Which neurologic finding would be considered abnormal in an 88-year-old patient?

Dizziness and problems with balance

Slow papillary response to light

Jerky eye movements

Absence of the Achilles tendon jerk

Answer and Explanation

The Correct Answer is D

A. Dizziness and problems with balance

While dizziness and problems with balance can occur more frequently in older adults due to age-related changes in the vestibular system and other factors, persistent or severe dizziness or balance issues should be evaluated further as they could indicate underlying neurological or medical conditions.

B. Slow papillary response to light

This finding may be considered abnormal, especially if it represents a significant change from the individual's baseline. While age-related changes in pupil function can occur, a slow or sluggish pupillary response to light may indicate dysfunction of the oculomotor nerve or other neurological issues and should be investigated further.

C. Jerky eye movements

Jerky eye movements, such as nystagmus, can be abnormal and may indicate dysfunction of the vestibular system or other neurological conditions. While some degree of nystagmus can occur with age, persistent or severe jerky eye movements should be evaluated further.

D. Absence of the Achilles tendon jerk

This finding may also be considered abnormal. The Achilles tendon reflex, tested using the deep tendon reflex (DTR) examination, can diminish with age but should not be completely absent in the absence of specific medical conditions affecting the reflex arc or spinal cord function.

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Correct Answer is A

Explanation

A. "Incorporate nonverbal cues in the conversation."

This is an appropriate response. Nonverbal cues, such as gestures, facial expressions, and body language, can help convey meaning and support comprehension for individuals with aphasia. Using visual aids or pointing to objects can also enhance communication.

B. "Ask multiple choice questions as part of the conversation."

While multiple choice questions can be helpful in some situations, they may not always be appropriate for individuals with aphasia. It's important to assess the client's specific communication needs and preferences. Open-ended questions and simple, direct language may be more effective for facilitating communication.

C. "Use a higher-pitched tone of voice when speaking."

Altering the tone of voice may not necessarily improve communication for individuals with aphasia. Instead, it's important to speak in a clear, natural tone at a moderate pace. Speaking too loudly or using a higher-pitched voice may be perceived as patronizing or condescending.

D. "Use simple child-like statements when speaking."

While it's important to use simple and clear language, using child-like statements may be inappropriate and demeaning to the client. Respectful communication that acknowledges the individual's intelligence and dignity is essential. Simplify language and sentences as needed, but avoid speaking down to the client.

A. The client should maintain systolic BP between 120 and 129 mm Hg. B. The client should maintain systolic BP between 130 and 135 mm Hg. C. The client should maintain systolic BP between 136 and 140 mm Hg. D. The client should maintain systolic BP between 141 and 145 mm Hg. E. Note the time the seizure started

Correct Answer is A

Explanation

A. The client should maintain systolic BP between 120 and 129 mm Hg.

This is an appropriate recommendation. The American Heart Association (AHA) guidelines recommend maintaining systolic BP below 130 mm Hg to reduce the risk of stroke and other cardiovascular events in individuals with a history of stroke or TIA.

B. The client should maintain systolic BP between 130 and 135 mm Hg.

This is slightly above the recommended range. While systolic BP below 135 mm Hg is generally recommended for individuals with a history of stroke or TIA, a range of 130-135 mm Hg may still be acceptable based on individual patient factors and risk assessments.

C. The client should maintain systolic BP between 136 and 140 mm Hg.

This is above the recommended range. Systolic BP between 136 and 140 mm Hg may be considered elevated and should be managed to lower levels to reduce the risk of recurrent TIA or stroke.

D. The client should maintain systolic BP between 141 and 145 mm Hg.

This is above the recommended range. Systolic BP above 140 mm Hg is generally considered elevated and should be managed to lower levels to reduce the risk of recurrent TIA or stroke.

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Which neurologic finding would be considered abnormal in an 88-year-old patient?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nursing 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 is an appropriate response by the nurse?

Correct Answer is A

Explanation

A nurse is providing discharge instruction to a client who has hypertension that has resulted in a transient ischemic attack (TIA). Which of the following information should the nurse discuss with the client regarding blood pressure (BP) management?

Correct Answer is A

Explanation

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Which neurologic finding would be considered abnormal in an 88-year-old patient?

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