Chapter 78 & 80 Nervous & Sensory System Disorders Review
A client has an eye patch to allow the eye to rest following an injury playing soccer. Which of the following is a teaching point for a client with one eye patch? A) Warn the client not to drive a car or other machinery. B) Tell the client to remove the patch at night. C) Tell the client to report any changes in depth perception. D) Tell the client to report any changes in peripheral vision.
A
A client visits a community clinic with complaints of severe allergies causing a "crackling sensation" in the ear. The diagnosis is serous otitis media. Which of the following is a characteristic of this condition? A) Fluid collects in the middle ear, causing an obstruction of the auditory tube. B) An upper respiratory infection spreads through the auditory tube. C) This condition develops if acute purulent otitis media is not treated promptly. D) This condition is usually associated with a punctured eardrum.
A
A client visits the healthcare facility with an insect fluttering in his ear. Which of the following should the nurse do to extract the insect? A) Administer a few drops of mineral oil. B) Apply eardrops containing acetic acid. C) Apply eardrops containing boric acid. D) Administer a few drops of glycerin.
A
A client with loss of control over his voluntary movements is admitted to a healthcare facility. Of which functions performed by the motor neurons should the nurse be aware? A) Receive and transmit messages from the central nervous system (CNS) B) Associate impressions and information C) Maintain constant level of blood pressure D) Regulate release of hormones
A
A mill worker with injuries to the spinal cord is under care at a healthcare facility and is now anxious about the paralysis that he has experienced. What would be the consequence of a transection of the spinal cord? A) Permanent paralysis B) Chronic headaches C) Confusion D) Loss of renal function
A
A nurse is caring for a client who complains that of being unable to read a newspaper or a magazine properly, even in normal light. Which is the most likely cause for this condition? A) Pupil is no longer able to dilate fully B) Debris has built up within the eye C) Slow body secretions D) Continuous strain on the eye
A
A nurse is caring for a client who experiences cluster headaches. The nurse knows that cluster headaches result from a vascular disturbance leading to vasodilation. What symptoms and signs of vasodilation should the nurse look for in the client? A) Tears forming B) Reduced respiratory rate C) Generalized shivering D) Shrunken eyes
A
A nurse is caring for a client who has been admitted for eye surgery. As part of client education, the nurse is required to explain the function of the various structures of the eye. What information should the nurse provide the client about the vitreous humor? 1. Helps maintain the eyeball's shape 2. Contributes to intraocular pressure 3. Loss of the vitreous humor can lead to blindness 4. Provides nutrients and oxygen to the avascular lens and cornea A) 1, 2, 3 B) 1, 2, 4 C) 1, 3, 4 D) 2, 3, 4
A
A nurse is caring for a client who was in a motor vehicle accident and suffered damage to the external ear. The client asks the nurse how hearing will be affected on a long-term basis. What is the best description the nurse can give the client about the function of the external ear? A) Responsible for protecting internal structures of the ear from foreign substances B) Responsible for the transmission of sound C) Responsible for transmitting sound waves D) Responsible for providing information about body position to the brain
A
A nurse is caring for a client with paraplegia. Which of the following important measures should the nurse follow when providing care for this client? A) Encourage the use of high-top sneakers to prevent footdrop. B) Use a trapeze bar to help in maintaining proper body alignment. C) Use trochanter rolls to assist the client when changing positions. D) Ask the client to avoid breathing deeply because it may lead to exertion.
A
A nurse is caring for a client with trigeminal neuralgia. The client is advised by the healthcare provider to undergo partial surgical removal of the trigeminal (5th cranial) nerve root. Of what should the nurse be aware regarding the characteristic of pain in the client? A) The pain may be triggered by the slightest touch of the trigger zone. B) The pain usually occurs in spasms that can last for days to weeks. C) The pain occurs most commonly in the upper extremities and trunk. D) The pain is temporarily eliminated by surgical removal of the partial nerve root.
A
A nurse is educating clients on the working of the sensory system. Which factor would the nurse tell the client vision dependent on? A) Contrast between object and background B) Protective outer layer of the eyeball C) Specific color of the eye D) Nutrient and oxygen provided to the eye
A
A nurse is irrigating the ear of a client to clear an external auditory canal obstruction. Which of the following measures should the nurse employ when caring for this client? A) Warm the irrigating solution to body temperature. B) Straighten the client's ear canal down and back. C) Place the syringe at the tip of the external auditory meatus. D) Keep the ear canal wet to promote client comfort.
A
During a routine eye examination, an elderly client provides a family history of wide-angle glaucoma. What early symptoms of wide-angle glaucoma should the nurse assess for in this client? A) Temporary blurring of vision B) Central blindness C) Halos around lights D) Flashers and floaters
A
Electrical and chemical influences make it possible for nerve impulses to occur. The nurse educator asks a student nurse to describe the resting potential of the nerve impulse. Based on this information, what would be the best explanation of the resting potential by the student nurse? 1. Nerve cell at rest 2. Plasma membrane more positive on outside 3. Sodium moves inside membrane, followed by potassium 4. Plasma membrane more positive on inside A) 1, 2 B) 1, 4 C) 2, 3 D) 3, 4
A
Several specialists are involved in the treatment of the eye. Which of the following would be licensed to perform cataract surgery? A) Ophthalmologist B) Optometrist C) Optician D) Ophthalmic technician
A
The five senses are seeing, hearing, tasting, smelling, and touching. The nurse is reviewing the location of the receptors for each of the five senses and how the brain interprets the stimulus for each sense to a group of nursing students. What statement by the nursing students demonstrates the best location of the receptors for the senses? 1. Receptors for the sense of smell are located in the upper nasal cavity. 2. Receptors for the sense of touch are located throughout most areas of the body. 3. Receptors for the sense of vision are located in lens of the eye. 4. Receptors for hearing are located in the semicircular canals. A) 1, 2 B) 1, 3 C) 2, 4 D) 3, 4
A
The nurse is assisting an ophthalmologist with a test to measure the pressure in the eyes of a client in order to detect glaucoma. Which of the following tests is being performed? A) Tonometry B) Slit lamp examination C) Ophthalmoscopic examination D) Refractive Examination
A
The nurse is caring for a hospitalized client with Guillain-Barré syndrome. Which of the following is a nursing consideration for this client? A) Excellent nursing care is necessary to prevent permanent damage. B) The nurse will start steroid therapy as the drug of choice. C) The client will be on bed rest and muscles will be rested until the disease resolves. D) Recovery is fast; nursing implications focus on physical rather than emotional aspects.
A
The nurse is caring for clients with neurologic deficits. Which of the following would the nurse describe as the most common complaint of these clients? A) Cephalgia B) Back pain C) Gastrointestinal disorders D) Respiratory distress
A
The nurse is providing a continuing education program to teenagers about the nervous system. The nurse is reviewing the parts of the neuron with the students. Based on this information, the nurse asks a student to describe the axon of a neuron. Which explanation by the student best describes a synapse? A) A junction or space between one neuron and dendrites of the next B) Allows nerve impulses to cross the synapse and reach the dendrites C) Carries impulses away from the neuron cell body D) Chemical released that enables nerve impulses to cross the synapse and reach the dendrite
A
The nurse is providing genetic counseling to a young couple hoping to start a family. The husband has the Huntington's disease (HD) gene and does not want to pass the disease on to his children. Which of the following teaching points should the nurse include in a teaching plan for this couple? A) A child with a parent who has HD has a 50-50 chance of inheriting the gene. B) A child with a parent who does not inherit the HD gene may still develop the disease. C) Of the children who inherit the gene, 50% will develop the disease. D) Symptoms of HD generally appear before the age of 12.
A
The nurse is reviewing the three types of neurons with the client. The client asks the nurse what is the function of the sensory neuron. What is the best explanation of the sensory neuron? 1. Receives and transmits messages to the central nervous system from all parts of the body 2. Receives and transmits messages from the central nervous system to muscle and glands in all parts of the body. 3. Usually has long dendrites and a short axon. 4. Usually has short dendrites and a long axon. A) 1, 3 B) 1, 4 C) 2, 3 D) 2, 4
A
The nurse monitors an 80-year-old male client's blood urea nitrogen (BUN) and creatinine before and after positron emission tomography. For which alteration is the older adult at risk related to the use of dye in the test? A) Kidney damage B) Cardiac dysrhythmias C) Respiratory distress D) Hypernatremia
A
The student nurse is preparing a chart of the twelve cranial nerves and the function of each. Based on this information, the nurse is collecting data of the cranial nerves of the eyes. Which cranial nerve is the nurse testing to see if a client's swallowing has been impacted from a stroke? A) IX B) X C) XI D) XII
A
The nurse is caring for a client who is having a myasthenic crisis. Which of the following are manifestations of this emergency situation? Select all that apply. A) Dysphagia B) Dysphasia C) Ptosis D) Diplopia E) Cardiac arrest F) Seizures
A, B, C, D
The nurse is providing client education for a client whose healthcare provider ordered a brain scan. Which of the following might the nurse mention are conditions diagnosed by a brain scan? Select all answers that apply. A) Vascular lesions B) Neoplasms C) Abscesses D) Cerebrovascular ischemia E) Increased intracranial pressure F) Infection of the meninges
A, B, C, D
The nurse is caring for a client who is having a migraine headache. Which of the following are signs or symptoms of this condition? Select all that apply. A) Mood changes B) Numbness of a body part C) Premonition the headache will occur D) Respiratory alterations E) Nausea and vomiting F) Hallucinations
A, B, C, E
A client is diagnosed with conductive hearing loss. Which of the following are common causes of this condition? Select all that apply. A) Otitis media B) Excessive noise C) Tumors D) Perforated eardrum E) Foreign bodies F) Viral infections
A, D, E
The nurse is caring for a patient in the hospital who is visually impaired. Which of the following nursing considerations would be appropriate for this client? Select all that apply. A) Let the client know when you are leaving the room. B) Speak in a louder tone to compensate for loss of vision. C) Touch clients before speaking to them to keep from frightening them. D) Identify self when entering the room. E) Place food on the plate in a "clock position" and identify the food. F) Lightly push the client from behind when helping the client to ambulate.
A, D, E
A nurse is caring for an elderly client who exhibits symptoms of vagus nerve stimulation, a parasympathetic response. Which finding would support stimulation of the vagus nerve? A) Dilation of the pupil B) Decreased heart rate C) Easier time with breathing D) Clenching of the jaw
B
A basketball player who has injured his shoulder during the game is admitted to a healthcare facility. The physician has diagnosed an injury to the cervical plexus in the client. Which effects of an injury to the cervical plexus should the nurse be aware of? A) Temporary paralysis B) Respiratory arrest C) True dementia D) Loss of equilibrium
B
A client complains to the nurse at the primary care physician's office of having difficulty with blurry vision. The client tells the nurse that the primary care physician says the blurry vision is the result of hyperopia. Based on this information, what is the best description the nurse can provide the client about hyperopia? A) Objects at a distance appear blurred B) Cannot see close objects clearly C) Cannot bring horizontal and vertical lies into focus at the same time D) Gradual loss of the function of accommodation
B
A client who has been in a car accident has severe head trauma. It is suspected that the trochlear nerve has been damaged. What is the function of the trochlear nerve? A) Innervates some of the voluntary muscles that move the eyeball and the eyelid B) Assists with some of the voluntary eyeball movement C) Coordinates with the cranial nerve to move the eye D) Carries the sensation of eye pain and temperature to the brain
B
A hospitalized client wakes up in the morning with his eyelids sticking together from a thick and copious discharge. After the nurse applies warm soaks to help remove the crusts, the client further complains of pain, redness, and itching of the eyes. What inflammatory disorder would the nurse suspect? A) Hordeolum B) Conjunctivitis C) Chalazion D) Keratitis
B
A nurse at a long-term care facility is caring for a client with myasthenia gravis. What important teaching should the nurse provide for this client? A) Wear Medic-Alert tag whenever he has to go out alone. B) Avoid exposure to temperature extremes and infections. C) Have regular eye examinations to check intraocular pressure. D) Avoid any form of exercise or activity to conserve energy.
B
A nurse is caring for a client who has been admitted for eye surgery. As part of client education, the nurse is required to explain the function of the various structures of the eye. What information should the nurse provide the client about the function of the lacrimal gland? A) Retractable covers for the eye's anterior surface B) Produces tears and keeps the eye's surface moist and lubricated C) Influences visual acuity by refracting light D) Gives the eye its specific color
B
A nurse is caring for a client who has had an accident. Which responses produced by the sympathetic division of the autonomiic nervous system (ANS) should the nurse identify in the client? A) Maintenance of water reabsorption level B) Involuntary defecation or urination C) Restoration of blood flow to the skin D) Resumption of digestive processes
B
A nurse is caring for a client with a contusion injury to his right eye. Which of the following signs would alert the nurse to a detached retina in this client? A) Severe eye pain B) Flashes of light C) Wavy lines D) Immediate loss of vision
B
A nurse is caring for a client with autonomic dysreflexia. The nurse has been ordered to monitor the client's blood pressure regularly because it is dangerously elevated. The nurse should be aware that a sudden onset of hypertension can result in which of the following? A) Chills and severe headache B) Seizures and strokes C) Respiratory distress D) Visual disturbances
B
A nurse is caring for a client with gustatory disorder. The nurse knows that which of the following is a sign of gustatory disorder? A) Inability to maintain balance B) Reduced interest in eating C) Lack of pain perception D) Inappropriate reaction to injuries
B
An elderly client is diagnosed with cataracts. The client complains of double vision and says he sees halos around lights. What should the nurse expect to find in the client's eyes during the nursing assessment? A) Redness of lid margins B) Cloudiness of the lens C) Drooping of the eyelid D) Dilation of the pupils
B
An elderly client visits a healthcare facility and complains that he has difficulty in remembering what happened a long time ago. Which could be the cause for the client's condition? A) Problem with the cerebellum B) Problem with the limbic system C) Problem with the midbrain D) Problem with the medulla
B
The nurse assists and educates client about the structure and function of the sensory system. When educating clients on the parts and functions of the ear, what is the nurse's best description of the function of the semicircular canal? A) Sends sensory information to the cerebellum and the midbrain B) Transmits information on the body's position to the brain C) Equalizes the pressure in the middle ear with atmospheric pressure D) Begins the transmission of nerve stimuli related to sound
B
The nurse assists and educates clients about the structure and function of the sensory system. The nurse is showing the client the path taken by sound waves to reach the brain. The nurse dropped the note cards with the correct sequence on the floor. The sequence of steps is scrambled and needs to be placed in the correct order. Which is the correct order of the steps in the path taken by sound waves to the brain? 1. Sound waves enter through the ear's external auditory canal and strike the tympanic membrane. 2. The stapes vibrates against the membrane, setting the fluid of the cochlea in motion, which in turn passes on to the hair-like nerve ending in the organ of Corti. 3. The stimuli in the organ of Corti are sent to the vestibulocochlear nerve and then to the temporal lobe in the cerebral cortex, where the sounds are interpreted. 4. The tympanic membrane vibrates at various speeds in response to various pitches of sounds. 5. The ossicles within the middle ear act as a moveable bridge to transmit these vibrations to the oval window, which amplifies the sound waves. A) 1, 3, 4, 2, 5 B) 1, 4, 5, 2, 3 C) 3, 4, 1, 2, 5 D) 4, 5, 1, 2, 3
B
The nurse is assisting a client with paraplegia into a special "neuro chair." What are the advantages/disadvantages of using these devices? A) They help to alleviate pain. B) They adjust to various positions. C) They provide exercise for the client. D) They are difficult to move from place to place.
B
The nurse is assisting with a caloric test to determine if an alteration exists in the vestibular origin of the acoustic nerve. Which of the following accurately describes a step in this procedure? A) Place the client in a prone position to perform the examination. B) Instill cold and/or warm water into the external ear canal. C) Test the affected side after testing the normal side. D) Replace water with hot air for a client with a punctured eardrum.
B
The nurse is aware that clients with tactile difficulties may be in danger because they cannot react appropriately to external injuries or internal disorders. Which of the following clients should the nurse monitor for tactile sense disorders? A) A client after a myocardial infarction B) A client who has uncontrolled diabetes C) A client with renal failure D) A client with rheumatoid arthritis
B
The nurse is caring for a client with amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease. Which of the following is a characteristic of this disease? A) There are periods of remission with ALS when no symptoms occur. B) ALS always progresses to respiratory dysfunction and death. C) There are new therapies that will lessen or halt the progress of ALS. D) Clients with ALS experience intellectual and sensory deficits near term.
B
The nurse is caring for a client with head trauma who has increased intracranial pressure (ICP). Which of the following is normal ICP? A) 2 to 10 mm Hg B) 4 to 13 mm Hg C) 5 to 15 mm Hg D) 6 to 18 mm Hg
B
The nurse is preparing a client who manifests with the signs and symptoms of status epilepticus for a test to diagnose seizure activity. Which of the following would be the best test to diagnose this condition? A) Lumbar puncture B) Electroencephalography C) Myelography D) Angiography
B
The nurse is providing discharge teaching for a client following ear surgery in an ambulatory care center. Which of the following would the nurse include in the teaching plan for this client? A) When changing positions, sit or stand up quickly to force the ears to adjust. B) Report any fever, headache, vertigo, or ear pain immediately. C) When lying down, lie on the operative side to facilitate drainage. D) Resume normal activities after about 1 week following a check-up.
B
The nurse is reviewing with a client that the limbic system is located between the cerebrum and the inner brain. The limbic system includes the hippocampus and reticular formation. Based on this information, what would be the best explanation by the nurse of the hippocampus' role in maintaining the client's physiologic adaptation? A) Largely responsible for maintaining a person's level of awareness B) Functions in learning and long-term memory C) Plays a role in allowing sensory input to enter the cerebral cortex D) Governs wakefulness and sleep
B
The nurse tells the client that the autonomic nervous system is divided into the sympathetic and parasympathetic nervous systems. Based on this information, what happens to the vital signs when the sympathetic nervous system is activated? 1. Tachycardia 2. Breathing rate normal 3. Maintains normal body functions 4. Prepares body for "fight-or-flight" response A) 1, 3 B) 1, 4 C) 2, 3 D) 3, 4
B
The nurse caring for a client with meningitis knows that signs and symptoms of meningitis usually appear abruptly. Which of the following are signs of this condition? Select all answers that apply. A) Impaired bladder function B) Photophobia C) Nuchal rigidity D) Loss of sensation E) Change in LOC F) Opisthotonos
B, C, E, F
The nurse is entering the hospital room of a client who has a severe hearing deficit. Which of the following nursing considerations would be appropriate for this client? Select all that apply. A) Speak first and then get the client's attention. B) Face the client on the same level. C) Speak slowly and clearly. D) Repeat specific words rather than entire phrases. E) Do not use hand motions to facilitate the conversation. F) Verify that the person understood the conversation.
B, C, F
The nurse is providing preoperative teaching for a client undergoing eye surgery. Which of the following are accurate teaching points to prepare this client following the surgery? Select all that apply. A) Remove the dressings when alert. B) Wear a metal shield, if prescribed, for up to 4 weeks. C) Sleep on the operative side for the first week. D) On the second postoperative day, clean the eye with moist cotton balls. E) Avoid sudden movements and straining at stool. F) Do not lift more that 20-30 pounds for about a week.
B, D, E
A nurse is caring for a client who has been admitted for eye surgery. As part of client education, the nurse is required to explain the function of the various structures of the eye. Several cranial nerves are involved in vision. Which nerve is responsible for carrying sensations of pain in and temperature to the brain that could be affected following surgery? A) Oculomotor nerve B) Optic nerve C) Trigeminal nerve D) Trochlear nerve
C
A client complains to the nurse at the primary care physician's office of having difficulty with blurry vision. The client tells the nurse that the primary care physician says the blurry vision is the result of astigmatism. Based on this information, what is the best description the nurse can provide the client about astigmatism? A) Objects at a distance appear blurred B) Cannot see close objects clearly C) Cannot bring horizontal and vertical lies into focus at the same time D) Gradual loss of the function of accommodation
C
A client has had a cerebrovascular accident affecting one brain hemisphere. According to the electronic medical record nursing care plan, the client has had damage to the Broca's area of the cerebrum. Based on this information, which aspects of speech and language can the nurse anticipate occurring when entering the client's room? 1. Damage impairs ability to comprehend written language. 2. Damage impairs ability to comprehend spoken language. 3. Damage causes speech impairment. 4. Individual is able to speak. 5. Individual language comprehension is not affected. A) 1, 2 B) 2, 3 C) 3, 5 D) 2, 5
C
A nurse conducting a session on eye care needs to educate clients about the aqueous humor and vitreous humor. Which is the function of the aqueous humor? A) Regulates the amount of light that enters the eye B) Gives the eye its specific color C) Provides nutrients and oxygen to the cornea D) Focuses the light rays on the retina
C
A nurse is assisting a neurosurgeon who is monitoring a client's intracranial pressure (ICP) in the intensive care unit. Which measure is most critical in monitoring the client's intracranial pressure? A) Monitor and document the client's vital and neurologic signs. B) Stop immediately if there is a break in the ICP monitoring system. C) Avoid moving the client's head up or down without physician orders. D) Observe the client's general appearance as well as mobility level.
C
A nurse is caring for a client who has been admitted for eye surgery. As part of client education, the nurse is required to explain the function of the various structures of the eye. Several cranial nerves are involved in vision. What is the function of the oculomotor nerve? A) Voluntary eye movement B) Carries visual images to the brain C) Constricts and dilates the pupil D) Carries sensations of eye pain and temperature to the brain
C
A nurse is caring for a client who has been admitted for eye surgery. As part of client education, the nurse is required to explain the function of the various structures of the eye. What information should the nurse provide the client about the function of the cornea? A) Retractable covers for the eye's anterior surface B) Produces tears and keeps the eye's surface moist and lubricated C) Influences visual acuity by refracting light D) Gives the eye its specific color
C
A nurse is caring for a client who is diagnosed with Ménière's disease. Which of the following measures should the nurse take when caring for this client? A) Encourage the client to take in more fluids. B) Elevate the head of the bed to about 45 degrees. C) Explain all actions to the client ahead of time. D) Provide the client a diet rich in sodium.
C
A nurse is caring for a client with a sty on his left upper eyelid. Which of the following measures should the nurse employ when caring for this client? A) Compress the sty to prevent spread of infection. B) Apply pressure patching for 24 to 48 hours. C) Apply warm, moist compresses over the eyelid. D) Administer miotic drops, as ordered.
C
A nurse is ordered to observe a female client suspected to have meningitis for positive Brudzinski's sign. Which of the following would the nurse document as a positive Brudzinski's sign? A) Evidence of pain when the client lies on the back and brings one leg up so that the hip and knee are flexed at 90 degrees. B) Evidence of pain when the client lies on the side and brings one leg up so that the hip and knee are flexed at 90 degrees C) Evidence of pain or resistance when the client lies on the back and brings her head forward toward the chest D) Evidence of pain or resistance when the client lies on the side and brings her head forward toward the chest
C
A nurse is taking care of a client who has sustained head trauma as a result of a motor vehicle accident. The nurse notices fluid leaking from the nose and ears. Based on this information, what diagnostic test should this fluid be tested for immediately? A) Sodium B) Calcium C) Glucose D) Potassium
C
An older adult is diagnosed with the condition known as presbyopia, and is experiencing errors in far and near vision. Which of the following is the most common treatment option for this client? A) Eye surgery B) Hard contact lenses C) Bifocals D) Lens implants
C
The nurse assists and educates nursing students about the structure and function of the sensory system. The nurse is tracing the path of light rays as they enter the eye and focus on the retina to the nursing students. Based on this information, the nurse should tell the students that which part of the brain is responsible for receiving visual information via the optic nerve? A) Temporal lobe B) Parietal lobe C) Occipital lobe D) Cerebellum
C
The nurse caring for a client following eye surgery reports to the surgeon that the client is showing signs of ptosis (drooping eyelid). What might this finding indicate? A) Dehydration B) Paralysis C) Edema D) Hemorrhage
C
The nurse caring for clients with spinal cord injuries explains the physiology of the spinal cord to the student nurse. Which of the following accurately describes this organ? A) The spinal cord is a tight cluster of white matter surrounded by gray matter. B) If the spinal cord is severed, the brain takes over communication to the body. C) The spinal cord is the communication system between the brain and body. D) The brain sends a signal to the spinal cord to initiate the reflex arc.
C
The nurse educator is reviewing the four cerebral lobes with the nursing students. The nurse educator asks a student nurse to identify the primary functions of each of the brain's four cerebral lobes. Which answer provide by a student nurse is the best answer? A) Frontal lobe is responsible for speech and some sensory input. B) Parietal lobe is responsible for lower mental processes. C) Temporal lobe is responsible for smell, hearing, and some memory. D) Occipital lobe is responsible for higher mental processes.
C
The nurse is caring for a 60-year-old female client who is diagnosed with a brain abscess. If left untreated, what condition may develop as a result of a brain abscess? A) Guillain-Barré syndrome B) Acute Transverse Myelitis C) Meningitis D) Shingles
C
The nurse is caring for a client following an angiogram. Which of the following is a nursing intervention recommended for this client? A) Apply a sandbag distal to the insertion site. B) Check the insertion site for bleeding every 2 hours. C) Encourage fluids, if not contraindicated. D) Call the healthcare provider if there is not a pulse at the injection site.
C
The nurse is counseling a 30-year-old woman diagnosed with paraplegia following a recent rock climbing accident. Which of the following would the nurse include in a teaching plan? A) The use of birth control pills is recommended. B) Menses usually resume within 1 year following the injury. C) Tampons are not recommended for use and can be dangerous. D) Labor and childbirth are easier and safer because of the paralysis.
C
The nurse is preparing a 25-year-old male client for a resting electroencephalogram (EEG). Which of the following accurately describes a nursing consideration for this client? A) Explain that the test delivers a mild electrical shock. B) Tell the client that he should keep his eyes open throughout the test. C) Tell the client that he will be asked to watch a pattern on a TV monitor. D) Tell the client not to sleep the night before the EEG.
C
The nurse is preparing a client for an electroretinogram (ERG) to confirm a diagnosis of retinitis pigmentosa. Which of the following explanations would be appropriate preparation for this client? A) "You will be placed in a brightly lit room for this test." B) "Radiopaque dye will be injected into your eye before the test." C) "A contact lens containing an electrode will be placed on your eye." D) "You will see a bright beam of light directed at your eye."
C
The nurse is providing a continuing education program to teenagers about the nervous system. The nurse is reviewing the parts of the neuron with the students. Based on this information, the nurse asks a student to describe the axon of a neuron. Which explanation by the student best describes the axon? A) A junction or space between one neuron and dendrites of the next B) Allows nerve impulses to cross the synapse and reach the dendrites C) Carries impulses away from the neuron cell body D) Short, often highly branched, extensions of the cell body.
C
The nurse is reviewing the role of several structures that assist in protecting the ear to the client. What would be the nurse's best explanation be of how the ossicles work in protecting the ear? A) Aid in protecting the ear from foreign objects B) Protect the two layers by separating the external from the middle ear C) Protect the vital internal organs of the middle and inner ear from injury D) Equalize the pressure in the middle ear with atmospheric pressure
C
The nurse is reviewing with the client that the brainstem is made up of the midbrain, pons, and medulla. Based on this information, what are the functions of the pons that the nurse should incorporate into the client's teaching about the brain stem? 1. Reflex center 2. Carries messages between the cerebrum and medulla 3. Responsible for respiration 4. Centers for vital body functions, such as heart rate, vasomotor tone, and respirations A) 1, 2 B) 1, 4 C) 2, 3 D) 3, 4
C
The nurse is reviewing with the client who is going to have surgery of the head and neck about taste buds that are responsible for the perceptions of sweet, salty, sour, and bitter. Based on this information, what is the location of the taste bud on the tongue for bitter tastes? A) Tip B) Sides C) Back D) Apex
C
The nurse performing a physical assessment of an 80-year-old client documents the structural disorder known as entropion. What occurs in this condition? A) There is an outward turning of the eyelid caused by the aging process. B) There is drooping of the upper eyelid owing to muscle weakness or nerve damage. C) There is an inward turning of the lid margin common in older adults D) There is increased fluid pressure within the eye.
C
A 30-year-old client arrives at the community healthcare center complaining of dizziness and a feeling of the room spinning. Based on the client's symptoms, which condition best describes what the client most likely experiencing? A) Presbycusis B) Inner ear infection C) Tinnitus D) Vertigo
D
A 5-year-old boy is brought to the emergency department with signs of plumbism (lead poisoning). On assessment, the nurse documents the following symptoms: violent headache, fever, nausea, vomiting, and drowsiness. The child displays muscle weakness and visual disturbances. Which of the following neurologic alterations would the nurse suspect has occurred as sequel to plumbism? A) Meningitis B) Guillain-Barré syndrome C) Acute Transverse Myelitis D) Encephalitis
D
A client has had an injury to the cerebellum. The nurse is collecting data from the client and family to document in preparing an individualized nursing care plan. Which is the best description of the function of the cerebellum that has to be considered when collecting data from the client? A) Regulates body temperature B) Regulates sleep wake cycle C) Influences release of hormones from the pituitary D) Responsible for muscle control
D
A client who was in a motor vehicle accident has a "black eye." What nursing intervention is appropriate for this client? A) Apply warm packs to the eye for the first 24 to 48 hours. B) Apply cold packs to the eye for the first 24 to 48 hours. C) Soak the eye with normal saline for the first 24 to 48 hours. D) Apply warm packs to the eye once the swelling has stopped.
D
A nurse is assisting a healthcare provider during a refractive error examination for a client with complaints of visual impairment. Which of the following measures should the nurse employ during the procedure? A) Position the client 10 feet from the phoropter. B) Place the phoropter at the sides of the client's eyes. C) Position the client 20 feet from the phoropter. D) Place the phoropter in front of the client's eyes.
D
A nurse is assisting in performing a cerebral arteriography for a client with a head injury. What is the nurse's role when assisting with this procedure? A) Restrict excess fluid intake during the arteriography procedure. B) Apply a pressure device after the procedure to prevent scarring. C) Check the insertion site every hour for signs of bleeding. D) Obtain a baseline neurologic assessment before the procedure
D
A nurse is assisting the anesthetist in performing a lumbar puncture on a client who is about to undergo a cesarean section under spinal anesthesia. What important factor should the nurse document before and after the procedure? A) Muscle tone and strength B) Function of the cranial nerves C) Direction of the eye movements D) Ability to move all extremities
D
A nurse is caring for a 12-year-old client who has had multiple seizure attacks since she was 5 years of age. Which of the following measures should the nurse employ when the client is having a seizure? A) Put something in the mouth to keep it open. B) Observe for a flushing of the skin. C) Elevate the head of the bed to 45 degrees. D) Place a soft pad beneath the client's head.
D
A nurse is caring for a child with an inner ear infection. The child's mother is worried because the child is having recurrent ear infections and wants to know how the function of the inner ear might be affected. What is the best description the nurse can give the mother about the function of the inner ear? 1. Responsible for protecting internal structures of the ear from foreign substances 2. Responsible for the transmission of sound 3. Responsible for transmitting sound waves 4. Responsible for providing information about body position to the brain A) 1, 2 B) 1, 3 C) 2, 3 D) 3, 4
D
A nurse is caring for a client who was in a motor vehicle accident and suffered damage to the ear. The client asks the nurse how hearing will be affected on a long-term basis. What is the best description the nurse can tell the client about the function of the inner ear? 1. Responsible for protecting internal structures of the ear from foreign substances 2. Responsible for the transmission of sound 3. Responsible for transmitting sound waves 4. Responsible for providing information about body position to the brain A) 1, 2 B) 1, 3 C) 2, 4 D) 3, 4
D
A nurse is educating a client about the function of the parts of the auditory system. Which is the function of the Eustachian tube? A) Transmits vibration to the fluid-filled inner ear at the oval window B) Separates the external from the middle ear C) Sends sensory information to the cerebellum and midbrain D) Equalizes the pressure in the middle ear with atmospheric pressure
D
A nurse is educating a client and family about the neurologic system as it relates to the stroke that the client had. Which is a function of a neuron that the nurse needs to include in the client's teaching? A) Connects the cerebral hemispheres B) Responsible for movement and coordination C) Responsible for long-term memory D) Conducts messages within the neurologic system
D
Electrical and chemical influences make it possible for nerve impulses to occur. The nurse educator asks a student nurse to describe the action potential of the nerve impulse. Based on this information, what would be the best explanation of the action potential by the student nurse? 1. Nerve cell at rest 2. Plasma membrane more positive on outside 3. Sodium moves inside membrane, followed by potassium 4. Plasma membrane more positive on inside A) 1, 2 B) 1, 4 C) 2, 3 D) 3, 4
D
The meninges, which cover the brain and spinal cord, include the dura mater, arachnoid, and pia mater. A student nurse is preparing a chart for a postclinical conference on the meninges. Based on this information, what should the student nurse include in the chart on the pia mater? 1. Tough fibrous covering that adheres to the bones of the skull 2. Middle layer of a delicate web of tissue 3. Lies closely over the brain and spinal cord 4. Contains many blood vessels that bring oxygen and nutrients to the nervous tissue A) 1, 3 B) 1, 4 C) 2, 4 D) 3, 4
D
The nurse assists and educates clients about the structure and function of the sensory system at the local senior citizen center. What should the nurse tell the senior citizens that is experienced as an effect of aging on the sense of vision? A) Hyperopia B) Myopia C) Astigmatism D) Presbyopia
D
The nurse assists and educates nursing students about the structure and function of the sensory system. The nurse is reviewing how the organs of the inner ear work to provide a sense of balance. What part of the brain should the nurse tell the students is responsible for maintaining equilibrium and coordination? A) Temporal lobe B) Parietal lobe C) Occipital lobe D) Cerebellum
D
The nurse educator is reviewing the four cerebral lobes with the nursing students. The nurse educator asks a student nurse to identify the primary functions of each of the brain's four cerebral lobes. The nurse educator shares that a client has difficulty with proper functioning of the occipital lobe owing to a large tumor in this lobe. Which answer provided by a student nurse is the best answer for the function of the occipital lobe? A) Responsible for speech and some sensory input B) Responsible for lower mental processes C) Responsible for smell, hearing, and some memory D) Responsible for vision
D
The nurse is caring for a client diagnosed with a subdural hematoma. Which of the following is the usual cause of this condition? A) Hemorrhage and edema from bleeding in the skull B) An accumulation of blood between the dura and skull C) A penetrating head injury D) Torn vein on the brain's surface
D
The nurse is caring for a client with a prosthetic eye. Which of the following is a recommended guideline for inserting a prosthetic eye? A) Make sure the prosthesis is dry when inserting it. B) Close the eyelid and slip the prosthesis under the top lid. C) Press inward on the bottom of the prosthesis to seat it in place. D) Ask the client to blink to seat the prosthesis in place.
D
The nurse is preparing the medications for a client who is in the early stages of Parkinson's disease. Which of the following is the medication of choice to help reduce the tremors and rigidity of Parkinson's syndrome? A) Antihypertensives B) NSAIDs C) Diazepam D) Levodopa
D
The nurse is providing teaching for a 7-year-old child who is having polyethylene (PE) tubes inserted because of recurrent inner ear infections. Which of the following is a teaching point for this client and family? A) The child will be on antibiotics for the first month. B) The child's ear should be plugged with cotton. C) The child should be trained to lip read. D) The child should not use a shower or swim.
D
The nurse is reviewing the three types of neurons with the client. The client asks the nurse what is the function of the motor neuron. What is the best explanation of the motor neuron? 1. Receives and transmits messages to the central nervous system from all parts of the body 2. Receives and transmits messages from the central nervous system to muscle and glands in all parts of the body 3. Usually has long dendrites and a short axon 4. Usually has short dendrites and a long axon A) 1, 3 B) 1, 4 C) 2, 3 D) 2, 4
D
The nurse is reviewing with a client that the limbic system is located between the cerebrum and the inner brain. The limbic system includes the hippocampus and reticular formation. Based on this information, what would be the best explanation by the nurse of the reticular formation's role in maintaining the client's physiologic adaptation? 1. Largely responsible for maintaining a person's level of awareness 2. Functions in learning and long-term memory 3. Plays a role in allowing sensory input to enter the cerebral cortex 4. Governs wakefulness and sleep A) 1, 2 B) 1, 3 C) 2, 4 D) 3, 4
D
The nurse is reviewing with the client that the brainstem is made up of the midbrain, pons, and medulla. Based on this information, what is the function of the medulla that the nurse should incorporate into the client's teaching about the brainstem? A) Reflex center B) Carries messages between the cerebrum and medulla C) Responsible for respiration D) Centers for vital body functions, such as heart rate, vasomotor tone, and respirations
D
The ophthalmologist examining a client's eyes documents that the client has astigmatism. Which of the following describes this condition? A) Elongation of the eyeball B) Shorter than normal eyeball C) Loss of elasticity of the lens D) Unequal curvature in shape of the lens
D
When educating a group of students about the different parts of the eyeball, the nurse identifies which as the function of the lens? A) Permits light rays to enter the front of the eye B) Brings oxygen and nutrients to the eye C) Gives the eye its specific color D) Focuses the light rays on the retina
D
