The nurse is assisting the physician in completing a lumbar puncture. Which would the nurse note as a concern?

Client states a piercing feeling.

Physician maintains aseptic procedure.

Client states pressure relief in the head.

Cerebrospinal fluid is cloudy in nature.

Answer and Explanation

The Correct Answer is D

Cerebrospinal fluid is cloudy in nature. Cloudy cerebrospinal fluid is a sign of infection or inflammation in the central nervous system, and lumbar puncture can be used to obtain cerebrospinal fluid for diagnostic purposes. The nurse should report this finding immediately to the physician for further evaluation and management.

Choice A, client states a piercing feeling, is incorrect because a piercing feeling is common during the procedure due to the insertion of the needle into the subarachnoid space.

Choice B, physician maintains aseptic procedure, is incorrect because maintaining aseptic technique during the procedure is standard protocol to prevent infection.

Choice C, client states a pressure relief in the head, is incorrect because this is not a concerning finding during the procedure.

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Correct Answer is C

Explanation

Tendon. A tendon is a fibrous connective tissue that connects muscle to bone. Musculoskeletal injuries that involve tendons can result from overuse, trauma, or degeneration. Tendinitis, for example, is a common condition characterized by inflammation of a tendon.

Choice A, Joint, is incorrect because a joint is the point of articulation between two or more bones.

Choice B, Cartilage, is incorrect because cartilage is a tough, flexible connective tissue that cushions joints and supports various structures in the body.

Choice D, Ligament, is incorrect because a ligament is a fibrous connective tissue that connects bone to bone and provides stability to joints.

A. Tissue hypoxia. B. Cardiac failure. C. Hypovolemia. D. Infection.

Correct Answer is C

Explanation

Hypovolemia. Following a serious thermal burn, the nurse takes action to prevent hypovolemia, which can result from fluid loss due to the burn. Hypovolemia can lead to hypoperfusion of vital organs, including the kidneys, and can cause acute renal failure. Preventing hypovolemia is critical to preventing other complications such as tissue hypoxia, cardiac failure, and infection.

A. Tissue hypoxia and cardiac failure are consequences of hypovolemia due to decreased blood flow to organs.

D. Infection is not the immediate complication to prevent but is a potential complication following burn injury.

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The nurse is assisting the physician in completing a lumbar puncture. Which would the nurse note as a concern?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client experiences a musculoskeletal injury that involves the structure that connects a muscle to the bone. The nurse understands that this injury involves which of the following?

Correct Answer is C

Explanation

Following a serious thermal burn, which complication will the nurse take action to prevent first?

Correct Answer is C

Explanation

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