Which behaviors by the patient diagnosed with a chronic head injury would the nurse expect to find?

Being increasingly non-compliant with therapeutic care plans.

Playing chess with fellow patients within one week of admission.

Difficulty planning and organizing thoughts and behaviors.

Ability to process multiple pieces of information at the same time.

Answer and Explanation

The Correct Answer is C

Choice A rationale

Chronic head injuries can impair judgment, leading to non-compliance with care plans due to reduced awareness and impulse control. However, non-compliance alone is not a definitive behavioral characteristic of chronic head injury.

Choice B rationale

Rapid engagement in cognitively demanding tasks like chess within a week suggests intact neurological and cognitive function, which contradicts the expected deficits in chronic head injury patients.

Choice C rationale

Chronic head injuries commonly affect the frontal lobe, impairing executive functions such as planning, organizing, and controlling thoughts and behaviors. These deficits result from damage to neural pathways crucial for these cognitive tasks.

Choice D rationale

The ability to process multiple pieces of information simultaneously requires intact cognitive functioning, typically disrupted in chronic head injuries due to neuronal damage, particularly in the prefrontal cortex.

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Correct Answer is A

Explanation

Choice A rationale

Hemiparesis on the right side and ataxia are common manifestations of left-sided stroke, where the motor cortex affecting the contralateral side is impaired, leading to muscle weakness and coordination loss.

Choice B rationale

Spasticity of the left arm suggests motor impairment on the ipsilateral side, which is inconsistent with the nature of left-sided strokes affecting the contralateral side. Apraxia lacks relation to motor loss here.

Choice C rationale

Impulsive behavior and hostility are more indicative of frontal lobe involvement, not motor loss secondary to left-sided strokes. These behaviors do not represent motor manifestations.

Choice D rationale

Visual defects like homonymous hemianopia and diplopia may occur in stroke but are not direct indicators of motor loss. They relate to occipital lobe or optic pathway damage.

A. T98.7 F (36.4 C), BP 220/46, HR 30, RR 6, O2 Sat 98% Room Air. B. T92.5 F (33.6 C), BP 90/64, HR 80, RR 14, O2 Sat 97% Room Air. C. T103.1 F (39.5 C), BP 82/50, HR 132, RR 30, O2 Sat 99% Room Air. D. T98.6 F (37 C), BP 200/94, HR 90, RR 18, O2 Sat 100% Room Air.

Correct Answer is A

Explanation

Choice A rationale

Extremely high systolic BP (220 mmHg), bradycardia (HR 30), and altered respirations (RR 6) suggest Cushing's triad, a hallmark of increased ICP due to severe brain injury.

Choice B rationale

Hypothermia (T92.5°F) and hypotension (BP 90/64) do not indicate increased ICP but may result from shock or hypothermic conditions affecting autonomic responses.

Choice C rationale

Hyperthermia (T103.1°F) and tachycardia (HR 132) are commonly seen in infection or hypermetabolic states, not directly pointing to raised ICP.

Choice D rationale

Mild hypertension (BP 200/94) with normal HR (90) and RR (18) does not fit the classic signs of increased ICP like Cushing's triad.

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Which behaviors by the patient diagnosed with a chronic head injury would the nurse expect to find?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client experiencing motor loss as the result of a left-sided stroke.Which clinical manifestations would the nurse document?

Correct Answer is A

Explanation

The nurse is caring for a patient with an acute brain injury.Which of the following sets of vital signs would concern the nurse about increasing intracranial pressure (ICP)?

Correct Answer is A

Explanation

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