A nurse is caring for a client who presents to the hospital with manifestations of a thoracic injury. Which of the following diagnostic tools would the nurse anticipate the health care provider to order? (Select all that apply.)
(Select All that Apply.)
Pleural cavity decompression via needle aspiration
Focused assessment with sonography in trauma (FAST)
Chest x-ray
Thoracentesis
Ultrasound
Correct Answer : B,C,D,E
Choice A Reason:
Pleural cavity decompression via needle aspiration is inappropriate. Pleural cavity decompression via needle aspiration may be indicated in cases of tension pneumothorax, a potentially life-threatening condition in which air accumulates in the pleural space and compresses the lung. While it is an intervention rather than a diagnostic tool, it may be performed emergently if tension pneumothorax is suspected based on clinical findings.
Choice B Reason:
Focused assessment with sonography in trauma (FAST) is appropriate. FAST is a bedside ultrasound examination commonly used in trauma settings to rapidly assess for the presence of free fluid in the pericardial, pleural, and peritoneal spaces. It can help identify hemopericardium, hemothorax, or intra-abdominal hemorrhage, which may be indicative of thoracic injury.
Choice C Reason:
Chest x-ray is appropriate. Chest x-ray is a commonly used imaging modality for evaluating thoracic injuries. It can help visualize abnormalities such as rib fractures, pneumothorax, hemothorax, pulmonary contusions, or other traumatic injuries to the chest.
Choice D Reason:
Thoracentesis is appropriate. Thoracentesis is a procedure used to sample fluid from the pleural space for diagnostic or therapeutic purposes. It may be indicated if there is a suspicion of pleural effusion or if fluid accumulation is seen on imaging studies such as chest x-ray or ultrasound.
Choice E Reason:
Ultrasound is appropriate. Ultrasound can be used to evaluate various aspects of thoracic injuries, including the presence of pneumothorax, hemothorax, or pleural effusion. It is often used as part of the FAST examination but can also be performed separately for more detailed assessment.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A Reason:
Vasogenic cerebral edema is appropriate response. Vasogenic cerebral edema occurs due to disruption of the blood-brain barrier (BBB), leading to leakage of fluid and proteins from the blood vessels into the brain parenchyma. This type of cerebral edema is commonly associated with conditions such as brain tumors, abscesses, and ischemic stroke.
Choice B Reason:
Osmotic cerebral edema is inappropriate response. Osmotic cerebral edema occurs when there is an imbalance of osmotic forces across the blood-brain barrier, leading to the movement of water into the brain cells. This type of cerebral edema can result from conditions such as hyponatremia or the administration of hypertonic solutions.
Choice C Reason:
Cellular cerebral edema is inappropriate response. Cellular cerebral edema involves the swelling of brain cells (neurons and glial cells) due to various insults, such as ischemia, hypoxia, or metabolic disturbances. This type of cerebral edema can occur in conditions such as ischemic stroke or traumatic brain injury.
Choice D Reason:
Interstitial cerebral edema is incorrect response. Interstitial cerebral edema involves the accumulation of fluid within the interstitial spaces of the brain tissue. This type of cerebral edema can occur in conditions such as hydrocephalus, where there is obstruction of cerebrospinal fluid (CSF) flow.
Correct Answer is ["A","B","D","E"]
Explanation
Choice A Reason:
Memory loss is correct. Memory loss can occur in individuals with PML due to damage to the white matter of the brain caused by the JC virus infection. This damage can affect cognitive function, including memory.
Choice B Reason:
Clumsiness is correct. Clumsiness or lack of coordination is a common neurological symptom of PML. It can result from damage to areas of the brain responsible for motor function and coordination.
Choice C Reason:
Tardive dyskinesia is incorrect. Tardive dyskinesia is a movement disorder characterized by involuntary, repetitive movements, often involving the face, lips, tongue, and limbs. While tardive dyskinesia can occur as a side effect of certain medications, it is not typically associated with PML.
Choice D Reason:
Seizures is correct. Seizures can occur in individuals with PML due to the involvement of the brain's white matter by the JC virus infection. Seizures may present as sudden, uncontrolled movements, altered consciousness, or other neurological symptoms.
Choice E Reason:
Vision difficulty is correct. Vision difficulties, including blurred vision, visual field deficits, and other visual disturbances, are common manifestations of PML. Damage to the optic nerves or areas of the brain involved in visual processing can result in vision difficulties.
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