The nurse is working in a college clinic when a student comes in and says, "I think I have a migraine. My head hurts, I cannot stand the bright light, and I feel sick to my stomach." What additional finding is most concerning?

Positive Romberg sign

A subnormal temperature

An ill college roommate

Positive Brudzinski sign

Answer and Explanation

The Correct Answer is D

A. A positive Romberg sign (difficulty maintaining balance with eyes closed) can indicate a neurological issue, but it is not directly associated with a migraine.

B. A subnormal temperature (low body temperature) is not typically associated with migraines and may indicate another issue, but it is not as concerning as other findings.

C. An ill college roommate might suggest a viral illness, but it is not a direct concern for the student’s migraine. Migraines are not contagious, and other signs of illness would be more concerning.

D. Positive Brudzinski sign, which involves involuntary flexion of the hips and knees when the neck is flexed, is indicative of meningeal irritation, a sign of meningitis. This is a medical emergency and much more concerning than the symptoms of a migraine. The student should be further assessed for signs of meningitis, which requires urgent treatment.

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Correct Answer is A

Explanation

A. A concussion is considered a mild traumatic brain injury (TBI) that typically results in a temporary loss of brain function. It is often caused by a blow to the head and may result in confusion, dizziness, and loss of consciousness. However, if concussions occur repeatedly, they can lead to long-term cognitive impairment and other serious conditions like chronic traumatic encephalopathy (CTE).

B. A brainstem contusion is a more severe injury that affects the brainstem, which controls vital functions like breathing and heart rate. It is not classified as a mild injury.

C. A subdural hematoma is a collection of blood between the brain and its outermost covering. It is a serious condition that can result from a traumatic brain injury and is not considered mild.

D. An epidural hematoma is a collection of blood between the skull and the dura mater. It is often caused by a traumatic head injury and is considered a medical emergency, not a mild injury.

A. Postictal phase B. Presence of absence seizures C. Aura phase D. Presence of automatisms

Correct Answer is A

Explanation

A. The postictal phase refers to the period immediately following a seizure when the client is often drowsy, confused, or difficult to arouse. This phase can last for several minutes to hours, depending on the individual.

B. Absence seizures are brief, generalized seizures characterized by staring and loss of awareness, often without a postictal phase.

C. The aura phase refers to the sensory warning or symptoms that precede a seizure, not the post-seizure state.

D. Automatisms are involuntary, repetitive movements (such as lip smacking or hand wringing) that can occur during a seizure, but they do not describe the postictal state.

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The nurse is working in a college clinic when a student comes in and says, "I think I have a migraine. My head hurts, I cannot stand the bright light, and I feel sick to my stomach." What additional finding is most concerning?

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Naxlex Comprehensive Predictor Exams

What is considered a mild brain injury, unless the injury occurs repeatedly?

Correct Answer is A

Explanation

A nurse is caring for a client who is difficult to arouse and very sleepy for several hours following a generalized tonic-clonic seizure. Which of the following descriptions should the nurse use when documenting this finding in the medical record?

Correct Answer is A

Explanation

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The nurse is working in a college clinic when a student comes in and says, "I think I have a migraine. My head hurts, I cannot stand the bright light, and I feel sick to my stomach." What additional finding is most concerning?