1. A 52-year-old male enters a sleep study to gather information about his sleep disturbances. He reports that his wife will not let him sleep in the bed
... [Show More] with her until he stops snoring so loudly. He also reports feeling tired a lot through the day. When the nurse checks the chart, what is the most likely diagnosis?
• Insomnia - Not Selected
• Correct answer: Obstructive sleep apnea syndrome (OSAS)
• Somnambulism - Not Selected
• Jet-lag syndrome - Not Selected
General Feedback
OSAS generally results from upper airway obstruction recurring during sleep with excessive snoring and multiple apneic episodes that last 10 seconds or longer. Insomnia is the inability to fall or stay asleep and may be mild, moderate, or severe. It does not involve snoring. Somnambulism is sleep-walking. Jet-lag syndrome is a disorder of waking and sleeping and does not involve snoring.
2. For legal purposes, brain death is defined as:
• Correct answer: cessation of entire brain function.
• lack of cortical function - Not Selected
• a consistent vegetative state (VS) - Not Selected
• death of the brainstem - Not Selected
General Feedback
Brain death occurs when there is cessation of function of the entire brain, including the brainstem and cerebellum. Lack of cortical function or brainstem death is not enough to define brain death. A VS is complete unawareness of the self or surrounding environment and complete loss of cognitive function.
3. An infant is diagnosed with congenital hydrocephalus. Whch of the following characteristics would the nurse expect to find?
• Correct answer: Enlarged ventricles
• Decreased cerebrospinal fluid (CSF) production - Not Selected
• Increased resorption of CSF - Not Selected
• Smaller than average head circumference - Not Selected
General Feedback
Congenital hydrocephalus is characterized by enlargement of the cerebral ventricles. Increased, not decreased, CSF production would lead to hydrocephalus. Decreased resorption of CSF would lead to hydrocephalus, not increased CSF. An infant with congenital hydrocephalus would have increased head circumference.
4. An 11-year-old is newly diagnosed with type 1 DM. Whch classic symptoms should the nurse assess the patient for?
• Recurrent infections, visual changes, fatigue, and paresthesia - Not Selected
• Correct answer: Polydipsia, polyuria, polyphagia, and weight loss
• Vomiting, abdominal pain, sweet, fruity breath, dehydration, and Kussmaul breathing - Not Selected
• Weakness, vomiting, hypotension, and mental confusion - Not Selected
General Feedback
Classic symptoms of type 1 DM include polydipsia, polyuria, polyphagia, and weight loss. Recurrent infections and visual changes are complications of diabetes. Vomiting, abdominal pain, and sweet breath are signs of diabetic ketoacidosis. Weakness, hypotension, and mental confusion are signs of hypoglycemia.
5. When should the nurse assess for the vomiting and headache that are the classic symptoms of childhood brain tumors?
• Correct answer: Morning
• Early afternoon - Not Selected
• As the sun goes down and darkness begins - Not Selected
• During the middle of the night - Not Selected
General Feedback
Headache and vomiting occur more commonly in the morning.
6. A patient is admitted to the intensive care unit with a closed head injury sustained in a motorcycle accident. The injury has caused severe damage to the posterior pituitary. Whch of the following complications should the nurse anticipate?
• Incorrect answer: Dilutional hyponatremia
• Correct Answer: Dehydration from polyuria
• Cardiac arrest from hyperkalemia - Not Selected
• Metabolic acidosis - Not Selected
General Feedback
Diabetes insipidus is a well-recognized complication of closed head injury and is manifested by polyuria leading to dehydration. The patient will experience hypernatremia, not hyponatremia. Electrolytes other than sodium are typically not affected with diabetes insipidus. Acidosis is not associated with diabetes insipidus.
7. A patient diagnosed with Graves disease is admitted to a medical-surgical unit. Whch of the following symptoms would the nurse expect to find before treatment?
• Weight gain, cold intolerance - Not Selected
• Slow heart rate, rash - Not Selected
• Correct answer: Skin hot and moist, rapid heart rate
• Constipation, confusion - Not Selected
General Feedback
Symptoms of Graves disease include heat intolerance and increased tissue sensitivity to stimulation by the sympathetic division of the autonomic nervous system. Weight loss, rather than weight gain, and heat intolerance would result. Tachycardia, not slow heart rate, would occur. Diarrhea would occur as opposed to constipation.
8. Whch finding indicates the patient is having complications from heat stroke?
• Mild elevation of core body temperatures - Not Selected
• Correct answer: Cerebral edema and degeneration of the CNS
• Spasmodic cramping in the abdomen and extremities - Not Selected
• Alterations in calcium uptake - Not Selected
General Feedback
Symptoms of heat stroke include high core temperature, absence of sweating, rapid pulse, confusion, agitation, and coma, and complications include cerebral edema and degeneration of the CNS. Neither cramping nor alterations in calcium uptake are considered complications of a heat stroke.
9. When a patient has a fever, whch of the following thermoregulatory mechanisms is activated?
• The body’s thermostat is adjusted to a lower temperature. - Not Selected
• Temperature is raised above the set point. - Not Selected
• Bacteria directly stimulate peripheral thermogenesis. - Not Selected
• Correct answer: The body’s thermostat is reset to a higher level.
General Feedback
Fever (febrile response) is a temporary “resetting of the hypothalamic thermostat” to a higher level in response to endogenous or exogenous pyrogens. Fever is the result of the body’s attempt to raise temperature, not adjust it to a lower level. When fever occurs, the temperature is raised, but the rise is due to a reset of the thermostat. Bacteria do not stimulate peripheral thermogenesis, but their endotoxins do.
10. What is the main source of bleeding in extradural (epidural) hematomas?
• Correct answer: Arterial
• Venous - Not Selected
• Capillary - Not Selected
• Sinus - Not Selected
General Feedback
An artery is the source of bleeding in 85% of extradural hematomas. The bleeding associated with an extradural hematoma is not a result of damage to a vein, a capillary, or a sinus.
11. What common neurologic disturbances should the nurse assess for in a patient with a pituitary adenoma?
• Coma - Not Selected
• Correct answer: Visual disturbances
• Confused states - Not Selected
• Breathing abnormalities - Not Selected
General Feedback
The clinical manifestations of pituitary adenomas are visual changes including visual field impairments (often beginning in one eye and progressing to the other) and temporary blindness. Coma, confusion, and breathing abnormalities are not associated with pituitary adenomas.
12. Spinal shock is characterized by:
• loss of voluntary motor function with preservation of reflexes. - Not Selected
• Correct answer: cessation of spinal cord function below the lesion.
• loss of spinal cord function at the level of the lesion only. - Not Selected
• temporary loss of spinal cord function above the lesion. - Not Selected
General Feedback
Spinal shock is the complete cessation of spinal cord function below the lesion. The reflexes are not preserved in spinal shock. Spinal shock is the complete cessation of spinal cord function below the lesion, not at the lesion only.
13. What is the purpose of the glycosylated hemoglobin (hemoglobin A1c) test?
• Measuring fasting glucose levels. - Not Selected
• Correct answer: Monitoring long-term serum glucose control.
• Detecting acute complications of diabetes. - Not Selected
• Checking for hyperlipidemia. - Not Selected
General Feedback
Glycosylated hemoglobin refers to the permanent attachment of glucose to hemoglobin molecules and reflects the average plasma glucose exposure over the life of a red blood cell (approximately 120 days). Glycosylated hemoglobin does not measure fasting, but rather glucose control over time. Glycosylated hemoglobin does not identify complications but could provide data if the patient is at risk. Glycosylated hemoglobin does not check for hyperlipidemia.
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