PrepU Neuro
The nurse, caring for a client with Ménière's disease, needs to assist with what when the client is experiencing an attack? a) Sleeping b) ADLs c) Coughing d) URIs
ADLs
A nurse assesses the patient's level of consciousness using the Glasgow Coma Scale. What score indicates severe impairment of neurologic function? a) 3 b) 15 c) 9 d) 6
Answer: 3
Which disturbance results in loss of half of the visual field? a) Anisocoria b) Nystagmus c) Diplopia d) Homonymous hemianopsia
Answer: D-Homonymous hemianopsia (loss of half the visual field)
A client with Parkinson's disease has been receiving levodopa as treatment for the past 7 years. The client comes to the facility for an evaluation and the nurse observes facial grimacing, head bobbing, and smacking movements. The nurse interprets these findings as which of the following? a) Dysphonia b) Micrographia c) Bradykninesia d) Dyskinesia
Dyskinesia
Acoustic neuromas are benign tumors of which of the following cranial nerves? a) V b) VII c) VIII d) VI
VIII
An osmotic diuretic, such as mannitol, is given to the patient with increased intracranial pressure (IICP) for which of the following therapeutic effects? a) To lower uncontrolled fevers b) To reduce cellular metabolic demands c) To increase urine output d) To dehydrate the brain and reduce cerebral edema
Answer: D-to dehydrate the brain & reduce cerebral edema
As a nurse practicing within a pediatric medicine group, you take your role quite seriously in preserving children's hearing and preventing hearing loss in your clients. What can you do to maintain hearing within your client base? a) Distribute earplugs to all clients. b) Prevent fevers. c) Reduce frequency and severity of ear infections. d) Increase antibiotic therapy use.
Answer: c-Reduce frequency and severity of ear infections.
The nurse is caring for a patient immediately following supratentorial intracranial surgery. What action by the nurse is appropriate? a) Place patient in the Trendelenburg position. b) Place patient in prone position with head turned to unaffected side. c) Place patient in the dorsal recumbent position. d) Place patient in supine position with head slightly elevated.
Answer: d-Place patient in supine position with head slightly elevated.
When performing the Weber test, where would the nurse place the vibrating tuning fork? Identify the area on the accompanying figure.
Answer: top of the forehead
Bell's palsy is a disorder of which cranial nerve? a) Trigeminal (V) b) Facial (VII) c) Vestibulocochlear (VIII) d) Vagus (X)
Answer:B-Facial (VII)
Which of the following nursing interventions is appropriate for a patient with double vision in the right eye due to MS? a) Apply an eye patch to the right eye. b) Administer eye drops as needed. c) Exercise the right eye twice a day (BID). d) Place needed items on the right side.
Apply an eye patch to the right eye.
High doses of which of the following medications can produce bilateral tinnitus? a) Dramamine b) Antivert c) Promethazine d) Aspirin
Aspirin
The nurse should monitor for which of the following manifestations in a patient who has had LASIK surgery? a) Excessive tearing b) Stye formation c) Cataract formation d) Halos and glare
Halos & glare
You are caring for a client admitted with a stroke. Imaging studies indicate an embolus partially obstructing the right carotid artery. What type of stroke do you know this client has? a) Ischemic b) Hemorrhagic c) Right-sided d) Left-sided
Ischemic
Which of the following is considered a central nervous system (CNS) disorder? a) Guillain-Barré b) Multiple sclerosis c) Myasthenia gravis d) Bell's palsy
Multiple sclerosis
Which of the following is the term for swelling of the optic disc due to increased IOP? a) Photophobia b) Ptosis c) Chemosis d) Papilledema
Papilledema
Which of the following is a late symptom of spinal cord compression? a) Urinary incontinence b) Paralysis c) Fecal incontinence d) Urinary retention
Paralysis
The nurse is caring for a patient immediately following supratentorial intracranial surgery. What action by the nurse is appropriate? a) Place patient in supine position with head slightly elevated. b) Place patient in prone position with head turned to unaffected side. c) Place patient in the Trendelenburg position. d) Place patient in the dorsal recumbent position.
Place patient in supine position with head slightly elevated.
The nurse is reviewing the medical record of a client with glaucoma. Which of the following would alert the nurse to suspect that the client was at increased risk for this disorder? a) Prolonged use of corticosteroids b) Hyperopia since age 20 years c) History of respiratory disease d) Age younger than 40 years
Prolonged use of corticosteroids
A client has undergone surgery for a spinal cord tumor that was located in cervical area. The nurse would be especially alert for which of the following? a) Hemorrhage b) Respiratory dysfunction c) Bowel incontinence d) Skin breakdown
Respiratory dysfunction
A client is hospitalized when they present to the Emergency Department with right-sided weakness. Within 6 hours of being admitted, the neurologic deficits had resolved and the client was back to their presymptomatic state. The nurse caring for the client knows that the probable cause of the neurologic deficit was what? a) Cerebral aneurysm b) Right-sided stroke c) Transient ischemic attack d) Left-sided stroke
Transient ischemic attack
A client with a tentative diagnosis of myasthenia gravis is admitted for a diagnostic workup. Myasthenia gravis is confirmed by: a) a positive edrophonium (Tensilon) test. b) Kernig's sign. c) a positive sweat chloride test. d) Brudzinski's sign.
a positive edrophonium (Tensilon) test
Level of consciousness (LOC) can be assessed based on criteria in the Glasgow Coma Scale (GCS). Which of the following indicators are assessed in the GCS? Select all that apply. a) Eye opening b) Muscle strength c) Intelligence d) Verbal response e) Motor response
eye opening, verbal response, motor response
A client with quadriplegia is in spinal shock. What finding should the nurse expect? a) Positive Babinski's reflex along with spastic extremities b) Spasticity of all four extremities c) Absence of reflexes along with flaccid extremities d) Hyperreflexia along with spastic extremities
Absence of reflexes along with flaccid extremities
A client with cerebral metastasis suddenly experiences a seizure for which phenytoin 10 mg/kg intravenously is ordered as an initial loading dose. The client weighs 165 pounds. How many milligrams of phenytoin should the client receive? Enter the number ONLY.
Answer: 750
Which of the following terms refers to surgical repair of the tympanic membrane? a) Myringotomy b) Tympanotomy c) Ossiculoplasty d) Tympanoplasty
Answer: D-Tympanoplasty
A client suffers a head injury. The nurse implements an assessment plan to monitor for potential subdural hematoma development. Which manifestation does the nurse anticipate seeing first? a) Alteration in level of consciousness (LOC) b) Decreased heart rate c) Bradycardia d) Slurred speech
Answer: A-alteration in LOC
A patient in the ER has bruising over the mastoid bone and rhinorrhea. The triage nurse suspects the patient has which type of skull fracture? a) Basilar b) Simple c) Comminuted d) Linear
Answer: A-basilar
A nurse is providing care to a client with Parkinson's disease. The nurse understands the the client's signs and symptoms are related to a depletion of which of the following? a) Dopamine b) Norepinephrine c) Serotonin d) Acetylcholine
Answer: A-dopamine
If untreated, squamous cell carcinoma of the external ear can spread through the temporal bone causing what effect? a) Facial nerve paralysis b) Diplopia c) Motor impairment d) Nystagmus
Answer: A-facial nerve paralysis
Which of the following is the earliest sign of increasing ICP? a) Posturing b) Vomiting c) Change in level of consciousness (LOC) d) Headache
Answer: C-change in LOC
Mildred McCarthy, an 89-year-old retired government clerk, is being admitted to your rehabilitation hospital as a result of the tetraplegia caused by stroke. Her condition is stable, and after admission, she will begin physical and psychological therapy. An important part of your nursing management is to reposition Mrs. McCarthy every 2 hours. What is the rationale behind this intervention? a) Maintain sufficient integument capillary pressure b) Passive exercise c) Change of scenery d) Maintain psychological well-being
Answer: A-maintain sufficient integument capillary pressure
An aging client is brought to the eye clinic by the son. The son states he has seen his parent holding reading materials at an increasing distance to focus properly. What age-related changes does this indicate? a) Presbyopia b) Myopia c) Cataract d) Macular degeneration
Answer: A-presbyopia
Which nursing diagnosis takes highest priority for a client admitted for evaluation for Ménière's disease? a) Risk for injury related to vertigo b) Risk for deficient fluid volume related to vomiting c) Acute pain related to vertigo d) Imbalanced nutrition: Less than body requirements related to nausea and vomiting
Answer: A-risk for injury r/t vertigo
A client has a herniated disk in the region of the third and fourth lumbar vertebrae. Which nursing assessment finding most supports this diagnosis? a) Severe lower back pain b) Weakness and atrophy of the arm muscles c) Hypoactive bowel sounds d) Sensory deficits in one arm
Answer: A-severe lower back pain
Which of the following conditions occurs when there is bleeding between the dura mater and arachnoid membrane? a) Subdural hematoma b) Intracerebral hemorrhage c) Extradural hematoma d) Epidural hematoma
Answer: A-subdural hematoma
A client has sustained a traumatic brain injury with involvement of the hypothalamus. The nurse is concerned about the development of diabetes insipidus. Which of the following would be an appropriate nursing intervention to monitor for early signs of diabetes insipidus? a) Take daily weights. b) Assess for pupillary response frequently. c) Assess vital signs frequently. d) Reposition the client frequently.
Answer: A-take daily weights
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? a) Turning the client from side to side, using the logroll technique b) Keeping a pillow under the client's knees at all times c) Maintaining bed rest for 72 hours after the laminectomy d) Placing the client in semi-Fowler's position
Answer: A-turning the client from side to side, using the legroom technique
Which of the following surgical procedures involves flattening the anterior curvature of the cornea by removing a stromal lamella layer? a) Keratoplasty b) LASIK c) PRK d) Keratoconus
Answer: B- LASIK
A 17-year-old adolescent with a history of muscular dystrophy is admitted with aspiration pneumonia. The nurse asks the parents if the client has an advance directive. Which response by the parents leads the nurse to believe that the parents don't understand the severity of the client's medical condition? a) "He has pneumonia; I shouldn't have let him go to that party last week." b) "He is only 17. He doesn't need an advance directive." c) "This is the third time he's had pneumonia in the past 6 months. I'm afraid he needs a feeding tube." d) "Yes, he has an advance directive."
Answer: B-"He is only 17. He doesn't need an advance directive."
A patient is newly diagnosed with relapsing-remitting multiple sclerosis (RRMS). Which instruction should the nurse provide? a) "Your type of MS is the least common, making it difficult to manage." b) "You must avoid stress and extreme fatigue, because these can trigger a relapse." c) "You should take your medications only during times of relapse." d) "You will have a steady and gradual decline in function."
Answer: B-"You must avoid stress and extreme fatigue, because these can trigger a relapse."
A patient's vision is assessed at 20/200. The patient asks what that means. Which of the following is the most appropriate response by the nurse? a) "You see an object from 200 feet away that a person with normal vision sees from 20 feet away." b) "You see an object from 20 feet away that a person with normal vision sees from 200 feet away." c) "You see an object from 200 feet away that a person with normal vision sees from 200 feet away." d) "You see an object from 20 feet away that a person with normal vision sees from 20 feet away."
Answer: B-"You see an object from 20 feet away that a person with normal vision sees from 200 feet away."
Thrombolytic therapy should be initiated within what time frame of an ischemic stroke for best functional outcome? a) 12 hours b) 3 hours c) 9 hours d) 6 hours
Answer: B-3 hours
A patient has been diagnosed as having global aphasia. The nurse recognizes that the patient will be unable to do which of the following actions? a) Form understandable words b) Form understandable words and comprehend the spoken word c) Comprehend the spoken word d) Speak at all
Answer: B-Form understandable words and comprehend the spoken word
A nurse in a primary care office is getting a client ready for an examination with a health care provider. While talking to the client, she notices that her left upper eyelid is drooping. She records on the client's record that she observed which of the following? a) Ptolemy b) Ptosis c) Proptosis d) Nystagmus
Answer: B-Ptosis(dropping or falling of the lower lid)
A female patient with meningitis has a history of seizures. Which of the following activities should the nurse do while the patient is actively seizing? a) Provide oxygen or anticonvulsants, whichever is available b) Turn the patient to the side during a seizure and do not restrain movements c) Place a cooling blanket beneath the patient d) Suction the patient's mouth and pharynx
Answer: B-Turn the patient to the side during a seizure and do not restrain movements
Christin Victor, a 24-year-old blind medical transcriptionist, is a client in the hospital where you practice nursing and is awaiting an appendectomy. Which of the following steps would you take, as her nurse, to effectively communicate with Ms. Victor? a) Notify Ms. Victor before touching her. b) All options are correct. c) Let Ms. Victor know when you leave her room. d) Announce your entrance into Ms. Victor's room.
Answer: B-all options are correct
While snowboarding, a 17-year-old client fell and struck his head, resulting in a loss of consciousness. Within an hour after his arrival via squad at the ED where you practice nursing, he regained consciousness. He was admitted for 24-hour observation and was discharged without neurologic impairment. What would you expect the neurologist's diagnosis to be? a) Laceration b) Concussion c) Contusion d) Skull fracture
Answer: B-concussion
The primary North American vector transmitting arthropod-borne virus encephalitis is which of the following? a) Flea b) Mosquito c) Horse d) Tick
Answer: B-mosquito
A patient with herpes simplex virus (HSV) encephalitis is receiving acyclovir (Zovirax). To ensure early intervention, the nurse monitors laboratory values and urine output for which of the following adverse reactions? a) Integumentary b) Renal c) Hepatic d) Musculoskeletal
Answer: B-renal
Which of the following is the treatment of choice for acoustic neuromas? a) Radiation b) Surgery c) Chemotherapy d) Palliation
Answer: B-surgery
You are caring for a client with chronic migraines who is prescribed medication. What drug-related instructions should the nurse give the client? a) Take medication only when migraine is intense. b) Take medication as soon as symptoms of the migraine begin. c) Take medication just before going to bed at night. d) Take medication only during the morning when it's calm and quiet.
Answer: B-take meds as soon as symptoms of migraine begins
A client who has just been diagnosed with mixed muscular dystrophy asks the nurse about the usual course of this disease. How should the nurse respond? a) "You should ask your physician about that." b) "This form of muscular dystrophy is a relatively benign disease that progresses slowly." c) "You may experience progressive deterioration in all voluntary muscles." d) "The strength of your arms and pelvic muscles will decrease gradually, but this should cause only slight disability."
Answer: C-"You may experience progressive deterioration in all voluntary muscles."
A nurse is caring for a client with a brain tumor and increased intracranial pressure (ICP). Which intervention should the nurse include in the care plan to reduce ICP? a) Position the client with the head turned toward the side of the brain tumor. b) Provide sensory stimulation. c) Administer stool softeners. d) Encourage coughing and deep breathing.
Answer: C-administer stool softeners
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) Perform the Heimlich maneuver b) Use pressure-relieving pads or a similar type of mattress c) Apply warm or cool cloths to the forehead or back of the neck d) Maintain hydration by drinking eight glasses of fluid a day
Answer: C-apply cool or warn cloths to the forehead or back of the neck
The nurse is instructing a client's family members on the most incapacitating symptom of Ménière's disease. Which nursing instruction associated with the symptom is most helpful? a) Keep a bucket beside the bed. b) Sit in front of the client when speaking. c) Assist the client when ambulating. d) Ensure low lighting in the room.
Answer: C-assist the client w/ambulating
When performing a postoperative assessment on a client who has undergone surgery to manage increased intracranial pressure (ICP), a nurse notes an ICP reading of 0 mm Hg. Which action should the nurse perform first? a) Continue the assessment because no actions are indicated at this time. b) Document the reading because it reflects that the treatment has been effective. c) Check the equipment. d) Contact the physician to review the care plan.
Answer: C-check the equipment
Which of the following terms will the nurse use when referring to blindness in the right or left halves of the visual fields of both eyes? a) Scotoma b) Nystagmus c) Homonymous hemianopsia d) Diplopia
Answer: C-homonymous hemianopsia
A 15-year-old baseball player was fielding a ground ball when it bounced and struck him in the left eye, leaving a large ecchymosis and edema. In your client education, after applying an ice pack, you explain to the client the functions of the various structures of the eye. What glands, contained in the eyelids, produce tears? a) Sebaceous b) Sweat c) Lacrimal d) Olfactory
Answer: C-lacrimal
Which of the following medications is the most effective agent in the treatment of Parkinson's disease (PD)? a) Amantadine (Symmetrel) b) Bromocriptine mesylate (Parlodel) c) Levodopa (Larodopa) d) Benztropine (Cogentin)
Answer: C-levadopa
The nurse is assessing an older client's vision. The nurse integrates knowledge of which of the following during the assessment? a) The skin around the eyes will be more elastic. b) The depth of the eyeball will be increased, leading to myopia. c) The power of the lens to accommodate will be decreased. d) Increased fat will be around the orbit.
Answer: C-the power of the lends to accommodate will be decreased
The nurse working on a neurological unit is mentoring a nursing student. The student asks about a client who has sustained a primary and and secondary brain injury. The nurse correctly tells the student which of the following, related to the primary injury? a) It results from inadequate delivery of nutrients and oxygen to the cells. b) It refers to the difficulties suffered by the client and family related to the changes in the client. c) It refers to the permanent deficits seen after the rehabilitation process. d) It results from initial damage to the brain from the traumatic event.
Answer: D-It results from initial damage to the brain from the traumatic event.
A nurse is reviewing a CT scan of the brain, which states that the client has arterial bleeding with blood accumulation above the dura. Which of the following facts of the disease progression is essential to guide the nursing management of client care? a) The crash cart with defibrillator is kept nearby. b) Bleeding continues into the intracerebral area. c) Symptoms will evolve over a period of 1 week. d) Monitoring is needed as rapid neurologic deterioration may occur.
Answer: D-Monitoring is needed as rapid neurologic deterioration may occur.
The geriatric advanced practice nurse (APN) is doing client teaching with a client who has had a cerebrovascular accident (CVA) and the client's family. One concern the APN addresses is a potential for falls related to the CVA and resulting muscle weakness. What would be most important for the APN to include in teaching of the client and family related to this concern? a) Leg exercises to strengthen muscle weakness. b) Use of tripod cane. c) Need for support group due to decreased self image related to restricted mobility. d) Remove throw rugs and electrical cords from home environment.
Answer: D-Remove throw rugs and electrical cords from home environment.
Glenn Middleton, a 67-year-old firefighter with a neurologic deficit, is informed that he will be transferred to a nursing home because his son is unable to care for him at home. While receiving a bed bath, the patient yells at the nurse, "You don't know what you are doing!" What is the best reaction by the nurse? a) Discontinue the bath and resume it later. b) Request that the patient be cared for by another nurse. c) Explain that he is getting good care. d) Accept the patient's behavior and do not take it personally.
Answer: D-accept the patient's behavior & do not take it personally
A patient with neurological infection develops cerebral edema from syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following is an important nursing action for this patient? a) Administering prescribed antipyretics b) Maintaining adequate hydration c) Hyperoxygenation before and after tracheal suctioning d) Restricting fluid intake and hydration
Answer: D-restricting fluid intake& hydration