vSim for Nursing: Fundamentals: Vernon Russell with
complete solution
When taking a patient's health history, which of the following does the nurse identify as
risk factors for having a stroke? (Select all that apply.)
a) Diabetes Mellitus
b) Smoking
c) Recent weight loss
d) Asthma
e) Hypertension
a) Diabetes Mellitus
b) Smoking
e) Hypertension
Explanation: Risk factors for stroke include hypertension, smoking, and diabetes.
Obesity, not weight loss, is a risk factor for stroke. Asthma is not a risk factor for stroke.
The nurse has an order to complete neurochecks every four hours. Which assessments
would the nurse include in the neurological examination? (Select all that apply.)
a) Range of motion
b) Level of consciousness
c) Sensory perception
d) Cranial nerves
e) Memory
b) Level of consciousness
c) Sensory perception
d) Cranial nerves
e) Memory
Explanation: Components of a neurological examination include memory, level of
consciousness, sensory perception, cranial nerves, patterns of speech, and bilateral
hand grips. Range of motion would be appropriate for a musculoskeletal assessment.
The nurse is caring for four medical-surgical patients. Which patient should be assessed
using the Glasgow Coma Scale?
a) A 47-year-old patient who suffered a brain injury and lost consciousness in a motor
vehicle accident.
b) A 51-year-old patient with cancer who is experiencing episodes of anxiety and
depression.
c) An 85-year-old patient with dementia and increasing confusion.
d) A 32-year-old patient who is paraplegic and has pneumonia.
a) A 47-year-old patient who suffered a brain injury and lost consciousness in a motor
vehicle accident.
Explanation: The Glasgow Coma Scale measures eye opening, verbal response, and
motor response and is typically used with patients who have suffered a brain injury as a
result of trauma.
complete solution
When taking a patient's health history, which of the following does the nurse identify as
risk factors for having a stroke? (Select all that apply.)
a) Diabetes Mellitus
b) Smoking
c) Recent weight loss
d) Asthma
e) Hypertension
a) Diabetes Mellitus
b) Smoking
e) Hypertension
Explanation: Risk factors for stroke include hypertension, smoking, and diabetes.
Obesity, not weight loss, is a risk factor for stroke. Asthma is not a risk factor for stroke.
The nurse has an order to complete neurochecks every four hours. Which assessments
would the nurse include in the neurological examination? (Select all that apply.)
a) Range of motion
b) Level of consciousness
c) Sensory perception
d) Cranial nerves
e) Memory
b) Level of consciousness
c) Sensory perception
d) Cranial nerves
e) Memory
Explanation: Components of a neurological examination include memory, level of
consciousness, sensory perception, cranial nerves, patterns of speech, and bilateral
hand grips. Range of motion would be appropriate for a musculoskeletal assessment.
The nurse is caring for four medical-surgical patients. Which patient should be assessed
using the Glasgow Coma Scale?
a) A 47-year-old patient who suffered a brain injury and lost consciousness in a motor
vehicle accident.
b) A 51-year-old patient with cancer who is experiencing episodes of anxiety and
depression.
c) An 85-year-old patient with dementia and increasing confusion.
d) A 32-year-old patient who is paraplegic and has pneumonia.
a) A 47-year-old patient who suffered a brain injury and lost consciousness in a motor
vehicle accident.
Explanation: The Glasgow Coma Scale measures eye opening, verbal response, and
motor response and is typically used with patients who have suffered a brain injury as a
result of trauma.
