A nurse is attending to a client with multiple sclerosis who reports a sensation of tightness around their torso. What condition should the nurse identify this symptom as indicating?

Trigeminal neuralgia

Lhermitte’s sign

MS hug

Paroxysmal spasms

Answer and Explanation

The Correct Answer is C

Choice A rationale
Trigeminal neuralgia is a chronic pain condition that affects the trigeminal nerve, which carries sensation from your face to your brain. It does not cause a sensation of tightness around the torso.
Choice B rationale

Lhermitte’s sign is a symptom of multiple sclerosis and other neurological conditions where a person feels an electric shock-like sensation running down the spine and into the limbs. It does not cause a sensation of tightness around the torso.
Choice C rationale
The sensation of tightness around the torso in a patient with multiple sclerosis is often referred to as the “MS hug”. It is caused by a lesion or an area of active inflammation within the spinal cord.
Choice D rationale
Paroxysmal spasms are a type of muscle spasm experienced by some people with multiple sclerosis. These spasms are usually painful and involve the muscles of the legs, but they do not cause a sensation of tightness around the torso.

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Correct Answer is A

Explanation

Choice A rationale
Maintaining the head of the bed between 30 and 45 degrees is a common intervention for a patient at risk of cerebral aneurysm rupture. This position can help reduce intracranial pressure and promote venous drainage from the brain.
Choice B rationale
Administering hypotonic intravenous solutions is not typically recommended for patients at risk of cerebral aneurysm rupture. Hypotonic solutions can lead to cerebral edema, which can increase intracranial pressure and potentially contribute to aneurysm rupture.
Choice C rationale
Keeping lights at a medium level in the evening is not a specific intervention for patients at risk of cerebral aneurysm rupture. While maintaining a comfortable and restful environment is important, there’s no evidence to suggest that the level of lighting has a direct impact on the risk of aneurysm rupture.
Choice D rationale
Repositioning the patient every shift is a standard nursing intervention to prevent pressure ulcers and promote comfort. However, it is not a specific intervention for patients at risk of cerebral aneurysm rupture.

A. Decreased visual acuity B. Motor vehicle crashes C. Polypharmacy D. Weakness E. Chronic hypertension

Correct Answer is ["A","C","D","E"]

Explanation

Choice A rationale

Decreased visual acuity can increase the risk of falls, which are a common cause of head injuries in older adults. Impaired vision can affect balance and coordination, making it more difficult for an individual to navigate their environment safely.
Choice B rationale
While motor vehicle crashes can certainly lead to head injuries, they are not one of the most common causes of head injuries in older adults. Falls are actually the leading cause of head injuries in this population.
Choice C rationale
Polypharmacy, or the use of multiple medications by a patient, is common in older adults and can increase the risk of falls and, consequently, head injuries. Certain medications can cause side effects such as dizziness or confusion, which can lead to falls.
Choice D rationale
Weakness, particularly in the lower body, can increase the risk of falls and subsequent head injuries in older adults. Lower body weakness can affect an individual’s balance and mobility, making falls more likely.
Choice E rationale
Chronic hypertension can lead to a variety of health complications, including an increased risk of falls and head injuries. Hypertension can cause dizziness and balance problems, which can increase the risk of falls.

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A nurse is attending to a client with multiple sclerosis who reports a sensation of tightness around their torso. What condition should the nurse identify this symptom as indicating?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing care for a patient who is at risk of cerebral aneurysm rupture. Which of the following interventions should the nurse include in the care plan?

Correct Answer is A

Explanation

A nurse is caring for an older adult patient in the emergency department who sustained a head injury due to a fall. Which of the following are common causes of head injuries in older adults?

Correct Answer is ["A","C","D","E"]

Explanation

The nurse is assisting with planning care for a client who has a subarachnoid hemorrhage (SAH). Which of the following relates to a high mortality rate for a client who has an SAH?

A nurse is educating a student about cerebral edema. The student nurse inquires, “What type of cerebral edema is associated with a patient who has had a stroke?” Which of the following is the best response from the nurse?

A nurse is caring for a client who has had a traumatic fall. Which of the following interventions should the nurse implement first?

A nurse is planning care for a client who has increased intracranial pressure. The nurse should understand that enteral nutrition should begin within 24 to 48 hr to help prevent which of the following complications?

A nurse is gathering neurological data on a patient with a neurological injury and observes signs indicative of Cushing’s Triad. The nurse understands that Cushing’s Triad is a nervous system response that could prevent which of the following conditions?

A nurse in the emergency department is evaluating a client who was brought in by a neighbor after suddenly falling while walking. What assessments should the nurse prioritize?

A client with uncontrolled diabetes mellitus reports experiencing numbness and tingling in their feet that disrupts their sleep.The nurse explains this as a nerve disorder known as peripheral neuropathy. Which statement by the client indicates they understand the cause of this condition?

A nurse is admitting a patient with a subarachnoid hemorrhage and expects to administer which of the following medications to decrease intracranial pressure (ICP)?