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A 68-year-old male presents to the emergency department with sudden onset of right-sided weakness and difficulty speaking. The symptoms resolved after 20 minutes. Which of the following are appropriate actions and considerations for this patient who has experienced a transient ischemic attack (TIA)?
(Select All that Apply.)

Assume the episode was a migraine and schedule a neurology follow-up for a later date.

Discharge the patient immediately since the symptoms resolved.

Initiate antiplatelet therapy, such as aspirin, to reduce the risk of future strokes.

Order a CT scan of the head to rule out intracranial hemorrhage.

Start anticoagulation therapy immediately without further evaluation.

Conduct a carotid ultrasound to assess for stenosis.

Refer the patient for lifestyle modifications, including smoking cessation and diet changes.

Answer and Explanation

Correct Answer : C,D,F,G

A.   Assuming the episode was a migraine and scheduling a follow-up is not appropriate. TIAs are serious warning signs of potential future strokes and require immediate attention and evaluation.
B.   Discharging the patient immediately after symptoms resolve is not appropriate. Even though symptoms resolve, TIAs are medical emergencies, and further evaluation is necessary to reduce the risk of a full-blown stroke.
C.   Initiating antiplatelet therapy, such as aspirin, is an appropriate action to reduce the risk of future strokes in patients who have had a TIA.
D.   Ordering a CT scan of the head is appropriate to rule out an intracranial hemorrhage and other causes of the symptoms.

E.   Starting anticoagulation therapy immediately without further evaluation is not recommended. The patient must be properly assessed before starting anticoagulation to determine the cause of the TIA and if anticoagulation is appropriate.
F.   Conducting a carotid ultrasound is appropriate to assess for stenosis, which could be contributing to the TIA.
G.   Referring the patient for lifestyle modifications, including smoking cessation and diet changes, is crucial to reduce future stroke risk. These interventions help prevent the recurrence of TIAs and strokes.

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Correct Answer is B

Explanation

A. Having the client breathe into a paper bag would help with respiratory alkalosis, not metabolic alkalosis.
B. Placing the client on seizure precautions is appropriate, as severe metabolic alkalosis can cause neurologic complications such as seizures.
C. Encouraging slow breathing may not significantly impact metabolic alkalosis.
D. Sodium bicarbonate administration would worsen metabolic alkalosis, not treat it.

A. Presence of anti-cyclic citrullinated peptide (anti-CCP) antibodies B. Elevated rheumatoid factor (RF) levels C. Decreased erythrocyte sedimentation rate (ESR) D. Elevated C-reactive protein (CRP) levels

Correct Answer is D

Explanation

A. Anti-cyclic citrullinated peptide (anti-CCP) antibodies are specific for rheumatoid arthritis but are not necessarily linked to disease activity.
B. Elevated rheumatoid factor (RF) levels are common in rheumatoid arthritis but not always indicative of disease activity.
C. A decreased erythrocyte sedimentation rate (ESR) is typically a sign of less inflammation, not more.
D. Elevated C-reactive protein (CRP) levels are a direct marker of inflammation and are often correlated with increased disease activity in rheumatoid arthritis.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has metabolic alkalosis. Which of the following actions should the nurse take?

Correct Answer is B

Explanation

A 55-year-old patient with rheumatoid arthritis is being evaluated for disease progression. Which of the following laboratory findings is most indicative of increased disease activity?

Correct Answer is D

Explanation

A nurse is assessing a client who has multiple sclerosis. The client reports that, since the onset of the disease, there are times when their symptoms are active and then followed by a period with no symptoms. Which of the following types of multiple sclerosis does this pattern indicate?

A 35-year-old female patient presents to the clinic with fatigue, pallor, and shortness of breath on exertion. Laboratory results reveal a hemoglobin level of 8 g/dL and a mean corpuscular volume (MCV) of 70 fL. Based on these findings, what is the most likely type of anemia?

A 60-year-old patient with a history of peptic ulcer disease is admitted to the hospital with complaints of coffee-ground emesis and melena. What is the nurse's most appropriate initial action?

A patient presents with numbness and tingling in the thumb, index, and middle fingers, and a positive Phalen's test. Which of the following interventions would be most appropriate to address the underlying cause of these symptoms?

A patient with a severe bacterial infection has been prescribed a continuous IV infusion of an antibiotic at a rate of 5 mg/kg/hour. The patient weighs 72 kg. The pharmacy provides the antibiotic in a concentration of 400 mg/100 mL what will be the infusion rate?

A nurse is assessing a patient diagnosed with peptic ulcer disease. Which findings would support this diagnosis? (Select All that Apply.)

A 65-year-old patient with a history of osteoarthritis reports increased pain and stiffness in the knees, particularly in the morning and after prolonged inactivity. Which intervention is most appropriate to recommend to this patient to help alleviate these symptoms?

A patient is diagnosed with gastritis after presenting with abdominal discomfort and nausea. As a nurse, which interventions would be appropriate for managing this patient's condition? (Select All that Apply.)