Alright, I've added some of my reasoning for the bolded answers I had previously posted. I also selected by 'best guess' answer for all but the question concerning thrombolytic therapy. I'm pretty clueless on that one. A rehabilitation nurse is approached by a stroke victim's family and asked why the patient has to do so much for himself when he is obviously struggling. What's the nurses best answer? A - "We are trying to help your family member be as useful as possible." – implies PT is useless, insulting B - "The focus on care in a rehabilitation facility is to teach the patient to resume as much self-care as possible." – This is true. Does not set unrealistic expectations. C - "We aren't here to care for the patient in the way the hospital staff did. We are here to help the patient get better so they can go home." – aggressive in tone, confrontational. D - "Rehabilitation means helping the patient do what they did before their stroke." – may set unrealistic expectations, possibly right but I don’t think so A nurse caring for a patient who is discharged home after a stroke is preparing patient/family teaching. What topics would be most important for the nurse to include? (MARK ALL THAT APPLY) A - Stroke Prevention - Preventing future strokes would be vital B - The rehabilitation process - Rehab process would be vital for aftercare C - Causes of stroke - not solid on this answer, knowing causes may prevent future events. D - Adequate nutrition E - Exercise In genetic and genomic medicine, what do nurses help both individuals and families understand? A - How genetic and psychological factors influence weekly rituals – the rituals parts makes this answer worse than others. B - How genomic and physical factors influence longevity – other factors than longevity would be important. C - How genetic and environmental factors influence health and disease – most likely candidate in my opinion focuses on the effects of genetic influence.. the environmental section does put me off a little. D - How physical factors influence genetics and wellness – it seems the priorities are swapped in this answer When caring for a patient who has had a stroke a priority is reduction of intracranial pressure. What position is indicated to assist with this goal? A - Head turned to the right side – non factor, especially since side effected by stroke isn’t indicated B - Elevation of the head of the bed – keeps head upright, above rest of body.. no pressure buildup by blow flowing to head C - Head turned to the left side – non factor, especially since side effected by stroke isn’t indicated D - Extension of the neck – not sure why, but doesn’t seem right While a nurse is taking a patient's history, the patient tells the nurse that she is trying to get pregnant and is very fearful she will have another miscarriage. She states she has lost two pregnancies and she shares with the nurse that she does not know why she lost the babies. Based on this PT's history, what recommendation should the nurse make at the present time? A - Instruct her to continue to try to get pregnant. – dismissed issue at hand B - Let the patient know that her loss may not occur again – while technically correct in ‘may not’ fails to address concern C - Instruct her on chromosome testing studies – may indicate genetic issue causing miscarriages, doesn’t directly address problem but indicates a possible resource. D - Tell her to have an amniocentesis with the next pregnancy – amniocentesis RAISES risk of miscarriage When assessing a patient, the nurse notes early signs of increasing ICP. What S/S might the nurse have noted? A - Increased respiratory effort B - Increased urinary output C - Decreased heart rate - these two seem most likely because ICP is related to blood flow, blood pressure, etc. D - Decreased blood pressure A family history that is obtained as a nursing assessment is the first step in what? A - Establishing the patten of inheritance B - Establishing a pedigree - pedigree allows visual representation of inherited traits and health status C - Answering the patient's genetic questions - family history is generally first genetic test done. would seem logical this may be an answer. D - Answering families' relationship questions As a member of the stroke team, you know that the contraindications for thrombolytic therapy include what? MARK ALL THAT APPLY A - INR above 1.0 B - Recent intracranial pathology C - Symptom onset greater than 2 hours prior to admission D - Current anticoagulation therapy E - Symptom onset greater than 3 hours prior to admission A patient with a cerebral aneurysm exhibits signs and symptoms of an increase in ICP. What nursing intervention would be most appropriate for this patient? A - Range of motion exercises to prevent contractures – may increase blood pressure and ICP due to changes in blood flow B - Encourage independence with ADLs to promote self-esteem – not a priority with ICP C - Encourage family visitations to decrease anxiety – stimulation may be counterproductive to stated goal D - Absolute bed rest in a quiet nonstimulating environment – no movement and lack of stimulation keeps PT at rest, keeps BP down, and may help with reducing ICP.