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The patient presents with a complaint of "always dropping things and falling down." During the neurologic assessment, the nurse observes that the patient's display of rapid alternating movements is slow and misses often. The patient also loses balance during the Romberg Test. What neurologic problem would the nurse suspect?

Lesion of cranial nerve IX

Vestibular disease

Dysfunction of the cerebellum

Arteriovenous malformation (AVM) at frontal lobe

Answer and Explanation

The Correct Answer is C

A. A lesion of cranial nerve IX primarily affects swallowing and taste sensations rather than motor coordination or balance, so this is unlikely to explain the patient's symptoms.

B. Vestibular disease typically results in vertigo and balance issues, but the specific observations of slow alternating movements and loss of balance during the Romberg Test suggest a different underlying cause.

C. Dysfunction of the cerebellum would explain the patient's difficulties with rapid alternating movements and balance issues, as the cerebellum is responsible for coordinating motor activity and maintaining posture and balance. This aligns with the assessment findings, indicating a probable cerebellar dysfunction.

D. While an AVM in the frontal lobe could affect motor control, the specific symptoms presented, such as the inability to perform rapid movements and balance issues, are more characteristic of cerebellar dysfunction rather than a frontal lobe lesion.

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A. Encourage client to rinse the mouth twice a day with mouthwash B. Encourage client to perform mouth care before and after every meal C. Offer the client 3 meals per day with a snack at bedtime D. Assess the client's oral pain level once a shift

Correct Answer is B

Explanation

A. Rinsing the mouth with mouthwash is not sufficient for managing oral lesions, and some mouthwashes may contain alcohol that can further irritate the lesions; therefore, this intervention is inadequate.

B. Performing mouth care before and after every meal can help minimize discomfort, remove debris, and maintain oral hygiene, which is crucial for someone with painful oral lesions to encourage better nutritional intake.

C. Offering three meals with a bedtime snack may not be effective if the client is unable to eat comfortably; focusing on smaller, more frequent meals or nutrient-dense options may be more beneficial.

D. While assessing oral pain is important, it should occur more frequently than once per shift to ensure ongoing management and adjustment of care based on the client’s comfort and needs.

A. to continue the antiepileptic drug to prevent seizure activity B. morphine will be administered post-op for adequate pain control C. to continue taking the daily Aspirin until the day of surgery D. to continue the use of alternative or complementary therapies with family approval

Correct Answer is A

Explanation

A. Continuing antiepileptic drugs is crucial in patients with brain tumors, as these medications help prevent seizure activity, which is a common complication associated with brain tumors and surgical procedures.

B. While pain control is important, the specific medications used for postoperative pain management are determined after surgery; patients should be informed about general pain management strategies rather than specific drug administration.

C. Aspirin, an anticoagulant, should typically be stopped before surgery to reduce the risk of bleeding complications; therefore, patients should not continue taking it unless specifically directed by their healthcare provider.

D. Patients are usually advised to discontinue alternative or complementary therapies before surgery due to potential interactions with anesthesia or surgical procedures, and it should be clarified with the healthcare provider before proceeding.

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Correct Answer is B

Explanation

Correct Answer is A

Explanation

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