The home health nurse is instructing a caregiver about caring for a patient with hypothermia. The nurse recognizes that further instruction when the caregiver states, "I will

instruct the patient to remain on strict bed rest

provide the patient with additional blankets"

encourage the patent to increase his muscle activity”

offer fluids to the patient if permitted

Answer and Explanation

The Correct Answer is C

A.   Keeping the patient on bed rest is appropriate as it conserves energy and helps prevent further heat loss.
B.   Providing additional blankets is a correct intervention to warm the patient gradually.
C.   Increasing muscle activity is contraindicated because it could cause vasoconstriction and worsen hypothermia, as the body focuses on preserving core temperature.
D.   Offering fluids (if permitted) is correct as hydration can help restore normal body temperature regulation.

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Correct Answer is B

Explanation

A. Bradycardia is defined as a heart rate lower than 60 beats per minute. Therefore, 62 beats per minute is not bradycardic.
B. 59 beats per minute would be considered bradycardic, as it is below 60.
C. 64 beats per minute is within normal limits.
D. 60 beats per minute is on the threshold of bradycardia but typically is still within normal limits for some individuals.

A. the state of consciousness. B. if the shape is regular. C. whether one pupil is larger than the other. D. if they have become smaller.

Correct Answer is C

Explanation

A. While pupil response can be an indicator of consciousness, the primary concern when assessing pupils is to check for signs of increased intracranial pressure, such as unequal pupil size.
B. The shape of the pupil is important to assess, but the concern here is typically more about the size and response to light, which can indicate a neurological issue.
C. Unequal pupil sizes (anisocoria) can indicate neurological problems, such as increased intracranial pressure or brain injury, and requires further evaluation.
D. Pupil size changes could indicate a variety of issues, but the focus should be on detecting unequal pupils, which can be a critical sign in head injury patients.

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The home health nurse is instructing a caregiver about caring for a patient with hypothermia. The nurse recognizes that further instruction when the caregiver states, "I will

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Naxlex Comprehensive Predictor Exams

The nurse would record a pulse as bradycardic if the rate were:

Correct Answer is B

Explanation

A 16-year-old patient sustained a head injury while playing soccer. When performing a neurologic check, the nurse looks at each pupil to determine

Correct Answer is C

Explanation

The nurse is informed that a patient had abnormal heart sounds during the night shift. When auscultating abnormal heart sounds, the nurse knows to listen to heart sounds with the:

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