Neuro & Cognition
A family says their loved one suddenly became confused after two days on bedrest. Name the most likely condition and one first nursing action.
Delirium, acute onset. Notify provider and assess for causes such as infection, meds, immobility, then implement reorientation and safety
A client starting donepezil states it will cure memory loss. What correction and timing instruction do you give.
It improves symptoms, it does not cure; typically take in the evening as prescribed, monitor for dizziness or GI upset.
Classic hip fracture presentation on assessment. Name two features.
Shortened, externally rotated leg with severe hip pain and inability to bear weight.
Confirmed pulmonary TB in the ED. What precautions and room type.
Airborne precautions with N95 and negative pressure room.
Define serosanguineous drainage.
Pale pink, watery mixture of serous fluid and small amount of blood.
Differentiate acute versus chronic pain by duration and vital sign pattern.
Acute: short-term, often increased HR and BP. Chronic: persistent, may have normal vitals.
A client misplaces items and forgets recent reading yet passes a basic exam in clinic. Name the general stage pattern and a nursing priority.
Early mild cognitive decline, support routines and organization tools, reinforce safety planning.
Why combine donepezil and memantine.
They target different mechanisms
SPLATT fall assessment, identify what P and L stand for.
P: Previous falls. L: Location of fall.
Post-op wound with redness, warmth, swelling, yellow drainage, fever. Priority nursing action.
Notify provider and obtain a wound culture to guide therapy.
A large open leg wound is healing from the base with granulation tissue. Healing type.
Secondary intention.
Nonpharmacologic support for moderate post-op pain when patient prefers to delay analgesics.
Frequent repositioning, splinting, relaxation, heat or cold when appropriate, combine with timely analgesia as needed.
Differentiate two features: Alzheimer disease versus frontotemporal dementia.
Alzheimer disease: memory first, plaques and tangles. Frontotemporal: early behavior and language changes due to protein accumulation in frontal and temporal lobes.
Metronidazole teaching for a weekend party.
Avoid alcohol during therapy and for 48 hours after the last dose.
Post-op hip ORIF teaching, which movement is contraindicated and why.
Do not cross legs or flex hip past 90 degrees, prevents dislocation.
Flu positive on day three wants to return to class. What is the patient teaching?
Stay home until fever free for at least 24 hours without antipyretics.
Identify the most common pressure site in a bedbound adult and one prevention measure.
Heels; offload with pillows or heel protectors and reposition at least every 2 hours.
Insomnia coaching, list two sleep hygiene strategies.
Consistent bedtime routine and reduce stimulating activities or screens before bed.
A patient with Parkinson disease asks why they developed it. Name one modifiable risk to explore and one safety teaching for meals.
Occupational toxin exposure such as pesticides; meal safety: upright posture, small bites, thickened liquids if indicated, aspiration precautions.
Doxycycline education for acne. List two key points.
Photosensitivity, use sun protection; avoid taking with dairy or calcium-rich products that reduce absorption.
Soft-tissue ankle sprain on day one. Name the correct acute phase plan.
RICE, rest, ice intermittently up to 20 minutes, compression, elevation, avoid heat and early weight bearing.
A client in the clinic reports a persistent dry cough, low grade fever, and night sweats. What condition should the nurse suspect and what initial test is typically ordered?
Possible tuberculosis infection. Order a TB skin test or IGRA blood test and follow with chest imaging if positive.
Stage this ulcer: full-thickness loss with exposed tendon and undermining.
Stage 4 pressure injury.
A patient says they fall asleep but wake up repeatedly because they "can’t shut their brain off" at night. What is one evidence based recommendation and one lifestyle factor to assess?
Recommend scheduled wind down time with relaxation techniques such as deep breathing or guided imagery. Assess caffeine intake, especially after midday.
You must distinguish delirium from dementia for discharge teaching. Give two differences in onset and course, and one family teaching point.
Delirium: sudden, fluctuates, usually reversible. Dementia: gradual, progressive. Teach families that treating the cause of delirium often restores baseline.
A client on ciprofloxacin reports a sudden sharp heel pain. What now and why.
Stop the medication and notify the provider immediately due to risk of tendonitis or tendon rupture.
Suspected compartment syndrome in a leg fracture. Name one early vascular sign and your priority.
Delayed capillary refill greater than 3 seconds or increasing pain out of proportion; notify provider immediately and prepare for urgent intervention.
A patient with confirmed influenza is admitted with severe shortness of breath. What transmission based precautions are required and what is one priority intervention.
Droplet precautions with mask use. Priority intervention is rapid assessment of oxygenation and initiation of supplemental oxygen as ordered.
Serum albumin is 1.9 g/dL in a slow-healing wound. What does this suggest and one nursing action?
Poor nutritional status, consult nutrition, optimize protein intake.
Cognitive decline with nighttime wakefulness and wandering. Best environmental intervention.
Dim lights and quiet environment at customary bedtime, maintain safety, minimize nighttime stimulation.