WorksheetsNCLEX - NERVOUS SYSTEM Day3 (Part 2)
Total questions: 11
Worksheet time: 11mins
Name
Class
Date
1.
The registered nurse (RN) and unlicensed assistive personnel (UAP) are caring for an 81-year-old client who had a total hip replacement 48 hours ago. When the UAP attempts to ambulate the client, the client yells and becomes combative. Which of the following statements would be appropriate for the RN to make to the UAP?
a)
Let the client rest and attempt to ambulate the client later.
b)
The client likely has dementia that has been exacerbated by the stress associated with surgery.
c)
Assist the client back to bed. I need to assess the client.
d)
The client does not seem satisfied with the care provided. I will try to make the client more comfortable.
e)
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2.
The nurse is giving a presentation at a community health event. The nurse should provide which instruction on how to prevent botulism?
a)
Boil water if unsure of its source
b)
Discard canned food with a bulging end
c)
Keep milk cold
d)
Wash hands
e)
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3.
The clinic nurse is assessing a previously healthy 60-year-old client when the client says, "My hand has been shaking when I try to cut food. I did some research online. Could I have Parkinson's disease?" Which response from the nurse is the most helpful?
a)
It can't be Parkinson's disease because you aren't old enough.
b)
Make sure you tell the physician about your concerns.
c)
Parkinson's disease does not cause that kind of hand shaking.
d)
Tell me more about your symptoms. When did they start?
e)
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4.
The nurse is teaching a client who had a partial laryngectomy and sustained damage to the ninth cranial nerve. Which of the following information should the nurse include?
a)
Your hearing has been affected, and you will need to be evaluated for a hearing aid.
b)
Your ability to blink and close your eye has been affected, and you will need to use artificial tears.
c)
Your balance has been affected, and you will need to be cautious when changing positions.
d)
Your gag reflex has been affected, and you will need to use a special swallowing technique.
e)
-
5.
The nurse in the emergency department is assessing a client who sustained a submersion injury in cold water. Which finding would indicate the most severe injury?
a)
Decreased body temperature
b)
Toes stiffly pointed down
c)
Weak and thready pulse
d)
Wheezing on auscultation
e)
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6.
The nurse is caring for a client who has bacterial meningitis. The client has a decreased level of consciousness. Temperature is 101.1 F (38.4 C) and blood pressure is 80/60 mm Hg. Which of the following actions should the nurse take first?
a)
Administer broad-spectrum antibiotics.
b)
Prepare the client for a lumbar puncture.
c)
Initiate an IV bolus of 0.9% sodium chloride.
d)
Prepare the client for a CT scan of the head.
e)
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7.
The nurse is caring for a client who developed Guillain-Barre syndrome after a recent gastrointestinal illness. It would be a priority to monitor the client for
a)
inability to cough
b)
unilateral leg swelling
c)
hypoactive bowel sounds
d)
diaphoresis with facial flushing
e)
-
8.
The nurse is caring for a client with left-sided weakness from a stroke. When assisting the client to a chair, what should the nurse do?
a)
Bend at the waist
b)
Keep the feet close together
c)
Pivot on the foot proximal to the chair
d)
Use a transfer belt
e)
-
9.
The nurse is caring for assigned clients. The nurse should first assess the client with a
a)
seizure disorder who is reporting nausea and an unsteady gait after receiving a dose of phenytoin
b)
spinal cord injury at L3 who is reporting lower abdominal pain and difficulty urinating
c)
malignant brain tumor who is reporting a headache and blurred vision
d)
closed head injury who is reporting drowsiness and vomiting
e)
-
10.
The nurse admits a client who fell off a 20-ft (6-m) ladder. On arrival in the emergency department, the client is arousable but lethargic. What is the nurse's priority action?
a)
Ask about client's chronic medical conditions
b)
Assess for level and duration of pain
c)
Obtain a Glasgow Coma Scale score
d)
Perform a head-to-toe assessment
e)
-
11.
The nurse is caring for a client who is experiencing status epilepticus and does not have a peripheral venous access device. Which of the following actions should the nurse take first?
a)
Administer rectal diazepam
b)
Transport the client for a CT scan
c)
Obtain a blood specimen for complete blood count
d)
Check the client for neck stiffness and Brudzinski sign
e)
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100 %
