A nurse in an emergency department is caring for a client who became unresponsive after stating she had a sudden, severe headache with vomiting and then seizure activity. The client's vital signs are as follows: blood pressure of 198/110 mm Hg pulse of 82 bpm, respirations of 24/min, and a temperature of 100.8 F (38.2° C). Which neurologic disorder would the nurse suspect?

Thrombotic stroke

Embolic stroke

Hemorrhagic stroke

Transient ischemic attack (TIA)

Answer and Explanation

The Correct Answer is C

A. Thrombotic stroke. A thrombotic stroke develops more gradually and is not typically associated with such sudden and severe symptoms.

B. Embolic stroke. An embolic stroke is often associated with a known embolic source, such as a clot from the heart, and can present more suddenly, but without all the symptoms seen here.

C. Hemorrhagic stroke: Hemorrhagic strokes often present with a sudden, severe headache, vomiting, seizure activity, and high blood pressure. A fever may also develop due to increased intracranial pressure.

D. Transient ischemic attack (TIA). TIAs are brief and resolve within minutes to hours and do not typically cause seizures.

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Correct Answer is A

Explanation

A. Hypokalemia: U waves are often seen on an electrocardiogram in clients with hypokalemia. They represent delayed repolarization of the Purkinje fibers due to low potassium levels.

B. Hypercalcemia: Hypercalcemia affects the QT interval, typically shortening it, but it does not cause U waves.

C. Hyponatremia: Electrocardiographic changes are not commonly associated with hyponatremia.

D. Hyperkalemia: Hyperkalemia causes peaked T waves, prolonged PR intervals, and wide QRS complexes, not U waves.

A. Insertion of central venous access B. Phlebotomy C. Fasciotomy D. Insertion of arterial line

Correct Answer is C

Explanation

A. Insertion of central venous access: This is not relevant to compartment syndrome management. Central venous access is used for fluid administration or monitoring central venous pressure.

B. Phlebotomy: This is unrelated to the management of compartment syndrome, as it involves drawing blood and does not address the increased pressure.

C. Fasciotomy: Compartment syndrome is a medical emergency where increased pressure within a closed compartment compromises circulation and tissue function. A fasciotomy involves surgically opening the compartment to relieve the pressure, prevent tissue necrosis, and save the limb. This is the definitive treatment.

D. Insertion of arterial line: While this may be useful for monitoring blood pressure in critical situations, it does not relieve compartment syndrome.

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Naxlex Comprehensive Predictor Exams

The nurse is teaching a group of staff nurses about cardiac rhythms. The nurse would indicate that a U wave may indicate which of the following?

Correct Answer is A

Explanation

The nurse is caring for a client who sustained a crushed injury to the lower extremity and has developed compartment syndrome. What intervention should the nurse plan for next?

Correct Answer is C

Explanation

The nurse is assessing a brain-injured client response to nail bed pressure. The client demonstrates internal rotation, adduction, and flexion of the arms, the nurse should report the response as which finding

The nurse is assessing a client who is near death. Which of the following findings would indicate to the nurse that the client is in the actively dying phase?

The nurse has received a change-of-shift report on the following clients. Which client should the nurse see first?

The nurse is caring for a client who is on cardiac telemetry monitoring and notes that the PR interval is 0.16 seconds. Which interpretation is correct for the nurse to make?

The nurse is caring for a client who has developed syndrome of inappropriate antidiuretic hormone (SIADH). Which type of intravenous solution would the nurse expect to administer to the client?

The nurse is assessing a client with unstable angina. Which finding would the nurse expect the client to report that differentiates this from other types of anginas?