A 25-year-old client was admitted yesterday after a motor vehicle collision.
Neurodiagnostic studies showed a basal skull fracture in the middle
... [Show More] fossa.
Assessment on admission revealed both halo and Battle signs. Which new symptom
indicates that the client is likely to be experiencing a common life-threatening
complication associated with a basal skull fracture?
Rationale:
Clients with basilar skull fractures are at high risk for infection of the brain, as
indicated by an increased oral temperature (B), because the fracture leaves the
meninges open to bacterial invasion. Clients may experience (C and D), but these
findings do not pose as great a life-threatening risk as infection. Jugular distention (A)
is not a typical complication of basal skull fractures.
A. Bilateral jugular venous distention
B. Oral temperature 102° F
C. Intermittent focal motor seizures
D. Intractable pain in the cervical region
Submit
Incorrect | Correct Answer: B
A home health nurse knows that a 70-year-old male client who is convalescing at
home following a hip replacement is at risk for developing decubitus ulcers. Which
physical characteristic of aging contributes to such a risk?
Rationale:
Thin, nonelastic skin (C), is an important factor in decubitus formation. Proportion of
body fat to lean mass increases with age (A), and might help decrease ulcer
tendency. (B) results in gray hair. (D) can contribute to broken bones, but it is
probably not a factor in decubitus formation.
A. 16% increase in overall body fat
B. Reduced melanin production
C. Thinning of the skin with loss of elasticity
D. Calcium loss in the bones
Submit
Incorrect | Correct Answer: C
A home health nurse knows that a 70-year-old male client who is convalescing at
home following a hip replacement is at risk for developing decubitus ulcers. Which
physical characteristic of aging contributes to such a risk?
Rationale:
Thin, nonelastic skin (C), is an important factor in decubitus formation. Proportion of
body fat to lean mass increases with age (A), and might help decrease ulcer
tendency. (B) results in gray hair. (D) can contribute to broken bones, but it is
probably not a factor in decubitus formation.
A. 16% increase in overall body fat
B. Reduced melanin production
C. Thinning of the skin with loss of elasticity
D. Calcium loss in the bones
Submit
Incorrect | Correct Answer: C
Which abnormal lab finding indicates that a client with diabetes needs further
evaluation for diabetic nephropathy? [Show Less]