Neurologic Case Study

Patient Profile:

Age: 68 years

Gender: Male

Medical History: Hypertension, Type 2 Diabetes Mellitus

Medications: Lisinopril, Metformin

Allergies: None

Chief Complaint: The patient presents to the emergency department (ED) with sudden onset of right-sided weakness and difficulty speaking that began approximately 1 hour prior to arrival.

Exhibits

Which condition is the patient most likely experiencing?

Hypoglycemia

Hemorrhagic stroke

Ischemic stroke

Multiple sclerosis

Answer and Explanation

The Correct Answer is C

Choice A reason: Hypoglycemia typically presents with symptoms such as sweating, trembling, hunger, confusion, and in severe cases, loss of consciousness. The patient's symptoms of sudden right-sided weakness and difficulty speaking are more consistent with a neurological event rather than low blood sugar levels.

Choice B reason: Hemorrhagic stroke involves bleeding within the brain. Although it can present with similar symptoms to ischemic stroke, the diagnostic tests indicate no evidence of hemorrhage. This makes a hemorrhagic stroke less likely.

Choice C reason: Ischemic stroke occurs when a blood clot blocks a blood vessel in the brain, leading to reduced blood flow and oxygen to a part of the brain. The patient's symptoms of sudden right-sided weakness and expressive aphasia are classic signs of an ischemic stroke, and the absence of hemorrhage on the head CT scan supports this diagnosis.

Choice D reason: Multiple sclerosis (MS) is a chronic, progressive disease that affects the central nervous system. It usually presents with episodic neurological symptoms rather than the sudden onset seen in this patient. MS symptoms develop over time and can vary widely, whereas the patient's acute presentation is more indicative of a stroke.

Nursing Test Bank

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Naxlex Comprehensive Predictor Exams

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Free Nursing Study Resources

Correct Answer is B

Explanation

Choice A reason: Monitoring the patient for shortness of breath or chest pain during the transfusion is a critical task that requires nursing judgment and immediate intervention if complications arise. It is not appropriate to delegate this task to unlicensed assistive personnel.

Choice B reason: Obtaining the patient's temperature and blood pressure before the transfusion is a task that can be safely delegated to nursing assistants. This task does not require the clinical judgment of a licensed nurse and is within the scope of practice for unlicensed assistive personnel.

Choice C reason: Double-checking the product numbers on the PRBCs with the patient ID band is a crucial safety step that must be performed by licensed nursing staff. This task ensures the correct blood product is given to the correct patient and involves verification that cannot be delegated to unlicensed personnel.

A. Administer antiemetics before chemotherapy B. Encourage carbonated beverages C. Recommend three large meals and two small snacks daily to increase calorie intake

Correct Answer is A

Explanation

Choice A reason: Administering antiemetics before chemotherapy is an effective intervention to help manage Sarah's nausea. Antiemetics can prevent or reduce the severity of nausea and vomiting associated with chemotherapy, making it easier for patients to tolerate treatment and maintain their nutritional status.

Choice B reason: Encouraging carbonated beverages is not a recommended intervention for managing nausea. Carbonated beverages can sometimes worsen nausea due to their acidity and carbonation.

Choice C reason: Recommending three large meals and two small snacks daily is not the best approach for managing nausea. Smaller, more frequent meals are generally more effective in preventing nausea and ensuring adequate calorie intake. Large meals can be overwhelming and may exacerbate nausea.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is planning to administer a transfusion of packed red blood cells (PRBCs) to a patient with blood loss from a gastrointestinal hemorrhage. Which action can the nurse delegate to the nursing assistant (unlicensed assistive personnel)?

Correct Answer is B

Explanation

Correct Answer is A

Explanation

Identify two causes of ascites related to liver cirrhosis:

A patient with diabetes is starting on insulin therapy. Which type of insulin will the nurse discuss using for mealtime coverage?

A necessary intervention for patients with pancreatitis is blood sugar monitoring.

Which action would the nurse take while providing home care to a patient with a stoma after a tracheostomy? Select all that apply. One, some, or all responses may be correct.

Which blood pressure (BP) finding by the nurse indicates that no changes in therapy are needed for a 48-year-old patient with newly diagnosed hypertension?

Which information is most important for the nurse to include when teaching a patient newly diagnosed with hypertension?

The nurse provides postoperative care to a patient who underwent peripheral artery bypass surgery. Thirty minutes after the initial assessment, the nurse reassesses the patient and detects a change in the Doppler sound over a pulse. Which action should the nurse take?