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)

Answer and Explanation

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.

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Correct Answer is B

Explanation

A) Obtaining a primary and secondary tubing set:
The primary tubing is used for the intravenous access, and the secondary tubing is attached for administering the blood product. This ensures that the blood transfusion will be delivered effectively, and it is a standard practice to use proper IV tubing for blood products to avoid contamination or complications.

B) Ensuring another licensed personnel is available:
. While it is required that two licensed healthcare professionals verify the blood product before starting the transfusion, this action itself is not contraindicated, it is required. Both individuals should independently check the patient's identification, blood type, and the matching of the blood product before administration. Therefore, the answer to the question should not be about ensuring availability of licensed personnel as this is actually a required safety measure, not contraindicated. The actual contraindications involve actions like using inappropriate fluids for transfusion or mismatching blood.

C) Obtaining 0.9% normal saline solution:
This is appropriate and necessary when preparing for a blood transfusion. Normal saline (0.9%) is the only compatible solution that should be used to flush the IV line before and after the transfusion or to prime the blood tubing. Other solutions, such as lactated Ringer's, can cause clotting when mixed with blood, making saline the only appropriate choice.

D) Checking ABO and Rh status of the donor and recipient:
This is essential and mandatory before administering a blood transfusion. It is critical to ensure that the ABO blood group and Rh factor of the donor and recipient are compatible to prevent hemolytic reactions. This compatibility check must be done every time before administering a transfusion, and it is an integral part of ensuring patient safety.

A. "The test will use a catheter to assess for blocked coronary arteries B. The test can show how well your heart pumps blood." C. The test will show proteins in the blood from damaged heart muscle. D. The test shows the electrical activity of the heart from multiple angles”

Correct Answer is B

Explanation

A) "The test will use a catheter to assess for blocked coronary arteries": This statement is incorrect. An echocardiogram does not involve the use of a catheter. It is a non-invasive imaging test that uses sound waves (ultrasound) to create images of the heart's structure and function. Assessing for blocked coronary arteries typically requires a different procedure, such as a coronary angiogram, which involves the use of a catheter.

B) "The test can show how well your heart pumps blood.": This is the correct statement. An echocardiogram is primarily used to assess how well the heart is functioning, including how effectively it pumps blood. It can provide detailed images of the heart's chambers, valves, and blood flow, helping to evaluate conditions such as heart failure, valve dysfunction, and other structural issues that may impair the heart’s ability to pump blood efficiently.
C) "The test will show proteins in the blood from damaged heart muscle.": This statement is incorrect. An echocardiogram does not measure blood proteins or markers from damaged heart muscle. Blood tests, such as troponin levels, are used to detect proteins released from heart muscle after injury, such as in a heart attack. The echocardiogram focuses on the heart's structure and function, not the chemical markers in the blood.

D) "The test shows the electrical activity of the heart from multiple angles.": This statement is inaccurate. The electrical activity of the heart is assessed by an electrocardiogram (ECG or EKG), not an echocardiogram. An ECG records the heart's electrical signals, while an echocardiogram uses sound waves to visualize the heart's anatomical structure and function.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is B

Explanation

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