A nurse is preparing to test a client's plantar Babinski reflex. Which of the following Instructions should the nurse give to prepare the client for this test?
"Lie down and I will stroke the bottom of your foot."
"Sit on the edge of the bed while I tap your knee."
"Place your foot in my hand and I will tap the back of your heel."
"Relax your arm across your chest and I will test your elbow extension."
The Correct Answer is A
A. Correct. The plantar Babinski reflex is elicited by stroking the sole of the foot along the lateral aspect, from the heel to the ball of the foot. The nurse's instruction to the client is accurate.
B. Tapping the knee is related to the knee jerk reflex, not the Babinski reflex.
C. Tapping the back of the heel does not elicit the plantar Babinski reflex.
D. Testing elbow extension is unrelated to the Babinski reflex.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. One fingerbreadth of space between the cast and the skin is important to prevent constriction, but diminished pulses suggest compromised blood circulation, which is a higher priority.
B. Muscle spasms are common and can cause discomfort, but diminished pulses indicate a more serious circulation issue.
C. Correct. Diminished pulses suggest reduced blood flow, which is a serious concern and requires immediate attention.
D. Ecchymosis might be related to the cast application, but it's less urgent than compromised circulation.
Correct Answer is ["0.25 mL"]
Explanation
To calculate the required amount of the medication, divide the desired dose (0.5 mg. by the concentration (2 mg/mL.:
0.5 mg / 2 mg/mL = 0.25 mL
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