The nurse working in the Neuro ICU is caring for a client with Guillain Barre Syndrome. Which of the following activities would be best assigned to the Licensed practical nurse (LPN)?

Begin initial discharge teaching on home care activities

Begin administration of red blood cells

Reassess the clients mobility in the upper extremity

Administration of morphine for pain

Answer and Explanation

The Correct Answer is D

A) Begin initial discharge teaching on home care activities:
While discharge teaching is a vital part of the care process, it is typically an activity assigned to a registered nurse (RN) because it involves comprehensive patient education on topics such as medication management, follow-up care, and recognizing signs of complications. Guillain-Barré syndrome (GBS) often requires intensive care in the acute phase, and the RN is responsible for evaluating the client’s readiness for discharge and ensuring they fully understand the care required at home

B) Begin administration of red blood cells:
Administering blood products, such as red blood cells, requires close monitoring for potential reactions, and it is typically the responsibility of the RN. The RN must assess the client’s baseline status, monitor for transfusion reactions, and adjust care accordingly during the procedure. This task requires a higher level of clinical judgment and nursing knowledge than an LPN.

C) Reassess the client's mobility in the upper extremity:
Reassessing a client’s mobility, especially in a neurological condition like Guillain-Barré syndrome, requires detailed and ongoing assessment to determine changes in the patient’s strength, motor function, and overall neurological status. This activity is a more complex task that requires a registered nurse's clinical expertise.

D) Administration of morphine for pain:
The administration of pain medications, including morphine, can be appropriately assigned to the LPN under the supervision of an RN. The LPN is trained to administer medications and monitor for common side effects such as respiratory depression, especially in clients who may be at risk due to their neurological condition. However, it is essential for the LPN to communicate with the RN and report any significant changes in the client’s condition during pain management.

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Correct Answer is D

Explanation

A) Infuse lipoproteins to restore the myelin sheath:
Multiple sclerosis (MS) is an autoimmune disease where the immune system attacks the myelin sheath around nerve fibers. Plasmapheresis does not work by infusing lipoproteins to restore the myelin sheath. The treatment's primary goal is to remove harmful substances from the blood that may be contributing to the autoimmune attack, particularly antibodies that target the nervous system, not by restoring the myelin itself.

B) Remove excess fluid from the bloodstream:
Plasmapheresis is a process used to remove certain substances from the plasma, including antibodies and immune complexes that might be exacerbating an autoimmune condition like MS. If the goal were to remove excess fluid, the treatment would be more akin to dialysis or a fluid management procedure, but this is not the case with plasmapheresis.

C) Restore protein levels in the blood:
While plasmapheresis can sometimes lead to a temporary decrease in protein levels due to the removal of plasma, this is not its primary purpose. The primary goal of plasmapheresis in the context of multiple sclerosis is to remove circulating antibodies and other immune-related substances.

D) Remove circulating antibodies from the bloodstream:
Plasmapheresis works by removing circulating antibodies from the bloodstream. In multiple sclerosis, the immune system mistakenly targets the myelin sheath, and plasmapheresis helps to remove the antibodies responsible for this autoimmune response. This can provide temporary relief of symptoms during acute flare-ups of MS by reducing the immune system's attack on the nervous system.

A. It is pain that can be relieved with rest B. It is normal pain that will go away on its own on C. It is pain that is not relieved by taking nitroglycerin D. It is pain that requires a cardiac catheterization

Correct Answer is A

Explanation

A) It is pain that can be relieved with rest:
Stable angina is typically predictable and occurs during physical exertion or emotional stress when the heart’s oxygen demand exceeds its supply. The pain associated with stable angina usually resolves with rest or after the cessation of the activity that triggered it. Additionally, nitroglycerin can help alleviate the discomfort by dilating blood vessels and improving blood flow to the heart muscle.

B) It is normal pain that will go away on its own:
Although stable angina pain may resolve on its own when the precipitating factor (e.g., exercise or stress) is removed, it is not considered "normal" pain. The pain is a symptom of underlying coronary artery disease (CAD), indicating that the heart muscle is not getting enough oxygen. It’s important for the client to manage angina carefully, as it may progress to more serious forms, such as unstable angina or myocardial infarction (heart attack), if not addressed appropriately.

C) It is pain that is not relieved by taking nitroglycerin:
Nitroglycerin is commonly effective in relieving stable angina by relaxing the coronary arteries and improving blood flow to the heart. If a client’s angina is not relieved by nitroglycerin, it may indicate that the angina is no longer stable (i.e., it has become unstable angina) or that a more serious cardiovascular event is occurring, such as a heart attack.

D) It is pain that requires a cardiac catheterization:
Cardiac catheterization is a diagnostic and interventional procedure typically used when a patient has unstable angina or a history of myocardial infarction or when other treatments have failed. However, stable angina usually does not require immediate catheterization unless the pain is refractory or there is evidence of significant coronary artery blockage. The most common management for stable angina is lifestyle modifications, medications (e.g., nitroglycerin, beta-blockers, calcium channel blockers), and addressing risk factors for coronary artery disease.

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The nurse working in the Neuro ICU is caring for a client with Guillain Barre Syndrome. Which of the following activities would be best assigned to the Licensed practical nurse (LPN)?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with a diagnosis of multiple sclerosis is scheduled to receive plasmapheresis treatments. A nurse explains to the client's spouse that the purpose of plasmapheresis is to:

Correct Answer is D

Explanation

A client is admitted into the Cardiac ICU unit with a diagnosis of chronic stable angina. The nurse should teach the client that the most common characteristic of stable angina pain is that?

Correct Answer is A

Explanation

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