A patient is admitted to the Emergency Department (ED). The nurse documents "postictal upon transfer" as evidenced by which observation?
Abnormal sensory sensations including tingling of the skin
Yellowing of the skin
Severe itching of the eyes
Is in a drowsy confused state after a seizure
The Correct Answer is D
A. Abnormal sensory sensations such as tingling may be associated with the aura phase of a seizure but are not typically observed postictally.
B. Yellowing of the skin is usually indicative of jaundice, unrelated to seizure activity or the postictal state.
C. Itching of the eyes is unrelated to seizure activity and would not typically be documented in the context of postictal observations.
D. The postictal state is characterized by drowsiness, confusion, and other altered mental statuses that follow a seizure. This period can vary in duration depending on the patient and seizure type.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"A":{"answers":"A"},"B":{"answers":"D"},"C":{"answers":"B"},"D":{"answers":"C"}}
Explanation
Macular degeneration: This condition leads to the loss of central vision due to damage to the macula, which is responsible for sharp, straight-ahead vision.
Presbyopia: A common age-related condition resulting in a gradual loss of near visual acuity as the lens becomes less flexible, making it harder to focus on close objects.
Glaucoma: Typically causes loss of peripheral vision due to increased intraocular pressure damaging the optic nerve, eventually leading to tunnel vision if untreated.
Cataracts: Causes blurry vision as the lens becomes clouded, leading to general visual disturbance that progresses over time.
Correct Answer is D
Explanation
A. Bradycardia is possible due to autonomic dysfunction but is not the leading cause of death.
B. Sepsis can occur due to immobility and pressure injuries but is secondary to respiratory compromise.
C. Hypertension is not directly linked to high cervical spine injuries and is less common than respiratory issues in this setting.
D. Respiratory compromise is the primary cause of complications or death in patients with a high cervical spine injury (C-3 and above) due to loss of innervation to the diaphragm and intercostal muscles, which impairs spontaneous breathing. Mechanical ventilation is often required to maintain adequate oxygenation.
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