While providing care for a patient with Guillain-Barre syndrome, the nurse conducts a neurological assessment every four hours. Which finding from the assessment requires immediate intervention by the nurse?

Profuse sweating.

Weakness in the lower legs.

Loss of sensation at T-8.

Leg pain that worsens at night.

Answer and Explanation

The Correct Answer is C

Guillain-Barre syndrome is a disorder in which the body’s immune system attacks the nerves, causing weakness and tingling, usually starting in the legs and hands. A loss of sensation, especially at the T-8 spinal level, could indicate that the syndrome is progressing, potentially leading to paralysis. This would require immediate intervention by the nurse to prevent further complications.

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Correct Answer is ["A","D","E"]

Explanation

Furosemide is a loop diuretic used to treat fluid retention and high blood pressure by increasing the amount of urine the body makes. Therefore, assessing urinary output is crucial to determine the patient’s response to treatment. Lung sounds and oxygen saturation should also be assessed as furosemide is often used to treat edema caused by heart failure. Improved lung sounds and oxygen saturation can indicate a reduction in fluid buildup in the lungs.

A. Latent hepatitis C. B. Crohn’s disease with colectomy. C. History of nephrotic syndrome. D. Type 2 diabetes mellitus.

Correct Answer is B

Explanation

Choice A rationale
Latent hepatitis C is not a contraindication for peritoneal dialysis. While it may require additional monitoring and treatment, it does not prevent a patient from receiving peritoneal dialysis.
Choice B rationale
Crohn’s disease with colectomy is a contraindication for peritoneal dialysis. The presence of extensive adhesions and fibrosis from the surgery can make the peritoneum unsuitable for dialysis.
Choice C rationale
A history of nephrotic syndrome is not a contraindication for peritoneal dialysis. Nephrotic syndrome is a kidney disorder, and peritoneal dialysis can be used as a treatment for patients with kidney disease.
Choice D rationale
Type 2 diabetes mellitus is not a contraindication for peritoneal dialysis. Many patients with diabetes undergo peritoneal dialysis. However, careful monitoring of blood glucose levels is necessary, as the dialysis solution used in peritoneal dialysis contains glucose.

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While providing care for a patient with Guillain-Barre syndrome, the nurse conducts a neurological assessment every four hours. Which finding from the assessment requires immediate intervention by the nurse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

An hour after administering 60 mg of furosemide intravenously (IV), which assessments should the nurse perform to determine the patient’s response to treatment? (Select all that apply.)

Correct Answer is ["A","D","E"]

Explanation

A client is diagnosed with chronic kidney disease and needs to begin dialysis. Which condition entered on the client’s medical record should the nurse recognize as a contraindication for peritoneal dialysis?

Correct Answer is B

Explanation

The nurse is providing discharge teaching to an older patient hospitalized for treatment of venous leg ulcers. What instructions should the nurse include in the teaching plan? (Select all that apply.)

While providing care for a patient with Guillain-Barre syndrome, the nurse conducts a neurological assessment every four hours. Which finding from the assessment requires immediate intervention by the nurse?

What information should the nurse include in the teaching plan for a patient diagnosed with gastroesophageal reflux disease (GERD)?

Following a transurethral resection of the prostate (TURP), a patient is discharged from the hospital with an indwelling urinary catheter. Which instruction is most important for the nurse to include in the discharge teaching plan?

The healthcare provider prescribes diagnostic tests for a patient whose chest x-ray indicates pneumonia. Which diagnostic test should the nurse prepare the patient for?

The nurse is providing discharge teaching to an older adult patient hospitalized for treatment of venous leg ulcers. Which instructions should the nurse include in the teaching plan? (Select all that apply.)

An overweight young adult diagnosed with type 2 diabetes mellitus is admitted for a hernia repair. The patient reports feeling very weak and jittery. What actions should the nurse take? (Select all that apply)