A nurse is providing care for a client experiencing obstructive shock. Which of the following diagnoses should the nurse expect?

Third spacing

Cardiomyopathy

Cardiac tamponade

Ruptured aneurysm

Answer and Explanation

The Correct Answer is C

A. Third spacing: Third spacing refers to the shifting of fluid from the intravascular space into the interstitial space, leading to decreased circulating volume. While third spacing can contribute to hypovolemic shock, it is not specific to obstructive shock.

B. Cardiomyopathy: Cardiomyopathy is a condition characterized by abnormalities in the heart muscle structure and function. While cardiomyopathy can lead to heart failure, it is not directly associated with obstructive shock.

C. Cardiac tamponade: Cardiac tamponade occurs when fluid accumulates in the pericardial sac, compressing the heart and impairing its ability to fill properly. This condition can lead to obstructive shock due to decreased cardiac output. Signs and symptoms include hypotension, muffled heart sounds, distended neck veins, and pulsus paradoxus.

D. Ruptured aneurysm: A ruptured aneurysm can lead to hypovolemic shock due to acute blood loss. While it can cause significant hemodynamic instability, it is not a characteristic diagnosis of obstructive shock.

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Correct Answer is C

Explanation

A. People who abstain from alcohol: Abstaining from alcohol does not necessarily increase the risk of sustaining a traumatic brain injury (TBI). In fact, excessive alcohol consumption can increase the risk of falls and accidents leading to TBIs, but abstaining from alcohol itself is not a risk factor for TBI.

B. People who live in rural areas: Living in rural areas may be associated with certain risk factors for TBIs, such as increased rates of motor vehicle accidents due to factors like higher speed limits and longer distances traveled. However, it is not a direct cause of TBIs.

C. People who play contact sports: Engaging in contact sports, such as football, soccer, or rugby, poses a higher risk of sustaining a traumatic brain injury due to the potential for collisions, falls, and impacts during gameplay.

D. People who are in their 30's: While traumatic brain injuries can occur at any age, individuals who are involved in activities with a higher risk of head injuries, such as contact sports or high-risk occupations, may be more prone to TBIs regardless of their age. Age alone is not a significant risk factor for TBIs.

A. Pooling of blood and edema around the eyes B. Ability to recall how the injury occurred C. Bruising over the mastoid process D. Chvostek’s sign

Correct Answer is A

Explanation

A. Pooling of blood and edema around the eyes: Basilar skull fractures can lead to leakage of cerebrospinal fluid (CSF) into the surrounding tissues, resulting in periorbital ecchymosis, also known as raccoon eyes, due to pooling of blood and edema around the eyes. This finding is characteristic of basilar skull fractures and is caused by disruption of the meninges and subsequent CSF leakage into the soft tissues of the face.

B. Ability to recall how the injury occurred: Memory loss regarding the events surrounding the injury, known as post-traumatic amnesia, is common with basilar skull fractures. This amnesia occurs due to the impact of the injury on the brain and may involve retrograde amnesia (loss of memory of events leading up to the injury) and anterograde amnesia (loss of memory of events occurring after the injury).

C. Bruising over the mastoid process: Bruising over the mastoid process, known as Battle sign, is associated with basilar skull fractures. Battle sign results from blood accumulation (hematoma) in the mastoid region behind the ear due to fracture-related injury to the middle meningeal artery or other blood vessels. This finding typically develops 24-48 hours after the injury.

D. Chvostek’s sign: Chvostek's sign is a clinical manifestation of hypocalcemia, not basilar skull fractures. It is elicited by tapping the facial nerve (facial nerve spasm) and is indicative of neuromuscular irritability due to decreased calcium levels. Chvostek's sign is not directly related to basilar skull fractures.

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A nurse is providing care for a client experiencing obstructive shock. Which of the following diagnoses should the nurse expect?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has a traumatic brain injury (TBI). Which of the following groups should the nurse understand has a higher risk of sustaining a TBI?

Correct Answer is C

Explanation

A nurse has received report on a client who has a basilar skull fracture. Which of the following findings should the nurse anticipate with this client?

Correct Answer is A

Explanation

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