neuro practice questions

what is the best room assignment for a client with increased intracranial pressure?

a room that is quiet with a decrease in environmental stimulation

the nurse would consider which metabolic response to traumatic brain injuries when developing a plan of care addressing nutrition?

accelerated catabolism

this cranial nerve (VII) is responsible for the sense of hearing

acoustic nerve

the nurse would encourage meningitis vaccination for which population?

adolescents

the total or partial loss of the ability to recognize familiar objects or people, as a result of organic brain damage, is termed _______.

agnosia

during the evaluation which assessment indicates an early sign of increased intracranial pressure for a client newly diagnosed with a cerebral vascular accident (CVA)?

an alteration in the ability to answer questions and respond to verbal stimuli

_________ is a total loss of comprehension and use of language, whereas _______ is difficult or poorly articulated speech.

aphasia and dysarthria

due to bradykinesia, dysphagia develops in most parkinson's patients, and all parkinson's patients should be placed on these precautions

aspiration precautions

a slowing down in the initiation and execution of movement is termed ________.

bradykinesia

the nurse is caring for a patient who received a gunshot wound to the side of the head. which concern is most worrisome for the nurse?

brain damage

this is the gold standard prescription for parkinson's disease. it improves the modulation of voluntary nerve impulses, enhancing movement and helping to decrease rigidity and bradykinesia

carbidopa-levodopa

which diagnostic test is most accurate when assessing for bacterial meningitis?

cerebrospinal fluid analysis

this is the largest part of the brain, divided into left and right hemispheres. each hemisphere controls movement on the opposite side of the body.

cerebrum

which clinical manifestation indicates an early central herniation

cheyne-strokes respirations

which one of these documentations in the client's chart indicates an understanding of the nursing care priority for a client diagnosed with amyotrophic lateral sclerosis (ALS)?

client turning, coughing, and deep breathing every 2 hours along with incentive spirometry and chest physiotherapy

the nurse is caring for a patient who is experiencing vasospasm after treatment of an aneurysmal subarachnoid hemorrhage. which intervention would the nurse implement?

closely monitor for fever

what topic would the nurse provide education about to decrease the risk of stroke from large artery atherosclerosis?

control of HTN, smoking cessation, healthy diet, and glucose control

flexion of the arms, wrists & fingers, with adduction of the upper extremeties, and extension, internal rotation and plantar flexion of the lower extremities describes this type of posturing, ________.

decorticate

what response would the nurse expect to see when hyperventilating a patient with acute increased intracranial pressure

decreased intracranial pressure

which change would decrease the cerebral perfusion pressure?

decreased mean arterial pressure

the nurse is preparing to admit a patient for bacterial meningitis. which precaution would the nurse include in the plan of care?

droplet

the nurse is caring for a patient with traumatic brain injury. which patient problem would the nurse closely monitor for?

dysphagia, fever, headache, constipation, altered communication

what monitoring device would the nurse use to assess the effects of sedation and neuromuscular blocking medications?

electroencephalographic

which side effect would the nurse monitor for when administering an osmotic diuretic to a patient with increased intracranial pressure?

electrolyte imbalance

for a client with increased intracranial pressure (IICP), which of these nursing actions by the LPN would require intervention by the charge nurse?

encourages client to cough and suction orally q 1-2 giyrs

which nursing intervention may increase intracranial pressure?

endotracheal suctioning

mnemonic F.A.S.T. stands for _________, _________, _________, __________, __________.

face, arms, speech, time

which type of seizure involves an area on both sides of the brain at the onset?

generalized motor

the most common type of seizure involves stiffening of the body with jerking of the extremities

generalized tonic-clonic seizure (formerly known as a grand mal)

if there is clear drainage from the nose following a head trauma, the nurse can check it for _______ with a test strip to determine if it is CSF

glucose - if the head injury or skull fracture is suspected, care should be taken to prevent the patient from becoming agitated or increasing the ICP (no loud stimulus, no coughing/sneezing. keep HOB at 30 degrees)

in this disorder, antibiotics attack the schwann cells, causing the myelin sheath to break down, leaving the uninsulated portion of the nerve open to inflammation. this interrupts nerve conduction and results in the classic signs of this disorder, which are muscle weakness, tingling, and numbness. if intercostal muscles become affected, respiratory failure may occur

guillan barre syndrome

when completing the national institutes of health stroke scale, how would the nurse assess for limb ataxia?

have the patient perform the finger-nose-finger and heel-shin tests

paralysis of one side of the body is termed

hemiplegia

when caring for a patient who underwent a craniotomy four hours ago, which finding would prompt the nurse to immediately contact the healthcare provider?

high fever and uncontrolled headache

which change would the nurse expect in a patient that is in phase 1 of status epilepticus?

hypertension

the nurse is caring for a patient with rhinorrhea of cerebrospinal fluid due to a dural tear and basilar

insert gastric tubes through the mouth instead of the nose

which intracranial pressure monitoring device would be best for a patient who requires cerebrospinal fluid drainage?

intraventricular catheter

strokes are classified as ______ or _______.

ischemic or hemorrhagic

this sign is elicited when the patient cannot extend the legs completely without extreme pain, ________; this other sign is elicited when a patient's neck is flexed, the hips and knees flex also due to extreme stiffness from inflammation, __________.

kernig's sign and Brudzinski's sign

which type of stroke occurs from small arterial vessel occlusion?

lacunar

a change in this is often the very first sign of a neurological problem or increased intercranial pressure

level of consciousness

a patient presents with a right-sided spinal cord injury. which manifestation would indicate the patient is experiencing Brown-Sequard syndrome?

loss of pain sensation on the left side

the nurse is preparing to endotracheal suction a patient with increased intracranial pressure. which intervention should the nurse include?

maintain the head in a neutral position

what would be the priority nursing intervention for a young adult who is being admitted to the neuro unit with the diagnosis of a closed-head injury following an accident? client is alert, oriented, but lethargic and has clear liquid draining from the nose

maintain the head of the bed elevated

the most distal area of the brain controls heartbeat, rhythm of breathing, swallowing, coughing, sneezing, vomiting, and hiccups.

medulla oblongata

often beginning in the adolescent years and presenting with an aura, this type of headache can have multiple triggers.

migraine headaches

what is the basic cell of the nervous system

neuron

this type of pain may result from post-herpetic neuralgia, diabetic neuropathies, phantom limb pain, or trigeminal neuralgia.

neuropathic pain

the most important thing to remember when caring for a patient experiencing a seizure is ________.

never leave them alone - stay with the patient, make sure they are lowered gently onto the floor and protect their head. if possible, turn their head to one side to facilitate saliva drainage.

the nurse inserts an intravenous line in a patient experiencing acute stroke. which type of fluid would the nurse anticipate administering?

normal saline

the cranial nerve (cranial nerve I) is responsible for the sense of smell

olfactory nerve

this cranial nerve (cranial nerve II) is responsible for vision

optic nerve

when using the mnemonic A-V-P-U to determine responsiveness, the "P" indicates that the patient is responsive to _______.

pain

this type of tremor is commonly seen in parkinson's patients

pill rolling

which nursing intervention would the nurse include in the plan of care for a patient with ischemic stroke who will be receiving rt-PA treatment?

place invasive lines prior to administering rt-PA, maintain systolic blood pressure at less than 185, closely monitor for signs of intracranial hemorrhage

this is the period following a seizure in which the patient in groggy, exhausted, and may be disoriented.

post-ictal phase

if the meningitis is thought to be bacterial, ________ antibiotic therapy may be ordered for close contacts of the patient

prophylactic - bacterial meningitis is deadly. the patient should be on droplet precautions and family members are likely to be treated

the body's sense, based on internal stimuli, of its own position and limb movements is called

proprioception

the nurse is conducting a physical assessment of a client with a neurological complication. what is the appropriate instruction to give the client to assess the function of the client's cranial nerve XI?

provide thickened liquids

when a head injury has occurred, two ominous signs are periorbital edema and ecchymosis and postaruicular ecchymosis. these two signs are better known as _______ and _______.

racoon eyes and Battle's sign

abnormal electrical activity in the brain can result in _______ activity.

seizure

a patient presents to the emergency room with stiff neck, photophobia, and pain behind the eyes. in triage, the patient states "this is the worst headache of my life." which condition would the nurse suspect?

subarachnoid hemorrhage

between the neurons, there are gaps called ________, where nerve impulses get transmitted through neurotransmitters.

synapse

often treated with nonopioid analgesics, these headaches often arise from psychological problems related to stress, or from medical problems like cervical arthritis.

tension headaches

what tests can the nurse anticipate for patients who are experiencing stroke or stroke-like symptoms

tests: CT scan, MRI, carotid ultrasound procedures: carotid endarterectomy, craniotomy with possible aneurysm clip, endovascular embolectomy, medication screening for a "clot buster" drug, such as TPA

the two divisions of the nervous system are the CNS and the PNS. the CNS is made up of the ________ and the PNS is divided further into the somatic and autonomic nervous systems.

the brain and spinal cord

epidemic encephalitis is transmitted by these two vectors, ______ & ________.

ticks and mosquitoes

what are 3 components of the classic parkinsonian triad

tremor, rigidity, bradykinesia

this cranial nerve (cranial nerve V) is responsible for sensations on the face, scalp, and teeth, and for chewing movements. it also has branches: ophthalmic, maxillary, and mandibular

trigeminal nerve

this cranial nerve (cranial nerve X) is responsible for functions of sensations in the throat, larynx, and thoracic and abdominal organs, swallowing, and decreasing heart rate and/or increasing peristalsis.

vagus nerve

which factor increases the risk of status epilepticus?

withdrawal from habitual use of alcohol, azotemia, hyponatremia, and infection

when admitting a client with amyotrophic lateral sclerosis (ALS) who has difficult communicating, the nurse is attempting to obtain an initial assessment. which question is most appropriate when addressing the client?

"do you ever have any difficulty breathing or swallowing?"

the nurse is educating the family of a patient admitted with acute hemorrhagic stroke due to an arteriovenous malformation. which statement indicates understanding of the education?

"he was born with the arteriovenous malformation."

which statement about cerebral oxygen monitoring shows understanding of the information?

"the partial pressure of oxygen within brain tissue should be greater than 20 mmHg."

the nurse is caring for a patient who underwent endovascular treatment of a cerebral aneurysm two days ago. the patient asks the nurse how the aneurysm was treated. how would the nurse respond?

"the physician placed coils into the aneurysm sac to occlude the aneurysm."

the nurse is caring for a patient with a concussion after a fall from a ladder. which patient statement indicates understanding of the diagnosis?

"with concussions, the neurological deficits are usually reversible."

which assessment finding indicates the resolution of spinal shock?

+3 deep tendon reflexes

a client with a history of myasthenia gravis is presenting with a HR of 112 bpm, RR 24/min with accessory muscle use, anxiety, and restlessness. which of these would be appropriate immediate nursing interventions?

-elevate HOB -O2 per MD prescription

which nursing interventions are appropriate to help decrease the development of increased intracranial pressure for a client with a head injury?

-maintain head in midline neutral position with HOB elevated to 30 degrees -keep client's room quiet and dark -administration of acetaminophen (Tylenol) for a temp of 100.1

this drug class is the first line of drug therapy now for moderate to severe headaches. they act on dilated receptors during a migraine attack and stimulating those receptors constricts cranial vessels thereby relieving the pain

-triptans (ex. sumatriptan or better known as Imitrex)

what are three diagnostic tests that may be utilized for diagnosing the type of headache present

1. CT scan 2. MRI 3. lumbar puncture

describe a meal that would be optimal for a parkinson's patient

1. appetizing 2. cut into small bites 3. well balanced (fiber: fruits & veggies to reduce constipation) 4. able to be chewed and swallowed easily 5. encourage oral fluids

what are possible triggers for recurring headaches

1. fatigue 2. alcohol. 3. stress 4. seasonal climate changes 5. hunger 6. menstruation 7. allergies

what can you educate your patient regarding reducing mosquito exposure, thereby reducing the risk for west nile virus

1. limit outdoor activities between dusk & dawn 2. place mosquito netting over baby cars eats and strollers 3. use mosquito repellants that contain DEET 4. install or repair window screens to prevent entry into the home 5. store containers inside or upside down so water doesn't pool inside them to attract mosquitoes

what are three activities should people with seizures should avoid until the seizures are under control

1. swimming 2. driving 3. operating machinery

the minimum score on the Glasgow coma scale that can be awarded is

3

a patient with a complete spinal cord lesion at which level would require long-term mechanical ventilation?

C2