Nurs 240 E5

A nurse assesses the patient's level of consciousness using the Glasgow Coma Scale. What score indicates severe impairment of neurologic function? a) 9 b) 6 c) 3 d) 15

3

Myasthenia gravis occurs when antibodies attack which receptor sites? a) Dopamine b) GABA c) Serotonin d) Acetylcholine

Acetylcholine

Which of the following terms refers to the inability to coordinate muscle movements, resulting in difficulty walking? a) Spasticity b) Ataxia c) Agnosia d) Rigidity

Ataxia

Which of the following is a disease in which there is a loss of motor neurons in the anterior horns of the spinal cord and motor nuclei of the lower brain stem? a) Amyotrophic lateral sclerosis (ALS) b) Parkinson's disease (PD) c) Alzheimer's disease d) Huntington disease

Aymotrophic lateral sclerosis (ALS)

A nurse caring for a patient with head trauma will be monitoring the patient for Cushing's triad. What will the nurse recognize as the symptoms associated with Cushing's triad? (Select all that apply.) a) Hypertension b) Bradypnea c) Tachycardia d) Bradycardia e) Pupillary constriction

Bradycardia Bradypnea Hypertension

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? a) CN IV b) CN III c) CN II d) CN I

CN I

A provider prescribes a disease-modifying drug for a patient with relapsing-remitting MS. The nurse advises the patient that the drug has to be taken subcutaneously on a daily basis, and it may take 6 months for evidence of any response. Which of the following is the medication most likely prescribed in this scenario? a) Novantrone b) Betaseron c) Copaxone d) Avonex

Copaxone

Bell's palsy is a disorder of which cranial nerve? a) Trigeminal (V) b) Vagus (X) c) Vestibulocochlear (VIII) d) Facial (VII)

Facial (VII)

A nurse is caring for a client with lower back pain who is scheduled for myelography using metrizamide (a water-soluble contrast dye). After the test, the nurse should place the client in which position? a) Supine with the head lower than the trunk b) Prone c) Supine with feet raised d) Head of the bed elevated 45 degrees

Head of the bed elevated 45 degrees

The nursing instructor gives their students an assignment of making a plan of care for a client with Huntington's disease. What would be important for the students to include in the teaching portion of the care plan? a) How to perform household tasks b) How to take a bath c) How to facilitate tasks such as using both hands to hold a drinking glass d) How to exercise

How to facilitate tasks such as using both hands to hold a drinking glass

Stephen Oswald, a 68-year-old retired salesman, was brought by squad into the acute care facility where you practice nursing. His wife accompanies him and relates how Stephen reported a severe headache and then was unable to talk or move his right arm and leg. After diagnostics are completed and Mr. Oswald is admitted to the hospital, when would you expect basic rehabilitation to begin? a) Immediately b) After 1 week c) Two to 3 days d) Upon transfer to a rehabilitation unit

Immediately

The nurse is planning care of a client admitted to the neurologic rehabilitation unit following a cerebrovascular accident. Which nursing intervention would be of highest priority? a) Assess client for ability to ambulate independently. b) Provide instruction on blood-thinning medication. c) Praise client when using adaptive equipment. d) Include client in planning of care and setting of goals.

Include client in planning of care and setting of goals.

The diagnosis of multiple sclerosis is based upon which of the following tests? a) MRI b) Neuropsychological testing c) CSF electrophoresis d) Evoked potential studies

MRI

What nursing intervention will best assist the patient with chorea? a) Monitor the patient on bed rest. b) Keep an oral airway at the bedside. c) Assist the patient with walking hourly. d) Administer pain medications every 4 hours.

Monitor the patient on bed rest.

The family nurse practitioner is performing the physical examination of a client with a suspected neurologic disorder. In addition to assessing other parts of the body, the nurse should assess for neck rigidity. Which method should help the nurse assess for neck rigidity correctly? a) Moving the head toward both sides b) Gently pressing the bones on the neck c) Lightly tapping the lower portion of the neck to detect sensation d) Gently pressing the bones on the neck

Moving the head and chin toward the chest

Which of the following is considered a central nervous system (CNS) disorder? a) Bell's palsy b) Multiple sclerosis c) Myasthenia gravis d) Guillain-Barré

Multiple sclerosis

A client is admitted to an acute care facility for treatment of a brain tumor. When reviewing the chart, the nurse notes that the client's extremity muscle strength is rated 1/5. Which assessment finding should the nurse anticipate? a) Normal, full muscle strength is present. b) Muscle contraction or movement is undetectable. c) Muscles move actively against gravity alone. d) Muscle contraction is palpable and visible.

Muscle contraction is palpable and visible.

The nurse is caring for a patient immediately following supratentorial intracranial surgery. What action by the nurse is appropriate? a) Place patient in the dorsal recumbent position. b) Place patient in prone position with head turned to unaffected side. c) Place patient in supine position with head slightly elevated. d) Place patient in the Trendelenburg position.

Place patient in supine position with head slightly elevated.

A client is weak and drowsy after a lumbar puncture. The nurse caring for the client knows that what priority nursing intervention should be provided after a lumbar puncture? a) Administer antihistamines to the client. b) Provide adequate caffeine-rich drinks to the client. c) Assess the level of consciousness (LOC) and the pupil response of the client. d) Position the client flat for at least 3 hours.

Position the client flat for at least 3 hours.

Which well-recognized sign of meningitis is exhibited when the patient's neck is flexed and flexion of the knees and hips is produced? a) Positive Brudzinski sign b) Positive Kerning's sign c) Nuchal rigidity d) Photophobia

Positive Brudzinski sign

A female patient is receiving hypothermic treatment for uncontrolled fevers related to increased intracranial pressure (ICP). Which of the following assessment finding requires immediate intervention? a) Cool, dry skin b) Capillary refill of 2 seconds c) Urine output of 100 mL/hr d) Shivering

Shivering

The nurse is preparing the patient for a diagnostic test to evaluate blood flow within intracranial blood vessels. For which of the following tests is the nurse preparing for the patient? a) Transcranial Doppler b) MRI c) CT d) Cerebral angiography

Transcranial Doppler

A patient comes to the emergency department with severe pain in the face that was stimulated by brushing the teeth. What cranial nerve does the nurse understand can cause this type of pain? a) VI b) III c) IV d) V

V

While performing a neurologic assessment on a client, the nurse notes that the client cannot close one eyelid. This deficit is related to which of the following cranial nerves? a) III b) VII c) X d) VIII

VII

A patient had a small pituitary adenoma removed by the transsphenoidal approach and has developed diabetes insipidus. What pharmacologic therapy will the nurse be administering to this patient to control symptoms? a) Phenobarbital b) Mannitol c) Furosemide (Lasix) d) Vasopressin

Vasopressin

Lesions in the temporal lobe may result in which of the following types of agnosia? a) Auditory b) Visual c) Tactile d) Relationship

auditory

Which of the following is the earliest sign of increasing ICP? a) Vomiting b) Posturing c) Change in level of consciousness (LOC) d) Headache

change in level of consciousness

The nurse determines that the client understands measures to prevent elevations in intracranial pressure if the nurse observes the client doing which activity? a. blowing the nose b. isometric exercises c. coughing vigorously d. exhaling during reposition

exhaling during reposition

After striking his head on a tree while falling from a ladder, a client is admitted to the emergency department. He's unconscious and his pupils are nonreactive. Which intervention should the nurse question? a) Elevating the head of his bed b) Giving him a barbiturate c) Placing him on mechanical ventilation d) Performing a lumbar puncture

performing a lumbar puncture

The nurse is caring for a patient with Huntington's disease in the long-term care facility. What does the nurse recognize as the most prominent symptom of the disease that the patient exhibits? a) Rapid, jerky, involuntary movements b) Dysphagia and dysphonia c) Slow, shuffling gait d) Dementia

rapid, jerky, involuntary movements

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

second lumbar vertebrae

During a routine physical examination to assess a client's deep tendon reflexes, a nurse should make sure to: a) use the pointed end of the reflex hammer when striking the Achilles tendon. b) tap the tendon slowly and softly. c) support the joint where the tendon is being tested. d) hold the reflex hammer tightly.

support the joint where the tendon is being tested.

A patient has been diagnosed with meningococcal meningitis at a community living home. When should prophylactic therapy begin for those who have had close contact with the patient? a) Within 72 hours after exposure b) Therapy is not necessary prophylactically and should only be used if the person develops symptoms. c) Within 24 hours after exposure d) Within 48 hours after exposure

within 24 hours after exposure

A patient has difficulty interpreting his awareness of body position in space. Which lobe is most likely to be damaged? a) Frontal b) Parietal c) Temporal d) Occipital

Parietal

Which of the following diseases is associated with decreased levels of dopamine due to destruction of pigmented neuronal cells in the substantia nigra in the basal ganglia of the brain? a) Parkinson's disease b) Huntington disease c) Creutzfeldt-Jakob disease d) Multiple sclerosis

Parkinson's disease

What nursing intervention will best help the patient with Huntington disease to increase nutrition? Select all that apply. a) Eliminating foods high in fat b) A pureed diet c) Phenothiazine (Chlorpromazine) prior to meals d) Increasing high carbohydrate foods e) Relaxation techniques

Relaxation techniques Phenothiazine (Chlorpromazine) prior to meals

A patient is scheduled for standard EEG testing to evaluate a possible seizure disorder. Nursing interventions prior to the procedure include which of the following? a) Instructing the patient that standard EEG takes 2 hours b) Maintaining NPO status for 6 hours prior to the procedure c) Withholding antiseizure medications for 24 to 48 hours prior to the exam d) Sedate the patient prior to the procedure, per order

Withholding antiseizure medications for 24 to 48 hours prior to the exam

The nurse is taking care of a patient with a history of headaches. The nurse takes measures to reduce headaches in the patient in addition to administering medications. Which of the following appropriate nursing interventions may be provided by the nurse to such a patient? a) Maintain hydration by drinking eight glasses of fluid a day b) Apply warm or cool cloths to the forehead or back of the neck c) Perform the Heimlich maneuver d) Use pressure-relieving pads or a similar type of mattress

apply warm or cool cloths to the forehead of back of the neck

Which of the following positions are employed to help reduce intracranial pressure (ICP)? a) Keeping the head flat with use of no pillow b) Rotating the neck to the far right with neck support c) Avoiding flexion of the neck with use of a cervical collar d) Extreme hip flexion supported by pillows

avoiding flexion of the neck with use of a cervical collar

Which of the following are sympathetic effects of the nervous system? a) Dilated pupils b) Decreased blood pressure c) Decreased respiratory rate d) Increased peristalsis

dilated pupils

The nurse is completing an assessment on a client with myasthenia gravis. Which of the following historical recounting provides the most significant evidence regarding when the disorder began? a) Shortness of breath b) Drooping eyelids c) Muscle spasms d) Sensitivity to bright light

drooping eyelids

A nurse observes that decerebrate posturing is a comatose client's response to painful stimuli. Decerebrate posturing as a response to pain indicates: a) dysfunction in the cerebrum. b) dysfunction in the brain stem. c) dysfunction in the spinal column. d) risk for increased intracranial pressure.

dysfunction in the brain stem

An acoustic neuroma is a benign tumor of which cranial nerve? a) Fifth b) Ninth c) Seventh d) Eighth

eighth

Cranial nerve IX is also known as which of the following? a) Vagus b) Glossopharyngeal c) Spinal accessory d) Hypoglossal

glossopharyngeal

A patient has recently been diagnosed with an acoustic neuroma. The nurse helps the patient understand that: a) Almost 80% of these tumors become malignant over time. b) Hearing loss usually occurs. c) Surgery is never needed; radiation has proven very effective. d) Compression of the seventh cranial nerve is a side effect.

hearing loss usually occurs

A client is experiencing muscle weakness and an ataxic gait. The client has a diagnosis of multiple sclerosis (MS). Based on these symptoms, the nurse formulates "Impaired physical mobility" as one of the nursing diagnoses applicable to the client. What nursing intervention should be most appropriate to address the nursing diagnosis? a) Use pressure-relieving devices when the client is in bed or in a wheelchair. b) Change body position every 2 hours. c) Use a footboard and trochanter rolls. d) Help the client perform range-of-motion (ROM) exercises every 8 hours.

help the client perform range of motion exercises every 8 hours

The nurse is caring for the client with increased intracranial pressure. The nurse would note which trend in vital signs if the intracranial pressure is rising? a. increased temp, increase pulse, increasing, resp, decrease BP b. increasing temp, decreasing pulse, decreased respirations, increasing BP c. decreasing temp, decreasing pulse, increasing resp, decrease BP

increasing temp, decreasing pulse, decreased respirations, increasing BP

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? a) Left basal ganglia b) Left frontoparietal region c) Right frontoparietal region d) Left temporal region

left frontoparietal region

The most common cause of cholinergic crisis includes which of the following? a) Undermedication b) Infection c) Compliance with medication d) Overmedication

overmedication

The nurse is planning to institute seizure precuations for a client who is being admitted from the ED. Which measures the nurse include in planning for the client's safety? Select All That Apply. a. padding side rails on the bed b. placing an airway at the bedside c. placing the bed in high position d. placing a padded tongue blade at the head of the bed e. placing oxygen and suction equipment at the bedside f. having an IV equipment ready for insertion of intravenous catheter

padding side rails on the bed placing an airway at the bedside placing oxygen and suction equipment at the bedside having an IV equipment ready for insertion of intravenous catheter

The nurse is assigned to care for a client with complete right sided hemiparesis. Which characteristics are associated with this condition? Select All That Apply a. the client is aphasic b. the client has weakness in the face and tongue c. the client has weakness on the right side of the body d. the client has complete bialteral paralysiis

the client is aphasic the client has weakness in the face and tongue the client has weakness on the right side of the body

A nurse is assessing a client diagnosed with multiple sclerosis (MS). Which symptom does the nurse expect to find? a) Vision changes b) Flaccid muscles c) Tremors at rest d) Absent deep tendon reflexes

vision changes

A patient is diagnosed with amyotrophic lateral sclerosis, also known as ALS or Lou Gehrig's disease. The nurse understands that the symptoms of the disease will begin in what way? a) Weakness starting in the muscles supplied by the cranial nerves b) Numbness and tingling in the lower extremities c) Ascending paralysis d) Jerky, uncontrolled movements in the extremities

weakness starting in the muscle supplied by the cranial nerve

A patient arrives to have an MRI done in the outpatient department. What information provided by the patient warrants further assessment to prevent complications related to the MRI? a) "I am trying to quit smoking and have a patch on." b) "I have been trying to get an appointment for so long." c) "I have not had anything to eat or drink since 3 hours ago." d) "My legs go numb sometimes when I sit too long."

"I am trying to quit smoking and have a patch on."

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? a) "The blood will seal the hole in the dura and prevent further loss of cerebral spinal fluid." b) "The blood provides moisture at the site, which encourages healing." c) "The blood can repair damage to the spinal cord that occurred with the procedure." d) "The blood will replace the cerebral spinal fluid that has leaked out."

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

The parents of a patient intubated due to the progression of Guillain-Barré syndrome ask if their child will die. What is the best response by the nurse? a) "Once Guillain-Barré syndrome progresses to the diaphragm there is a significant decrease in surviving." b) "Don't worry; your child will be fine." c) "It's too early to give a prognosis." d) "There are no guarantees, but a large portion of people with Guillain-Barré syndrome survive."

"There are no guarantees, but a large portion of people with Guillain-Barré syndrome survive."

The nurse is assessing the throat of a client with throat pain. In asking the client to stick out the tongue, the nurse is also assessing which cranial nerve? a) Cranial nerve XII b) Cranial nerve I c) Cranial nerve V d) Cranial nerve XI

Cranial XII

The nurse is employed in a neurologist's office, performing a history and assessment on a client experiencing hearing difficulty. The nurse is most correct to gather equipment to assess the function of which cranial nerve? a) Cranial nerve VI b) Cranial nerve II c) Cranial nerve XI d) Cranial nerve VIII

Cranial nerve VIII

A nurse is working in a neurologist's office. The physician orders a Romberg test. Which nursing action is correct? a) Have the client close his eyes and jump on one foot. b) Have the client close his eyes and discriminate between dull and sharp. c) Have the client touch his nose with one finger. d) Have the client close his eyes and stand erect.

Have the client close his eyes and stand erect.

Which of the following is the only known risk factor for brain tumors? a) Use of hair dyes b) Cellular telephones c) Head trauma d) Ionizing radiation

Ionizing radiation

A male client who has undergone a cervical discectomy is being discharged with a cervical collar. Which of the following would be most appropriate to include the client's discharge plan? a) Wearing the cervical collar when sleeping b) Keeping the head in a neutral position c) Moving the neck from side to side when the collar is off d) Removing the entire collar when shaving

Keeping the head in a neutral position