NURS 218 Personal Care of Head Emergencies at Baton Rouge Community College
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Free NURS 218 Personal Care of Head Emergencies at Baton Rouge Community College Questions
A nurse is caring for a client following a total laryngectomy. Which of the following is the priority nursing problem for the client?
- A. Patency of the intravenous line
- B. Need for suctioning
- C. Integrity of the dressing
- D. Level of pain
Explanation
After a total laryngectomy, ensuring airway patency is the priority. The patient will likely have a tracheostomy or a stoma, and suctioning is necessary to clear any mucus or secretions that could obstruct the airway. Difficulty breathing or labored breathing due to secretions can quickly become a life-threatening situation, so suctioning to clear the airway takes precedence over other concerns.
A client with attention-deficit hyperactivity disorder demonstrates symptoms of Tourette's disorder. The client is treated with clonidine. Which would indicate that the medication is effective?
- A. An increase in seizure activity
- B. There is a decrease in motor tics
- C. The client's attention span is longer
- D. The client is less impulsive
Explanation
Clonidine is commonly used to treat both ADHD and Tourette's disorder. It works by affecting receptors in the brain that regulate attention and impulsivity, as well as modulating symptoms like tics. A decrease in motor tics is a direct sign that clonidine is effective in managing symptoms of Tourette's disorder. While clonidine may also affect attention span and impulsivity, its primary action in this scenario is to reduce the tics associated with Tourette's.
A nurse is providing teaching to an adolescent patient who is to begin taking atomoxetine (Strattera) for Attention Deficit Hyperactivity Disorder. The nurse should instruct the patient to monitor for which adverse effect?
- A. Increased appetite
- B. Somnolence
- C. Yellowing skin
- D. Weight gain
Explanation
Atomoxetine (Strattera) is a non-stimulant medication used to treat Attention Deficit Hyperactivity Disorder (ADHD). A rare but serious adverse effect of atomoxetine is liver damage, which can present with symptoms like yellowing of the skin (jaundice) or eyes. The nurse should instruct the patient to monitor for any signs of liver problems, such as yellowing of the skin, and report them immediately, as this could indicate liver toxicity.
Prescribed: Phenytoin oral suspension 80 mg po TID
Available: Phenytoin per label. See attachment.
How many mL will the nurse administer per dose? Record your answer to the tenth (one decimal place).
Explanation
Calculation:
- Concentration: 125 mg ÷ 5 mL = 25 mg/mL
- Prescribed Dose: 80 mg
- Volume to Administer: 80 mg ÷ 25 mg/mL = 3.2 mL
An unconscious teenager is treated in the emergency department. The teenager's friends suspect the teenager was drugged and raped at a party: Which action is priority?
- A. Obtaining a description of the rape from a friend
- B. Preserving rape evidence
- C. Maintaining physiological stability
- D. Determining what drug was ingested
Explanation
The priority in any emergency situation, particularly when the patient is unconscious, is to maintain physiological stability. This includes ensuring that the patient's airway is open, breathing is adequate, and circulation is stable. If the patient is unconscious and possibly drugged or assaulted, stabilizing their vital signs and preventing further harm is the first action to take. Once the patient is physiologically stable, other actions like preserving evidence and determining what drugs were ingested can follow.
The nurse is assigned to a group of patients in the emergency department. Which individual should be considered at highest risk for completing suicide?
- A. A 38-year-old single, African American female church member with fibrocystic breast disease
- B. An adolescent Asian American girl with superior athletic and academic skills who has asthma
- C. A 60-year-old married Hispanic man with 12 grandchildren who has type 2 diabetes
- D. A 79-year-old single, white male diagnosed recently with terminal cancer of the prostate
Explanation
The patient at the highest risk for completing suicide is the 79-year-old single male diagnosed with terminal prostate cancer. Risk factors for suicide in older adults include being male, being single or living alone, having a recent diagnosis of a terminal illness, and experiencing significant physical pain or a loss of independence. Individuals diagnosed with terminal illnesses, such as cancer, often have an increased risk of suicide due to feelings of hopelessness and fear of prolonged suffering.
A child has been placed on central nervous system (CNS) stimulants for attention-deficit hyperactivity disorder (ADHD). The nurse should include which side effects of the medication while teaching the parents?
- A. Growth retardation, urinary retention, and bradycardia
- B. Nervousness, nausea and vomiting, and dystonia
- C. Headache, insomnia, and possible growth retardation
- D. Bradycardia, weight gain, and insomnia
Explanation
CNS stimulants, such as methylphenidate and amphetamines, are commonly prescribed for ADHD. The most common side effects include headache, insomnia (difficulty sleeping), and potential growth retardation (slowed growth or weight gain). These side effects occur due to the stimulating effects of the medication on the central nervous system. Parents should be made aware of these potential side effects and should monitor the child's response to medication, including any changes in growth patterns or sleep disturbances.
Which personality traits will most likely be documented by the nurse regarding a patient demonstrating characteristics of an obsessive-compulsive personality disorder?
- A. Dramatic speech, Impulsive
- B. Perfectionist, inflexible
- C. Suspicious, holds grudges
- D. Affable, generous
Explanation
Obsessive-compulsive personality disorder (OCPD) is characterized by a preoccupation with orderliness, perfectionism, and control. People with OCPD are often very detail-oriented, have high standards, and are inflexible about how things should be done. They may focus excessively on rules, order, and procedures, and may struggle to adapt to changes or to delegate tasks. This rigid, perfectionistic behavior is a hallmark of OCPD.
A nurse in a pediatric clinic is caring for a preschool-age child who has a new diagnosis of Attention Deficit Hyperactivity Disorder (ADHD). When teaching the guardian about this disorder, which statement should the nurse include in the teaching?
- A. "Below-average intellectual functioning is associated with ADHD."
- B. "Behaviors associated with ADHD are present prior to age 3."
- C. "This disorder is characterized by argumentativeness."
- D. "Because of this disorder, your child is at an increased risk for injury."
Explanation
Children with ADHD often exhibit hyperactivity, impulsivity, and inattention, which can increase their risk for accidents and injuries. Due to their impulsive behavior and difficulty focusing, they may engage in risky behaviors without considering the potential consequences. This can lead to a higher likelihood of injuries, such as falls, cuts, or other accidents, especially in environments where supervision may be lessened.
A client with attention-deficit hyperactivity disorder is assessed by a nurse. Which assessment findings are expected? Select all that apply.
- A. Distractibility
- B. Increased attention to detail
- C. Increased level of activity
- D. A history of accidental injuries
- E. Reluctance to talk
- F. Impulsiveness
Explanation
A. Distractibility Distractibility is a hallmark symptom of ADHD. Individuals with ADHD often have difficulty staying focused on tasks or activities, leading them to become easily distracted by external stimuli or irrelevant thoughts. This constant shifting of attention interferes with their ability to complete tasks, whether at school, work, or home.
C. Increased level of activity Hyperactivity is a core feature of ADHD. This manifests as an excessive need for movement or fidgeting, difficulty staying still, and being constantly on the go. This increased level of activity can be evident in both children and adults with ADHD and may result in challenges in situations that require prolonged focus or calm behavior, such as in classrooms or meetings.
D. A history of accidental injuries Due to impulsivity and hyperactivity, individuals with ADHD are at an increased risk of accidents. They may act without considering the consequences, making them more prone to injuries. Additionally, their constant movement and inability to focus on safety can lead to frequent accidents or mishaps, which can be reflected in a history of injuries.
F. Impulsiveness Impulsivity is a central feature of ADHD. This can lead to actions taken without thinking through the consequences, such as interrupting others, making decisions without adequate consideration, or engaging in risky behaviors. Impulsive behaviors can also extend to difficulty waiting for one's turn or acting inappropriately in social situations.
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