In the context of an initial assessment for a client admitted to rule out Guillain-Barre syndrome, which of the following symptoms would the nurse expect to observe?
Ascending muscle weakness
Difficulty with urination
Ptosis and diplopia
Ear distortion and pain
The Correct Answer is A
Choice A rationale
Ascending muscle weakness is a classic symptom of Guillain-Barre syndrome. It often starts in the feet and legs before spreading to the upper body and arms.
Choice B rationale
Difficulty with urination is not a typical symptom of Guillain-Barre syndrome.
Choice C rationale
Ptosis (drooping of the upper eyelid) and diplopia (double vision) are not common symptoms of Guillain-Barre syndrome.
Choice D rationale
Ear distortion and pain are not associated with Guillain-Barre syndrome.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["56"]
Explanation
Step 1 is to calculate the total drops per hour. This is done by multiplying the total volume of the solution by the drop factor and then dividing by the total time in minutes. So, (1000 mL × 10 gtt/mL) ÷ 180 min = 55.56 gtt/min. The final calculated answer is approximately 56 gtt/min when rounded to the nearest whole number.
Correct Answer is C
Explanation
Choice A rationale
While participation in multiple-step activities can provide mental stimulation, it may be challenging for a patient with Alzheimer’s disease. These activities often require a level of cognitive functioning that may be impaired in Alzheimer’s patients. As a result, these activities could lead to frustration and agitation rather than fostering socialization.
Choice B rationale
Hobbies involving fine motor skills can be beneficial for maintaining dexterity and coordination. However, as Alzheimer’s disease progresses, these skills often decline. Therefore, while these hobbies may be enjoyable, they may not necessarily foster socialization.
Choice C rationale
Limiting visitors to one or two at a time can help to prevent overstimulation, which can be distressing for a person with Alzheimer’s disease. Smaller, more intimate gatherings can also foster more meaningful social interactions. Therefore, this approach can be beneficial for promoting socialization.
Choice D rationale
While social interaction is important for people with Alzheimer’s disease, frequent lengthy visits from friends may be overwhelming and lead to fatigue. It’s important to balance socialization with rest and relaxation. Therefore, promoting frequent lengthy visits may not be the best approach to foster socialization.
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