A nurse is caring for an older adult client in the emergency department who sustained a head injury due to a fall. Which of the following are common reasons for head injuries in older adults?
(Select All that Apply.)
Decreased visual acuity
Motor vehicle crashes
Polypharmacy
Weakness
Chronic hypertension
Previous military experience
Correct Answer : A,C,D,E
Choice A Reason:
Decreased visual acuity is correct. Yes, decreased visual acuity, including issues such as poor depth perception, reduced peripheral vision, and difficulty with contrast sensitivity, can contribute to falls and head injuries in older adults.
Choice B Reason:
Motor vehicle crashes is incorrect. While motor vehicle crashes can cause head injuries in individuals of all ages, they are less common among older adults compared to younger age groups.
Choice C Reason:
Polypharmacy is correct. Yes, polypharmacy, which refers to the use of multiple medications concurrently, is a common risk factor for falls and head injuries in older adults. Certain medications, especially those with sedative or psychotropic effects, can increase the risk of falls and accidents.
Choice D Reason:
Weakness is correct. Yes, weakness, frailty, and decreased muscle strength are common age-related changes that can increase the risk of falls and subsequent head injuries in older adults.
Choice E Reason:
Chronic hypertension, particularly when poorly controlled, can contribute to an increased risk of falls in older adults through various mechanisms:Hypertension medications or the condition itself can lead to orthostatic hypotension. This can cause dizziness or lightheadedness, increasing the risk of falls. Chronic hypertension is a major risk factor for cerebrovascular disease, including strokes. These events can lead to neurological deficits such as weakness, numbness, or impaired balance, predisposing individuals to falls.
Choice F Reason:
Previous military experience is incorrect. While previous military experience may contribute to certain health conditions or injuries in older adults, it is not a common reason for head injuries specifically related to falls or accidents in this population.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C","D","E","F"]
Explanation
Choice A Reason:
Easily getting back to sleep after awakening is incorrect. This is not typically a manifestation of obstructive sleep apnea. Instead, individuals with OSA often experience fragmented sleep due to frequent awakenings caused by apnea episodes.
Choice B Reason:
Many episodes of apnea per night is correct. Yes, individuals with obstructive sleep apnea experience many episodes of apnea (complete cessation of breathing) or hypopnea (partial obstruction of airflow) per night. These episodes can occur multiple times throughout the night, disrupting normal sleep patterns.
Choice C Reason:
Loud snort after breathing cessation is correct. This is a characteristic manifestation of obstructive sleep apnea. Individuals with OSA often make choking, snorting, or gasping sounds after a period of breathing cessation as they attempt to resume breathing.
Choice D Reason:
10 seconds or longer of breathing cessation is correct. Yes, breathing cessation episodes in obstructive sleep apnea typically last for 10 seconds or longer. These prolonged episodes of apnea contribute to oxygen desaturation and disrupted sleep.
Choice E Reason:
Daytime sleepiness is correct. Yes, daytime sleepiness is a common symptom of obstructive sleep apnea. Disrupted sleep patterns and frequent awakenings during the night can lead to excessive daytime sleepiness, fatigue, and decreased alertness.
Choice F Reason:
Frequent, loud snoring is correct. Yes, frequent, loud snoring is a hallmark symptom of obstructive sleep apnea. Snoring occurs due to the partial obstruction of airflow in the upper airway during sleep.
Correct Answer is ["B","C","D","E"]
Explanation
Choice A Reason:
Light sensitivity is incorrect. Light sensitivity (photophobia) is not typically a direct manifestation of a ruptured cerebral aneurysm. However, it may occur as a secondary symptom due to other neurological disturbances or increased intracranial pressure.
Choice B Reason:
Loss of consciousness is correct. Loss of consciousness is a common manifestation of a ruptured cerebral aneurysm, particularly if the bleeding leads to significant brain injury or compression of vital brain structures.
Choice C Reason:
A dilated pupil is correct. A dilated pupil (mydriasis) may occur as a result of compression of the oculomotor nerve (cranial nerve III) by the expanding hematoma or increased intracranial pressure following a ruptured cerebral aneurysm.
Choice D Reason:
Visual disturbances is correct. Visual disturbances, such as blurred vision, double vision (diplopia), or loss of vision, may occur due to compression of the optic nerve or damage to visual pathways as a result of the hemorrhage.
Choice E Reason:
Nausea and vomiting is correct. Nausea and vomiting are common symptoms associated with a ruptured cerebral aneurysm, often due to irritation of the meninges and increased intracranial pressure resulting from the bleeding.
Choice F Reason:
Numbness on one side of the face is incorrect. Numbness on one side of the face is not typically a direct manifestation of a ruptured cerebral aneurysm. However, it may occur if the hemorrhage affects specific regions of the brain responsible for sensation or if there is associated compression of cranial nerves.
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