The nurse learns in report that a client is stuporous. Which assessment should the nurse perform to confirm this report?
Observe for any facial asymmetry.
Determine the response to stimuli.
Assess for a positive Romberg sign.
Check the pupillary response to light.
The Correct Answer is B
A. Facial asymmetry may indicate neurological issues, but it does not directly assess the stuporous state.
B. A stuporous state is characterized by a reduced level of consciousness, and the nurse should assess
the client’s response to stimuli to confirm the report of stupor.
C. A positive Romberg sign indicates a balance issue, but it is not directly related to confirming a stuporous state.
D. While pupillary response is important, it does not provide sufficient information to confirm a stuporous state without assessing responsiveness to stimuli.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. A lifestyle with minimal physical activity may contribute to general health issues, but it is not as directly linked to erectile dysfunction as conditions like diabetes.
B. Working long hours can cause stress or fatigue, which may indirectly affect sexual function, but it is not a direct cause of erectile dysfunction.
C. Type 2 diabetes mellitus is a well-known risk factor for erectile dysfunction due to its impact on blood flow and nerve function, both of which are essential for normal erectile function.
D. A phosphodiesterase inhibitor is often used to treat erectile dysfunction, but its presence on the medication list is more likely a treatment rather than a cause.
Correct Answer is ["A","C"]
Explanation
WRIST - ABLE TO BEND WRIST BACK TOWARD FOREARM:
Abduction
Abduction refers to the movement of a body part away from the body's midline. This movement is typically used for fingers, arms, or legs, but not for the wrist. Therefore, this choice is incorrect for the wrist's range of motion.
Flexion
Flexion refers to the bending of a joint that reduces the angle between two body parts. For the wrist, flexion would involve bending the wrist forward, toward the palm of the hand. Since the patient is able to bend the wrist backward (toward the forearm), this is not the correct choice.
Extension
Extension refers to straightening a joint, which increases the angle between the body parts. For the wrist, extension is the movement where the hand moves away from the palm (backward toward the forearm). This is the correct choice because the patient is able to bend the wrist back toward the forearm, which is extension.
Adduction
Adduction refers to the movement of a body part toward the body's midline. This is not relevant to the wrist, so it is an incorrect option.
SHOULDER - UNABLE TO MOVE THE ARM AWAY FROM THE BODY:
Extension
Extension refers to the movement that straightens a joint, increasing the angle between two parts of the body. For the shoulder, this would involve moving the arm behind the body, and it's not the movement of the arm away from the body, so this is not the correct choice.
Adduction
Adduction refers to moving a body part toward the midline of the body. For the shoulder, this would involve moving the arm closer to the body. This does not correspond to the action of moving the arm away from the body, so this is not the correct choice either.
Flexion
Flexion refers to the bending of a joint that decreases the angle between two body parts. For the shoulder, this would involve raising the arm forward, not moving it away from the body. This is not the correct choice for the described movement.
Abduction
Abduction refers to the movement of a body part away from the midline of the body. In this case, the shoulder movement of moving the arm away from the body is abduction. Since the client is unable to move the arm away from the body (i.e., is experiencing weakness or limited ROM), the shoulder’s range of motion has a restriction in abduction.
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