Neuro and MusculoSkeletal Socrative

Which disease can result in symptoms that can occur when a brain tumor causes damage to the nigrostriatal pathway?

Parkinson Disease

A client recently diagnosed with rheumatoid arthritis (RA) tells the nurse she is glad there is nothing "really wrong with her" besides some joint swelling. Which information should the nurse tell the client about RA?

"Extra-articular manifestations may include anemia and deformities of the affected joints."

A client has been diagnosed with rheumatoid arthritis (RA). What will the nurse tell the client about this disorder's etiology?

"Genetic predisposition is very likely"

A client presents to the orthopedic clinic for evaluation since the primary care provider thinks the client may have rheumatoid arthritis (RA). Which statement by the client correlates with the diagnosis of RA? Select all that apply.

"I'm having a hard time opening doors since it hurts so bad."

A client sought care because of increasing pain and inflammation in the toe and ankle of one foot. Diagnostic testing has resulted in a diagnosis of gouty arthritis. When educating the client about the treatment and management of the disease, what should the nurse teach the client?

"Losing some weight and reducing your alcohol intake will likely be beneficial."

A nurse is caring for a client with a fractured elbow. Which instruction is important to give the client to prevent cartilage degeneration while the elbow is immobilized?

"To prevent cartilage atrophy, slowly and gradually resume exercising."

The nurse determines that additional client education is needed when a client with gout makes which statement?

"When I have an exacerbation of my symptoms, a glass of red wine will be helpful."

One day following SCI a patient asks about the extent of impairment that will result from the injury. What is your best response?

"the extent of your injury cannot be determined until the secondary injury to the cord is resolved."

Which female patients are at risk for developing osteoporosis? (select all that apply)

- 58, Native American, started menopause prematurely - 68, white, underweight, and inactive - 55, Asian, cigarette smoke

A client sustains a musculoskeletal injury of the right foot. In addition to pain, which manifestations would accompany a fracture? Select all that apply.

- Deformity of the affected part - Abnormal mobility - Swelling - Loss of function

Which assessment findings would confirm that a client with spinal cord injury has developed autonomic dysreflexia? Select all that apply

- Pallor - Pounding headache - pulse rate 51 - BP 182/99

When assessing a client with acute gout, for which of these signs and symptoms does the nurse assess? Select all that apply.

- Redness and swelling of the affected joint - Pain and swelling in one joint -Intake of alcohol - Obesity

The nurse assessing a client with a traumatic brain injury assesses for changes in which neurologic component? Select all that apply

- Sensory Function - Motor function - Level of consciousness - Cognition

Aimee attends a support group for MS. All of the group members talk about their associated symptoms. Which symptoms do the support group members have in common? Select all that apply.

- mental acuity progressively declines - debilitating fatigue - visual acuity progressively declines

Which of the following risk factors for stroke are NON-modifiable? (select all that apply)

-Age - Hereditary/Genetics - Sex - Ethnicity

which intracranial pressure (ICP) would the nurse consider a normal reading?

0 to 15 mm Hg

Which statement accurately reflects the typical person afflicted with multiple sclerosis (MS)?

25 year old women

The nursing student who is studying about osteoporosis correctly identifies which female to be at highest risk for suffering a fracture?

A 68-year-old who gets bumped several times while riding the bu

Which of these is the strongest risk factor for developing Alzheimer's?

Age

Which clients should the nurse assess to determine if they have premature osteoporosis?

Anyone with an eating disorder

The nurse working in an emergency room is caring for a client who is exhibiting signs and symptoms of a stroke. What does the nurse anticipate that the physician's orders will include?

CT scan

The nurse expects that loss of respiratory effort occurs with a spinal injury at which level?

C1-3

A 14-year-old girl has been thrown from the back of a pick-up truck. MRI shows complete cord injury at the level of C2. What is the main significance of an injury at this level of the spinal column?

Cannot breathe on own, needs ventilator

Which clients with rheumatoid arthritis (RA) will the nurse prioritize to assess first?

Client with systemic lupus erythematosus (SLE) and chest pain

Aimee was diagnosed with multiple sclerosis (MS) at the age of 22. She has tremors associated with MS. As the nurse, how would you explain MS to Aimee?? Due to demyelination of neurons that occur in MS:

Communication being sent through neurons is slowed

Parkinson's patients are at a high risk of falling. What should you teach your patient to do to reduce risk of falls?

Consciously lift the toes when stepping

What term describes an injury to the soft tissue of the body?

Contusion

The nurse is caring for a 31-year-old trauma victim admitted to the neurologic intensive care unit. While doing the initial assessment, the nurse finds that the client is flexing the arms, wrists, and fingers. There is adduction of the upper extremities with internal rotation and plantar flexion of the lower extremities. How would the nurse describe this in the notes?

Decorticate posturing

The demyelination and degeneration of nerve fibers characteristic of multiple sclerosis (MS) is the result of which pathophysiologic event?

Decreased oligodendrocytes

Regarding the pathophysiology of Parkinson disease, which statement is true?

Degeneration of the nigrostriatal dopamine neurons occurs

Alzheimer disease is the most common cause of which of these?

Dementia

A client's recent diagnosis of Parkinson disease has prompted the care provider to promptly begin pharmacologic therapy. The drugs prescribed will likely influence the client's levels of which substance?

Dopamine

A client with Parkinson disease presents with bradykinesia and an altered gait. These symptoms arise in response to the progressive deterioration of which structure in the brain?

Dopamine nigrostriatal system

Acceleration-deceleration (coup-contrecoup) movements of the head often result in polar injuries in which

Focal injuries occur in two places at opposite poles

The family of a multiple sclerosis client asks, "What psychological manifestations may we expect to see in our mother?" The health care provider informs them to expect which of the following? Select all that apply.

Forgetfulness, Depression, and Inattentiveness

A client with a fractured clavicle is told that the bone will heal well if immobilized for the next 6 to 8 weeks, but there will be a large "bump" where the break occurred. This bump will be caused by:

Formation of a bony callus

Teddy fell off a ladder and has an injury at the level of T2. Which finding is of most concern to the nurse?

Heart rate of 42 bpm

You are planning community education for prevention of spinal cord injuries. Who do you target for the education?

High School Boys

The average time from the onset of symptoms to death is how long?

I don't know this feels like something that depends on the patient and their presentation of the illness so I should assess them further?

An older adult client has had mobility and independence significantly impaired by the progression of rheumatoid arthritis (RA). What is the primary pathophysiologic process that has contributed to this client's decline in health?

Immunologically mediated joint inflammation

Which assessment finding is a positive outcome of treatment with diet and exercise for hypercholesterolemia?

Increased high-density lipoproteins

Which signs and symptoms should prompt a young woman's primary care provider to assess for systemic lupus erythematosus (SLE)?

Joint pain and proteinuria

What describes the manifestations of OA?

Pain and immobility are aggravated by falling barometric pressure.

A patient who has severe Alzheimer's disease (AD) is being admitted to the hospital for surgery. Which intervention will the nurse include in the plan of care?

Maintain a consistent daily routine for the patient's care

The nurse is assessing a female client's risk for osteoporosis. Which factor places this client at greatest risk?

Menopause

Frank complains of a red/green color distortion. Which disease process do you suspect?

Multiple Sclerosis

The nurse is caring for an older adult client with hemiplegia following a stroke. While planning the client's care, the nurse knows the client is at risk for developing which condition?

Muscle atrophy

A client diagnosed with Parkinson disease is displaying the following manifestations: tremor, rigidity, and slowness of movement. The nurse would interpret these as

Normal manifestations of Parkinson disease

Which description is more characteristic of OA when compared to RA?

Not systemic of symmetric

Nystagmus due to cerebellar dysfunction would most likely interfere with which activity?

Reading

Which symptom is unique to amyotrophic lateral sclerosis (ALS) and is not observed in multiple sclerosis (MS)?

Respiratory muscle impairment

A client comes to the clinic and informs the nurse that he believes he is suffering from Parkinson disease. What objective data assessed by the nurse would correlate with the client's concern? Select all that apply.

Rigidity Tremor Bradykinesia

A family brings their father to his primary care physician for a checkup. Since their last visit, they note their dad has developed a tremor in his hands and feet. He also rolls his fingers like he has a marble in his hand. The primary physician suspects the onset of Parkinson disease when he notes which abnormality in the client's gait?

Slow to start walking and has difficulty when asked to "stop" suddenly

A nurse is caring for a client admitted with a malar rash on the nose and cheeks. The nurse recognizes that this rash is characteristic of which disease process?

Systemic lupus erythematosus (SLE)

Warren, an 80-year-old male, has been diagnosed with a stroke that resulted in an infarct to the cerebellum. Which of the following clinical findings would be most closely associated with cerebellar insult?

Unsteady gait and difficulty speaking and swallowing

A client has been diagnosed with a cerebral aneurysm and placed under close observation before treatment commences. Which pathophysiologic condition has contributed to this client's diagnosis?

Weakness in the muscular wall of an artery

Loss of coordinated movement, muscle rigidity, and immobility without paralysis is likely due to damage to:

extrapyramidal tracts

After a rolling MVA George goes to the ER for a C4 spinal cord injury. His BP is 86/60 and heartrate is 44 beats per minute. The nurse determines that this pathophysiologic response is caused by

loss of sympathetic nervous system innervation resulting in vasodilation

The nurse is assessing a client and notes the client is now displaying decerebrate posturing. The position would be documented as:

rigidity of the arms with palms of the hands turned away from the body and with stiffly extended legs and plantar flexion of the feet

Manny is diagnosed with a subdural hematoma following a horse riding accident. Which of the following best describes a subdural hematoma?

Blood is accumulating between the dura and subarachnoid space

What is a priority concern for a client who has a hip dislocation?

Blood supply to the femoral head

A client who has experienced a spinal cord injury still has use of the arms but has impaired motor and sensory function of the trunk, legs, and pelvic organs. Which term best describes how this injury is classified?

Paraplegia

The nurse assesses the neurovascular status of a client who had surgery to repair a fractured hip. Which assessment data for the affected leg indicates that the client has developed a neurologic complication?

Tingling sensations

What is most likely to cause the pain associated with OA in the later stages?

Bone surfaces rubbing together

Which cardinal assessment finding would lead the nurse to suspect a client has developed Parkinson disease?

Bradykinesia

A nurse is teaching a group of nursing students about the presentation of systemic lupus erythematosus (SLE). Which statement is the nurse likely to make?

"More women than men are affected by lupus."

You are assigned Henry, an 82-year-old man with Alzheimer's Disease. After visiting with him, his daughter asks you what the cure is. What is your best response?

"Some medications may be beneficial to relieve symptoms, but there is no true cure."

While there is no specific test to diagnose Alzheimer's, which of the following indications on a CT scan would help confirm a suspected diagnosis of Alzheimer's?

Numerous beta-amyloid plaque deposits

The nurse is conducting a health promotion class on osteoarthritis (OA). Which statement should the nurse include?

Obesity is a strong risk factor for developing OA

A 62-year-old male patient comes to the ER presenting with signs of a stroke. Which lab would you assess first?

Blood glucose

The nurse is caring for a client with a spinal cord injury. Assessment reveals shallow breath sounds with a very weak cough effort. The nurse correlates this with which level of injury on the spinal column?

C5

Which complication of spinal cord injury is the most preventable in a paraplegic client?

Skin breakdown

A patient is being evaluated for Alzheimer's disease (AD). The nurse explains to the patient's adult children that

a diagnosis of AD is made only after causes of dementia are ruled out

A 60-year-old woman has pain when moving her fingers and asks you if this is just due to aging. What s your best response?

"Changes in the cartilage and bones of joints may cause symptoms of pain and loss of function."

A man arrives in the ER with a severe head injury. Your priority assessment is what?

Assessing and maintaining the patency of the airway

As the nurse of an 89 year old woman on bedrest, which of the following actions can you take to decrease risks associated with clot formation and skin breakdown?

Assist with passive leg exercises

An older adult is brought to the emergency department after experiencing some confusion, slurred speech, and a weak arm. Now the client is back to acting normally. Suspecting a transient ischemic attack (TIA), the health care provider prescribes diagnostic testing looking for which cause of this episode?

Atherosclerotic lesions in cerebral vessels

A 16-year-old male football player suffered a fracture of his radius and ulna. Assessment of the fracture includes the following data: (1) the fracture does not protrude through the skin, and (2) both bones broke completely through into two pieces. Select the best description of the injury.

Closed comminuted fracture

A nurse is caring for a client who has systemic lupus erythematosus (SLE). Which of the following causes the disease?

Autoimmune process

After a skydiving accident Eugene is taken to the ER with a closed head injury. He is awake, but very lethargic. When you first take his vitals they are BP 120/80, HR 70, RR 20. Two hours later you reassess Eugene. Which assessment indicates deterioration?

BP 160/70, HR 43, RR 8

A patient experienced an open fracture at the humerus 2 weeks ago and is having increased pain in the fracture site. Which testing would help identify the causative agent of osteomyelitis?

Bone Biopsy

Intracranial aneurysms that rupture cause subarachnoid hemorrhage in the client. How is the diagnosis of intracranial aneurysms and subarachnoid hemorrhage made?

CT scan

A nurse on a neurology unit is assessing a client with a brain injury. The client is unresponsive to speech, with dilated pupils that do not react to light. The client is breathing regularly with a respiratory rate is 45 breaths per minute. In response to a noxious stimulus, the client's arms and legs extend rigidly. What is the client's level of impairment?

Coma

Which diagnostic finding has been strongly linked to systematic lupus erythematosus(SLE)?

Elevated anti-nuclear antibodies (ANA)

The nurse is planning an in service on hypoxia versus ischemia in brain-injured clients. The nurse should include which of the following?

Hypoxia produces a generalized depressive effect on the brain.

Restoration of the integrity of myelin sheaths would likely result in a slowing or stopping of the progression of:

Multiple Sclerosis (MS)

When assessing a client with rheumatoid arthritis, which statement about joint involvement is most accurate?

Involvement is symmetric and polyarticular, initially starting in the fingers, hands, and wrists

A patient is seen in an outpatient clinic for a sudden inflammation and severe pain in the great toe. A diagnosis of gouty arthritis is based on:

Monosodium urate crystals found in synovial fluid

During assessment of a patient admitted for acute exacerbations of MS, what would you as the nurse expect to find?

Motor impairment, visual disturbances, and paresthesia

While getting up out of bed for the first time after surgery, a client reports feeling dizzy and faint. Which condition is the client most likely experiencing?

Orthostatic intolerance

Tina has been a lifelong horse rider. At the age of 16 she was thrown off the back of her horse, Jericho. She can move her arms, but she has lost all motor function below the lumbar region of her spinal cord. What is this called?

Paraplegia

What disease results from the degeneration of the dopamine nigrostriatal system of the basal ganglia?

Parkinson disease

When Tina fell off her horse and went to the ER for her spinal cord injury, you as her nurse knew the priority of assessment was

Patency of her airway

The client with a suspected diagnosis of osteoarthritis asks the health care provider, "How will this diagnosis be confirmed?" Which response is most appropriate?

Physical examination and x-ray studies

A major complication of prolonged bed rest is an increased risk of kidney stones. The nurse knows that this is most likely related to:

Saturation of urine with calcium salts

An older adult client has recently been diagnosed with rheumatoid arthritis. The nurse should focus assessment on which aspects?

Weight and nutritional status