The nurse observes that a client with Parkinson’s disease (PD) has a mask-like face. Which follow-up assessment is most important for the nurse to implement?

Note the frequency of drooling.

Observe the appearance of oral mucosa.

Assess patterns of speech.

Determine the ability to chew and swallow.

Answer and Explanation

The Correct Answer is D

Choice A reason: While noting the frequency of drooling is important, it is not the most critical assessment.
Choice B reason: Observing the appearance of oral mucosa is less critical than assessing the ability to swallow.
Choice C reason: Assessing speech patterns is important but secondary to swallowing ability in terms of immediate safety.
Choice D reason: This is the correct choice. The ability to chew and swallow is crucial for preventing aspiration and maintaining nutrition.

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Correct Answer is A

Explanation

Choice A reason: This is the correct choice. An 8-year-old is typically capable of understanding and using PCA effectively, especially after a major surgery like spinal fusion.
Choice B reason: A 6-year-old may not fully understand how to use PCA and could be at risk for under or overdosing.
Choice C reason: While a 10-year-old could use PCA, the presence of a concussion may impair their ability to use it properly.
Choice D reason: A 16-year-old with Down Syndrome may have cognitive impairments that could hinder the safe use of PCA.

A. High-pitched cry. B. Decreased lower extremity movement. C. Excessive wet diapers. D. Bulging fontanel when crying.

Correct Answer is D

Explanation

Choice A reason: A high-pitched cry can be a sign of distress in an infant, but it is not a specific indicator of increased intracranial pressure. It could be due to a variety of reasons, including discomfort, hunger, or other forms of distress.
Choice B reason: Decreased lower extremity movement could be a sign of a neurological issue, but it is not a direct indicator of increased intracranial pressure. It would require further evaluation to determine the cause.
Choice C reason: Excessive wet diapers are not typically associated with increased intracranial pressure. This symptom could be related to other conditions such as diabetes insipidus or excessive fluid intake.
Choice D reason: This is the correct choice. A bulging fontanel when crying is a classic sign of increased intracranial pressure in an infant. The fontanel, or soft spot on the baby's head, can bulge when there is increased pressure within the skull. This should be promptly evaluated by a healthcare professional.

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The nurse observes that a client with Parkinson’s disease (PD) has a mask-like face. Which follow-up assessment is most important for the nurse to implement?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

In a pediatric surgical unit, when discussing patient-controlled analgesia (PCA) in a preoperative parental meeting, which client would be the most appropriate candidate for PCA?

Correct Answer is A

Explanation

What notable sign most likely indicates increased intracranial pressure in an infant?

Correct Answer is D

Explanation

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