when assessing a patient's neurologic status upon arrival to the emergency room, which reliable indicator would the nurse utilize first?

Dim vision.

Papilledema

Body temperature

Level of consciousness

Answer and Explanation

The Correct Answer is D

A.   Dim vision could be a sign of many conditions but is not the first indicator the nurse should assess for neurologic status.

B.   Papilledema (swelling of the optic disc) is a late sign of increased intracranial pressure and is not immediately available on assessment.
C.   Body temperature is important but not as directly related to the neurological status as LOC.
D.   The level of consciousness (LOC) is one of the most important initial indicators of a patient's neurologic status, as it helps assess brain function and the severity of potential neurological injury. A decrease in LOC can indicate significant brain injury or dysfunction.

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Correct Answer is A

Explanation

A. Damage to the right hemisphere, particularly the parietal and temporal lobes, can cause difficulty with recognition (prosopagnosia) and spatial awareness.
B. Right hemiparesis (weakness of the left side of the body) is common with left hemisphere damage, not right hemisphere damage.
C. Aphasia (language impairment) is typically associated with left hemisphere damage.
D. Difficulty reading (alexia) is more common with left hemisphere stroke, which controls language processing.

A. Manifestations preceded by a severe headache B. Gradual onset of several hours C. History of neurologic deficits lasting less than 1 hr D. Maintains consciousness

Correct Answer is A

Explanation

A. A hemorrhagic stroke, especially after a ruptured cerebral aneurysm, often presents with a sudden, severe headache. This headache is typically described as the "worst headache of my life."
B. Gradual onset of several hours is more typical of an ischemic stroke, not a hemorrhagic stroke.
C. History of neurologic deficits lasting less than 1 hour would suggest a transient ischemic attack (TIA), not a hemorrhagic stroke.
D. Maintains consciousness is not typical of a hemorrhagic stroke, as the client may lose consciousness or be altered in their mental status due to the bleeding.

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when assessing a patient's neurologic status upon arrival to the emergency room, which reliable indicator would the nurse utilize first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has had a stroke involving the right hemisphere. Which of the following alterations in function should the nurse expect?

Correct Answer is A

Explanation

A nurse is caring for a client who has had a hemorrhagic stroke following a ruptured cerebral aneurysm. Which of the following manifestations should the nurse expect?

Correct Answer is A

Explanation

A nurse is caring for a client who has aphasia following a stroke. A family member asks the nurse how she should communicate with the client. Which of the following responses by the nurse is appropriate?

A nurse is monitoring a client who had a cerebral aneurysm rupture. Which of the following findings should the nurse identify as a manifestation of increased intracranial pressure?

Which refractive error describes the vision of a patient for whom nearby objects are clear but objects at a distance are blurred?

A nurse is caring for a client who has increased intracranial pressure (ICP) following a closed- head injury. Which of the following actions should the nurse take?

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A nurse is caring for a client who had a stroke involving the left cerebral hemisphere. The nurse should monitor for which of the following findings?

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