client whose mother and uncle were diagnosed with this same condition. B. The client who is recovering from a recent illness that caused vomiting and diarrhea. C. The client who is out of work and has been experiencing increased stress. D. The client who uses oxygen at night to treat obstructive sleep apnea.

Correct Answer is A

Explanation

A. The client whose mother and uncle were diagnosed with this same condition: Hypertrophic cardiomyopathy (HCM) often has a genetic component, with a familial predisposition observed in many cases. Individuals with a family history of HCM, especially in first-degree relatives such as parents or siblings, are at higher risk of developing the condition due to genetic factors.

B. The client who is recovering from a recent illness that caused vomiting and diarrhea: Acute illnesses such as vomiting and diarrhea can lead to dehydration, electrolyte imbalances, and transient changes in cardiac function. While dehydration and electrolyte imbalances may exacerbate symptoms in individuals with existing cardiac conditions, they are not primary risk factors for developing hypertrophic cardiomyopathy (HCM).

C. The client who is out of work and has been experiencing increased stress: Chronic stress and psychosocial factors may contribute to the progression of cardiovascular disease in general, but they are not specific risk factors for developing hypertrophic cardiomyopathy (HCM).

D. The client who uses oxygen at night to treat obstructive sleep apnea: While obstructive sleep apnea is associated with cardiovascular complications, including hypertrophic cardiomyopathy (HCM), the use of oxygen therapy at night to treat sleep apnea does not directly increase the risk of developing HCM. However, untreated obstructive sleep apnea may lead to chronic hypoxia and other cardiac issues over time.

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A nurse is caring for a client who had a traumatic brain injury (TBI). Which of the following manifestations indicate a mild TBI?

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