A patient with a severe head injury assumes a posture of flexed arms at the elbows and extended lower legs. The nurse recognizes this posturing as
decreasing intracranial pressure with decerebrate posturing.
increasing intracranial pressure with decorticate posturing.
decreasing intracranial pressure with decorticate posturing.
increasing intracranial pressure with decerebrate posturing.
The Correct Answer is B
Choice A reason: Decreasing intracranial pressure with decerebrate posturing is not the correct answer. Decerebrate posturing is a sign of severe brain damage that involves the extension and outward rotation of the arms and legs, and the arching of the back. It is not associated with decreasing intracranial pressure, but rather with increased pressure or brainstem compression.
Choice B reason: Increasing intracranial pressure with decorticate posturing is the correct answer. Decorticate posturing is a sign of severe brain damage that involves the flexion of the arms at the elbows and the extension of the legs. It is associated with increased intracranial pressure or lesions in the cerebral hemispheres.
Choice C reason: Decreasing intracranial pressure with decorticate posturing is not the correct answer. Decorticate posturing is a sign of severe brain damage that involves the flexion of the arms at the elbows and the extension of the legs. It is not associated with decreasing intracranial pressure, but rather with increased pressure or lesions in the cerebral hemispheres.
Choice D reason: Increasing intracranial pressure with decerebrate posturing is not the correct answer. Decerebrate posturing is a sign of severe brain damage that involves the extension and outward rotation of the arms and legs, and the arching of the back. It is associated with increased intracranial pressure or brainstem compression, but it is not the posture described in the question.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: This is incorrect. Arm and leg weakness, paresthesia, blurred vision, and facial frown are not specific to Parkinson disease, but may be seen in other neurological disorders, such as multiple sclerosis or stroke.
Choice B reason: This is incorrect. Uncontrollable rapid jerky movements in arms, trunk and facial muscles are characteristic of Huntington disease, not Parkinson disease. Huntington disease is a genetic disorder that causes progressive degeneration of the nerve cells in the brain.
Choice C reason: This is incorrect. Stumbling, backward tilt of the head, quick fluttering hand movements, and quick uncontrolled gait are signs of cerebellar ataxia, not Parkinson disease. Cerebellar ataxia is a disorder that affects the coordination and balance of the movements, caused by damage to the cerebellum.
Choice D reason: This is correct. Hand tremors, bradykinesia, skeletal muscle rigidity, and postural instability are the cardinal signs and symptoms of Parkinson disease. Parkinson disease is a chronic and progressive disorder that affects the dopamine-producing neurons in the brain, resulting in movement problems.
Correct Answer is C
Explanation
Choice A reason: Relaxing in a hot bath before bedtime is not the best suggestion to help decrease fatigue for a patient with multiple sclerosis. Heat can worsen the symptoms of multiple sclerosis, such as muscle weakness, numbness, and vision problems. Therefore, the patient should avoid hot baths, showers, or saunas, and use cool compresses or fans to lower their body temperature.
Choice B reason: Performing deep breathing exercises every two hours is not the best suggestion to help decrease fatigue for a patient with multiple sclerosis. Deep breathing can help reduce stress and anxiety, but it does not address the underlying causes of fatigue, such as inflammation, nerve damage, or sleep problems. Therefore, the patient should consult their doctor for appropriate treatment options and medication adjustments.
Choice C reason: Scheduling short periods of rest throughout the day is the best suggestion to help decrease fatigue for a patient with multiple sclerosis. Fatigue is a common and disabling symptom of multiple sclerosis, which can affect the patient's daily activities and quality of life. Therefore, the patient should plan their tasks according to their energy level, prioritize the most important ones, and take frequent breaks to conserve their energy and prevent exhaustion.
Choice D reason: Including daily multivitamins in your diet is not the best suggestion to help decrease fatigue for a patient with multiple sclerosis. Multivitamins can provide some nutritional benefits, but they are not a substitute for a balanced and healthy diet. Therefore, the patient should eat a variety of foods, such as fruits, vegetables, whole grains, lean proteins, and low-fat dairy, and avoid processed, fried, or sugary foods that can increase inflammation and fatigue.
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