Would someone mind helping with a few study guide questions?

[aaabbbccc]

Hello everyone! I'm a new poster and I'm in need of some assistance. I'm currently working on a take-home study guide and while I have completed most of it, I'm hung up on about nine questions.

If anyone could help me with answering them, I'd really appreciate it. For the record, we are allowed to use any and all online resources to complete the guide. I've bolded the answers I suspect to be correct on the handful of questions I've been able to find a little information about. The questions are as follows:

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."

B - "The focus on care in a rehabilitation facility is to teach the patient to resume as much self-care as possible."

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."

D - "Rehabilitation means helping the patient do what they did before their stroke."

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

B - The rehabilitation process

C - Causes of stroke

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

B - How genomic and physical factors influence longevity

C - How genetic and environmental factors influence health and disease

D - How physical factors influence genetics and wellness

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

B - Elevation of the head of the bed

C - Head turned to the left side

D - Extension of the neck

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.

B - Let the patient know that her loss may not occur again

C - Instruct her on chromosome testing studies

D - Tell her to have an amniocentesis with the next pregnancy

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

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

C - Answering the patient's genetic questions

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

B - Encourage independence with ADLs to promote self-esteem

C - Encourage family visitations to decrease anxiety

D - Absolute bed rest in a quiet nonstimulating environment

[StudentOfHealing]

DI is caused when the ICP is so high that the brain smooshes down up against the bottom of the skill, making the pituitary ischemic. You see this all the time in organ donors :) Result: No ADH, lots of water out the renals, clear urine with a specific gravity of 1.000 or close to it, massive intravascular loss.

Absent other reasons for huge water losses through the kidney (lithium poisoning is a good one-- disables the kidneys from recognizing ADH even if there's lots of it around; smaller effects from ordinary alcohol, which is why you pee so much after a few drinks), DI is a late sign.

So they do a water deprivation to r/o nephrogenic origin ? Lithium is nephrogenic origin ?

[nurseprnRN, BSN, RN]

You can lose liters and liters per hour with DI of any origin (no ADH with normal kidneys vs. kidneys that don't recognize ADH, all the same effect in the Foley bag), so I don't think a water deprivation regimen would last too long :)

You'd get the diagnosis from the history-- no head trauma, history of lithium use, lotsa dilute pee: bingo.

[KelRN215, BSN, RN]

So they do a water deprivation to r/o nephrogenic origin ? Lithium is nephrogenic origin ?

They do water deprivation if the diagnosis isn't obvious. DI can be complete or partial. They distinguish between neurogenic and nephrogenic DI by the body's response to DDAVP. Someone who's in DI because they lack ADH will concentrate urine after receiving DDAVP. Someone who's in DI because their kidneys don't respond to their circulating ADH will not respond to DDAVP. If a patient is hypernatremic with polyuria, water deprivation is unnecessary and potentially harmful.

[StudentOfHealing]

They do water deprivation if the diagnosis isn't obvious. DI can be complete or partial. They distinguish between neurogenic and nephrogenic DI by the body's response to DDAVP. Someone who's in DI because they lack ADH will concentrate urine after receiving DDAVP. Someone who's in DI because their kidneys don't respond to their circulating ADH will not respond to DDAVP. If a patient is hypernatremic with polyuria, water deprivation is unnecessary and potentially harmful.

Gotha!!! makes sense :)

[MendedHeart]

As a student it's good to know that real NCLEX questions are never all of the above. However, just yesterday in MedSurg we had a question on a quiz where the answer WAS all of the above. So, it is possible that all of the above is correct on this poster's question.[/quote']

I would challenge that. That happened one time with a newer instructor. We challenged and the question was nullified.

[nurseprnRN, BSN, RN]

I would challenge that. That happened one time with a newer instructor. We challenged and the question was nullified.

I hate to break it to you, but that doesn't mean you were right. Been there, done that.

[MendedHeart]

I hate to break it to you, but that doesn't mean you were right. Been there, done that.

Excuse me? Not sure what you mean. I may leave this site. Between you and Esme, the two "all-knowing and powerful oz's"- im really tired of being told what im saying is wrong..Seems like yall are the only ones that can answer these posts with " true answer". Ugg, it doesnt matter if I was right or not, its the point and principal that we were told that we will NEVER have all correct because its not NCLEX style. So whatever. Just saying, and by the way, I graduated this year not 20 years ago, the info is rather fresh.

[Esme12, ASN, BSN, RN]

I am positive that you are correct. I am sure your program has told you that NCLEX will never have all of the answers correct.

I am so sorry you feel upset that is never my intention. While your school was very good about this it doesn't mean that every program is the same, nor maintains the same standards as your program did. I think that we all can agree that there are so many different programs out there and they are not all cut from the same cloth....of course you can answer any question you like. All members are welcome to post in what ever thread they like, as long as they follow the TOS, which does make for differences of opinions now and then.

All members contributions are valuable and in this instance...I have agreed with you. I know that when I post in a public forum I accept the fact that not everyone is going to agree with me and not everyone will what I post...and that is ok with me. I take no offense. I take into consideration that all nursing programs are not the same and try to formulate my answers accordingly. I do not give answers and require students to answer what they have , show their work, so I know how best to help them and make them the best nurse they can be...that is my only goal.

I always try to remember that when I answer questions I am giving the best answer that I can give using my extensive experience as a nurse and as an educator. There are several members that assist in the student forum that are educators and try our very best to help students. Are we always right ? ...NO. Do we try our best? Yes we do.

I don't take posts to heart. I know people are going to disagree. I respect their opinion, take into consideration, and move on. A mentor here once told me....when posts upset you....Don't respond... report them and sometimes it si best to put the keyboard done and back away slowly...take a break and come back.

I wish you the best.

[ERnursebythebay]

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

Increasing ICP effects the pituitary gland which in turn can inhibit the production of ADH and lead to DI. The increasing urinary output is an indicator of DI. These patients will put out large amounts of urine and become hypovolemic quickly without intervention.

[Exhaustipated, ADN, BSN]

I just finished my first semester of nursing school, and on at least 2 (maybe 3) of our Fundamentals exams we had SATA questions with all four choices correct. I have also heard that won't happen with NCLEX questions, but it happened with our unit exams.

[MendedHeart]

^^^thats a shame....just keep that in mind for the NCLEX.

[springchick1, ADN, RN]

I just finished my first semester of nursing school and on at least 2 (maybe 3) of our Fundamentals exams we had SATA questions with all four choices correct. I have also heard that won't happen with NCLEX questions, but it happened with our unit exams.[/quote']

We've had the same thing a e also had a select all that apply that was only one answer.