Module 11 (Intracranial Regulation and Cognition)

A client preparing to undergo a lumbar puncture states he doesn't think he will be able to get comfortable with his knees drawn up to his abdomen and his chin touching his chest. He asks if he can lie on his left side. Which statement is the best response by the nurse? "Lying on your left side will be fine during the procedure." "Although the required position may not be comfortable, it will make the procedure safer and easier to perform." "I'll report your concerns to the physician." "There's no other option but to assume the knee-chest position."

"Although the required position may not be comfortable, it will make the procedure safer and easier to perform."

Which term refers to the inability to recognize objects through a particular sensory system? Agnosia Aphasia Dementia Ataxia

Agnosia

Lesions in the temporal lobe may result in which type of agnosia? Relationship Visual Tactile Auditory

Auditory

The nurse is performing an assessment of cranial nerve function and asks the patient to cover one nostril at a time to see if the patient can smell coffee, alcohol, and mint. The patient is unable to smell any of the odors. The nurse is aware that the patient has a dysfunction of which cranial nerve? CN III CN I CN IV CN II

CN I

A patient recently noted difficulty maintaining his balance and controlling fine movements. The nurse explains that the provider will order diagnostic studies for the part of his brain known as the: Midbrain. Pons. Medulla oblongata. Cerebellum.

Cerebellum.

A nurse is working in a neurologist's office. The physician orders a Romberg test. What should the nurse instruct the client to do? Close eyes and jump on one foot. Close eyes and discriminate between dull and sharp. Touch nose with one finger. Close eyes and stand erect.

Close eyes and stand erect.

The critical care nurse is giving report on a client they are caring for. The nurse uses the Glasgow Coma Scale (GCS) to assess the level of consciousness (LOC) of a female client and reports to the on-coming nurse that the client has an LOC of 6. What does an LOC score of 6 in a client indicate? Comatose Stupor Somnolence Normal

Comatose

Low levels of the neurotransmitter serotonin lead to which of the following disease processes? Depression Myasthenia gravis Seizures Parkinson's disease

Depression

Which safety action will the nurse implement for a client receiving oxygen therapy who is undergoing magnetic resonance imaging (MRI)? Note that no special safety actions need to be taken. Securely fasten the client's portable oxygen tank to the bottom of the MRI table after the client has been positioned on the table. Ensure that no client care equipment containing metal enters the room where the MRI table is located. Check the client's oxygen saturation level using a pulse oximeter after the client has been placed on the MRI table.

Ensure that no client care equipment containing metal enters the room where the MRI table is located.

Which cerebral lobes is the largest and controls abstract thought? Occipital Parietal Frontal Temporal

Frontal

A patient is having a lumbar puncture and the physician has removed 20 mL of cerebrospinal fluid. What nursing intervention is a priority after the procedure? Have the patient lie flat for 1 hour and then sit for 1 hour before ambulating. Have the patient lie flat for 6 hours. Have the patient lie in a semi-Fowler's position with the head of the bed at 30º. Early ambulation

Have the patient lie flat for 6 hours.

Which of the following areas of the brain are responsible for temperature regulation? Hypothalamus Medulla Thalamus Pons

Hypothalamus

A male client is scheduled for an electroencephalogram (EEG). When the nurse caring for the client is preparing him for the test, the client states that during childhood he was mildly electrocuted but miraculously lived. Therefore, he is quite afraid of going through an EEG. In what ways can the nurse help dispel the client's fear regarding the test? Encourage adequate water intake by the client. Distract the client's attention from the test. Inform the client that he will experience only mild electrical shock. Inform the client that he will not experience any electrical shock.

Inform the client that he will not experience any electrical shock.

A 53-year-old man presents to the emergency department with a chief complaint of inability to form words, and numbness and weakness of the right arm and leg. Where would you locate the site of injury? Left frontoparietal region Left basal ganglia Left temporal region Right frontoparietal region

Left frontoparietal region

A client is diagnosed with a brain tumor. The nurse's assessment reveals that the client has difficulty interpreting visual stimuli. Based on these findings, the nurse suspects injury to which lobe of the brain? Temporal Occipital Frontal Parietal

Occipital

Which cranial nerve is responsible for muscles that move the eye and lids? Vestibulocochlear Facial Trigeminal Oculomotor

Oculomotor

The pre-nursing class is learning about the nervous system in their anatomy class. What part of the nervous system would the students learn is responsible for digesting food and eliminating body waste? Parasympathetic Central Peripheral Sympathetic

Parasympathetic

The Family Nurse Practitioner is assessing a 55-year-old who came to the clinic complaining of being "unsteady" on their feet. What would be a test for equilibrium? Carlsberg test Walking and turning abruptly Romberg test Heel-to-toe test

Romberg test

A patient has been diagnosed with damage to Broca's area of the left frontal lobe. To document the extent of damage, the nurse would assess the patient's: Hearing. Speech. Vision. Balance.

Speech

A client who has sustained a head injury to the parietal lobe cannot identify a familiar object by touch. The nurse knows that this deficit is which of the following? Positive Romberg Ataxia Visual agnosia Tactile agnosia

Tactile agnosia

The nurse assists the health care provider (HCP) in completing a lumbar puncture (LP). Which should the nurse note as a concern? The pressure is noted to be 90 mm H20. The HCP administers a drug by intrathecal injection. The cerebrospinal fluid (CSF) is cloudy in nature. The HCP maintains aseptic procedure.

The cerebrospinal fluid (CSF) is cloudy in nature.

A client experienced a stroke that damaged the hypothalamus. The nurse should anticipate that the client will have problems with: thinking and reasoning. body temperature control. visual acuity. balance and equilibrium.

body temperature control.

A nurse is caring for a client who has a history of a cerebral aneurysm. Which diagnostic test does the nurse anticipate to monitor the status of the aneurysm? electroencephalogram milligram echoencephalography cerebral angiography

cerebral angiography

After a plane crash, a client is brought to the emergency department with severe burns and respiratory difficulty. The nurse helps to secure a patent airway and attends to the client's immediate needs, then prepares to perform an initial neurologic assessment. The nurse should perform an: examination of the fundus of the eye. evaluation of bowel and bladder functions. assessment of the client's gait. evaluation of the corneal reflex response.

evaluation of the corneal reflex response.

A nurse is completing a neurological assessment and determines that the client has significant visual deficits. Considering the functions of the lobes of the brain, which area will most likely contain the neurologic deficit? frontal parietal temporal occipital

occipital

The nurse has completed evaluating the client's cranial nerves. The nurse documents impairment of the right cervical nerves (CN IX and CN X). Based on these findings, the nurse should instruct the client to: wear any hearing aids while in the hospital. have their spouse bring in the client's glasses. use the walker when walking. refrain from eating or drinking for now.

refrain from eating or drinking for now.

A client is actively hallucinating during an assessment. The nurse would be correct in documenting the hallucination as a disturbance in intellectual function. emotional status. motor ability. thought content.

thought content.

The nurse is preparing a client for a neurological examination by the physician and explains tests the physician will be doing, including the Romberg test. The client asks the purpose of this particular test. The correct reply by the nurse is which of the following? "It is a test for coordination." "It is a test for balance." "It is a test for motor ability." "It is a test for muscle strength."

"It is a test for balance."

A nurse and nursing student are caring for a client recovering from a lumbar puncture yesterday. The client reports a headache despite being on bedrest overnight. The physician plans an epidural blood patch this morning. The student asks how this will help the headache. The correct reply from the nurse is which of the following? "The blood can repair damage to the spinal cord that occurred with the procedure." "The blood will seal the hole in the dura and prevent further loss of cerebral spinal fluid." "The blood will replace the cerebral spinal fluid that has leaked out." "The blood provides moisture at the site, which encourages healing."

"The blood will seal the hole in the dura and prevent further loss of cerebral spinal fluid."

The nurse is assessing the client's mental status . Which question will the nurse include in the assessment? "Can you count backward from 100?" "Can you write your name on this piece of paper?" "Are you having hallucinations now?" "Who is the president of the United States?"

"Who is the president of the United States?"

A client is waiting in a triage area to learn the medical status of family members following a motor vehicle accident. The client is pacing, taking deep breaths, and handwringing. Considering the effects in the body systems, what does the nurse anticipate the liver will do? Produce a toxic byproduct in relation to stress. Cease function and shunt blood to the heart and lungs. Maintain a basal rate of functioning. Convert glycogen to glucose for immediate use.

Convert glycogen to glucose for immediate use.

Which is a sympathetic effect of the nervous system? Decreased blood pressure Increased peristalsis Dilated pupils Decreased respiratory rate

Dilated pupils

A patient is being tested for a gag reflex. When the nurse places the tongue blade to the back of the throat, there is no response elicited. What dysfunction does the nurse determine the patient has? Dysfunction of the facial nerve Dysfunction of the vagus nerve Dysfunction of the spinal accessory nerve Dysfunction of the acoustic nerve

Dysfunction of the vagus nerve

The nurse is assessing the client's pupils following a sports injury. Which of the following assessment findings indicates a neurologic concern? Select all that apply. Absence of pupillary response Pupil reaction quick Pinpoint pupils Unequal pupils Pupil reacts to light

Pinpoint pupils Absence of pupillary response Unequal pupils

The nurse is caring for a client who is to have a lumbar puncture. What are the lowest vertebrae that contain the spinal cord? Fifth lumbar vertebrae Eleventh thoracic vertebrae Coccyx Second lumbar vertebrae

Second lumbar vertebrae

The nursing instructor is talking with her clinical group about the central nervous system. What should the instructor tell the students about the function of the spinal cord? Provides centers for planned action Serves as a conduit for impulses to and from the brain Supports the skeletal system Extends through the whole vertebral column

Serves as a conduit for impulses to and from the brain

A nurse is performing a neurologic assessment on the client and notes a positive Romberg test. This test for balance is related to which of the following cranial nerves? III X VIII VII

VIII

Lower motor neuron lesions cause flaccid muscles. hyperactive and abnormal reflexes. no muscle atrophy. increased muscle tone.

flaccid muscles.