A nurse in an emergency department is assessing a client who has a nasal fracture. Which of the following findings should cause the nurse to suspect a skull fracture?

Clear fluid drainage from the nares

Report of pain around the eyes

Dried blood in the mouth

Mandibular asymmetry

Answer and Explanation

The Correct Answer is A

A. Clear fluid drainage from the nares: Clear, watery drainage following facial trauma can indicate cerebrospinal fluid (CSF) leakage, which is a hallmark sign of a basilar skull fracture. The presence of CSF raises concern for a more serious intracranial injury and requires immediate reporting and further evaluation.

B. Report of pain around the eyes: Periorbital pain is common with nasal fractures and facial trauma but is not specific for a skull fracture. While it warrants assessment, it does not suggest intracranial involvement or CSF leakage.

C. Dried blood in the mouth: Blood in the mouth may result from oral or nasal trauma and is expected with nasal fractures. It does not indicate a skull fracture unless accompanied by other neurological or cerebrospinal signs.

D. Mandibular asymmetry: Misalignment of the jaw is consistent with a mandibular fracture rather than a skull fracture. While it may be present in facial trauma, it does not indicate intracranial injury or CSF leakage.

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Correct Answer is D

Explanation

A. "My living will names my health care surrogate, who will be responsible for my medical expenses.": A health care surrogate is designated to make medical decisions if the client is unable, not to manage financial obligations. Advance directives focus on treatment preferences, so this statement reflects a misunderstanding of their purpose.

B. "Having advance directives requires participation in organ donation.": Advance directives do not require organ donation. Organ donation is a separate legal decision and can be indicated independently of advance directives. Associating the two shows a misconception about advance directive requirements.

C. "Advance directives are not legally enforceable unless signed by an attorney.": Advance directives are legally recognized when properly witnessed or notarized, depending on state law, but do not require an attorney’s signature. This statement overstates the legal requirements, indicating incomplete understanding.

D. "My advance directives communicate my decision to remain on a breathing machine.": Advance directives allow clients to express treatment preferences, including life-sustaining interventions. This statement demonstrates accurate understanding that advance directives guide health care decisions when the client cannot communicate.

A. A room with a laminar airflow filtration system B. A room with a cool temperature C. A room that has a private bathroom D. A room near the nurses station

Correct Answer is B

Explanation

A. A room with a laminar airflow filtration system: Laminar airflow rooms are designed for clients who are immunocompromised to reduce exposure to airborne pathogens. Clients with hyperthyroidism do not require this level of infection control, so this room type is unnecessary.

B. A room with a cool temperature: Hyperthyroidism increases the client’s metabolic rate, which can lead to heat intolerance and excessive sweating. Assigning a room with a cooler temperature helps maintain comfort and prevent overheating, making it the most appropriate choice for this client.

C. A room that has a private bathroom: While a private bathroom may be convenient for some clients, it is not specifically necessary for hyperthyroidism. The client’s primary needs relate to temperature control and symptom management rather than isolation or frequent toileting.

D. A room near the nurses’ station: Proximity to the nurses’ station is helpful for clients requiring close monitoring, but a client with stable hyperthyroidism does not typically need continuous observation. Room placement near the station is not the priority compared to maintaining a comfortable ambient temperature.

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A nurse in an emergency department is assessing a client who has a nasal fracture. Which of the following findings should cause the nurse to suspect a skull fracture?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a client about advance directives. Which of the following statements by the client indicates an understanding of the teaching?

Correct Answer is D

Explanation

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Correct Answer is B

Explanation

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