Author: Anonymous

A nurse educator is educating new nurses about the various medications used to manage seizure disorders. Which of the following medications should the nurse include as commonly used for the treatment of seizures? Select all that apply

A nurse educator is educating new nurses about the various medications used to manage seizure disorders. Which of the following medications should the nurse include as commonly used for the treatment of seizures? Select all that apply

H&P: 24 y/o healthy male comes to the emergency department (ED) after a motor vehicle accident (MVA). Transported to the ED via a spinal backboard and with a cervical collar to maintain head and neck alignment. Per emergency services, the client was unconscious at the site of the MVA and regained consciousness after 4 minutes. Client has since awakened and is ALOx3, moving all extremities. Client c/o dull headache, dizziness, and unable to remember how the accident occurred. No visual changes, weakness, or incontinence. No significant past medical or surgical history, except for a concussion during high school while playing contact football. Denies alcohol, tobacco, or illicit drug use.  Physical Assessment:  1/18/22 at 0943: VS as followed: 99.2F, Pulse: 98 and regular, Blood pressure: 134/81mmHg, and respirations: 20 and regular. ALOx3. GSC: 15. Skin has scattered bruising and scabs. Pupils equal and reactive, periorbital ecchymosis present. Heart and lung sounds normal. Head normocephalic with mild swelling to the basilar area of the head. Neck exam WNL w/ full range of motion. Abd soft, nontender, with positive bowel sounds.    For each finding, specify if the finding is a risk factor or not a risk factor for spinal injury.

The client is a 63-year-old female who arrived via emergency services with right-sided weakness, right facial droop, and slurred speech.  History and Physical History: Diabetes mellitus type II, hypertension, and rheumatoid arthritis. Spouse is answering questions for her at the bedside. Per spouse, the client has experienced recent increased stress and does not monitor her blood pressure. The client was in her usual health the night prior. She woke up around 0500 and having a typical morning until approximately 0630 when she noticed that she wasn’t able to hold her brush with her right hand. Spouse states he noticed that her face was also drooping at that time and called 911. Nurses Note: 07/05/20XX 0712: Client arrived and stroke alert initiated. Client is alert and oriented x 3 with slurred speech and aphasia. Client unable to lift or maintain gravity in right arm and right leg. Drooping to the right side of the face noted. Healthcare provider at bedside.    Nurses Note 7/5/20XX 0745:  The client is able to speak a few words and states that she has a history of atrial fibrillation and her gallbladder removed 4 months ago. The client begins to moan, hold her head, and complains of extreme pain in the back of her head. The lab has called with the stat laboratory results:   Lab Result Reference Range White blood cell 6.4 4.5-11 per microliter Hemoglobin 13.3 12-16 g/dL Hematocrit 39 38-46% Platelet 180,000 150,000-45000/microliter PT 11 11-13.5 seconds INR 1.1 0.8-1.2      Vitals 07/05/20XX 0712:   Temp: 98.6*F Pulse: 99 Respirations: 22 Blood Pressure: 180/118 O2 Saturation: 98% on Room Air 07/05/20XX 0810 – Client to radiology for CT without contrast. CT results: no evidence of hemorrhage.   07/05/20XX 0820: Client returns from Radiology and placed on bedside telemetry monitoring. Client remains in Atrial fibrillation. Healthcare provider at the bedside and orders to lower the blood pressure before administering thrombolytic to reduce the risk of hemorrhage. 07/05/XX 0830 – Client resting quietly. Right side remains weak, unable to maintain gravity in right arm and right leg, speech is slurred with some word finding difficulty. Client is frustrated and tearful. Remains in A-fib on the monitor with a rate of 90. Healthcare provider orders to administer thrombolytic – Tenecteplase 20 mg IV. Vitals: Temp: 98.6*F Pulse 90 Respirations: 20 Blood Pressure: 141/89 Oxygen Saturation: 98% on Room Air.    Following the administration of Tenecteplase, which symptoms would have priority to alert the health care provider? Select all that apply.

After receiving a sternal rub, a client demonstrates an extension of the upper left arm and rigidly extended left leg with plantar flexion. The nurse documents this response as:

A 62 y/o male is arriving via Emergency Medical Services (EMS) with chest pain.   Nurse’s Note:  12/16/20xx 1010: 62 y/o male c/o crushing sternal pain, radiating down the left arm. States the pain becomes worse with activity and started approximately two hours ago while shoveling snow. Patient states he is also short of breath with activity. Pt is ALOx3. Lungs clear throughout. Abd soft, nontender, bowel sounds active. Pt states urinary output is “normal” with no c/o of odor, pain, pressure. Skin is C/D/I. 18G in the left forearm.    Vital Signs:  98.4 F, HR – 99, RR – 18, BP 162/89, Pulse Ox: 93% on RA    ECG:  Sinus Tachycardia rate 99 bpm. ST elevation noted in V3 and V4    Laboratory Results:  Lab  Results  Reference Range:  WBC  9 x 10^3 cells/mm3  4500–11,000/mm3  RBC  5.3 × 106/μL  4.7-6.1 × 106/μL  Hgb  15.8 g/dL  Male: 14–17.4 g/dL  Hct  44%  Male: 42–52%  Plts  254,000/mm3  140,000–400,000/mm3  Na  144 mEq/L  135-147 mEq/L  Cl  104 mEq/L  95-106 mEq/L  K  4.8 mEq/L  3.5-5.3 mEq/L  CO2  29 mEq/L  22-30 mEq/L  BUN  12 mg/dL  6-20 mg/dL  Cr  1.1 mg/dL  0.6-1.3 mg/dL  Troponin T  0.7 ng/mL  0-0.04 ng/mL  Creatine Kinase MB (CK-MB)  187 IU/L  5-25 IU/L  Cholesterol  265 mg/dL  240 high  Which findings require immediate follow-up? Select all that apply

A nurse caring for a group of neurologic clients is receiving the change-of-shift report on four assigned patients. Which patient should the nurse assess first?

A client arrives at the emergency department with increasing shortness of breath, productive cough, and wheezing for the past 3 days.  Past Medical History Chronic obstructive pulmonary disease (COPD) – diagnosed 10 years ago, Hypertension, Hyperlipidemia, Former smoker: 40 pack-years, quit 2 years ago   Current Medications Tiotropium inhaler once daily Albuterol MDI as needed Lisinopril 10 mg daily Atorvastatin 20 mg nightly   Assessment Vitals: 100.6 *F, 112 bpm, 28/min labored, 152/88 mmHg, 86% on room air Client is ALOx3. Client has diminished breath sounds with expiratory wheezing and accessory muscle use, prolonged expiratory phase. Productive cough with thick, green sputum. Heart rate 112bpm, regular rhythm.  Bowel sounds present in all four quadrants. Voiding concentrated yellow urine with no complaints of pain. Skin clean, dry, and intact. Clubbing of fingernails present. 20G peripheral IV inserted into the right antecubital.  Laboratory and Diagnostic Test Results ABGs Results Reference pH 7.31 7.35-7.45 PaCO2 58 35-45 mmHg HCO3 30 22-26 mEq/L PaO2 55 75-100 mmHg     CXR: hyperinflation, no focal consolidation CBC Results Reference White blood cells 14.5 4000-11000/mcL Red blood cells 5.8 million/mcL 4.7-6.1 million/mcL Hemoglobin 13.1 g/dL 13.2-16.6 g/dL Hematocrit 38% 38.3-48.6% Platelets 152 150-400 K/uL   Which provider orders should the nurse anticipate for a client with an acute COPD exacerbation? (Select all that apply)

A nurse is teaching a client who has multiple sclerosis about their new prescription for dantrolene. Which of the following statements by the client indicates an understanding of the teaching?

What measures should be taken to lower the risk of increased intracranial pressure (ICP) when suctioning the client?