ADULT EDUCATION FINAL GUIDE WITH QUESTIONS AND 100% ACTUAL ANSWERS

ADULT EDUCATION FINAL GUIDE WITH QUESTIONS AND 100% ACTUAL ANSWERS What group should the nurse target when planning community education on preventing spinal cord injuries? a. Older men b. Teenage girls c. Elementary school-age children d. Adolescent and young men - ANSWER d. Adolescent and young men Primary or Secondary SCI? Ongoing progressive damage that occurs after injury. Causes further permanent damage - ANSWER Secondary Which type of seizure occurs in children, is also known as a petit mal seizure, and consists of a staring spell that lasts for a few seconds? a. Atonic b. Typical absence c. Atypical absence d. Focal impaired awareness - ANSWER b. Typical absence 1. A nurse is developing a plan of care for a client with nephrotic syndrome. The nurse documents that which important parameter needs to be assessed on a daily basis? a. Total protein levels b. Weight c. Blood urea nitrogen (BUN) d. Activity level - ANSWER B 1. A male patient with a diagnosis of Parkinson's disease (PD) has been admitted recently to a long-term care facility. Which action should the health care team take in order to promote adequate nutrition for this patient? a. Provide a diet that is low in complex carbohydrates and high in protein. b. Provide small, frequent meals throughout the day that are easy to chew and swallow c. Provide the patient with a minced or pureed diet that is high in potassium and low in sodium. d. Request placement of a feeding tube to prevent aspiration - ANSWER B 1. The nurse provides information to the caregiver of a 68-year-old man with epilepsy who has tonic-clonic seizures. Which statement, if made by the caregiver, requires further teaching? a. "It is normal for a person to be sleepy after a seizure. b. "I should call 911 if breathing stops during the seizure." c. "The jerking movements may last for 30 to 40 seconds." d. "Objects should not be placed in the mouth during a seizure." - ANSWER B Which of the following conditions can cause a hiatal hernia? 1. Increased intrathoracic pressure 2. Weakness of the esophageal muscle 3. Increased esophageal muscle pressure 4. Weakness of the diaphragmatic muscle - ANSWER D Risk factors for the development of hiatal hernias are those that lead to increased abdominal pressure. Which of the following complications can cause increased abdominal pressure? 1. Obesity 2. Volvulus 3. Constipation 4. Intestinal obstruction - ANSWER A The hospitalized client with GERD is complaining of chest discomfort that feels like heartburn following a meal. After administering an ordered antacid, the nurse encourages the client to lie in which of the following positions? 1. Supine with the head of the bed flat 2. On the stomach with the head flat 3. On the left side with the head of the bed elevated 30 degrees 4. On the right side with the head of the bed elevated 30 degrees. - ANSWER 3 A patient is admitted to the hospital with a C4 spinal cord injury after a motorcycle collision. The patient's blood pressure is 83/49 mm Hg and pulse is 39 beats/minute. He remains orally intubated. What is the cause of this pathophysiologic response? A. Increased vasomotor tone after the injury B. A temporary loss of sensation and flaccid paralysis below the level of injury C. Loss of parasympathetic nervous system innervation resulting in vasoconstriction D. Loss of sympathetic nervous system innervation resulting in peripheral vasodilation - ANSWER D. Loss of sympathetic nervous system innervation resulting in peripheral vasodilation What are the goals of rehabilitation for the patient with an injury at the C6 level (select all that apply)? A. Stand erect with leg brace B. Feed self with hand devices C. Drive an electric wheelchair D. Assist with transfer activities E. Drive adapted van from wheel chair - ANSWER B. Feed self with hand devices C. Drive an electric wheelchair D. Assist with transfer activities E. Drive adapted van from wheel chair A 68-year-old patient with a spinal cord injury has a neurogenic bowel. Beyond the use of bisacodyl (Dulcolax) suppositories and digital stimulation, which measures should the nurse teach the patient and the caregiver to assist the patient with bowel evacuation (select all that apply)? A. Drink more milk. B. Eat 20-30 g of fiber per day. C. Use oral laxatives every day. D. Drink 1800 to 2800 mL of water or juice. E. Establish bowel evacuation time at bedtime. - ANSWER B. Eat 20-30 g of fiber per day. D. Drink 1800 to 2800 mL of water or juice. A 58-yr-old woman is 1-day postoperative after an abdominal hysterectomy. Which intervention should the nurse perform to prevent deep vein thrombosis (DVT)? Place the patient in a high Fowler's position. Provide pillows to place under the patient's knees. Encourage the patient to change positions frequently. Teach the patient deep breathing and coughing exercises. - ANSWER Encourage the patient to change positions frequently. The health care provider is considering the use of sumatriptan for a 54 year old male patient with migraine headaches. Which information obtained by the nurse is most important to report to the healthcare provider? A. The patient drinks 1 to 2 cups of coffee lately B. The patient had a recent acute myocardial infarction C. The patient has had migraine headaches for 30 years D. The patient has taken Topamax for 2 months - ANSWER B. The patient had a recent acute myocardial infarction triptans cause coronary artery vasoconstriction and should be avoided in patients with coronary artery disease The nurse observes a patient ambulating in the hospital hall when the patient's arms and legs suddenly jerk and the patient falls to the floor. The nurse will first A. Assess the patient for a possible head injury B. Give the scheduled dose of divalproex C. Document the timing and description of the seizure D. Notify the patients HCP about the seizure - ANSWER A. Assess the patient for a possible head injury Which prescribed intervention will the nurse implement first for a patient in the emergency department who is experiencing continuous tonic-clonic seizures? a. Give phenytoin (Dilantin) 100 mg IV. b. Monitor level of consciousness (LOC). c. Obtain computed tomography (CT) scan. d. Administer lorazepam (Ativan) 4 mg IV. - ANSWER d. Administer lorazepam (Ativan) 4 mg IV. benzo first line for status epilepticus Family members of a patient who has a traumatic brain injury ask the nurse about the purpose of the ventriculostomy system being used for intracranial pressure monitoring. Which response by the nurse is best for this situation? a. "This type of monitoring system is complex and it is managed by skilled staff." b. "The monitoring system helps show whether blood flow to the brain is adequate." c. "The ventriculostomy monitoring system helps check for alterations in cerebral perfusion pressure." d. "This monitoring system has multiple benefits including facilitation of cerebrospinal fluid drainage." - ANSWER ANS: B The patient is diagnosed with focal impaired awareness seizures. Which characteristics are related to this type of seizures (select all that apply)? a. Formerly known as "grand mal" seizures b. Often accompanied by incontinence or tongue or cheek biting c. Psychomotor seizures with repetitive behaviors and lip smacking d. Altered memory, sexual sensations, and distortions of visual or auditory sensations e. Loss of consciousness and stiffening of the body with subsequent jerking of extremities f. Often involves behavioral, emotional, and cognitive functions with altered consciousness - ANSWER c. Psychomotor seizures with repetitive behaviors and lip smacking d. Altered memory, sexual sensations, and distortions of visual or auditory sensations f. Often involves behavioral, emotional, and cognitive functions with altered consciousness Which condition is most likely to cause death for the patient? a. Status epilepticus b. Myoclonic seizures c. Subclinical seizures d. Psychogenic seizures - ANSWER a. Status epilepticus A patient admitted to the hospital following a generalized tonic-clonic seizure asks the nurse what caused the seizure. What is the best response by the nurse? a. "So many factors can cause epilepsy that it is impossible to say what caused your seizure." b. "Epilepsy is an inherited disorder. Does anyone else in your family have a seizure disorder?" c. "In seizures, some type of trigger causes sudden, abnormal bursts of electrical brain activity" d. "Scar tissue in the brain alters the chemical balance, creating uncontrolled electrical discharges." - ANSWER c. "In seizures, some type of trigger causes sudden, abnormal bursts of electrical brain activity" A patient with seizure disorder is being evaluated for surgical treatment of the seizures. What should the nurse recognize as one of the requirements for surgical treatment? a. Identification of scar tissue that is able to be removed b. An adequate trial of drug therapy that had unsatisfactory results c. Development of toxic syndromes from long-term use of antiseizure drugs d. The presence of symptoms of cerebral degeneration from repeated seizures - ANSWER b. An adequate trial of drug therapy that had unsatisfactory results The patient is taking antiseizure drugs. Which method should the nurse teach the patient is most commonly used to assess compliance and monitor for drug toxicity? A. A daily seizure log B. Urine testing for drug levels C. Blood testing for drug levels D. Monthly EEG - ANSWER C. Blood testing for drug levels When teaching a patient with a seizure disorder about the medication regimen, what is most important for the nurse to emphasize? a. The patient should increase the dosage of the medication if stress is increased b. Most over-the-counter and prescription drugs are safe to take with antiseizure drugs c. Stopping the medication abruptly may increase the intensity and frequency of seizures d. If gingival hypertrophy occurs, the HCP should be notified and the drug may be changed - ANSWER c. Stopping the medication abruptly may increase the intensity and frequency of seizures During the diagnosis and long-term management of a seizure disorder, the nurse recognizes that one of the major needs of the patient is assistance to: a. Manage the complicated drug regimen of seizure control b. Cope with the effects of negative social attitudes toward epilepsy c. Adjust to the very restricted lifestyle required by a diagnosis of epilepsy d. Learn to minimize the effect of the condition in order to obtain employment - ANSWER b. Cope with the effects of negative social attitudes toward epilepsy A patient at the clinic for a routine health examination mentions that she is exhausted because her legs bother her so much at night that she cannot sleep. The nurse's questions about the patient's leg symptoms should be based on what knowledge of restless legs syndrome? a. The condition can be readily diagnosed with EMG b. Other more serious nervous system dysfunctions may be present c. Dopaminergic agents are often effective in managing the symptoms d. Symptoms can be controlled by vigorous exercise of the legs during the day - ANSWER c. Dopaminergic agents are often effective in managing the symptoms Primary or Secondary SCI Results from direct physical trauma to the spinal cord. Either blunt or penetrating trauma - ANSWER Primary Primary or Secondary SCI Trauma from the injury can cause spinal cord compression, bone displacement, interruption of the blood supply, or distraction from pulling - ANSWER Primary Primary or Secondary SCI Results in edema, ischemia, and inflammation- causes cell death, demyelination, and increased deficits. - ANSWER Secondary Damage to the motor neurons in the frontal cortex or their tracts results in.... - ANSWER Upper motor neuron deficits The upper motor neurons transmit information from the brain to the _____________________. - ANSWER spinal cord The lower motor neurons transmit information from the spinal cord to the ______________. - ANSWER Skeletal muscles Upper motor neuron deficits are characterized by - ANSWER -spastic paralysis -minimal muscle atrophy -weakness -HYPER-reflexic -diminished or absent deep tendon reflex -Babinski sign Injuries to the neurons or their fibers in the ventral horn of the cord result in - ANSWER lower motor neuron deficits Lower motor neuron deficits include - ANSWER -Flaccid paralysis- loss of movement, tone, and reflex activity -No signal is getting to the muscles, so no response to stimulation -Muscle atrophy -Diminished or absent reflexes The following description best describes...? -Occurs directly after spinal cord injury -Masks post-injury neurologic function- complicates neuro exam -Lasts days to weeks -Characterized by changes below the level of injury- decreased reflexes, loss sensation, and flaccid paralysis - ANSWER Spinal Shock The following best describes...? -Occurs in most people with SCI -Entire cord below the level of the lesion is in flaccid paralysis and hypomotility (no reflex activity) - ANSWER Spinal Shock The following best describes...? -Occurs with cervical and high thoracic injuries (T6 or higher) -Lasts multiple weeks -Causes peripheral vasodilation which manifests as hypotension, bradycardia, and temperature dysregulation - ANSWER Neurogenic Shock A construction worker fell from a two story building. Upon admission, vital signs are HR 40, BP 84/40, RR 14, T 95. His lower extremities are flaccid, bowel sounds absent and his bladder is distended. Based on the assessment findings, the patient is exhibiting: a. Neurogenic shock b. Autonomic dysreflexia c. Central cord syndrome d. Tetraplegia - ANSWER a. Neurogenic shock A 70-year-old patient is admitted after falling from his roof. He has an SCI at the C7 level. What assessment finding would indicate the presence of spinal shock? a. Paraplegia with flaccid paralysis b. Tetraplegia with total sensory loss c. Total hemiplegia with sensory and motor loss d. Spastic tetraplegia with loss of pressure sensation. - ANSWER b. Tetraplegia with total sensory loss Spastic tetraplegia with loss of pressure sensation= spinal shock A patient with SCI has spinal shock. The nurse plans care for the patient based on what knowledge? a. Rehabilitation measures cannot be started until the spinal shock has resolved b. The patient needs continuous monitoring for hypotension, tachycardia, and hypoxemia c. Resolution of the spinal shock is manifested by spasticity, reflex return, and neurogenic bladder d. Patient will have complete loss of motor and sensory functions below the level of the injury, but autonomic functions are not affected. - ANSWER c. Resolution of the spinal shock is manifested by spasticity, reflex return, and neurogenic bladder