An 82-year-old client who sustained a head injury in a motor vehicle crash while on warfarin therapy is admitted for observation. The nurse is providing teaching regarding the client's diagnosis of a subdural hematoma. Which of the following statements by the client indicates an understanding of teaching?

"I developed a hematoma because an artery burst in my brain when my head hit the windshield."

"I developed a bleed in my brain because my platelets were too high."

"I developed a hematoma because I take a blood thinner and my head hit the windshield."

"I developed a hematoma because my bleeding times were too low and I hit my head."

Answer and Explanation

The Correct Answer is C

A. A subdural hematoma is typically caused by venous bleeding, not arterial bleeding. An arterial rupture would more likely cause an epidural hematoma, which is not the case here.
B. High platelet counts are not commonly associated with the formation of subdural hematomas. Subdural hematomas are usually due to bleeding related to anticoagulant use or trauma.
C. Taking a blood thinner like warfarin increases the risk of bleeding and hematoma formation, particularly when combined with head trauma. This statement correctly links the anticoagulant therapy and head injury as contributing factors to the subdural hematoma.
D. Low bleeding times are not a cause of hematomas. In fact, elevated bleeding times due to anticoagulant therapy would increase the risk of bleeding, not low bleeding times.

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Correct Answer is A

Explanation

A. A decrease in the Glasgow Coma Scale score from 13 to 10 indicates a significant change in consciousness and may suggest worsening of the brain injury. This is a critical sign that requires immediate reporting and evaluation.
B. Diplopia (double vision) can be a concerning symptom, but it is not as immediately critical as a significant change in the Glasgow Coma Scale score. It still warrants attention but may not be the highest priority.
C. Ataxia (lack of voluntary coordination of muscle movements) is a serious symptom that could indicate worsening of the brain injury but is not as immediately critical as a significant change in the Glasgow Coma Scale score.
D. A drop in heart rate from 76 to 70/min is generally not significant in the context of mild TBI. Changes in heart rate are less critical compared to changes in the level of consciousness.

A. Increase fluid intake. B. Decrease protein intake. C. Decrease carbohydrate intake. D. Limit intake of potassium-rich foods.

Correct Answer is C

Explanation

A. Increasing fluid intake is not recommended, as clients with Cushing disease often have fluid retention.
B. Decreasing protein intake is not recommended because muscle wasting is a concern in Cushing disease, and adequate protein is necessary to maintain muscle mass.
C. Decreasing carbohydrate intake is recommended because Cushing disease can cause hyperglycemia, and reducing carbohydrates can help manage blood glucose levels.
D. Limiting potassium-rich foods is not advisable as Cushing disease can lead to hypokalemia, and clients may need to increase their potassium intake.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has a mild traumatic brain injury (TBI). Which of the following manifestations is the priority for the nurse to report to the healthcare provider?

Correct Answer is A

Explanation

A nurse is providing dietary teaching for a client who has Cushing disease. Which of the following recommendations should the nurse include in the teaching?

Correct Answer is C

Explanation

A nurse is caring for a client who has syndrome of inappropriate antidiuretic hormone (SIADH) and a sodium level of 123 mEq/L (nl. 135-145 mEq/L). Which of the following prescriptions should the nurse anticipate?

A nurse is caring for a 72-year-old client who has type 1 diabetes mellitus. Exhibits Select the 3 findings that require immediate follow-up.

A diabetes nurse educator is discussing "sick day rules" with a client newly diagnosed with diabetes mellitus type 1. Which statement by the client indicates a need for further teaching?

A nurse is assessing the depth and extent of injury on a client who has severe burns to the face, neck, and upper extremities. Which of the following factors is the nurse's priority when assessing the severity of the client's burns?

The nurse is assessing a client who reports ear pain for the past 3 days that has suddenly resolved with a new onset of otorrhea. The nurse should recognize the client has manifestations of which condition?

A nurse is caring for a client in septic shock. The client is still hypotensive and lethargic following a 2,500 mL fluid bolus of lactated Ringer (LR) solution. Which of the following interventions does the nurse anticipate next?

A client is exploring treatment options after being diagnosed with age-related cataracts that affect their vision. What treatment is most likely to be used in this client's care?

An immunocompromised older adult has developed a urinary tract infection, and the healthcare team recognizes the need to prevent an exacerbation of the client's infection that could result in sepsis and septic shock. What action should the nurse perform to reduce the client's risk of septic shock?