neuro test
The nurse should recommend medical attention if a child with a slight head injury experiences which of the following? a. Vomiting, even once b. Sleepiness c. Headache, even if slight d. Confusion or abnormal behaviour
d) Confusion or abnormal behaviour
Which of the following is not a function of the central nervous system (CNS)? a) integrating sensory information b) evaluating the information c)initiating an outgoing response d) all of the above are functions
d) all of the above are functions
Which is not true of the myelin sheath? a) it is associated with white fibres in the brain b) it is important for nerve impulse conduction c) it covers cell bodies in the brain and spinal cord d) It is destroyed in multiple sclerosis
c) it covers cell bodies in the brain and spinal cord
The following orders are received for a patient who is unconscious after a head injury caused by an automobile accident. Which one should the nurse question? a. Perform neurological checks every 15 minutes. b. Do computed tomography scanning with and without contrast. c. Prepare the patient for lumbar puncture. d. Obtain X-ray films of the skull and spine.
c) prepare the patient for lumbar puncture
The myelin sheath is formed by: a) nil bodies b) nodes of Ranvier c) Schwann cells d) neutron cell bodies
c) schwann cells
The following orders are received for a patient who is unconscious after a head injury caused by an automobile accident. Which one should the nurse question? a. Perform neurological checks every 15 minutes. b. Prepare the patient for lumbar puncture. c. Obtain X-ray films of the skull and spine. d. Do computed tomography scanning with and without contrast.
b. Prepare the patient for lumbar puncture.
During an assessment of an 80-year old patient, the nurse notes the patient's inability to identify vibrations at the ankle and to identify the position of the big toe, a slower and more deliberate gait, and slightly impaired tactile sensation. All other neurological findings are normal. The nurse knows that these findings indicate: a) cranial never dysfunction b) a lesion in the cerebral cortex c) normal changes due to aging d) demyelination of nerves due to a lesion
c) normal changes due to a lesion
Aspirin is ordered for a patient who is admitted with a possible stroke. Which information obtained during the admission assessment indicates that the nurse should consult with the physician? a. The patient has a history of brief episodes of right hemiplegia. b. The patient has dysphasia. c. The patient has atrial fibrillation. d. The patient states, "I suddenly developed a terrible headache."
d. the patient states, "i suddenly developed a terrible headache"
During the initial phase of care for a patient with spinal cord trauma at C5, why must the nurse give high priority to maintaining respiratory function? a. Immobilization of the patient's spine promotes pooling of respiratory secretions. b. At the C5 level, diaphragmatic and intercostal muscle function is lost. c. Extension of edema above the site of the injury may affect phrenic nerve function. d. Without abdominal muscle control, the patient cannot adequately cough to clear the lungs.
extension of edema above the site of the injury may affect phrenic nerve function
A nurse is teaching a group of caregivers about how to detect the early warning signs of alzheimer's disease. What are the warning signs that the nurse should include in the teachings? Select all that apply 1) memory loss that affects jobs 2) patient requiring help with getting dressed 3) problems with language 4) disorientation to time and place 5) patient requiring assistance while walking
1) memory loss that affects job skills 3) problems with language 4) disorientation to time and place
The nurse is teaching a group of caregivers about how to help patients with sever agitation in Alzheimers disease. What are the teachings that the nurse should include in the plan? Select all that apply 1) redirection 2) distraction 3) restraining 4) ignoring 5) reassurance
1) redirection 2) distraction 5) reassurance
For which patient should the nurse prioritize an assessment for depression? a) a patient in the early stages of Alzheimers disease b) a patient who is the final stages of the disease c) a patient experiencing delirium due to dehydration d) a patient who has become delirious following an atypical drug response
a) a patient in the early stages of Alzheimers disease
In obtaining a history for a 74-year old patien, the nurse notes that he drinks alcohol daily and that he has noticed a tremor in his hands that affects his ability to hold things. With this information, what should the nurses' response be? a) does your family know you are drinking every day b) Does the tremor change when you drink the alcohol c) we'll do some tests to see what is causing the tremor d) you really shouldn't drink so much alcohol; it may be causing your tremor
b) does the tremor change when you drink the alcohol
A synapse consists of: a) synaptic knob b) a synaptic cleft c) the plasma membrane of a postsynaptic neutron d) all of the above
d) all of the above
a 50- year old woman is visiting the clinic for "weakness in my left arm and leg for the past week" the nurse will perform which type of neurological examination? a) glasgow coma scale b) neurological recheck examination c) screening neurological examination d) complete neurological examination
d) complete neurological examination
The first event to occur when an adequate stimulus is applied to a neutron is: a) the membrane potential moves immediately to a value of 30mV b) the potassium channels open c) the sodium channels are inactivated d) some of the sodium channels at the point of stimulation open
d) some of the sodium channels at the point of stimulation open
Which one of the following manifestations would the nurse expect to assess on a patient with right-brain damage from a stroke? a. Right-sided hemiplegia b. Aware of deficits, depression c. Slow performance, cautiousness d. Impulsive behaviour
d. impulsive behaviour
A neuron that transmits a nerve impulse toward the central nervous system is called: a) motor neuron b) sensory neuron c) interneuron d) bipolar neuron
b) sensory neuron
What should be included in the nursing plan for prevention of skin breakdown in a stroke patient? select all that apply 1-Good skin hygiene 2- minimizing the frequency of position changing 3- massaging the damaged area 4- applying the emollients to dry skin 5- administering back rubs with alcohol for a cooling affect
1- good skin hygiene 4- applying the emollients to dry skin
A nurse is caring for a patient who has aphasia after suffering from a stroke. How will the nurse communicate with the patient? select all that apply 1-make use of gestures 2-present only one thought at a time 3-Do not interrupt the patient if he is taking too long to communicate 4-keep communicating, even if the patient is upset, to help him change his mood 5- pretent to understand the patient even if he or she does not make sense
1-make use of gestures 2-present only one thought at a time 3-Do not interrupt the patient if he is taking too long to communicate
A patient is admitted to the hospital with a head injury resulting from an automobile accident. On admission, the patient's vital signs are temperature 37°C, blood pressure 128/68 mm Hg, pulse 110 beats/min, and respiration 26 breaths/min. One hour after admission, which of the following vital signs does the nurse note indicates the presence of Cushing's triad? a. Blood pressure 140/60 mm Hg, pulse 60 beats/min, respiration 14 breaths/min b. Blood pressure 130/72 mm Hg, pulse 90 beats/min, respiration 24 breaths/min c. Blood pressure 110/70 mm Hg, pulse 120 beats/min, respiration 30 breaths/min d. Blood pressure 148/78 mm Hg, pulse 112 beats/min, respiration 28 breaths/min
a) Blood pressure 140/60 mmHg, pulse 60
What clinical manifestations would suggest hydrocephalus in a neonate? a. Bulging fontanel and dilated scalp veins b. Depressed fontanel and decreased blood pressure c. Closed fontanel and high-pitched cry d. Constant low-pitched cry and restlessness
a) Bulging fontanel and dilated scalp veins
Which internal structure arises from the basilar and two internal carotid arteries? a. Circle of Willis b. Anterior communicating centre c. Reticular formation d. Blood-brain barrier
a) Circle of willis
The largest and most numerous type(s) of neuroglia is/are the: a) astrocytes b) microglia c) ependymal cells d) oligodendrocytes
a) astrocytes
Which of the following is an age-related change in the nervous system? a. Decrease in electrical activity b. Increased efficiency of temperature-regulating mechanism c. Increase in deep-tendon reflexes d. Decreased size of ventricles in the brain
a) decrease in electrical activity
Which modifiable risk factors for stroke would be most important for the nurse to include when planning a community education program? a) hypertension b) hyperlipidemia c) alcohol consumption d) oral conception use
a) hypertension
Which set of the following symptoms are characteristic of spastic cerebral palsy? a. Hypertonicity and poor control of posture, balance, and coordinated motion b. Tremors and lack of active movement c. Wide-based gait and poor performance of rapid, repetitive movements d. Athetosis and dystonic movements
a) hypertonicity and poor control of posture, balance and coordinated motion
What is a clinical manifestation of increased intracranial pressure in an infant? a. Irritability b. Sunken fontanel c. Increased blood pressure d. Low-pitched cry
a) irritability
ICP monitoring is instituted for a patient with a head injury. The patient's arterial blood pressure is 92/50 mm Hg, and her ICP is 18 mm Hg. Which nursing action is most appropriate? a. Notify the physician about the assessments. b. Elevate the head of the patient's bed. c. Check the patient's pupillary response to light. d. Document and continue to monitor the parameters.
a) notify the physician about the assessments
The nurse is preparing a school-age child for a computed tomography (CT scan) to assess cerebral function. When preparing the child for the scan, which statement should the nurse make? a. "The scan will not hurt." b. "Pain medication will be given." c. "You will be able to move once the equipment is in place." d. "Unfortunately, no one can remain in the room with you during the test."
a) the scan will not hurt
During the history, a patient tells the nurse that "it feels like the room is spinning around me" The nurse should document this as: a) vertigo b) syncope c) dizziness d) seizure activity
a) vertigo
A patient has progressive memory deficits associated with dementia. Which nursing intervention would best help the individual function in the environment? Selected Answer: a. Read one story from the newspaper to the patient every day. b. Assist the patient to perform simple tasks by giving step-by-step directions. c. Reduce frustration by performing activities of daily living for the patient. d. Stimulate intellectual function by discussing new topics with the patient.
assist the patient to perform simple tasks by giving step-by-step directions
The parents of a child with cerebral palsy ask the nurse if any drugs can decrease their child's spasticity. What knowledge should the nurse base his response on? a. Anticonvulsant medications are sometimes useful for controlling spasticity. b. A pump can be implanted that delivers medication into the intrathecal space to decrease spasticity. c. Many different medications can be highly effective in controlling spasticity. d. Medications that would be useful in reducing spasticity are too toxic for use in children.
b) a pump can be implanted that delivers medication into the intrathecal space to decrease spasticity
A patient is brought to the emergency department by ambulance after she was found unconscious on the bathroom floor by her husband. In admitting the patient, what is it most important for the nurse to assess first? a. Status of bodily functions b. Airway patency c. Neurological status d. Health history
b) airway patency
During the neurological assessment of a "healthy" 35-year old patient, the nurse asks him to relax his muscles completely. The nurse them moves each extremity through the full range of motion. Which of the following would the nurse expect to find? a)firm, riding resistance to movement b) mild, even resistance to movement c) hypotonic muscles as a result of total relaxation d) slight pain with some directions of movement
b) mild, even resistance to movement
During an assessment of a patient's cranial nerves, the nurse finds a lack of blink in the right eye, with corneal reflex, intact ability to sense light touch on the face, and loss of movement with facial features on the right side. this would indicate dysfunction of which of the following cranial nerves? a) motor component of CN IV b) motor component of CN VII c) motor and sensory components of CN X1 d) Motor component of CN X and sensory component of CN V11
b) motor component of CN VII
The autonomic nervous system consists of the: a) peripheral and afferent nervous systems b) sympathetic and parasympathetic nervous systems c) sympathetic and efferent nervous systems d) parasympathetic and somatic nervous systems
b) sympathetic and parasympathetic nervous systems
When the nurse applies a painful stimulus to an unconscious patient, the patient responds by stiffly extending and adducting the arms and hyperpronating the wrists. How should the nurse interpret this finding? a. Decerebrate posturing indicating an interruption of voluntary motor tracts b. Decorticate posturing indicating a disruption of motor fibres in the midbrain and brainstem c. Decerebrate posturing indicating a disruption of motor fibres in the midbrain and brainstem d. Decorticate posturing indicating an interruption of voluntary motor tracts
c) Decerebrate posturing indicating a disruption of motor fibres in the midbrain and brainstem
Which statement best describes a subdural hematoma? a. Bleeding is generally arterial, and brain compression occurs rapidly. b. Bleeding occurs between the dura and the skull. c. Bleeding occurs between the dura and the cerebrum. d. The hematoma commonly occurs in the parietotemporal region.
c) bleeding occurs between the dura and the cerebrum
When assessing a patient with a head injury, what will the nurse recognize as an early indication of increased ICP? a. Headache b. Sluggish pupillary response to light c. Change in the LOC d. Vomiting
c) change in the LOC
When doing the history on a patient with a seizure disorder, the nurse assesses whether the patient has an aura. Which of the following would be the best question to ask in order to obtain this information? a) does your muscle tone seem tense or limp? b) after the seizure do you spend a lot of time sleeping? c) do you have any warning signs before your seizure starts d) do you experience any colour change or incontinence during the seizure?
c) do you have any warning signs before your seizures start
What is the priority nursing intervention when a child is unconscious after a fall? a. Determine whether a neck injury is present. b. Monitor intercranial pressure. c. Establish adequate airway. d. Perform neurological assessment.
c) establish adequate airway
A nurse assesses an individual who commonly experiences anxiety. Which comment by this person indicates the possibility of obsessive-compulsive disorder? a. "My legs often feel weak and spastic." b. "I keep reliving a car accident." c. "I check where my car keys are eight times." d. "I'm embarrassed to go out in public.
c) i check where my car keys are eight times
A patient has a systemic blood pressure of 120/60 mm Hg and an intracranial pressure (ICP) of 24 mm Hg. What does the nurse determine that the cerebral perfusion pressure (CPP) of this patient indicates? a. Normal ICP b. Adequate autoregulation of cerebral blood flow c. Impaired blood flow to the brain d. High blood flow to the brain
c) impaired blood flow to the brain
When a patient's ICP is being monitored with an intraventricular catheter, what is a priority nursing intervention? a. Maintaining the patient's head in a fixed position b. Removing CSF to keep pressure at normal levels c. Maintaining strict aseptic technique to prevent infection d. Continuous monitoring of the ICP waveform
c) maintaining strict aseptic technique to prevent infection
The nurse is closely monitoring a child who is unconscious after a fall and notices that he suddenly has a fixed and dilated pupil. How should the nurse interpret this finding? a. Severe brainstem damage b. Indication of brain death c. Neurosurgical emergency d. Eye trauma
c) neurosurgical emergency
A patient who sustained a T1 spinal cord injury a week ago refuses to discuss the injury and becomes verbally abusive to the nurses and other staff. The patient demands to be transferred to another hospital, where "they know what they are doing." What is the best response to the patient's behaviour? a. Clarify that abusive behaviour will not be tolerated. b. Reassure the patient that the anger will pass and rehabilitation will then progress. c. Ask for the patient's input into the plan for care. d. Ignore the patient's anger and continue to perform needed assessments and care.
c. ask for the patient's input into the plan for care
Which one of the following sentences describes a concussion? a. Petechial hemorrhages that cause amnesia b. A slight lesion that develops remote from the site of trauma c. Visible bruising and tearing of cerebral tissue occurs d. A transient, reversible neuronal dysfunction
d) a transient, reversible neuronal dysfunction
A woman is admitted unconscious to the emergency department after striking her head on a boulder while hiking. Her husband and three teenaged children will not leave her side and constantly ask about the treatment being given. What is the best approach to the patient's family? a. Ask the family to wait in the waiting room until the initial assessment can be completed and care can be started. b. Call the family's pastor or spiritual advisor to support them while initial care is given. c. Refer the family members to the hospital counselling service to deal with their anxiety. d. Allow the family to stay with the patient, and explain all procedures thoroughly to them.
d) allow the family to stay with the patient, and explain all procedures thoroughly to them.
While obtaining a history of a 3-month infant from its mother, the nurse asks about the baby's ability to suck and grasp the mother's finger. What is the nurse assessing? a) reflexes b) intelligence c) cranial nerves d) cerebral cortex function
d) cerebral cortex function
The nurse is testing the function of CN XI. Which of the following best describes the response the nurse would expect if the nerve is intact? a) demonstrates full range of motion of the neck b) sticks tongue out midline without tremors of deviation c) follows an object with the eyes without nystagmus or strabismus d) moves the head and shoulders against resistance and with equal strength
d) mores the head and shoulders against resistance and with equal strength
Which is true of an action potential? a) the plasma membrane is impermeable to Na+ and K+ ions b) Na+ ions move extracellularly c) the charges become equal on the outside and inside of the plasma d) the outside of the plasma membrane is negatively charged, and the inside is positively charged
d) the outside of the plasma membrane is negatively charged, and the inside is positively charged
Which is true of a neurone with a resting potential? a) the cell membrane is permeable to Na+ but impermeable to k+ ions b) the outer surface of the plasma membrane has a negative charge c) the highest concentration of K+ is extracellular d) the sodium pump had moved Na+ to the outside of the plasma membrane
d) the sodium pump has moved the Na+ to the outside of the plasma membrane
A 70 year old woman tells the nurse that every time she gets up in the morning or after she's been sitting, she gets "real dizzy" and feels like she is going to"fall over" The nurse's best response would be: a) have you been extremely tired lately? b) you probably just need to drink more liquids c) I'll refer you for a complete neurological examination d) you need to get up slowly when you've been lying or sitting
d) you need to get up slowly when you've been lying or sitting