The nurse is conducting an assessment on a patient suspected of having a stroke. Which assessment finding is most indicative of a stroke?
Facial droop
Dysrhythmias
Periorbital edema
Projectile vomiting
The Correct Answer is A
Choice A rationale
Facial droop is a classic symptom of stroke. It occurs when there’s weakness or paralysis on one side of the face, which is caused by a disruption in the nerve signals due to a stroke. This can be easily observed in the person’s smile, as it will appear uneven.
Choice B rationale
While dysrhythmias can be associated with stroke, they are not the most indicative symptom. Dysrhythmias are more commonly associated with heart conditions.
Choice C rationale
Periorbital edema, or swelling around the eyes, is not typically a symptom of stroke. It can be caused by various conditions such as allergies, infections, or kidney problems.
Choice D rationale
Projectile vomiting is not typically a symptom of stroke. It can be caused by various conditions such as gastrointestinal issues, brain tumors, or increased intracranial pressure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["35 "]
Explanation
Step 1 is to calculate the total daily dosage in milligrams. This is done by multiplying the weight of the client by the ordered daily dosage. So, 70 kg × 25 mg/kg = 1750 mg/day.
Step 2 is to divide the total daily dosage by the number of doses per day to get the dosage per dose. So, 1750 mg ÷ 2 = 875 mg/dose.
Step 3 is to calculate the volume of the dose in milliliters. The supply of Amoxicillin is 125 mg/5 mL, which means there are 125 mg of Amoxicillin in every 5 mL. So, to find out how many milliliters contain 875 mg, we set up a proportion: (125 mg / 5 mL) = (875 mg / x mL). Solving for x gives x = (875 mg × 5 mL) ÷ 125 mg = 35 mL. Therefore, the correct dosage for one dose is 35 mL.
Correct Answer is A
Explanation
Choice A rationale
Maintaining a patent airway is the highest priority when providing care for a patient in status epilepticus. Status epilepticus is a medical emergency characterized by prolonged or recurrent seizures. It can lead to severe complications, including respiratory distress and hypoxia.
Therefore, ensuring a patent airway is crucial to prevent hypoxia and further brain damage. This involves positioning the patient to prevent aspiration, potentially suctioning the airway, and providing supplemental oxygen as needed.
Choice B rationale
While placing an intravenous catheter (IV) is an important intervention, it is not the highest priority. An IV allows for the administration of medications and fluids, which are necessary in the management of status epilepticus. However, it is secondary to maintaining a patent airway.
Choice C rationale
Administering diazepam or other antiepileptic drugs is a key intervention in managing status epilepticus. These medications help to stop the seizures. However, medication administration should only occur after a patent airway has been established.
Choice D rationale
Inserting a nasogastric tube (NG) may be necessary in some cases to protect the airway or for administering medications or nutrition. However, this is not the highest priority intervention. The first step in managing status epilepticus is always to ensure a patent airway.
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