A patient with left-sided weakness that started 60 minutes earlier is admitted to the emergency department and diagnostic tests are ordered. Which test should be done first?
Complete blood count (CBC)
Electroencephalogram (EEG)
Computed tomography (CT) scan
Chest radiograph (chest x-ray)
The Correct Answer is C
A) "Complete blood count (CBC)":
. A CBC can provide important information about the patient's overall health, including potential signs of infection, anemia, or other underlying conditions. However, in the context of acute neurological symptoms such as left-sided weakness, CT scan is the priority test because it will help quickly determine if there is an acute neurological event, such as a stroke or hemorrhage. While a CBC might be useful later to assess for underlying
conditions or potential causes, it is not the first test to perform in this scenario.
B) "Electroencephalogram (EEG)":
. An EEG is primarily used to diagnose and assess seizure activity or epileptic disorders. While seizures can cause neurological deficits, the patient's sudden onset of left-sided weakness is more suggestive of a stroke, not a seizure. The priority is to rule out stroke with a CT scan, not to assess for seizures with an EEG.
C) "Computed tomography (CT) scan":
. A CT scan is the first diagnostic test to perform in patients with acute neurological deficits such as sudden-onset weakness, especially when a stroke is suspected. A CT scan can quickly detect if the cause is an ischemic stroke (lack of blood flow due to a clot) or a hemorrhagic stroke (bleeding in the brain). Time is critical in the management of stroke, as early intervention with treatments like tPA (tissue plasminogen activator) for ischemic stroke can greatly improve outcomes. The CT scan can help determine if the patient is a candidate for thrombolysis or if other interventions are needed.
D) "Chest radiograph (chest x-ray)":
. While a chest x-ray can be useful for diagnosing respiratory issues, such as pneumonia or congestion, it is not helpful in evaluating the cause of acute neurological symptoms like left-sided weakness. The priority test is a CT scan to evaluate the brain and rule out conditions like stroke or hemorrhage, not a chest x-ray.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. "Promptly change out of wet clothing such as bathing suits after use":
This is a key recommendation for preventing urinary tract infections (UTIs), especially in women. Wet clothing, such as swimsuits or damp exercise clothes, creates a warm, moist environment that encourages bacterial growth, particularly in the genital and perineal areas. Changing out of wet clothing promptly helps reduce the risk of bacteria entering the urinary tract, which is an important preventive measure for recurrent UTIs.
B. "Buy synthetic underwear rather than cotton fabric":
This statement is incorrect. Cotton underwear is recommended because it is breathable and helps keep the genital area dry, reducing the likelihood of bacterial growth. Synthetic fabrics, on the other hand, trap moisture and heat, creating an environment where bacteria can thrive, increasing the risk of UTIs. Therefore, wearing cotton underwear is advised rather than synthetic fabric.
C. "Be sure to empty your bladder every 6-8 hours":
This recommendation is somewhat inaccurate. To prevent UTIs, it is essential to empty the bladder more frequently than every 6-8 hours, especially if the person feels the urge to urinate. Holding urine for long periods can increase the risk of bacterial growth in the urinary tract. It is generally recommended to urinate at least every 3-4 hours during the day to prevent urine stagnation and reduce the risk of infection.
D. "Try to drink 500-1000 ml of fluid per day":
This fluid intake recommendation is too low. To prevent UTIs, a higher fluid intake is necessary—typically 2-3 liters (2000-3000 mL) of fluid per day. Adequate hydration helps ensure frequent urination, which flushes out bacteria from the urinary tract. Consuming only 500-1000 mL of fluid per day is insufficient and would likely increase the risk of UTIs due to less frequent urination and less flushing of the urinary system.
Correct Answer is A
Explanation
A) Pernicious anemia:
Vitamin B12 injections are most commonly used to treat pernicious anemia, which is caused by a deficiency in vitamin B12 due to an inability to absorb the vitamin from the gastrointestinal tract. This condition is often associated with a lack of intrinsic factor, a protein required for vitamin B12 absorption. As a result, the body cannot make enough healthy red blood cells, leading to anemia. The treatment of pernicious anemia typically involves lifelong vitamin B12 injections, making this the correct answer.
B) Hemolytic anemia:
It is not typically treated with vitamin B12 injections. Instead, hemolytic anemia may require treatments that address the underlying cause of red blood cell destruction, such as corticosteroids, immunosuppressive therapy, or splenectomy, depending on the type of hemolysis. Therefore, vitamin B12 would not be the primary treatment for this type of anemia.
C) Iron deficiency anemia:
It is typically treated with iron supplements, either orally or intravenously, rather than vitamin B12. While both conditions cause anemia, the treatment for iron deficiency anemia is not vitamin B12, so this is not the correct choice.
D) Aplastic anemia:
This condition is usually treated with treatments such as bone marrow stimulants, blood transfusions, or bone marrow transplantation, rather than vitamin B12. Vitamin B12 supplementation would not be indicated for the treatment of aplastic anemia.
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