The nurse is assigned to a patient who presents to the emergency department with a severe headache. Upon physical assessment, the patient’s heart rate is 114 bpm, temperature is 38.2[Symbol]C (100.8[Symbol]F), and the blood pressure is 149/93 mmHg. Which of the following questions by the nurse is most important?

“Are you experiencing neck stiffness?”. A patient who presents with severe headache and fever should be assessed for meningitis, which can be deadly as well as contagious. Once the nurse has assessed the patient for meningitis, the nurse can ask about myalgia, arthralgia, nausea, vomiting, and infectious contact, which are of secondary priority.

The nurse is assigned to a patient who presents to the emergency ...

NCLEX Practice
Categories
Reduction of Risk Potential
View Question

Category: Reduction of Risk Potential
Difficulty: 4

Topics: Disease Prevention Neurology

Want help? View the answer with rationale.

Additional Reduction of Risk Potential Questions

During postoperative day 1 after a suprapubic prostatectomy, which assessment is most important for the drainage from the surgical wound?

Question Type: Multiple Choice - Select One
Difficulty: 8

Upon auscultating the patient’s heart, the nurse notes an S3 heart sound in the mitral area. How does the nurse interpret this assessment?

Question Type: Multiple Choice - Select One
Difficulty: 6

The nurse is observing the student nurse preparing a 6-year-old for the insertion of an intravenous catheter. Which statement by the student nurse prompts the nurse to intervene?

Question Type: Multiple Choice - Select One
Difficulty: 8

Show Calculator

Want help? View the answer with rationale.

Rationale

Additional Reduction of Risk Potential Questions

Nursing Careers

Nursing Degrees

NCLEX