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NSG 4100 (AH111) EXAM 4 NEWEST 2025 ACTUAL
EXAM COMPLETE QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS)
|ALREADY GRADED A+
The nurse is caring for a pt w permanent neurologic impairments resulting from a traumatic head injury. When working w this pt and family, what mutual goal should be prioritized?
- achieve as high a level of function as possible
- enhance the quantity of the pt's life
- teach the family proper care of the pt
- provide community assistance - ANSWER-A
The nurse is caring for a pt whose recent health hx includes an altered LOC. What should be the nurses first action when assessing this pt?
- assessing the pt's verbal response
- assessing the pt's ability to follow complex commands
- assessing the pt's judgment
- assessing the pt's response to pain - ANSWER-A
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The nurse for a pt in a persistent vegetative state is regularly assessing for potential complications. Complications of neurologic dysfunction for which the nurse should assess
include which of the following? Select all that apply:
- contractures
- hemorrhage
- pressure ulcers
- venous thromboembolism
- pneumonia - ANSWER-A, C, D, E
The nurse is caring for a pt w a brain tumor. What drug would the nurse expect to be ordered to reduce the edema surrounding the tumor?
- solumedrol
- dextromethorphan
- dexamethasone
- furosemide - ANSWER-C
The nurse is caring for a pt who sustained a moderate head injury following a bicycle accident. The nurses most recent assessment reveals that the pt's respiratory effort has increased.What is the nurses most appropriate response? 2 / 4
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- inform the care team and assess for further signs of possible
- administer bronchodilators and monitor the pt's LOC
- increase the pt's bed height and reassess in 30 mins
- administer a bolus of normal line as ordered - ANSWER-A
increased ICP
A pt has a poor prognosis after being involved in a motor vehicle accident resulting in a head injury. As the pt's ICP increases and condition worsens, the nurse knows to assess for indications of approaching death. These indications include which of the following?
- hemiplegia
- dry mucous membranes
- signs of internal bleeding
- loss of brain stem reflexes - ANSWER-D
When caring for a pt w increased ICP the nurse knows the importance of monitoring for possible secondary complications, including syndrome of inappropriate antidiuretic hormone (SIADH). What nursing interventions would the nurse most likely initiate if the pt developed SIADH?
- fluid restriction 3 / 4
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- transfusion of platelets
- transfusion of fresh frozen plasma (FFP)
- electrolyte restriction - ANSWER-A
A pt is recovering from an intracranial surgery performed approximately 24 hrs ago and is complaining of a headache that the pt rates at 8 on a 10-point pain scale. What nursing action is most appropriate?
- administer morphine sulfate as ordered
- reposition the pt in a prone position
- apply a hot pack to the pt's scalp
- implement distraction techniques - ANSWER-A
A pt is postoperative day 1 following intracranial surgery. The nurses assessment reveals that the LOC is slightly decreased w the day of surgery. What is the nurses best response to this assessment finding?
- recognize that this may represent the peak of post-surgical
- alert the surgeon to the possibility of an intracranial
- understand that the surgery may have been unsuccessful
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cerebral edema
hemorrhage
