Which assessment tool is commonly used to evaluate the level of consciousness in a neurologically impaired patient?
Numerical Rating Scale
Wong-Baker FACES Pain Rating Scale
Visual Analog Scale
Glasgow Coma Scale
The Correct Answer is D
A. Numerical Rating Scale is used to assess pain intensity, not consciousness.
B. Wong-Baker FACES is also a pain assessment tool, mainly for children.
C. Visual Analog Scale measures subjective pain levels.
D. Glasgow Coma Scale (GCS) is the standard tool used to assess a patient’s level of consciousness, evaluating eye opening, verbal response, and motor response.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Distended abdomen is more commonly associated with right-sided heart failure due to liver congestion and ascites.
B. Anorexia can be a nonspecific symptom and is not a primary indicator of left-sided heart failure.
C. Weight gain and edema in both legs are typical signs of right-sided heart failure, caused by systemic venous congestion.
D. Breathlessness (dyspnea) accompanied by crackles and wheezes indicates pulmonary congestion and fluid buildup, which are classic signs of left-sided heart failure where the heart fails to effectively pump blood out to the body, causing fluid to back up into the lungs.
Correct Answer is D
Explanation
A. Loss of consciousness may occur with concussion, but "translucent dreaming" is not a recognized symptom.
B. The Glasgow Coma Scale (GCS) score ranges from 3 to 15; a score of 20 is not possible.
C. Nuchal rigidity is a sign of meningeal irritation, not typically seen with concussion.
D. Sensitivity to touch (allodynia) or light sensitivity (photophobia) can occur after a concussion as part of the post-concussive symptoms.
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