PrepU 65

Growth is slow and symptoms are caused by compression rather than tissue invasion.

A 37-year-old mother of three has just been diagnosed with a grade I meningioma. As part of patient education, the nurse tells the patient that:

Cerebellum

A client comes to the clinic for evaluation because of complaints of dizziness and difficulty walking. Further assessment reveals a staggering gait, marked muscle incoordination, and nystagmus. A brain tumor is suspected. Based on the client's assessment findings, the nurse would suspect that the tumor is located in which area of the brain?

Suicidal ideations

A client diagnosed with Huntington's disease has developed severe depression. What would be most important for the nurse to assess for?

laminectomy.

A nurse is working on a surgical floor. The nurse must logroll a client following a:

Chorea

A nurse suspects that a client has Huntington disease based on which assessment finding?

under investigation.

Anticoagulants usually are not prescribed because of the risk for central nervous system (CNS) hemorrhage; however, prophylactic therapy with low-molecular-weight heparin is

Parkinson's disease.

Benztropine amantadine and bromocriptine are used to treat

meningiomas, neuromas, and pituitary adenomas.

Brain tumors arising from the supporting structures include

occipital lobe tumor

Contralateral homonymous hemianopia suggests an

Cerebellum.

In which location are most brain angiomas located?

Protecting the client from falls

The nurse cares for a client with Huntington disease. What intervention is a priority for safe care?

Irregular respirations

The nurse is caring for a client with increased intracranial pressure (ICP) after surgical resection of a brain tumor. The nurse recognizes the client is demonstrating late signs of ICP when which sign is observed?

Explaining hospice care and services

The nurse is caring for a client with mid-to-late stage of an inoperable brain tumor. What teaching is important for the nurse to do with this client?

Dysphonia

The nurse is performing an assessment for a patient in the clinic with Parkinson's disease. The nurse determines that the patient's voice has changed since the last visit and is now more difficult to understand. How should the nurse document this finding?

Papilledema

Which term is used to describe edema of the optic nerve?

Agnosia

failure to recognize familiar objects perceived by the senses.

glioblastoma multiforme tumor

the most common and aggressive malignant brain tumor. In most cases, a tissue biopsy, which can be obtained at the time of surgical removal, is needed to confirm the diagnosis.

The disease has entered the late stages.

A client diagnosed with Parkinson's disease has developed slurred speech and drooling. The nurse knows that these symptoms indicate which of the following?

Respiratory dysfunction

A client has undergone surgery for a spinal cord tumor that was located in the cervical area. The nurse would be especially alert for which of the following?

Have the client lie on the back and lift the leg, keeping it straight.

A client is admitted reporting low back pain. How will the nurse best determine if the pain is related to a herniated lumbar disc?

Hemorrhagic stroke

A client is diagnosed with a brain angioma. When teaching the client about the risks associated with this type of brain tumor, the nurse would educate about signs and symptoms associated with which condition?

Riluzole (Rilutek)(MOA)

A client is diagnosed with amyotrophic lateral sclerosis (ALS) in the early stages. Which medication would the nurse most likely expect to be prescribed as treatment?

Turning the client from side to side, using the logroll technique

A client is scheduled for a laminectomy to repair a herniated intervertebral disk. When developing the postoperative care plan, the nurse should include which action?

Stereotactic radiosurgery

A client is scheduled to receive Gamma Knife therapy. The nurse interprets this as which form of therapy?

Pain radiating down the posterior thigh

A client seeks care for lower back pain of 2 weeks' duration. Which assessment finding suggests a herniated intervertebral disk?

Related to impaired balance

A client with a cerebellar brain tumor is admitted to an acute care facility. The nurse formulates a nursing diagnosis of Risk for injury. Which "related-to" phrase should the nurse add to complete the nursing diagnosis statement?

"Intravenous immunoglobulin infusion may help you."

A client with post-polio syndrome displays fatigue and decreased muscle strength. How should the nurse best respond to the client?

magnetic resonance imaging (MRI)

A client with spinal cord compression from a tumor must undergo diagnostic testing. Which of the following is the most likely procedure for this client?

Positron-emission tomography (PET)

A health care provider needs help in identifying the precise location of a brain tumor. To measure brain activity, as well as to determine structure, the nurse expects the health care provider to order which of the following tests?

Huntington's disease

A human genetic disease caused by a dominant allele; characterized by uncontrollable body movements and degeneration of the nervous system; usually fatal 10 to 20 years after the onset of symptoms.

Keeping the head in a neutral position

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?

Increased intracranial pressure

A nurse assesses a patient who has been diagnosed with having a pituitary adenoma that is pressing on the third ventricle. The nurse looks for the associated sign/symptom. What is that sign/symptom? occurs when the third ventricle is affected.

Urine retention or incontinence

A nurse is caring for a client who underwent a lumbar laminectomy 2 days ago. Which finding requires immediate intervention?

surgery

A nurse is providing care to a client recently diagnosed with a brain tumor. When planning this client's care, the nurse anticipates which therapy as providing the best outcome for the client?

Improved quality of life

A nurse is providing care to a client who has been diagnosed with metastatic brain cancer. When developing the client's plan of care, which outcome would the nurse most likely identify?

Surgery can improve survival time but the results are not guaranteed.

A patient has been diagnosed with a brain tumor, a glioblastoma multiforme. The nurse met with the family after the diagnosis to help them understand that:

Spinal metastasis

A patient is diagnosed with a spinal cord tumor and has had a course of radiation and chemotherapy. Two months after the completion of the radiation, the patient complains of severe pain in the back. What is pain an indicator of in a patient with a spinal cord tumor?

Originated within the brain tissue.

A patient is diagnosed with an aggressive, primary malignant brain tumor. The nurse is aware that the glioma:

Dopamine

A patient is exhibiting bradykinesia, rigidity, and tremors related to Parkinson's disease. The nurse understands that these symptoms are directly related to what decreased neurotransmitter level?

Adopt a diet with moderate fiber intake.

A patient with Parkinson's disease asks the nurse what can be done to prevent problems with bowel elimination. What would be an intervention that would assist this patient with a regular stool pattern?

Position client side lying with head of bed elevated to 30 degrees

After assessing a client who is in postoperative recovery from surgery to resect a brain tumor, the nurse notes the client is at risk for aspiration. Which nursing intervention should be included in the client's postoperative care plan?

CNS hemorrhage.

Although deep vein thrombosis and pulmonary embolism occur in about 15% of patients with brain tumor and cause significant morbidity, anticoagulants are not prescribed due to the risk for

reduce cerebral edema.

Corticosteroids are used in the management of brain tumors to

Cerebral edema Headache Altered level of consciousness

Corticosteroids are used in the treatment of brain tumors for which of the following clinical manifestations? Select all that apply.

muscles responsible for speech.

Dysphonia (voice impairment or altered voice production) may occur as a result of weakness and incoordination of the

The exact cause is unknown, but aging or muscle overuse is suspected.

How should the nurse best teach the client admitted with post-polio syndrome about causative pathophysiology?

treatment of brain tumors.

Osmotic diuretics, corticosteroids, and anticonvulsants are utilized in the treatment of brain tumors.

frontal lobe tumor.

Short-term memory impairment occurs with a

"Going through this experience with your partner has been very difficult for you, I'm sure. Can you tell me about your experience so far?"

The community health nurse is conducting a home visit with a client who was discharged from hospital 3 days ago after surgical resection of a brain tumor and radiation therapy. The client is accompanied by his partner during the nurse's visit. During the visit, the client's partner becomes tearful. How should the nurse respond?

Evaluation of gag reflex and ability to swallow

The nurse determines which nursing intervention would best assist the client with a brain tumor who may be at increased risk for aspiration?

Cushing disease can result from a functioning tumor.

The nurse educator knows which statement about pituitary adenomas is true?

Mannitol

The nurse explains to the client with projectile vomiting and severe headache that a medication is being prescribed to reduced edema surrounding the brain and lessen these symptoms. What medication is the nurse preparing to administer?

Client participates in daily hygiene activities with assistive devices.

The nurse identifies a nursing diagnosis of self-care deficit, bathing related to motor impairment and decreased cognitive function for a client with cerebral metastasis. Which outcome would the nurse most likely identify on this client's plan of care?

Spinal cord compression

The nurse is assessing a client with a confirmed spinal cord tumor. The client states, "I've been too embarrassed to tell anyone but, I have been awakened at night because I've wet the bed." It would be a priority for the nurse to further assess the client for which complication?

Cerebrospinal fluid leakage

The nurse is caring for a client who underwent surgery to remove a spinal cord tumor. When conducting the postoperative assessment, the nurse notes the presence of a bulge at the surgical site. The nurse suspects the client is experiencing what complication from the surgery?

Take prescribed pain medication prior to commencing a meal

The nurse is providing discharge instructions for a client who was admitted to the oncology unit due to dehydration and anorexia after chemotherapy treatment. What information should the nurse provide to the client to promote improve the client's nutritional intake at home?

"There is a risk for seizures in people who have this diagnosis. What have you already discussed with your primary health care provider regarding management of seizures?"

The nurse is providing health education to a client recently diagnosed with a brain tumor. During the appointment, the client states, "I'm really worried that I will have a seizure while I am at work or with my kids. Should I be concerned about this?" How should the nurse respond?

"Grade 1 is the most common type of this tumor."

The nurse is seeing a client who has just been diagnosed with a grade I meningioma. The nurse is correct when stating what information about the client's diagnosis?

Tissue biopsy

The nurse is seeing a client who is suspected of having a glioblastoma multiforme tumor. The nurse anticipates the client will require which diagnostic test to confirm the client has this form of brain tumor?

Coumadin

The nurse reviews the patient's drug regimen for treatment of a brain tumor. She explains to the patient why one of the following drugs would not be prescribed, even though it might have therapeutic benefits. Which drug would not be prescribed for this patient?

parietal lobe tumor.

The nurse should expect to find tactile agnosia (inability to identify objects by touch), a sign of a

Parkinson disease

The nurse teaches the client with which disorder that the disease is due to decreased levels of dopamine in the basal ganglia of the brain?

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

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?

Thyroid-stimulating hormone

The nursing is assessing a client who has been diagnosed with a pituitary adenoma, but has not yet started treatment. The client reports having increased heart rate, hand tremors, difficulty sleeping, weight loss and hyperthermia. The nurse anticipates the client will require blood work to assess for overproduction of which hormone?

parietal lobe function

The parietal lobe is behind the frontal lobe, separated by the central sulcus. Areas in the parietal lobe are responsible for integrating sensory information, including touch, temperature, pressure and pain

Ionizing radiation

What is the only known risk factor for brain tumors?

Use Relaxation techniques Take phenothiazine prior to meals

What nursing intervention will best help the client with Huntington disease to increase nutrition? Select all that apply.

tactile agnosia.

When caring for a client diagnosed with a brain tumor of the parietal lobe, the nurse expects to find:

The client with Huntington disease.

Which client should the nurse assess for degenerative neurologic symptoms?

Amyotrophic lateral sclerosis

Which disease includes loss of motor neurons in the anterior horns of the spinal cord and motor nuclei of the lower brain stem?

Parkinson disease.

Which disease is associated with decreased levels of dopamine due to destruction of pigmented neuronal cells?

Anticoagulants

Which medication classification should be avoided in the treatment of brain tumors?

Ineffective airway clearance

Which nursing diagnosis takes the highest priority for a client with parkinsonian crisis?

Client participates in activities of daily living using adaptive devices.

Which of the following outcomes would be most appropriate to include in the plan of care for a client diagnosed with a muscular dystrophy?

Provide care aimed at slowing the loss of strength and maintaining overall well-being.

Which statement indicates appropriate nursing intervention for a client with post-polio syndrome?

Huntington disease (Huntington chorea)

a chronic, progressive, degenerative neurologic hereditary disease of the nervous system that results in progressive involuntary choreiform movement and dementia.

Paget's disease

a musculoskeletal disorder, characterized by localized rapid bone turnover, most commonly affecting the skull, femur, tibia, pelvic bones, and vertebrae.

Secondary brain tumors

are more common. These cancers start somewhere else in your body and travel to the brain. Lung, breast, kidney, colon, and skin cancers are among the most common cancers that spread to your brain.

Intracerebral tumors include

astrocytomas, medulloblastoma, and glioblastoma multiforme.

A meningioma is

benign, encapsulated, and slow-growing. Sometimes the patient has no symptoms because of the slow-growing nature of the tumor.

A PET scan is most diagnostic for

brain activity, as well as for assessment of tumor size. It can also be useful in differentiating a tumor from scar tissue or radiation necrosis.

The most prominent clinical features of Huntington disease include

chorea, intellectual decline, and often emotional disturbance. As the disease progresses, speech becomes slurred, gait becomes disorganized, and cognitive function is altered with dementia.

laminectomy with diskectomy

excision of the posterior arch of a vertebra; excision of an intervertebral disk

muscular dystrophy

group of hereditary diseases characterized by degeneration of muscle and weakness

temporal lobe function

hearing and smell: auditory

ataxia

impaired ability to coordinate movement, often seen as a staggering gait or postural imbalance.

aphasia

inability to express oneself or to understand language.

aptaxia

inability to perform previously learned purposeful motor acts on a voluntary basis.

frontal lobe function

involved in motor function: problem solving, memory, judgment, impulse control

Osteomyelitis

is an infection of the bone.

Malignant glioma

is the most common type of brain tumor.

Riluzole .

is the only medication that is approved for use in treating ALS. It is used for its neuroprotective effect in the early stages of the disease.

Gamma Knife therapy

specific radiation therapy on tumors that are very deep in the brain

Pain is the hallmark of

spinal metastasis. Patients with sensory root involvement may suffer excruciating pain, which requires effective pain management.

primary brain tumors

start in the brain and tend to stay there.

Brain angiomas occur most often in

the cerebellum. Most brain angiomas do not occur in the hypothalamus, thalamus, or brainstem (midbrain, pons, medulla).

Post-polio syndrome

the recurrence later in life of some polio symptoms in individuals who have had childhood poliomyelitis and have recovered from it recurrence later in life of some polio symptoms

Meningiomas

tumors composed of arachnoidal cells Which of the following is a brain tumor arising from the supporting structures?

occipital lobe function

vision