A patient is being evaluated for a possible spinal cord tumor. Which finding should the nurse recognize as requiring the most immediate action?

The patient reports chronic severe back pain.

The patient expresses anxiety about having surgery.

The patient has new-onset weakness of both legs.

The patient starts to cry and says, "I feel hopeless."

Answer and Explanation

The Correct Answer is C

A. The patient reports chronic severe back pain: Chronic severe back pain may indicate underlying spinal issues but does not necessarily require immediate action compared to acute symptoms such as new-onset weakness of both legs.

B. The patient expresses anxiety about having surgery: While addressing the patient's anxiety is important for providing holistic care, it is not the most immediate concern compared to new- onset weakness of both legs, which may indicate spinal cord compression requiring urgent
intervention.

C. The patient has new-onset weakness of both legs: New-onset weakness of both legs suggests potential spinal cord compression or neurological deficit requiring immediate evaluation and intervention to prevent further neurological damage or complications.

D. The patient starts to cry and says, "I feel hopeless": While addressing the patient's emotional needs is important, it is not the most immediate concern compared to addressing acute neurological symptoms such as new-onset weakness of both legs.

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Correct Answer is C

Explanation

A. “You might benefit from some psychological counseling." While psychological counseling may be helpful for coping with the emotional impact of epilepsy, it does not directly address the patient's concern about the possibility of having a seizure at work.

B. “The Department of Vocational Rehabilitation can help with work retraining." While
vocational rehabilitation services may be beneficial for individuals with disabilities, it may not directly address the patient's concern about continuing to work as a teacher.

C. "Epilepsy usually can be well controlled with medications." This response addresses the patient's concern by providing reassurance that epilepsy can often be effectively managed with medications. By effectively controlling seizures, the patient may be able to continue working without the fear of having a seizure at work.

D. “You will want to contact the Epilepsy Foundation for assistance." While the Epilepsy Foundation provides valuable resources and support for individuals with epilepsy, this response does not directly address the patient's concern about continuing to work.

A. The patient's blood pressure (BP) is 144/90 mm Hg. B. The patient takes a diuretic because of a history of hypertension. C. The patient has atrial fibrillation and takes warfarin (Coumadin). D. The patient's speech is difficult to understand.

Correct Answer is C

Explanation

A. The patient's blood pressure (BP) is 144/90 mm Hg: While elevated blood pressure may contribute to the risk of intracerebral hemorrhage, the patient's current BP is not excessively high and may not be the most critical factor in this situation compared to other factors such as anticoagulant use.

B. The patient takes a diuretic because of a history of hypertension: While the patient's history of hypertension and diuretic use are relevant to their overall health status, they may not be the most immediate concern in the context of intracerebral hemorrhage.

C. The patient has atrial fibrillation and takes warfarin (Coumadin): This information is crucial as it indicates that the patient is anticoagulated, which can significantly impact the severity and management of intracerebral hemorrhage. Anticoagulant use increases the risk of bleeding and can worsen outcomes in cases of intracranial hemorrhage.

D. The patient's speech is difficult to understand: While difficulty with speech may indicate neurological impairment, it is not as immediately concerning as the patient's anticoagulant use, which increases the risk of bleeding complications and may require specific interventions such as reversal agents.

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A patient is being evaluated for a possible spinal cord tumor. Which finding should the nurse recognize as requiring the most immediate action?

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Naxlex Comprehensive Predictor Exams

A high school teacher who has been diagnosed with epilepsy after having a generalized tonic- clonic seizure tells the nurse, "I cannot teach anymore. It will be too upsetting if I have a seizure at work." How should the nurse respond to specifically address the patient's concern?

Correct Answer is C

Explanation

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Correct Answer is C

Explanation

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