After completing a neurological assessment, the nurse documents that the client is stuporous. Which of the following describes this level of consciousness?

Minimal movement, verbal responses limited to sounds, awakens briefly only with extreme vigorous stimulation.

Extremely drowsy, minimally responsive, limited ability to follow commands, vigorous stimulation needed to waken.

Alert and oriented x3, sluggish, drowsy, wakes to voice or gentle shaking.

Does not respond to verbal stimuli, does not speak, decorticate/decerebrate posturing in response to pain.

Answer and Explanation

The Correct Answer is A

Choice A reason: This is the correct answer because this describes a stupor, which is a state of near-unconsciousness or reduced responsiveness. A stuporous client shows minimal movement and verbal responses and requires extreme vigorous stimulation such as painful stimuli to awaken briefly.

Choice B reason: This is incorrect because this describes obtundation, which is a state of reduced alertness or awareness. An obtunded client is extremely drowsy and minimally responsive and requires vigorous stimulation such as shaking or shouting to wake.

Choice C reason: This is incorrect because this describes lethargy, which is a state of decreased energy or activity. A lethargic client is alert and oriented x3 (to person, place, and time), but sluggish and drowsy, and wakes to voice or gentle shaking.

Choice D reason: This is incorrect because this describes a coma, which is a state of deep unconsciousness or unresponsiveness. A comatose client does not respond to verbal stimuli or speak and shows abnormal posturing in response to pain, such as decorticate (flexion of arms and extension of legs) or decerebrate (extension of arms and legs).

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Correct Answer is D

Explanation

Choice A Reason: This is incorrect because phototherapy is not a recommended therapy for contact dermatitis. Phototherapy involves exposing the skin to artificial light sources that emit specific wavelengths of light that can have anti-inflammatory or immunomodulatory effects. Phototherapy can be used for some skin conditions, such as psoriasis or eczema, but not for contact dermatitis.

Choice B Reason: This is incorrect because antibiotics are not a recommended therapy for contact dermatitis. Antibiotics are drugs that kill or inhibit bacteria that cause infections. Contact dermatitis is not an infection, but an allergic or irritant reaction to a substance that comes in contact with the skin. Antibiotics have no effect on contact dermatitis and may cause adverse effects or resistance.

Choice C Reason: This is incorrect because UV light is not a recommended therapy for contact dermatitis. UV light refers to ultraviolet radiation from sunlight or artificial sources that can damage DNA and cause skin cancer or aging. UV light can also worsen contact dermatitis by increasing inflammation and sensitivity to allergens or irritants.

Choice D Reason: This is correct because avoidance is the best therapy for contact dermatitis. Avoidance means identifying and avoiding the substance that causes the skin reaction. This can prevent further exposure and allow the skin to heal. The nurse can help the client by providing education on how to read labels, use protective clothing or gloves, or substitute safer products.

A. Stand directly in front of the client. B. Rephrase statements the client does not hear. C. Speak using his usual tone of voice. D. Determine if the client uses hearing aids.

Correct Answer is D

Explanation

Choice A Reason: This is incorrect because standing directly in front of the client is not the priority action by the nurse when admitting a client who has a partial hearing loss. Standing directly in front of the client can enhance communication, but it is not as important as assessing the client's hearing status and needs.

Choice B Reason: This is incorrect because rephrasing statements the client does not hear is not the priority action by the nurse when admitting a client who has a partial hearing loss. Rephrasing statements can improve understanding, but it is not as essential as evaluating the client's hearing level and preferences.

Choice C Reason: This is incorrect because speaking using his usual tone of voice is not the priority action by the nurse when admitting a client who has a partial hearing loss. Speaking using his usual tone of voice may or may not be appropriate, depending on the client's hearing ability and comfort. The nurse should adjust his tone of voice based on the client's feedback and response.

Choice D Reason: This is the correct choice because determining if the client uses hearing aids is the priority action by the nurse when admitting a client who has a partial hearing loss. Hearing aids are devices that amplify sound and improve hearing for people with hearing loss. The nurse should determine if the client uses hearing aids, and if so, check their function, fit, and battery life. The nurse should also ask about any other assistive devices or strategies that the client uses to communicate effectively.

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After completing a neurological assessment, the nurse documents that the client is stuporous. Which of the following describes this level of consciousness?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client diagnosed with contact dermatitis is receiving education from the nurse. Which of the following therapies will the nurse recommend to the client?

Correct Answer is D

Explanation

A nurse is admitting a client who has a partial hearing loss. Which of the following is the priority action by the nurse?

Correct Answer is D

Explanation

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