A patient with a suspected traumatic brain injury has bloody nasal drainage. What observation should cause the nurse to suspect that this patient has a cerebrospinal fluid (CSF) leak?
A. A halo sign on the nasal drip pad
B. Decreased blood pressure and urinary output
C. A positive reading for glucose on a Test-tape strip
D. Clear nasal drainage along with the bloody discharge
Answer: A. A halo sign on the nasal drip pad
You might also like to view...
At the end of the shift, the nurse is ready to leave, but has not been relieved by the oncoming shift nurse. The nurse's responsibility to provide care for clients is part of the nurse's:
1. code of ethics. 2. critical thinking. 3. nursing process. 4. quality assurance.
Ma huang is an herbal product that has been used to relieve cold symptoms and for weight loss. The nurse would instruct a client receiving which of the following to avoid products containing ma huang? Select all that apply
A) Digoxin (Lanoxin) B) Phenelzine (Nardil) C) Guanethidine (Ismelin) D) Oxytocin (Pitocin) E) Halothane (Avestan)
Education for a patient receiving a cholesterol-lowering medication would include:
a. "This medication will take over for other interventions you have been trying in order to decrease your cholesterol." b. "It is important for you to make up your dose if you miss one in order to maintain therapeutic blood levels." c. "Stop taking the medication if you develop nausea and vomiting." d. "You should continue your exercise program in order to increase your high-density lipoprotein (HDL) serum levels."
The ability to mentally understand that 1 + 3 = 4 and 4 – 1 = 3 occurs in which stage of cognitive development?
a. Concrete operations b. Formal operations c. Intuitive thought d. Preoperations