A nurse is caring for a client who has a traumatic brain injury and is being mechanically ventilated. Which of the following can cause unfavorable outcomes for this client?
Hyperoxia
Platelet count 250,000/mm^3
Hemoglobin 16 g/dL
Glasgow Coma Scale 16
The Correct Answer is A
Choice A rationale
Hyperoxia, or high oxygen levels, can cause unfavorable outcomes for a client who has a traumatic brain injury and is being mechanically ventilated. Too much oxygen can lead to oxygen toxicity and cause damage to the lungs and other organs, including the brain.
Choice B rationale
A platelet count of 250,000/mm^3 is within the normal range and would not typically cause unfavorable outcomes for a client who has a traumatic brain injury and is being mechanically ventilated.
Choice C rationale
A hemoglobin level of 16 g/dL is within the normal range and would not typically cause unfavorable outcomes for a client who has a traumatic brain injury and is being mechanically ventilated.
Choice D rationale
A Glasgow Coma Scale score of 16 is not possible as the maximum score is 15. A higher score indicates a less severe injury, so it would not typically cause unfavorable outcomes for a client who has a traumatic brain injury and is being mechanically ventilated.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Maintaining systolic BP between 141 and 145 mm Hg is considered high and can increase the risk of stroke.
Choice B rationale
The client should maintain systolic BP between 120 and 129 mm Hg. This is considered a normal blood pressure range and can help reduce the risk of stroke.
Choice C rationale
Maintaining systolic BP between 130 and 135 mm Hg is considered elevated and can increase the risk of stroke.
Choice D rationale
Maintaining systolic BP between 136 and 140 mm Hg is considered high and can increase the risk of stroke.
Correct Answer is A
Explanation
Choice A rationale
A Computerized Tomography Angiography (CTA) scan is often used to diagnose a Transient Ischemic Attack (TIA). This imaging test can provide detailed images of blood vessels in the brain and neck, allowing healthcare providers to identify blockages or other abnormalities that could have caused the TIA12.
Choice B rationale
A Transesophageal Echocardiogram (TEE) is a type of echocardiogram that uses a probe passed down the esophagus to obtain detailed images of the heart. While it can be useful in diagnosing certain heart conditions, it is not typically the first-line diagnostic test for a TIA12.
Choice C rationale
A Complete Blood Count (CBC) is a blood test that measures different components of the blood, including red and white blood cells and platelets. While it can provide useful information about a person’s overall health, it is not typically used to diagnose a TIA12.
Choice D rationale
Prothrombin Time (PT) is a blood test that measures how long it takes for your blood to clot. While it can provide information about clotting disorders, it is not typically used to diagnose a
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