2. As a nurse in a clinic that is held weekly in the local senior center, you perform comprehensive
physical assessments and prepare your patients for a general exam by the gerontologist, who
offers free care to low-income seniors. The physician places great importance on detecting early
neurologic changes in this population. (Learning Objectives #1 & #5)
a. In a mental status assessment, what findings would be considered outside normal limits?
b. In the early stages of neurological impairment, which orientation is typically lost first?
C. How might you assess this orientation?
d. Which inquiries could be used to assess a patient's immediate memory?
e. What might a patient's inability to follow a simple command indicate?

A62-year-old man is being treated for an acute myocardial infarction. he originally came to the ed with substernal chest pain and diaphoresis. given his risk factors of hypertension, diabetes, tobacco use, and family history, he is considered high risk. an ecg in the ed reveals a left-bundle branch pattern, and cardiac enzymes are elevated slightly. after a focused evaluation in the ed, the patient receives iv thrombolytics. although his bundle branch pattern never resolves, the patient is chest pain-free and haemodynamically stable after thrombolysis. two days later, however, the patient reports episodes of recurrent chest discomfort and shortness of breath overnight. in evaluating for potential myocardial reinfarction, which of the following is the most appropriate diagnostic test? - creatinine kinase- dynamic ecg changes- lactate dehydrogenase- myoglobin levels- troponin i level