The nurse is preparing to collect data for a patient's neurological status. What equipment should the nurse gather?
Blood pressure cuff
Pen light
Thermometer
Stethoscope
The Correct Answer is B
A. A blood pressure cuff is not directly needed to assess neurological status. While blood pressure is important to monitor in neurological assessments, it is not the primary tool used for assessing neurological function.
B. A pen light is essential for assessing pupil reaction, which is a key part of a neurological exam. The nurse can use the pen light to check for pupil dilation, constriction, and reaction to light, which are important indicators of brain function.
C. A thermometer is useful for measuring body temperature but is not a primary tool for assessing neurological status. Although fever can be a sign of infection affecting the brain, it is not part of the basic neurological exam.
D. A stethoscope is useful for listening to heart and lung sounds, but it is not typically used for assessing neurological function. The pen light is the more appropriate tool for this purpose.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","D","E"]
Explanation
A. Neck stiffness is a common symptom of a herniated cervical disc due to irritation of the surrounding tissues and nerve roots.
B. Pain in the neck is one of the hallmark symptoms of a cervical disc herniation, as the disc presses on the nerves in the cervical spine.
C. Low back pain is typically associated with lumbar disc herniation, not cervical disc herniation. A herniated cervical disc would more likely cause symptoms in the neck, shoulders, and arms.
D. Shoulder pain is a common symptom of a herniated cervical disc because the nerves that are compressed in the cervical spine also innervate the shoulders.
E. Tingling in the arms is a common symptom of a herniated cervical disc, as the disc can compress the nerves that supply sensation to the arms, leading to numbness and tingling.
Correct Answer is D
Explanation
A. Educating the client on anticonvulsant medications is important, but it is not the priority during an active seizure. Education should be provided after the seizure has ended.
B. Monitoring vital signs is important but should not be the immediate priority during a seizure. The nurse should focus on airway management first.
C. Restraining the client is contraindicated during a seizure. Restraining can cause injury to both the client and the nurse. The focus should be on protecting the client from harm.
D. The prevention of occlusion of the airway or aspiration is the priority. During a tonic-clonic seizure, there is a risk of the client choking, biting their tongue, or having difficulty breathing. The nurse should ensure the airway is open, prevent aspiration, and protect the client from injury during the seizure.
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