The nurse is caring for several patients in the Intensive Care Unit (ICU). Which of the following patients is at the greatest risk of anoxic brain injury?

A patient who was in an assault resulting in basilar skull fracture.

A patient who was found face down in water for an unknown length of time.

A patient who suffered an epidural or subdural hematoma.

A patient who experienced prolonged seizures without regaining consciousness.

Answer and Explanation

The Correct Answer is B

Choice A rationale

Basilar skull fractures can lead to cerebral injuries and CSF leaks, but do not typically cause anoxic brain injury unless they compromise oxygenation or cause cerebral edema severely reducing blood flow.

Choice B rationale

Prolonged submersion compromises oxygen delivery, leading to diffuse cerebral hypoxia or anoxia, the primary cause of brain injury in drowning victims due to interruption of arterial oxygenation over unknown durations.

Choice C rationale

Epidural or subdural hematomas elevate intracranial pressure and compress brain tissue, but they are not as immediately hypoxic as situations involving complete oxygen deprivation like submersion.

Choice D rationale

Prolonged seizures, or status epilepticus, may disrupt normal metabolic processes, potentially causing neuronal injury. However, primary hypoxia is generally less pronounced than in submersion cases.

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Correct Answer is C

Explanation

Choice A rationale

Monitoring frequency of urination indicates bladder involvement, often related to cystitis. However, it does not indicate ascending progression to the kidneys, which is more severe and requires additional symptoms.

Choice B rationale

Dysuria, or painful urination, typically signifies lower urinary tract infection rather than progression to upper urinary tract infection, such as pyelonephritis. It is not specific to kidney involvement.

Choice C rationale

Flank pain and fever are hallmark symptoms of pyelonephritis, indicating ascending progression of infection from the bladder to the kidneys. These symptoms signal systemic involvement and require immediate medical attention.

Choice D rationale

Pyuria and hematuria are signs of bladder infection but do not indicate progression to kidney infection. These are specific to inflammation or infection in the lower urinary tract.

A. Repeat short phrases at slightly increased speed. B. Limit her daily caffeine intake. C. Face her directly when you are speaking to her. D. Occasionally vary between higher and lower pitch of your voice.

Correct Answer is C

Explanation

Choice A rationale

Speaking at increased speed may hinder comprehension in individuals with sensorineural hearing loss, as clarity diminishes with rapid verbalization.

Choice B rationale

Reducing caffeine intake is irrelevant to auditory function; caffeine influences systemic effects but does not aid hearing impairment.

Choice C rationale

Facing the individual directly ensures clear visual cues, including lip reading, critical for communication with sensorineural hearing loss.

Choice D rationale

Varying pitch disrupts consistency in auditory perception; maintaining a steady tone aids clarity for impaired auditory processing.

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The nurse is caring for several patients in the Intensive Care Unit (ICU). Which of the following patients is at the greatest risk of anoxic brain injury?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

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