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The nurse is caring for a client who was admitted 24 hours ago with a traumatic brain injury. Which medications would the nurse anticipate being prescribed to reduce cerebral edema and prevent a secondary brain injury? Select All That Apply

Morphine

Lactated Ringers

Selected Medications

Dexamethasone

Mannitol

Hypertonic saline

Furosemide

Answer and Explanation

Correct Answer : D,E,F,G

A. Morphine is typically used for pain relief, but it is not used to reduce cerebral edema.

B. Lactated Ringers is a balanced electrolyte solution, but it does not address the need for reducing cerebral edema.

D. Dexamethasone is a corticosteroid used to reduce inflammation and cerebral edema in cases of brain injury.

E. Mannitol is an osmotic diuretic used to reduce cerebral edema by drawing fluid out of the brain and into the bloodstream.

F. Hypertonic saline is used to increase serum osmolality, helping to pull water out of the brain and reduce edema.

G. Furosemide is a loop diuretic that can also help reduce cerebral edema by promoting diuresis.

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Correct Answer is C

Explanation

A. Heart rate of 134 bpm. A heart rate of 134 bpm is expected during a cardiac stress test, as the goal is to increase the heart rate to a target range to evaluate cardiac function under stress.

B. Mild shortness of breath. Mild shortness of breath is a common response to exercise and is not an indication to stop the test unless it becomes severe or is accompanied by other concerning symptoms like chest pain or cyanosis.

C. Three premature ventricular contractions in a row indicate a potential serious arrhythmia (ventricular tachycardia), which is a contraindication for continuing the stress test. This finding could place the client at risk for life-threatening cardiac events, such as ventricular fibrillation.

D. Blood pressure 152/88 mmHg. This is a slightly elevated but normal physiological response to exercise and does not warrant discontinuation of the test unless the blood pressure rises to dangerously high levels (e.g., >200/110 mmHg).

A. “There is some swelling in your right leg that is making you feel this way." B. "Your brain is responding to being inactive from the surgery." C. "Don't worry about your right foot. The pain will go away within a few days." D. "Your brain is still receiving impulses about your right foot."

Correct Answer is D

Explanation

A. “There is some swelling in your right leg that is making you feel this way.” Swelling would typically cause discomfort or pressure, but it would not be responsible for the sensation of pain in the amputated limb.

B. "Your brain is responding to being inactive from the surgery." This answer does not address the real cause of the pain, which is related to the brain's continued perception of the missing limb.

C. "Don't worry about your right foot. The pain will go away within a few days." Phantom limb pain is a common phenomenon after amputation and may persist long-term. Dismissing it is not appropriate.

D. "Your brain is still receiving impulses about your right foot." This is an accurate explanation for phantom limb pain. After amputation, the brain may still interpret sensations from the absent limb, causing pain or discomfort in the "missing" foot.

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The nurse is caring for a client who was admitted 24 hours ago with a traumatic brain injury. Which medications would the nurse anticipate being prescribed to reduce cerebral edema and prevent a secondary brain injury? Select All That Apply

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is monitoring a 53-year-old client who is undergoing a cardiac exercise stress test after experiencing an episode of angina. Which client finding will require the test to be discontinued?

Correct Answer is C

Explanation

The nurse is caring for a client who is postoperative following a right below-the-knee amputation. The client asks the nurse, " I keep having pain in my right foot. Why is that?" Which response would be appropriate for the nurse to make?

Correct Answer is D

Explanation

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