NUR 211 Unit 4 Practice Question
The nurse is assessing the motor and sensory function of an unconscious client. The nurse
should use which technique to test the client's peripheral response to pain?
A. Sternal rub
B. Nail bed pressure
C. Pressure on the orbital rim
D. Squeezing the sternocleidomastoid muscle
B. Nail bed pressure
We have an expert-written solution to this problem!
The nurse is caring for the client with increased ICP. The nurse would note which trend in Vital
signs if the ICP is rising?
A. Increasing temperature, increasing pulse, increasing Respirations, decreasing Blood
pressure.
B. Increasing temperature, decreasing pulse, decreasing respirations, increasing blood
pressure.
C. Decreasing temperature, decreasing pulse, increasing respirations, decreasing blood
pressure.
D. Decreasing temperature, increasing pulse, decreasing respirations, increasing blood
pressure.
B. Increasing temperature, decreasing pulse, decreasing respirations, increasing blood
pressure.
Previous
Play
Next
Rewind 10 seconds
Move forward 10 seconds
Unmute
0:00
/
0:15
Full screen
Brainpower
Read More
A client recovering from a head injury is participating in care. The nurse determines that the
client understands measures to prevent elevations in ICP if the nurse observes the client doing
which activity?
, A. Blowing the nose
B. Isometric exercises
C. Coughing vigorously
D. Exhaling during repositioning
D. Exhaling during repositioning
A client has clear fluid leaking from the nose following a skull fracture. Which finding would alert
the nurse that CSF is present?
A. Fluid is clear and tests negative for glucose
B. Fluid is grossly bloody in appearance and has a pH of 6
C. Fluid clumps together on the dressing and has a pH of 7
D. Fluid separates into concentric ring and tests positive for glucose
D. Fluid separates into concentric ring and tests positive for glucose
The nurse is caring for a client who begins to experience seizure activity while in bed. WHich
actions should the nurse take? (select all that apply)
A. loosening restrictive clothing
B. Restraining the clients limbs
C. Removing the pillow and raising padded side rails
D. Positioning the client to the side, if possible, with head flexed forward
E. Keeping the curtain around the client and the room door open so when help arrives they can
quickly enter to assist
A. loosening restrictive clothing
C. Removing the pillow and raising padded side rails
D. Positioning the client to the side, if possible, with head flexed forward
The nurse is assigned to care for a client with complete right-sided hemiparesis from a stroke.
Which characteristics are associated with this condition? (select all that apply)
A. The client is aphasic
B. The client has weakness on the right side of the body
C. The client has complete bilateral paralysis the arm and legs
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller LECTDERRICK. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $11.49. You're not tied to anything after your purchase.
