The nurse is caring for a client with a deteriorating neurological condition. The nurse is performing an assessment at the beginning of the shift and notes a falling blood pressure and heart rate. The client is lying flat with arms and legs that are extended, stiff, and rigid, and the feet are plantar flexed. What would be the correct documentation of this posturing?

Stuporous.

Decerebrate.

Decorticate.

Flaccidity.

Answer and Explanation

The Correct Answer is B

Choice A is incorrect because stuporous is a state of reduced consciousness, and does not describe the posturing observed in the client.

Choice B is correct because decerebrate posturing is characterized by extension of the arms, wrists, and fingers, and extension and internal rotation of the legs, with plantar flexion of the feet.

Choice C is incorrect - Decorticate posturing is characterized by flexion of the arms, wrists, and fingers, extension, internal rotation, and adduction of the legs, with plantar flexion of the feet. This is caused by damage to the cerebral cortex and is indicative of a neurological problem.

Choice D is incorrect because flaccidity is a state of complete lack of muscle tone, and does not describe the posturing observed in the client.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is B

Explanation

cryptorchidism as an infant. Cryptorchidism, or undescended testicles, is a known risk factor for testicular cancer. During fetal development, the testicles form in the abdomen and descend into the scrotum before birth. Failure of one or both testicles to descend into the scrotum can increase the risk of testicular cancer later in life. Therefore, a history of cryptorchidism as an infant is the most important assessment finding to identify clients at higher risk of developing testicular cancer.

Choice A, previous sexually transmitted infection (STI), is incorrect because although STIs can increase the risk of certain types of cancer, they are not a significant risk factor for testicular cancer.

Choice C, low sperm count, is incorrect because although low sperm count can be associated with testicular cancer, it is not a reliable indicator for determining a higher risk for testicular cancer. Low sperm count may also be caused by various other factors, such as hormonal imbalances, infections, varicocele, and genetic abnormalities. While it is important to monitor and treat low sperm count, it is not a definitive indicator of testicular cancer risk.

A. Strain. B. Sprain. C. Contusion. D. Fracture.

Correct Answer is C

Explanation

Contusion. The nurse would suspect a contusion as the client was hit by a baseball bat and has localized pain and swelling with ecchymosis (bruising).

Option A, Strain, is unlikely as a strain is a stretching or tearing of a muscle or tendon, and it is not usually caused by blunt force trauma.

Option B, Sprain, is unlikely as a sprain is a stretching or tearing of a ligament, and it is not usually caused by blunt force trauma.

Option D, Fracture, is unlikely as a fracture is a break in the bone and usually involves more severe pain and may be accompanied by deformity.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which assessment finding is most important in determining which client has a higher risk for developing testicular cancer?

Correct Answer is B

Explanation

A client comes to the emergency department complaining of localized pain and swelling of his lower leg. Ecchymotic areas are noted. History reveals that the client got bit in the leg with a baseball bat. Which of the following would the nurse suspect as most likely?

Correct Answer is C

Explanation

Which of the following is a true statement regarding psoriasis?

A client with increased intracranial pressure is receiving mannitol via intravenous infusion. Which assessment finding is most important in determining the effectiveness of this treatment?

Which zone consists of the area where the injury is most severe and deepest?

When performing a physical examination on a client with cirrhosis, a nurse notices that the abdomen is enlarged. Which of the following interventions should the nurse consider?

The nurse is caring for a client with a degenerative joint disorder and is providing education about different medications that may be used to help the disorder. The nurse provides education for (SATA):.

A client experiences a musculoskeletal injury that involves the structure that connects a muscle to the bone. The nurse understands that this injury involves which of the following?

Examination of a client's bladder stones reveals that they are primarily composed of uric acid. The nurse would expect to provide the client with which type of diet?

On initial nursing rounds, the diabetic client reports "not feeling well." Later, the nurse finds the client to be diaphoretic and in a stuporous state. What is the immediate action taken by the nurse?