Neurologic Case Study

Patient Profile:

Age: 68 years

Gender: Male

Medical History: Hypertension, Type 2 Diabetes Mellitus

Medications: Lisinopril, Metformin

Allergies: None

Chief Complaint: The patient presents to the emergency department (ED) with sudden onset of right-sided weakness and difficulty speaking that began approximately 1 hour prior to arrival.

Exhibits

Which condition is the patient most likely experiencing?

Hypoglycemia

Hemorrhagic stroke

Ischemic stroke

Multiple sclerosis

Answer and Explanation

The Correct Answer is C

Choice A reason: Hypoglycemia typically presents with symptoms such as sweating, trembling, hunger, confusion, and in severe cases, loss of consciousness. The patient's symptoms of sudden right-sided weakness and difficulty speaking are more consistent with a neurological event rather than low blood sugar levels.

Choice B reason: Hemorrhagic stroke involves bleeding within the brain. Although it can present with similar symptoms to ischemic stroke, the diagnostic tests indicate no evidence of hemorrhage. This makes a hemorrhagic stroke less likely.

Choice C reason: Ischemic stroke occurs when a blood clot blocks a blood vessel in the brain, leading to reduced blood flow and oxygen to a part of the brain. The patient's symptoms of sudden right-sided weakness and expressive aphasia are classic signs of an ischemic stroke, and the absence of hemorrhage on the head CT scan supports this diagnosis.

Choice D reason: Multiple sclerosis (MS) is a chronic, progressive disease that affects the central nervous system. It usually presents with episodic neurological symptoms rather than the sudden onset seen in this patient. MS symptoms develop over time and can vary widely, whereas the patient's acute presentation is more indicative of a stroke.

Nursing Test Bank

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Free Nursing Study Resources

Correct Answer is D

Explanation

Choice A reason: Health care providers such as medical doctors (MDs) and nurse practitioners (NPs) are responsible for diagnosing and treating medical conditions. While they play a crucial role in patient care, the development of a detailed, individualized nursing plan of care typically falls under the domain of nursing professionals.

Choice B reason: Licensed practical/vocational nurses (LPNs/LVNs) provide basic patient care under the supervision of registered nurses and physicians. They assist with implementing care plans but do not usually develop comprehensive nursing plans of care themselves.

Choice C reason: Nursing supervisors oversee the nursing staff and ensure that nursing care is delivered effectively. They may be involved in developing and overseeing care plans at a higher level but are not typically responsible for creating the individualized care plans for each patient.

Choice D reason: Registered nurses (RNs) are trained and licensed to develop individualized care plans that include nursing diagnoses, interventions, and outcomes. They work closely with patients to create and implement care plans that address specific health needs and promote self-management.

A. Amber fluid B. Clear drainage C. Purulent, draining wound D. Blood-tinged fluid

Correct Answer is C

Explanation

Choice A reason: Amber fluid is typically a sign of serous exudate, which is a normal part of the inflammatory process and wound healing. It indicates the body's immune response to the injury and is generally not a cause for concern unless the volume significantly increases or changes in appearance.

Choice B reason: Clear drainage, or serous fluid, is also a normal finding in wound healing. It indicates that the wound is exuding plasma, which helps to keep the wound moist and supports the healing process. This type of drainage is typically not worrisome unless there are other signs of infection or complications.

Choice C reason: Purulent, draining wound is a major concern as it indicates the presence of pus, which is often a sign of infection. Purulent drainage can be yellow, green, or brown and is usually thick and malodorous. The presence of pus suggests that there are bacteria or other pathogens in the wound, and immediate medical intervention is necessary to prevent further complications and promote healing.

Choice D reason: Blood-tinged fluid, or serosanguinous drainage, is common in fresh wounds or after debridement. It indicates a mixture of plasma and red blood cells and can be seen in the early stages of wound healing. While it is generally not alarming, the nurse should monitor the volume and changes in the drainage to ensure there are no signs of excessive bleeding or infection.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

In any clinical setting, which health care team member is responsible for developing an individualized plan of care that includes nursing diagnoses, interventions, and outcomes including the patient's self-management care plan?

Correct Answer is D

Explanation

The nurse is caring for a patient who has had a pressure injury. When assessing the wound, which finding causes the greatest concern for the nurse?

Correct Answer is C

Explanation

The nurse works in a clinic located in a community where many of the residents are Hispanic. Which strategy, if implemented by the nurse, would decrease health care disparities and promote health equity for this community?

Indicate which two tests might be prescribed for patients admitted with symptoms of cholecystitis? Select all that apply.

The nurse is caring for a patient who has nausea and vomiting. Which assessment data should be of most concern to the nurse?

The nurse provides postoperative care to a patient who underwent peripheral artery bypass surgery. Thirty minutes after the initial assessment, the nurse reassesses the patient and detects a change in the Doppler sound over a pulse. Which action should the nurse take?