A patient is distressed to learn that a sibling is diagnosed with both neurologic and cognitive manifestations of Huntington disease. When the patient asks the nurse how to determine the incidence of the disease, which answer is most appropriate?

"All family members are now at risk for the disease."

"Only your children need to be tested for a genetic connection."

"If you are not diagnosed by age 20, you are considered safe."

"You definitely need to have genetic testing for the disease."

Answer and Explanation

The Correct Answer is A

A. Huntington disease is an autosomal dominant genetic disorder, meaning that if one parent has the gene, each child has a 50% chance of inheriting it. Therefore, all family members are at risk for the disease.

B. While genetic testing may be relevant for the patient’s children, it is not limited only to them. The patient and other family members are also at risk and may choose to be tested.

C. Huntington disease typically manifests between ages 30 and 50, and there is no age cutoff for determining risk. Early diagnosis may occur, but not being diagnosed by age 20 does not rule out the disease.

D. While genetic testing can confirm the presence of the gene, it is not the only way to determine risk. Family history and clinical symptoms are also key factors in understanding the risk for Huntington disease.

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Correct Answer is D

Explanation

A. A positive Romberg sign (difficulty maintaining balance with eyes closed) can indicate a neurological issue, but it is not directly associated with a migraine.

B. A subnormal temperature (low body temperature) is not typically associated with migraines and may indicate another issue, but it is not as concerning as other findings.

C. An ill college roommate might suggest a viral illness, but it is not a direct concern for the student’s migraine. Migraines are not contagious, and other signs of illness would be more concerning.

D. Positive Brudzinski sign, which involves involuntary flexion of the hips and knees when the neck is flexed, is indicative of meningeal irritation, a sign of meningitis. This is a medical emergency and much more concerning than the symptoms of a migraine. The student should be further assessed for signs of meningitis, which requires urgent treatment.

A. Have the client wear a cervical collar for the first 12 hr. B. Head of her bed elevated 30 degrees C. Logroll the client every 2 hr. D. Supine with her arms elevated on pillows

Correct Answer is C

Explanation

A. A cervical collar is not necessary for a lumbar laminectomy. A cervical collar is used for neck surgeries or spinal cord injuries involving the cervical spine, not for lumbar procedures.

B. The head of the bed elevated 30 degrees may be appropriate for certain conditions, but after a lumbar laminectomy, it is typically recommended to keep the head of the bed flat or slightly elevated to reduce pressure on the spine.

C. Logrolling the client every 2 hr is the correct action. After a lumbar laminectomy, the nurse should use the logroll technique to turn the patient to prevent strain on the spine and promote proper healing.

D. Supine with her arms elevated on pillows is not the best position. While elevation of the arms may be helpful for comfort, the focus should be on protecting the lumbar spine and ensuring proper positioning to prevent strain.

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A patient is distressed to learn that a sibling is diagnosed with both neurologic and cognitive manifestations of Huntington disease. When the patient asks the nurse how to determine the incidence of the disease, which answer is most appropriate?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is working in a college clinic when a student comes in and says, "I think I have a migraine. My head hurts, I cannot stand the bright light, and I feel sick to my stomach." What additional finding is most concerning?

Correct Answer is D

Explanation

A nurse is caring for a client following a lumbar laminectomy. Which of the following actions should the nurse take?

Correct Answer is C

Explanation

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