Exam on Ch. 14 Care of the Patient with a Neurologic Disorder.

What is the basic problem that prompts most of the early signs of Alzheimer's disease? A. Changes in mood B. Misplacing things C. Memory that disrupts daily life D. Problems with words in speaking

C. Memory that disrupts daily life

What should the nurse do when the child arrives on the floor with the diagnosis of bacterial meningitis? A. Arrange for humidified oxygen per mask. B. Place the child in respiratory isolation. C. Inquire about drug allergy. D. Hold NPO until orders arrive.

B. Place the child in respiratory isolation.

What is the purpose of a "drug holiday" in the treatment of Parkinson disease? A. Change all drugs. B. Allow the natural dopamine levels to rise. C. Restart drugs at a lower dosage with favorable results. D. Reduce the extrapyramidal symptoms.

C. Restart drugs at a lower dosage with favorable results.

What does the nurse know about the stroke patient who has expressive aphasia? A. Has difficulty comprehending spoken and written communication. B. Cannot make any vocal sounds. C. Has total loss and comprehension of language. D. Can understand the spoken word, but cannot speak.

D. Can understand the spoken word, but cannot speak.

What are the two divisions of the nervous system? B. Somatic and the autonomic C. Cerebellum and the brainstem C. Medulla oblongata and the diencephalon D. Central and the peripheral

D. Central and the peripheral

What is the normal pupillary response when you shine your pen light in the eye?

The pupil should constrict briskly.

The nurse is caring for a home health patient who had a spinal cord injury at C5 3 years ago. The nurse bases the plan of care on the knowledge that the patient will be able to: A. feed self with setup and adaptive equipment. B. transfer self to wheelchair. C. stand erect with full leg braces. D. sit with good balance.

A. feed self with setup and adaptive equipment.

A patient is in which stage of Alzheimer's disease when she demonstrates "sundowning"? A. Early stage B. Second stage C. Third stage D. Final stage

B. Second stage

Which foods should the person who suffers from migraine headaches avoid? (Select all that apply.) A. Yogurt B. Caffeine C. Beef D. Pears E. Marinated foods F. Milk

A. Yogurt B. Caffeine E. Marinated foods

Which of the following techniques are necessary for safely feeding a hemiplegic patient? (Select all that apply.) A. Mixing liquids and solid foods together B. Taking the patient's dentures out to prevent choking C. Checking the affected side of mouth for food accumulation D. Offering small bites of food E. Elevating the patient to no more than 30 degrees F. Adding a thickening agent to liquids

C. Checking the affected side of mouth for food accumulation D. Offering small bites of food F. Adding a thickening agent to liquids

What is the first sign of Bell's palsy? A. Inability to wrinkle forehead and pucker lips on affected side B. Sudden pain in nostril on affected side C. Excessive salivation on the affected side D. Excessive mucus running from nostril on affected side

A. Inability to wrinkle forehead and pucker lips on affected side

An 83-year-old patient has had a stroke. He is right handed and has a history of hypertension and "little" strokes. He presents with right hemiplegia. To afford him the best visual field, the nurse should approach him: A. from the right side. B. from the left side. C. from the center. D. from either side.

B. from the left side.

Why are the drugs neostigmine (Prostigmin) and pyridostigmine (Mestinon) helpful to the person with myasthenia gravis? A. Improves speech. B. Improves visual disturbances. C. Reduces pain. D. Promotes nerve impulse transmission.

D. Promotes nerve impulse transmission.

The nurse explains that the triad of signs of Parkinson disease is: _______, rigidity, and bradykinesia.

Tremors

A right-handed patient has right-sided hemiplegia and aphasia from a stroke. What is the most likely location of the lesion? A. Left frontal lobe B. Right brainstem C. Motor areas of the right cerebrum D. Medial superior area of the temporal lobe

A. Left frontal lobe

A patient with a spinal cord injury at T1 complains of stuffiness of the nose and a headache. The nurse notes a flushing of the neck and "goose flesh." What should be the primary nursing intervention based on these assessments? A. Place patient in flat position and check temperature. B. Administer oxygen and check oxygen saturation. C. Place on side and check for leg swelling. D. Sit upright and check blood pressure.

D. Sit upright and check blood pressure.

What is the cranial nerve that supplies most of the organs in the thoracic and abdominal cavities and carries motor fibers to glands that produce digestive juices and other secretions? A. Somatic motor nerve B. Visceral sensory nerve C. Abducens nerve D. Vagus nerve

D. Vagus nerve

The nurse explains that the two divisions of the autonomic nervous system work to maintain homeostasis. Which is the first autonomic event? A. Parasympathetic nervous system dominates B. Extremely stressful or frightening event C. Blood pressure, heart rate, and adrenaline output decrease D. Sympathetic nervous system dominates E. Heart rate and blood pressure rise, secretion of adrenaline

E. Heart rate and blood pressure rise, secretion of adrenaline

The nurse is aware that the drug t-PA (Activase), a tissue plasminogen activator, must be given in ______ hours of the onset of symptoms to have maximum benefit. A. 3 hours B. 4 hours C. 6 hours D. 8 hours

A. 3 hours

The nurse assures an anxious family member of a 92-year-old patient who is demonstrating signs of dementia that many causes of dementia are reversible and preventable. What is one example? A. Hypotension B. Alzheimer's disease C. Diabetes D. Parkinson disease

A. Hypotension

The newly admitted patient to the emergency room 30 minutes ago after a fall off a ladder has gradually decreased in consciousness and has slowly reacting pupils, a widening pulse pressure, and verbal responses that are slow and unintelligible. What is the most appropriate position for the patient? A. Neck placed in a neutral position. B. Head raised slightly with hips flexed. C. Supine in gravity neutral position. D. Turn on right side with head elevated.

A. Neck placed in a neutral position.

A patient, age 45, is to have a myelogram to confirm the presence of a herniated intervertebral disk. Which nursing action should be planned with respect to this diagnostic test? A. Obtain an allergy history before the test. B. Ambulate the patient when returned to the room after the test. C. Use heated blanket to keep patient warm after procedure. D. Keep NPO for 6 to 8 hours after the test.

A. Obtain an allergy history before the test.

What are the three signs of Cushing response? (Select all that apply.) A. Increased pulse rate B. Increased blood pressure C. Widened pulse pressure D. Bradycardia E. Increased systolic blood pressure F. Uncontrolled thermoregulation

B. Increased blood pressure D. Bradycardia E. Increased systolic blood pressure

A frantic family member is distressed about the flaccid paralysis of her son following a spinal cord injury several hours ago. What does the nurse know about this condition? A. It is an ominous indicator of permanent paralysis. B. It is possibly a temporary condition and will clear. C. It degenerates into a spastic paralysis. D. It will progress up the cord to cause seizures.

B. It is possibly a temporary condition and will clear.

What are the effects of normal aging on the nervous system? (Select all that apply.) A. Small vessel occlusion B. Loss of neurons C. Calcification of cerebrum D. Reduction of cerebral blood flow E. Lipofuscin G. Decrease in oxygen use

B. Loss of neurons D. Reduction of cerebral blood flow E. Lipofuscin G. Decrease in oxygen use

Which question is likely to elicit the most valid response from the patient who is being interviewed about a neurologic problem? A. "Do you have any sensations of pins and needles in your feet?" B. "Does the pain radiate from your back into your legs?" C. "Can you describe the sensations you are having?" D. "Do you ever have any nausea or dizziness?"

C. "Can you describe the sensations you are having?"

What Glasgow Coma Scale rating would a patient receive who opens the eyes spontaneously, but has incomprehensible speech and obeys commands for movement? A. 8 B. 10 C. 11 D. 12

D. 12 This patient gets a 4 for eye opening, a 2 for incomprehensible speech, and a 6 for moving on demand.

The client with a cervical spine injury has Crutchfield tongs applied in the emergency department. The nurse should perform which essential action when caring for this client? A. Providing a standard bed frame B. Removing the weights to reposition the client C. Removing the weight if the client is uncomfortable D. Comparing the amount of prescribed weights with the amount in use

D. Comparing the amount of prescribed weights with the amount in use

What is the cardinal sign of increased intracranial pressure in a brain injured patient? A. Pupil changes B. Ipsilateral paralysis C. Vomiting D. Decrease in the level of consciousness

D. Decrease in the level of consciousness

What is the nurse assessing when asking the patient, "Who is the president of the United States?" during a level of consciousness assessment? A. Orientation B. Memory C. Calculation D. Fund of knowledge

D. Fund of knowledge

A 12-year-old has a history of generalized tonic-clonic seizures. The nurse educates the patient and his family by including which teaching points? A. Most people feel normal immediately after the seizure. B. It is important to place a tongue blade in his mouth during the seizure. C. The tonic phase of the seizure usually lasts for 3 to 4 minutes. D. It is not uncommon to lose consciousness during this type of seizure.

D. It is not uncommon to lose consciousness during this type of seizure.

A family member of a patient who has just suffered a tonic-clonic seizure is concerned about the patient's deep sleep. What is this behavior called? A. Convalescent period B. Neural recovery period C. Sombulant period D. Postictal period

D. Postictal period

When caring for a patient who has undergone a craniotomy, what is the primary nursing intervention? A. Preventing infection B. Ensuring patient comfort C. Avoiding need for secondary surgery D. Preventing increased intracranial pressure

D. Preventing increased intracranial pressure

Which symptom is specific to migraine headaches? A. Tachycardia B. They become worse in the evening C. They involve the entire head D. They are preceded by an aura

D. They are preceded by an aura

A patient has been diagnosed with Bell's Palsy. This condition affects which cranial nerve? A. Cranial nerve V B. Cranial Nerve VI C. Cranial Nerve VII D. Cranial Nerve VIII

C. Cranial Nerve VII

A patient has recently suffered a stroke with left-sided weakness and has problems with choking, especially when drinking thin liquids. What nursing interventions would be most helpful in assisting this patient to swallow safely? A. Use a straw. B. Tuck chin when swallowing. C. Take a sip of liquid with each bite. D. Turn head to the left.

B. Tuck chin when swallowing.

What is the nurse aware of when assessing a person with a craniocerebral injury? A. Most injuries of this type are irreversible. B. Open injuries are always more serious than closed injuries. C. Signs and symptoms may not occur until several days after the trauma. D. Trauma to the frontal lobe is more significant than to any other area.

C. Signs and symptoms may not occur until several days after the trauma.

The client with spinal cord injury is prone to experiencing autonomic dysreflexia. The least appropriate measure to minimize the risk of autonomic dysreflexia is which action? A. Strictly adhering to a bowel retraining program B. Keeping the linen wrinkle free under the client C. Avoiding unneccessary pressure on the lower limbs D. Limiting bladder catheterization to once every 12 hours

B. Keeping the linen wrinkle free under the client

The client was seen and treated in the emergency department (ED) for a concussion. Before discharge, the nurse explains the signs/symptoms of a worsening condition. The nurse determines that the family needs further teaching if they state they will return to the ED if the client experiences which sign/symptom? A. Vomiting B. Minor headache C. Difficulty speaking D. Difficulty awakening

B. Minor headache

As the result of a stroke, a patient has difficulty discerning the position of his body without looking at it. In the nurse's documentation, which would best describe the patient's inability to assess spatial position of his body? A. Agnosia B. Proprioception C. Apraxia D. Sensation

B. Proprioception

The nurse is caring for a patient with myasthenia gravis. The patient asks the nurse about the causes of the disease. Which response by the nurse is correct? A. "Myelin sheath breakdown has caused your myasthenia gravis." B. "Degeneration of the dopamine-producing neurons in the midbrain most commonly causes the disease." C. "Antibodies attacking the acetylcholine receptors, damaging them, and reducing their number is the most likely cause of myasthenia gravis." D. "Myasthenia gravis is usually caused by inflammation of cranial nerve VII."

C. "Antibodies attacking the acetylcholine receptors, damaging them, and reducing their number is the most likely cause of myasthenia gravis."

Why is the patient with suspected Guillain-Barre Syndrome (GBS) hospitalized immediately? A. The infection needs to be treated with IV antibiotics to prevent paralysis. B. The brain may swell quickly causing seizures. C. The disease can rapidly progress into respiratory failure. D. IV hydration is needed to prevent possible fatal hypotension.

C. The disease can rapidly progress into respiratory failure.

How would the nurse instruct a patient with Parkinson disease to improve activity level? A. To use a soft mattress to relax the spine. B. To walk with a shuffling gait to avoid tripping. C. To walk with hands clasped behind back to help balance. D. To sit in hard chair with arms for posture control.

C. To walk with hands clasped behind back to help balance.

The nurse is aware that the characteristic gait of the person with Parkinson disease is a propulsive gait, which causes the patient to: A. stagger and need support of a walker. B. shuffle with arms flexed. C. fall over to one wide when walking. D. take small steps balanced on the toes.

B. shuffle with arms flexed.

A patient experiencing TIAs is scheduled for a carotid endarterectomy. The patient asks the nurse what this procedure is. The nurse correctly responds with which response? A. "This procedure promotes cerebral flow to decrease cerebral edema." B. "This procedure reduces the brain damage that occurs during a stroke." C. "This procedure helps prevent a stroke by removing atherosclerotic plaques obstructing cerebral blood flow." D. "This procedure provides a circulatory bypass around thrombotic plaques obstructing cranial circulation."

C. "This procedure helps prevent a stroke by removing atherosclerotic plaques obstructing cerebral blood flow."

The newly admitted patient to the emergency room after a motorcycle accident has serosanguineous drainage coming from the nose. What is the most appropriate nursing response to this assessment? A. Cleanse nose with a soft cotton-tipped swab. B. Gently suction the nasal cavity. C. Gently wipe nose with absorbent gauze. D. Ask patient to blow his nose.

C. Gently wipe nose with absorbent gauze.

A 13-year-old student is admitted to the pediatric unit with possible meningitis. The nurse finds that the patient cannot extend her legs completely without experiencing extreme pain. The nurse correctly documents this as which sign? A. Brudzinski's sign B. Battle's sign C. Kernig's sign D. Cosgrow's sign

C. Kernig's sign

Following a myelogram the nurse should include in the postprocedure care assessment for: A. elevation of blood pressure. B. urine retention. C. sensation in lower extremities. D. slurred speech.

C. sensation in lower extremities.

How would a nurse record the behavior when a patient with Alzheimer's disease attempts to eat using a napkin rather than a fork? A. Apraxia B. Agnosia C. Aphasia D. Dysphagia

B. Agnosia

The nurse is aware that when assessing a patient by the FOUR score coma scale, the patient is assessed in four categories: eye response, brainstem reflexes, motor response, and respiration. How are these results reported? A. As a sum of the scores of the four categories B. As part of the Glasgow Coma Scale C. As individual scores in each category D. As progressive scores during a 24-hour period

C. As individual scores in each category