A patient is having 20 mL of cerebral spinal fluid removed via a lumbar puncture. What intervention is important after the procedure?

Have the patient lie flat for 6 hours.

Have the patient lie in a semi-Fowler’s position with the head of the bed at 35 degrees.

Early ambulation.

Have the patient lie flat for 1 hour, then sit up for 1 hour before ambulating.

Answer and Explanation

The Correct Answer is A

Choice A rationale
After a lumbar puncture, it is important for the patient to lie flat for approximately 6 hours. This position helps to prevent headaches that can occur after the procedure, which are caused by leakage of cerebrospinal fluid at the needle puncture site. Lying flat allows the puncture site to seal and prevents the leakage of cerebrospinal fluid.
Choice B rationale
Having the patient lie in a semi-Fowler’s position with the head of the bed at 35 degrees is not typically recommended immediately after a lumbar puncture. This position could potentially increase the risk of a post-lumbar puncture headache.
Choice C rationale
Early ambulation is not recommended after a lumbar puncture. Moving around too soon after the procedure can increase the risk of a headache and may also increase the risk of complications at the puncture site.
Choice D rationale
Having the patient lie flat for 1 hour, then sit up for 1 hour before ambulating is not a typical recommendation after a lumbar puncture. The standard recommendation is to have the patient lie flat for approximately 6 hours to reduce the risk of complications.

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Correct Answer is A

Explanation

Choice A rationale
Slowing of activity, also known as bradykinesia, is a common symptom of Parkinson’s disease. It is characterized by a general reduction in the speed and amplitude of voluntary movements, leading to difficulties with tasks such as walking, talking, and performing other self-care activities.
Choice B rationale
Muscle flaccidity is not typically associated with Parkinson’s disease. Instead, people with Parkinson’s often experience muscle rigidity or stiffness.
Choice C rationale
A gait with the body leaning backward is not a typical symptom of Parkinson’s disease. People with Parkinson’s disease often have a stooped posture, with the body leaning forward.
Choice D rationale
Continuous tremors are a hallmark symptom of Parkinson’s disease, but they are not present in all cases. Tremors in Parkinson’s disease are often described as a “pill-rolling” tremor because the movement resembles the motion of trying to roll a pill between the thumb and index finger.

A. Instill mineral oil into the canal and immediately irrigate to remove the impacted wax. B. Instill a small amount of mineral oil into the canal, then have the patient return in 30 minutes for wax removal. C. Irrigate the ear with cold water until all the wax is removed. D. Irrigate the ear with warm water and a high amount of otic pressure.

Correct Answer is B

Explanation

Choice A rationale
Instilling mineral oil into the canal and immediately irrigating to remove the impacted wax is not typically recommended. This approach may not allow enough time for the mineral oil to soften the cerumen, making it more difficult to remove and potentially causing discomfort or injury.
Choice B rationale
Instilling a small amount of mineral oil into the canal, then having the patient return in 30 minutes for wax removal is a common and effective method for managing cerumen impaction. The mineral oil helps to soften the cerumen, making it easier to remove through irrigation.
Choice C rationale
Irrigating the ear with cold water is not typically recommended. Cold water can cause discomfort and potentially lead to vertigo.
Choice D rationale
Irrigating the ear with warm water and a high amount of otic pressure is not typically recommended. High pressure can potentially damage the ear canal or tympanic membrane.

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A patient is having 20 mL of cerebral spinal fluid removed via a lumbar puncture. What intervention is important after the procedure?

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Naxlex Comprehensive Predictor Exams

A nurse is conducting an assessment on a patient diagnosed with Parkinson’s disease. Which of the following symptoms is the nurse likely to observe?

Correct Answer is A

Explanation

A patient is being evaluated for hearing loss. The doctor is unable to examine the tympanic membrane due to a blockage caused by cerumen. What actions can the nurse take to allow for an examination?

Correct Answer is B

Explanation

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