A nurse is caring for a client who has a head injury. The client states they fell off a ladder while painting approximately 2 hours ago and lost consciousness for 45 minutes according to their partner. The nurse should determine that the client is experiencing which of the following classifications of traumatic brain injury?
Moderate
Severe
Mild
No traumatic brain injury
The Correct Answer is A
The correct answer is A. Moderate.
Choice A: Moderate
A moderate traumatic brain injury (TBI) is characterized by a loss of consciousness (LOC) lasting between 30 minutes and 6 hours. In this scenario, the client lost consciousness for 45 minutes, which falls within this range. Moderate TBIs often result in more significant symptoms and may require more intensive medical intervention compared to mild TBIs.
Choice B: Severe
Severe TBIs are typically defined by a loss of consciousness lasting more than 6 hours. Since the client in this case was unconscious for only 45 minutes, this classification does not apply. Severe TBIs often involve extensive brain damage and can lead to long-term complications or disabilities.
Choice C: Mild
Mild TBIs, also known as concussions, are characterized by a loss of consciousness lasting less than 30 minutes. Given that the client was unconscious for 45 minutes, this classification is not appropriate. Mild TBIs usually result in temporary symptoms that resolve with minimal medical intervention.
Choice D: No traumatic brain injury
This option is incorrect because the client experienced a significant head injury with a loss of consciousness for 45 minutes. Such an event clearly indicates a traumatic brain injury, and it is essential to classify it correctly to ensure appropriate medical care.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Impaired sense of humor is not a common finding for a client who had a stroke involving the left cerebral hemisphere. Impaired sense of humor is more likely to occur after a stroke involving the right cerebral hemisphere, which is responsible for processing humor, irony, and sarcasm.
Choice B reason: Poor judgment is not a typical finding for a client who had a stroke involving the left cerebral hemisphere. Poor judgment is more likely to occur after a stroke involving the frontal lobe, which is involved in executive functions, such as planning, reasoning, and decision making.
Choice C reason: Intellectual impairment is a possible finding for a client who had a stroke involving the left cerebral hemisphere. The left cerebral hemisphere is dominant for language and analytical thinking in most people. A stroke affecting this hemisphere can impair the ability to speak, read, write, calculate, and comprehend information.
Choice D reason: Loss of depth perception is not a frequent finding for a client who had a stroke involving the left cerebral hemisphere. Loss of depth perception is more likely to occur after a stroke involving the occipital lobe, which is involved in visual processing, or the parietal lobe, which is involved in spatial awareness.
Correct Answer is ["B","C","D"]
Explanation
Choice A reason: This is incorrect. Weight gain is not a manifestation of pulmonary tuberculosis. In fact, weight loss is a common symptom of tuberculosis, as the infection causes the body to use more energy and reduce appetite. Weight loss can also be a result of malnutrition, dehydration, or other complications of tuberculosis.
Choice B reason: This is correct. Night sweats are a manifestation of pulmonary tuberculosis. They occur because the infection causes the body to produce more heat and sweat to fight off the bacteria. Night sweats can also be a sign of fever, which is another symptom of tuberculosis.
Choice C reason: This is correct. Low-grade fever is a manifestation of pulmonary tuberculosis. It occurs because the infection causes the body to raise its temperature to kill the bacteria. Fever can also be accompanied by chills, fatigue, or weakness.
Choice D reason: This is correct. Blood in the sputum is a manifestation of pulmonary tuberculosis. It occurs because the infection causes damage and inflammation to the lungs and the airways, which can bleed and mix with the mucus that is coughed up. Blood in the sputum can also be a sign of a serious complication, such as a ruptured blood vessel or a lung abscess.
Choice E reason: This is incorrect. Flushed cheeks are not a manifestation of pulmonary tuberculosis. They can be caused by various factors, such as embarrassment, exercise, alcohol, or hot weather. Flushed cheeks are not related to the infection or the inflammation of the lungs.
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