A client who has suffered a stroke is unable to maintain respiration and is intubated and placed on mechanical ventilator support.

What portion of the brain is most likely responsible for the inability to breathe?

Brain stem.

Parietal lobe.

Occipital lobe.

Frontal lobe.

Answer and Explanation

The Correct Answer is A

Choice A rationale

The brain stem controls vital functions, including respiration. Damage to the brain stem, especially the medulla oblongata, can impair respiratory control, leading to the need for mechanical ventilation.

Choice B rationale

The parietal lobe is responsible for sensory processing and does not directly influence respiratory functions. Damage here would more likely affect sensation and spatial awareness.

Choice C rationale

The occipital lobe is primarily responsible for visual processing. Injury to this area would result in visual deficits rather than impaired respiration.

Choice D rationale

The frontal lobe is involved in cognitive functions, voluntary movement, and speech production, but it does not control respiration. Damage here would affect higher cognitive functions and motor planning.

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Correct Answer is D

Explanation

Choice A rationale

Pressing the bones on the neck does not adequately assess for rigidity and may cause discomfort without providing useful information about the neurologic status.

Choice B rationale

Moving the head toward both sides is a method used to assess range of motion but does not specifically assess for neck rigidity, which requires specific positioning and movement.

Choice C rationale

Lightly tapping the lower portion of the neck to detect sensation does not assess for rigidity; it may be used to test sensory function rather than muscular stiffness or tension.

Choice D rationale

Moving the head and chin toward the chest is the standard method to assess for neck rigidity, especially in cases of suspected meningitis. This movement can reveal stiffness or resistance, which are key indicators of neurologic involvement.

A. Wound size. B. Wound bed. C. Periwound skin. D. Pattern of eruption.

Correct Answer is ["A","B","C"]

Explanation

Choice A rationale

Documenting wound size includes measuring the length, width, and depth of the wound to track the healing process and plan appropriate interventions.

Choice B rationale

The wound bed should be assessed for tissue type (granulation, slough, or eschar), color, and the presence of any exudate or infection.

Choice C rationale

The periwound skin is the area around the wound which should be assessed for color, temperature, swelling, and signs of maceration or excoriation.

Choice D rationale

Pattern of eruption is more relevant to dermatological conditions such as rashes or lesions, and not a primary focus for documenting acute open wounds.

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A client who has suffered a stroke is unable to maintain respiration and is intubated and placed on mechanical ventilator support. What portion of the brain is most likely responsible for the inability to breathe?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is performing the physical examination of a client with a suspected neurologic disorder. In addition to assessing other parts of the body, the nurse should assess for neck rigidity. Which method should help the nurse assess for neck rigidity correctly?

Correct Answer is D

Explanation

The nurse documenting an acute open wound should include which characteristics? Select all that apply.

Correct Answer is ["A","B","C"]

Explanation

A client is diagnosed with a brain tumor. The nurse's assessment reveals that the client has difficulty interpreting visual stimuli. Based on these findings, the nurse suspects injury to which lobe of the brain?

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Pressure ulcers are caused by:

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The nurse is assessing a client with toxic epidermal necrolysis (TEN). What assessment data would indicate that the client may be progressing to keratoconjunctivitis? Select all that apply.

A client who has suffered a stroke is unable to maintain respiration and is intubated and placed on mechanical ventilator support.

What portion of the brain is most likely responsible for the inability to breathe?