The nurse is preparing a client with an acoustic neuroma for a magnetic resonance image (MRI). Which client complaint is life-threatening and should be reported to the healthcare provider immediately?

Right ear hearing loss.

Difficulty with balance.

Intensifying headache.

Facial numbness.

Answer and Explanation

The Correct Answer is C

A.   Right ear hearing loss. While significant, right ear hearing loss is not immediately life- threatening.
B.   Difficulty with balance. Balance issues may be concerning but are not typically indicative of a life-threatening condition.
C.   Intensifying headache. An intensifying headache can be a sign of increased intracranial pressure, which is a medical emergency and requires immediate attention.
D.   Facial numbness. Facial numbness can indicate nerve involvement but is not as immediately concerning as an intensifying headache, which could indicate a serious neurological issue such as bleeding or swelling in the brain.

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Correct Answer is C

Explanation

A. Maintaining nasal packing may be important post-hypophysectomy to prevent bleeding or cerebrospinal fluid leaks. However, in the context of Cushing's disease, ensuring oral hygiene is
paramount due to increased risk of infection, especially if the patient is on corticosteroid therapy, which suppresses the immune system.

B. Keeping the head of the bed at 30° helps prevent complications such as cerebral edema and increased intracranial pressure. While this is important post-hypophysectomy, it's not specific to Cushing's disease or a priority over oral care.

C. Providing frequent mouth care is crucial in Cushing's disease due to increased cortisol levels leading to immunosuppression and susceptibility to infections. Additionally, glucocorticoid therapy can cause mucosal dryness and ulceration, necessitating meticulous oral hygiene.

D. Monitoring intake and output is essential postoperatively to assess fluid balance and renal function. While important, it's not the priority in this context compared to oral care, especially considering the risk of dehydration due to increased cortisol levels in Cushing's disease.

Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"C"}

Explanation

Semi Fowler's position:

- This position involves raising the head of the bed to an angle of 30 to 45 degrees. It is

commonly used to improve respiratory function and comfort in patients who are experiencing

difficulty breathing. By elevating the head and torso, this position facilitates better lung expansion, helping to improve oxygenation.

Promote lung expansion:

- In patients with respiratory issues such as pneumonia, positioning that enhances lung expansion is critical. Semi Fowler's position helps to reduce pressure on the diaphragm, allowing for more effective lung expansion and improved oxygenation. This is particularly important for a patient with decreased breath sounds and consolidation in the lungs, as it aids in alleviating respiratory distress and improving gas exchange.

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The nurse is preparing a client with an acoustic neuroma for a magnetic resonance image (MRI). Which client complaint is life-threatening and should be reported to the healthcare provider immediately?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is monitoring a client with Cushing's disease in the postanesthesia care unit (PACU) after a hypophysectomy. Which intervention is most important for the nurse to include in the client's plan of care?

Correct Answer is C

Explanation

Exhibits The nurse should place the client in a position to promote

Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"C"}

Explanation

Exhibits For each statement, click to specify whether the statement is consistent with iron deficiency anemia, vitamin B12 deficient anemia, or folic acid deficient anemia. Each row must have at least one, but may have more than one, response option selected.

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Exhibits Based on the client's status at 1400, the nurse should plan to do which of the following? Select all that apply.

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