A nurse plans care for the patient with increased intracranial pressure with the knowledge that the best way to position the patient is to
maintain patient in Trendelenburg position
use a continuous-rotation bed to continuously change patient position
elevate the head of the bed to 30 degrees
keep the head of the bed flat
The Correct Answer is C
A. Trendelenburg position (head lower than feet) can increase intracranial pressure and is contraindicated.
B. Continuous rotation may increase ICP due to frequent position changes and is generally avoided.
C. Elevating the head of the bed to 30 degrees promotes venous drainage from the brain, helping reduce intracranial pressure while maintaining cerebral perfusion.
D. Keeping the head flat can impair venous drainage and increase ICP.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Cerebrospinal fluid leakage is important to note but not the immediate priority.
B. Assessing for neck injury is crucial but airway management takes precedence to prevent life-threatening hypoxia.
C. Ensuring airway patency is the highest priority in trauma care to maintain oxygenation and ventilation, which are vital for survival.
D. Neurological assessment with the Glasgow Coma Scale is important but comes after securing airway, breathing, and circulation.
Correct Answer is A
Explanation
A. Cor pulmonale causes right-sided heart failure, leading to systemic venous congestion and dependent edema.
B. Chest pain is more commonly associated with left-sided heart issues or coronary artery disease.
C. Crackles in the lungs are signs of left-sided heart failure due to pulmonary congestion.
D. Hypotension is not a typical early sign of cor pulmonale or right-sided heart failure.
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