Susan, 55, presents with a right Intracerebral hemorrhage. Lab results show an elevated ICP. What would you expect to find in your neurological assessment?
Left-sided hemiparesis and dilated right pupil
Right-sided hemiparesis and dilated right pupil
Bilateral handgrip strength is equal and reactive pupils
Pupils are pinpoint but reactive
The Correct Answer is A
A. Right intracerebral hemorrhage typically causes symptoms on the opposite side of the body (left-sided hemiparesis) and a dilated ipsilateral (right) pupil due to pressure on the oculomotor nerve.
B. Right intracerebral hemorrhage typically results in left-sided hemiparesis due to damage to the motor pathways on the right side of the brain, along with a dilated right pupil due to compression of the ipsilateral (right) oculomotor nerve.
C. Bilateral handgrip strength being equal suggests no focal motor deficits, which would be unusual in the context of an intracerebral hemorrhage. Reactive pupils would not be expected in this scenario.
D. Pinpoint pupils are typically associated with opioid overdose or pontine lesions, not intracerebral hemorrhage.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Lithotomy position requires the patient to lie on his back with his legs raised and spread apart, which may be difficult for a nonambulatory patient and may cause pressure on his lower back and pelvis.
B. This position allows for easy access to the rectum and prostate without causing discomfort or strain to the patient or examiner. The patient lies on his left side with his right leg flexed at the hip and knee and his left leg slightly flexed at the hip and straight at the knee.
C. Bent forward with hips flexed requires the patient to stand up and lean over a table or chair, which may also be challenging for a nonambulatory patient and may cause dizziness or loss of balance.
D. Standing position requires the patient to stand up straight with his feet apart, which may not provide adequate exposure or comfort for the examination.
Correct Answer is B
Explanation
A. While coughing may be a symptom of certain conditions, it's not directly related to the presence of white lesions in the throat.
B. Chemotherapy can suppress the immune system and predispose patients to oral candidiasis (thrush). It's important to inquire about other medications that may contribute to this condition or interact with chemotherapy.
C. Oral herpes typically presents as cold sores or fever blisters and may not be directly related to the white lesions observed.
D. While oral hygiene is important, the presence of white lesions in James's throat is more likely related to his medical condition and treatment than to dental hygiene habits.
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