511 Week 5 Quiz, Patho questions exam 5, Quiz 11, Patho Final, CH. 35 Pathophysiology, Chapter 37, Patho Practice Questions Ch. 36 (Disorders of Neuromuscular Function), Patho Quiz Ch. 36, Exam 3, Patho final: part 5, Head Injury Practice Questions,...

7. Unlike disorders of the motor cortex and corticospinal (pyramidal) tract, lesions of the basal ganglia disrupt movement:

A) without causing paralysis.

Parents with a profoundly deaf child ask, "How can you test such a young infant for hearing loss?" The health care provider will likely explain which of the following testing procedures? Select all that apply

A)Tuning fork B)Audioscope C)EEG with auditory brain stem-evoked responses (ABRs)

The health care provider is assessing a client to differentiate a herniated disk from other causes of acute back pain. The most important test for the provider to perform would be:

Straight-leg test

The nurse taking a report on a client coming into the emergency room plans care for a client with brain dysfunction based on which of the following symptoms?

Stupor

The nurse taking a report on a client coming into the emergency room plans care for a client with brain dysfunction based on which symptom?

Stupor

What term is used to describe a level of consciousness that sees a client responding only to vigorous and repeated stimuli and has minimal or no spontaneous movement?

Stupor

The MRA scan of a client with a suspected stroke reports ruptured berry aneurysm. The nurse plans care for a client with which of the following?

Subarachnoid hemorrhage

The MRA scan of a client with a suspected stroke reports ruptured berry aneurysm. The nurse plans care for a client with:

Subarachnoid hemorrhage

When lecturing about heart attacks (myocardial infarctions), the instructor will emphasize the client may present with: Select all that apply.

Substernal chest pain Neck pain Pain that radiates to the left arm

In assessing the skeletal muscles, the clinican turns the patient's forarm so that the palm is face up. this is called: - Eversion - Supination - Abduction - Pronation

Supination

epilepsy

Syndromes of associated seizure types: EEG patterns Exam findings Hereditary patterns Precipitating factors

A

The nurse is caring for a patient with myasthenia gravis. Which assessment should the nurse complete to determine respiratory functioning? A) Vital capacity B) Pulse oximetry C) Auscultate lung sounds D) Arterial blood gas analysis

The chart of a client admitted because of seizures notes that the seizure activity began simultaneously in both cerebral hemispheres. The nurse should interpret this to mean that the client experienced:

generalized seizure.

A high school senior sustained a concussion during a football game. Which of the following signs and symptoms would indicate the presence of postconcussion syndrome in the days and weeks following his injury?

headaches and memory lapses

A high school senior sustained a concussion during a football game. Which of the following signs and symptoms would indicate the presence of postconcussion syndrome in the days and weeks following his injury?

headaches and memory lapses

5. An intracranial epidural hematoma causes focal symptoms that can include:

A) ipsilateral pupil dilation.

2. Disorders of the pyramidal tracts, such as a stroke, are characterized by:

A) paralysis.

9. A sudden traumatic complete transection of the spinal cord results in _______ below the level of injury.

A) flaccid paralysis

The nurse is educating parents of a child with arteriovenous malformation. The nurse determines that the parents need additional education when the parents state:

"It is a rare complication of concussions."

A 44-year-old woman has sought treatment for headaches that have been increasing in severity & frequency, & has subsequently diagnosed with migraines. Which of the following teaching points should her care provider emphasize?

"It would be helpful to take control of your diet, sleep schedule, & stress level."

The parent of an infant who developed hydrocephalus while in utero is very concerned that the child will have significant intellectual dysfunction. The best response to the parent would be:

"Because the skull sutures are not fused there may be no brain damage."

Which of the following statements by the husband of a client with Alzheimer disease demonstrates an accurate understanding of his wife's medication regimen?

"I'm really hoping these medications will slow down her mental losses"

Which of the following statements by the husband of a client with Alzheimer disease demonstrates an accurate understanding of his wife's medication regimen?

"I'm really hoping these medications will slow down her mental losses."

Which of the following statements by the husband of a patient with Alzheimer disease demonstrates an accurate understanding of his wife's medication regimen? "I'm really hoping these medications will slow down her mental losses." "We're both holding out hope that this medication will cure her Alzheimer's." "I know that this won't cure her, but we learned that it might prevent a bodily decline while she declines mentally." "I learned that if we are vigilant about her medication schedule, she may not experience the physical effects of her disease."

"I'm really hoping these medications will slow down her mental losses."

A female client with rheumatoid arthritis has taken high doses of aspirin for several years to control inflammatory pain. Which of the following statements leads the health care provider to suspect the client has developed ototoxicity?

"I've been getting dizzy and light-headed. I seem to have a constant ringing in my ear"

A client presents to a health clinic complaining of several vague symptoms. As the history/physical continues, the health care provider clearly thinks the client may have myasthenia gravis. Which statements by the client would correlate with this diagnosis? Select all that apply.

"Sometimes I have double vision." "I have more energy in the morning but get worse as the day goes by." "I feel like I don't have enough energy to chew my food sometimes."

Following a fracture, the nurse is educating the client and his family about bone healing. The nurse begins by stating:

"in order to initiate the cellular events essential to bone healing, within a day or so, your body will develop a blood clot at the fracture site"

classifications of brain tumors

*Benign- well-differentiated & histologically benign tumor may grow and cause death because of its location. Malignant- cancerous

generalized seizures

*TONIC-CLONIC "grand mal seizures" Vague warning (focal seizure) and experiences a sharp tonic contraction of the muscles with extension of the extremities and immediate loss of consciousness. Incontinence of bladder and bowel is common ABSENSE: Generalized, non-convulsive epileptic events (disturbances in consciousness) MYOCLONIC: Brief involuntary muscle contractions induced by stimuli of cerebral origin CLONIC: Loss of consciousness & sudden hypotonia TONIC: Sudden onset of increased tone, often associated with falling ATONIC: Sudden, split-second loss of muscle tone leading to slackening of the jaw, drooping of the limbs, or falling to the ground.

The nurse is caring for a client who has received tissue plasminogen activator (tPA). The nurse's discharge planning should include education related to which interventions to prevent recurrent stroke? Select all that apply.

- Antiplatelet agents like warfarin therapy - Reduction of risk factors by controlling hypertension or diabetes - Monitoring for signs and symptoms of recurrence

When trying to explain the difference between vasogenic versus cytotoxic cerebral edema, the physiology instructor mentions that cytotoxic edema displays which of the following functions in the brain? Select all that apply.

- Causes ischemia to build up lactic acid due to anaerobic metabolism - Allows cells to increase volume to the point of rupture, damaging neighboring cells

The nurse assessing a client with a traumatic brain injury assesses for changes in which neurologic component? Select all that apply.

- Cognition - Level of consciousness - Motor function - Sensory function

A client with a traumatic brain injury has developed extreme cerebral edema. Which clinical manifestations of brain herniation correlate to upward herniation of the midbrain known as uncal herniation? Select all that apply.

- Deep coma - Respiratory rate of 8 with intermittent sighs - Bilateral small, fixed pupils

A traumatic brain injury client has developed extreme cerebral edema. The nurse is monitoring the client closely for signs of brain herniation. Which clinical manifestations would correlate to upward herniation of the midbrain from the infratentorial compartment? Select all that apply.

- Deep coma - respiratory rate of 8 with intermittent sighs - bilateral small, fixed pupils

A client works as a data entry worker for a large company. The client goes to employee health with pain in the wrist/hand. The nurse suspects that it is carpal tunnel syndrome based on which of the following assessment findings? Select all that apply.

- Describes numbness/tingling in the thumb and first digit - Precision grip weakness in the affected hand - Pain interferes with sleeping

The nurse contacts the health care provider regarding a client's early signs of diminishing level of consciousness based on which manifestations? Select all that apply.

- Inattention - Disorientation - Blunted responsiveness

Following his annual influenza vaccination, a client begins to feel achy, like he has developed the flu. An hour later, the client is rushed to the emergency department. Diagnosis of Guillain-Barré syndrome was made based on which of the following assessment findings? Select all that apply.

- rapid deterioration of respiratory status - flaccid paralysis of limbs - BP 90/62

criteria for dx vegetative state

-absence of awareness of self and environment -inability to interact with others -absence of voluntary response -lack of language comprehension -hypothalmic and brain stem function to maintain life -bowel/bladder incontinence -preserved cranial nerve and spinal reflexes -condition has continues for more than 1 month

medical documentation of brain death

-cause and irreversibility of condition -absence of brain stem reflexes/motor response(pain) -absence of respiration with pco2 60 or more -justification for confirmatory tests

intracranial aneurysms that rupture cause subarachnoid hemorrhage in the client. how is the diagnosis of intracranial aneurysms and subarachnoid hemorrhage made? 1) MRI 2) loss of cranial nerve reflexes 3) venography 4) CT scan

4) CT scan

brain herniation

-cingulate: involves cerebral artery (leg weakness) -central transtentorial: invovles reticular activating system and corticospinal tract (altered LOC, decorticate posturing) -Uncal: involves cerebral peduncle, oculomotor nerve, posterior cerebral artery, cerebellar tonsil, respiratory center (hemiparesis, pupil dilation, visual field loss, respiratory arrest)

hypoxia ischemia

-deprivation of oxygen within maintained blood flow -reduced or interrupted blood flow *focal cerebral ischemia: (localized injury) stoke *global cerebral ischemia: (inadequate blode flow to the brain) MI

coup contra-coup injuries

-direct contusion of the brain at the site of force -rebound injury on the opposite side of the brain brain floats freely in csf, blunt force accelerates the brain and then it decelerates abruptly hiding the skull

signs of diminished LOC

-earliest signs: inattention, mild confusion, disorientation, blunted response -with further deterioration: markedly inattentive/lethargic/agitated, may progress to become obtunded- respond to only vigorous/ noxious stimuli

there are several types of brain injuries that can occur. what are the primary or direct brain injuries? select all that apply

-hemorrhage -focal lesions of laceration -diffuse axonal -contusion

classifications of skull fractures

-simple or linear: break in the continuity of the bone -comminuted: splintered or multiple fx line -depressed: bone fragments embedded in brain tissue -basilar: fracture at base of skull

blood flow to the brain

-two internal carotid arteries anteriorly -vertebral arteries posteriorly internal carotid and vertebral arteries communicate together through the circle of willis -controlled by autoregulation, sympathetic stimulation, o2, co2, hydrogen

Which intracranial pressure (ICP) would the nurse consider a normal reading?

0 to 15 mm Hg

The client diagnosed with a mild concussion is being discharged from the emergency department. Which discharge instruction should the nurse teach the client's significant other? 1. Awaken the client every two (2) hours. 2. Monitor for increased intracranial pressure. 3. Observe frequently for hypervigilance. 4. Offer the client food every three (3) to four (4) hours.

1 *1. Awakening the client every two (2) hours allows the identification of headache, dizziness, lethargy, irritability, and anxiety—all signs of postconcussion syndrome—that would warrant the significant other's taking the client back to the emergency department.* 2. The nurse should monitor for signs of increased intracranial pressure (ICP), but a layman, the significant other, would not know what these signs and medical terms mean. 3. Hypervigilance, increased alertness and super-awareness of the surroundings, is a sign of amphetamine or cocaine abuse, but it would not be expected in a client with a head injury. 4. The client can eat food as tolerated, but feeding the client every three (3) to four (4) hours does not affect the development of postconcussion syndrome, the signs of which are what should be taught to the significant other.

The client diagnosed with a gunshot wound to the head assumes decorticate posturing when the nurse applies painful stimuli. Which assessment data obtained three (3) hours later would indicate the client is improving? 1. Purposeless movement in response to painful stimuli. 2. Flaccid paralysis in all four extremities. 3. Decerebrate posturing when painful stimuli are applied. 4. Pupils that are 6 mm in size and nonreactive on painful stimuli.

1 *1. Purposeless movement indicates that the client's cerebral edema is decreasing. The best motor response is purposeful movement, but purposeless movement indicates an improvement over decorticate movement, which, in turn, is an improvement over decerebrate movement or flaccidity.* 2. Flaccidity would indicate a worsening of the client's condition. 3. Decerebrate posturing would indicate a worsening of the client's condition. 4. The eyes respond to light, not painful stimuli, but a 6-mm nonreactive pupil indicates severe neurological deficit.

The client is diagnosed with a closed head injury and is in a coma. The nurse writes the client problem as "high risk for immobility complications." Which intervention would be included in the plan of care? 1. Position the client with the head of the bed elevated at intervals. 2. Perform active range-of-motion exercises every four (4) hours. 3. Turn the client every shift and massage bony prominences. 4. Explain all procedures to the client before performing them.

1 *1. The head of the client's bed should be elevated to help the lungs expand and prevent stasis of secretions that could lead to pneumonia, a complication of immobility.* 2. Active range-of-motion exercises require that the client participate in the activity. This is not possible because the client is in a coma. 3. The client is at risk for pressure ulcers and should be turned more frequently than every shift, and research now shows that massaging bony prominences can increase the risk for tissue breakdown. 4. The nurse should always talk to the client, even if he or she is in a coma, but this will

the nurse working in an emergency room is caring for a client who is exhibiting signs and symptoms of a stroke. what does the nurse anticipate that the physicians orders will include? 1) CT scan 2) intravenous antibiotics 3) pain medication 4) MRI

1) CT scan

a nurse at along term care facility provides care for a client who has had recent transient ischemic attacks (TIAs). what significance should the nurse attach to clients TIAs? 1) TiAs by definition resolve rapidly but they constitute an increased risk for stroke 2) TIAs result in an assimilation of small defects that may eventually equal the effects of a CV 3) the small belles that define TIAs can be warning sign go an impending stroke 4) TIAs are relatively benign phenomena that necessitate monitoring but not treatment

1) TiAs by definition resolve rapidly but they constitute an increased risk for stroke

the parents of an infant born with hydrocephalus are concerned about the size of the baby's head. the doctors are telling them that the infant needs the surgical placement of a shunt. the nurse caring for the infant in the neonatal intensive care unit explains that placement of a shunt will 1) decrease the likelihood if further neurological deficits 2) not affect the size of the infants head 3) reverse any neurologic depicts that are present 4) increase intracranial pressure

1) decrease the likelihood if further neurological deficits

while lecturing to a group of physiology students the instructor asks "what metabolic factors cause vasodilation of cerebral vessels thereby increasing cerebral blood flow to the brain". the best student response would be 1) increased carbon dioxide level 2) increased oxygen saturation 3) decreased serum scum level 4) decreased hydrogen ion concentration

1) increased carbon dioxide level

the emergency room doctor suspects a client may have bacterial meningitis. the most important diagnostic test to perform would be 1) lumbar puncture 2) CT pf the head 3) blood cultures 4) sputum culture

1) lumbar puncture

the nurse is caring for an older adult client with hemiplegia following a stroke. while planning the client care the nurse knows the client is at risk for developing which condition? 1) muscle atrophy 2) pseudohypertrophy 3)muscular dystrophy 4) involuntary movements

1) muscle atrophy

as a client explains to the nurse what occurred prior to the onset of seizure activity the client describes receiving a feelings or warning that the seizure would occur. the nurse documents the perceived warning as which of the following 1) prodrome 2) profermal 3) atonic 4) aerola

1) prodrome

a client suffering a thrombotic stroke is brought into the emergency department by ambulance and the health care team is preparing to administer a synthetic tissue plasminogen activator for which purpose? 1) thrombolysis 2) thrombogenesis 3) hemolysis 4) hemostasis

1) thrombolysis

manifestations of brain tumors are focal disturbances in brain function and increased ICP. what causes the focal disturbances manifested by brain tumors? 1)brain edema and disturbances in blood flow 2) tumor infiltration and increased blood pressure 3) tumor infiltration and decreased ICP 4) brain compression and decreased ICP

1)brain edema and disturbances in blood flow

The nurse is monitoring a client with increased intracranial pressure (ICP). What indicators are the most critical for the nurse to monitor? Select all that apply. 1. Systolic blood pressure. 2. Urine output. 3. Breath sounds. 4. Cerebral perfusion pressure. 5. Level of pain.

1, 4 1. Systolic blood pressure. 4. Cerebral perfusion pressure. The nurse must monitor the systolic and diastolic blood pressure to obtain the mean arterial pressure (MAP), which represents the pressure needed for each cardiac cycle to perfuse the brain. The nurse must also monitor the cerebral perfusion pressure (CPP), which is obtained from the ICP and the MAP. The nurse should also monitor urine output, respirations, and pain; however, crucial measurements needed to maintain CPP are ICP and MAP. When ICP equals MAP, there is no CPP.

When evaluating an arterial blood gas report from a client with a subdural hematoma who had surgery and is now on a ventilator, the nurse notes the PaCO2 is 35 mm Hg (4.7 kPa). The ventilator settings are: TV 400, respiration rate 24, FIO2 100%. What should the nurse do first? 1. Ask the respiratory technician to decrease the respiration rate on the ventilator to 18. 2. Position the client with the head of bed elevated. 3. Continue to monitor the client. 4. Inform the charge nurse of the results of the report.

1. Ask the respiratory technician to decrease the respiration rate on the ventilator to 18. CO2 has vasodilating properties; therefore, lowering PaCO2 through hyperventilation will lower ICP caused by dilated cerebral vessels. Since the client's PaCO2 level is normal (35 to 45 mm Hg or 4.7 to 6.0 kPa), paging the respiratory technician to change the respiration rate is an appropriate action. Elevating the head of the client's bed is contradicted with this client's condition: that would lower blood pressure and care of these patients involves maintenance of a flat position in bed for 24 hours after surgery. Continuing to monitor the client is inappropriate because the PaCO2 level is normal and the respiratory technician needs to adjust the hyperventtilation setting to normal on the ventilator since the lab indicates that PaCo2 is normal. Informing the charge nurse about the change in ventilator settings is not necessary at this time because this is expected care for this client.

The client is admitted to the medical floor with a diagnosis of closed head injury. Which nursing intervention has priority? 1. Assess neurological status. 2. Monitor pulse, respiration, and blood pressure. 3. Initiate an intravenous access. 4. Maintain an adequate airway.

1. Assessing the neurological status is important, but ensuring an airway is priority over assessment. 2. Monitoring vital signs is important, but maintaining an adequate airway is higher priority. 3. Initiating an IV access is an intervention the nurse can implement, but it is not the priority intervention. *4. The most important nursing goal in the management of a client with a head injury is to establish and maintain an adequate airway.*

An unconscious client with multiple injuries arrives in the emergency department. Which nursing intervention receives the highest priority? 1. Establishing an airway. 2. Replacing blood loss. 3. Stopping bleeding from open wounds. 4. Checking for a neck fracture.

1. Establishing an airway. The highest priority for a client with multiple injuries is to establish an open airway for effective ventilation and oxygenation. Unless the client has a patent airway, other care measures will be futile. Replacing blood loss, stopping bleeding from open wounds, and checking for a neck fracture are important nursing interventions to be completed after the airway and ventilation are established.

Which of the following respiratory patterns indicates increasing intracranial pressure in the brain stem? 1. Slow, irregular respirations. 2. Rapid, shallow respirations. 3. Asymmetric chest excursion. 4. Nasal flaring.

1. Slow, irregular respirations Neural control of respiration takes place in the brain stem. Deterioration and pressure produce irregular respiratory patterns. Rapid, shallow respirations, asymmetric chest movements, and nasal flaring are more characteristic of respiratory distress or hypoxia.

the health care provider is concerned that a client may be at risk for problems with cerebral blood flow. the most important data to assess would be 1) decreased level of carbon dioxide 2) decreased level of oxygen 3) decreased level of PCO2 4) decreased hydrogen ions

2) decreased level of oxygen

The client has a sustained increased intracranial pressure (ICP) of 20 mm Hg. Which client position would be most appropriate? 1. The head of the bed elevated 30 to 45 degrees. 2. Trendelenburg's position. 3. Left Sims' position. 4. The head elevated on two pillows.

1. The head of the bed elevated 30 to 45 degrees. The client's ICP is elevated, and the client should be positioned to avoid extreme neck flexion or extension. The head of the bed is usually elevated 30 to 45 degrees to drain the venous sinuses and thus decrease the ICP. Trendelenburg's position places the client's head lower than the body, which would increase ICP. Sims' position (side lying) and elevating the head on two pillows may extend or flex the neck, which increases ICP.

A client is at risk for increased intracranial pressure (ICP). Which of the following would be the priority for the nurse to monitor? 1. Unequal pupil size. 2. Decreasing systolic blood pressure. 3. Tachycardia. 4. Decreasing body temperature.

1. Unequal pupil size. Increasing ICP causes unequal pupils as a result of pressure on the third cranial nerve. Increasing ICP causes an increase in the systolic pressure, which reflects the additional pressure needed to perfuse the brain. It increases the pressure on the vagus nerve, which produces bradycardia, and it causes an increase in body temperature from hypothalamic damage.

The client diagnosed with a closed head injury is admitted to the rehabilitation department. Which medication order would the nurse question? 1. A subcutaneous anticoagulant. 2. An intravenous osmotic diuretic. 3. An oral anticonvulsant. 4. An oral proton pump inhibitor.

2 1. The client in rehabilitation is at risk for the development of deep vein thrombosis; therefore, this is an appropriate medication. *2. An osmotic diuretic would be ordered in the acute phase to help decrease cerebral edema, but this medication would not be expected to be ordered in a rehabilitation unit.* 3. Clients with head injuries are at risk for post-traumatic seizures; thus an oral anticonvulsant would be administered for seizure prophylaxis. 4. The client is at risk for a stress ulcer; therefore, an oral proton pump inhibitor would be an appropriate medication.

The 29-year-old client who was employed as a forklift operator sustains a traumatic brain injury secondary to a motor-vehicle accident. The client is being discharged from the rehabilitation unit after three (3) months and has cognitive deficits. Which goal would be most realistic for this client? 1. The client will return to work within six (6) months. 2. The client is able to focus and stay on task for 10 minutes. 3. The client will be able to dress self without assistance. 4. The client will regain bowel and bladder control.

2 1. The client is at risk for seizures and does not process information appropriately. Allowing him to return to his occupation as a forklift operator is a safety risk for him and other employees. Vocational training may be required. *2. "Cognitive" pertains to mental processes of comprehension, judgment, memory, and reasoning. Therefore, an appropriate goal would be for the client to stay on task for 10 minutes.* 3. The client's ability to dress self addresses self-care problems, not a cognitive problem. 4. The client's ability to regain bowel and bladder control does not address cognitive deficits.

The resident in a long-term care facility fell during the previous shift and has a laceration in the occipital area that has been closed with Steri-Strips. Which signs/symptoms would warrant transferring the resident to the emergency department? 1. A 4-cm area of bright red drainage on the dressing. 2. A weak pulse, shallow respirations, and cool pale skin. 3. Pupils that are equal, react to light, and accommodate. 4. Complaints of a headache that resolves with medication.

2 1. The scalp is a very vascular area and a moderate amount of bleeding would be expected. *2. These signs/symptoms—weak pulse, shallow respirations, cool pale skin—indicate increased intracranial pressure from cerebral edema secondary to the fall, and they require immediate attention.* 3. This is a normal pupillary response and would not warrant intervention. 4. A headache that resolves with medication is not an emergency situation, and the nurse would expect the client to have a headache after the fall; a headache not relieved with Tylenol would warrant further investigation.

the nurse working in an emergency room is caring for a client who is exhibiting signs and symptoms of a stroke . what does the nurse anticipate that the physicians orders will include 1) MRI 2) CT scan 3) pain medication 4) intravenous antibiotics

2) CT scan

a client is brought to the emergency department and is diagnosed with an ischemic stroke confirmed by CT scan. the most important treatment for this client would be to 1) monitor vital signs closely for improvement 2) adminiter IV tissue plasminogen activator (tPA) 3) administer analgesics for the relief of pain 4) prepare the client for emergency surgery

2) adminiter IV tissue plasminogen activator (tPA)

the nurse is caring for a client experiencing a seizure. during the seizure the nurse notes that the client repetitively rubs his/her clothing. when contacting the clients physician the nurse notes that the client exhibited 1) myoclonic activity 2) automatisms 3) hallucination 4) aura

2) automatisms

the nurse caring for a client with an aneurysmal subarachnoid hemorrhage understands that the most common cause of this condition is 1) hypertension 2) berry aneurysm 3) subdural hematoma 4) arteriovenous malformation

2) berry aneurysm

which intracranial volume is most capable of compensating for increasing intracranial pressure? 1) intravascular blood 2) cerebrospinal fluid 3) brain cell tissue 4) surface sulk fluid

2) cerebrospinal fluid

1. More complex patterns of movements, such as throwing a ball or picking up a fork, are controlled by the ______ cortex in the frontal lobe.

A) premotor

following a head injury a client is diagnosed with intracrianal epidural hematoma. during the initial assessment the client suddenly becomes unconscious. what additional clinical manifestations correlate with this diagnosis? 1) ipsilateral hemiparesis 2) ipsilateral pupil dilation 3) diffuse venous bleeding from the nose 4) increased head circumference with hydrocephalus

2) ipsilateral pupil dilation

A client's emergency magnetic resonance imaging (MRI) has been examined by the physician and tissue plasminogen activator (tPA) has been administered to the client. What was this client's most likely diagnosis? 1) subarachnoid hemorrhage 2) ischemic stroke 3) status epilepticus 4) encephalitis

2) ischemic stroke

a clients recent CT scan has revealed the presence of hydrocephalus. which treatment measures is most likely to resolve this health problem 1) adminstaction of hypertonic intravenous solution 2) placemat of a shunt 3) aggressive diuresis 4) lumbar puncture

2) placemat of a shunt

the nurse is explaining to a clients family how vasogenic brain edema occurs. the most appropriate information for the nurse to provide would be 1) there is a decrease in the amount of fluid volume in the brian 2) the blood Brian barrier is disrupted allowing fluid to escape into the extracellular fluid 3) normal physiologic circumstances result in decreased absorption of CSF 4) there is an increase in the production of cerebrospinal fluid volume

2) the blood Brian barrier is disrupted allowing fluid to escape into the extracellular fluid

A client with a contusion has been admitted for observation following a motor vehicle accident when he was driving his wife to the hospital to deliver their child. The next morning, instead of asking about his wife and baby, he asked to see the football game on television that he thinks is starting in 5 minutes. He is agitated because the nurse will not turn on the television. What should the nurse do next? Select all that apply. 1. Find a television so the client can view the football game. 2. Determine if the client's pupils are equal and react to light. 3. Ask the client if he has a headache. 4. Arrange for the client to be with his wife and baby. 5. Administer a sedative.

2, 3 2. Determine if the client's pupils are equal and react to light. 3. Ask the client if he has a headache. The nurse should determine if the client's pupils are equal and react to light, and ask the client if he has a headache. Confusion, agitation, and restlessness are subtle clinical manifestations of increased intracranial pressure (ICP). At this time, it is not appropriate for the nurse to find a television or arrange for the client to see his wife and baby. Administering a sedative at this time will obscure assessment of increased ICP.

The nurse has established a goal to maintain intracranial pressure (ICP) within the normal range for a client who had a craniotomy 12 hours ago. What should the nurse do? Select all that apply. 1. Encourage the client to cough to expectorate secretions. 2. Elevate the head of the bed 15 to 30 degrees. 3. Contact the health care provider if ICP is greater than 20 mm Hg. 4. Monitor neurologic status using the Glasgow Coma Scale. 5. Stimulate the client with active range-of- motion exercises.

2, 3, 4 2. Elevate the head of the bed 15 to 30 degrees. 3. Contact the health care provider if ICP is greater than 20 mm Hg. 4. Monitor neurologic status using the Glasgow Coma Scale. The nurse should maintain ICP by elevating the head of the bed and monitoring neurologic status. An ICP greater than 20 mm Hg indicates increased ICP, and the nurse should notify the health care provider. Coughing and range-of-motion exercises will increase ICP and should be avoided in the early postoperative stage.

The nurse is caring for a client diagnosed with an epidural hematoma. Which nursing interventions should the nurse implement? *Select all that apply.* 1. Maintain the head of the bed at 60 degrees of elevation. 2. Administer stool softeners daily. 3. Ensure that pulse oximeter reading is higher than 93%. 4. Perform deep nasal suction every two (2) hours. 5. Administer mild sedatives.

2,3,5 1. The head of the bed should be elevated no more than 30 degrees to help decrease cerebral edema by gravity. *2. Stool softeners are initiated to prevent the Valsalva maneuver, which increases intracranial pressure.* *3. Oxygen saturation higher than 93% ensures oxygenation of the brain tissues; decreasing oxygen levels increase cerebral edema.* 4. Noxious stimuli, such as suctioning, increase intracranial pressure and should be avoided. *5. Mild sedatives will reduce the client's agitation; strong narcotics would not be administered because they decrease the client's level of consciousness.*

A client who has had a spinal injury now has sensory changes on the distal forearm and fourth and fifth fingers. The nurse can predict that this client has experienced an injury to the: Select all that apply.

2. Cervical (C) 8 3. Thoracic (T) 1 dorsal root

In planning the care for a client who has had a posterior fossa (infratentorial) craniotomy, which of the following is contraindicated when positioning the client? 1. Keeping the client flat on one side or the other. 2. Elevating the head of the bed to 30 degrees. 3. Logrolling or turning as a unit when turning. 4. Keeping the neck in a neutral position.

2. Elevating the head of the bed to 30 degrees. Elevating the head of the bed to 30 degrees is contraindicated for infratentorial craniotomies because it could cause herniation of the brain down onto the brain stem and spinal cord, resulting in sudden death. Elevation of the head of the bed to 30 degrees with the head turned to the side opposite the incision, if not contraindicated by the increased intracranial pressure, is used for supratentorial craniotomies.

The nurse administers mannitol (Osmitrol) to the client with increased intracranial pressure. Which parameter requires close monitoring? 1. Muscle relaxation. 2. Intake and output. 3. Widening of the pulse pressure. 4. Pupil dilation

2. Intake and output. After administering mannitol, the nurse closely monitors intake and output because mannitol promotes diuresis and is given primarily to pull water from the extracellular fluid of the edematous brain. Mannitol can cause hypokalemia and may lead to muscle contractions, not muscle relaxation. Signs and symptoms, such as widening pulse pressure and pupil dilation, should not occur because mannitol serves to decrease ICP.

A client receiving vent-assisted mode ventilation begins to experience cluster breathing after recent intracranial occipital bleeding. The nurse should: 1. Count the rate to be sure that ventilations are deep enough to be suffcient. 2. Notify the physician of the client's breathing pattern. 3. Increase the rate of ventilations. 4. Increase the tidal volume on the ventilator.

2. Notify the physician of the client's breathing pattern. Cluster breathing consists of clusters of irregular breaths followed by periods of apnea on an irregular basis. A lesion in the upper medulla or lower pons is usually the cause of cluster breathing. Because the client had a bleed in the occipital lobe, which is just superior and posterior to the pons and medulla, clinical manifestations that indicate a new lesion are monitored very closely in case another bleed ensues. The nurse should notify the physician immediately so that treatment can begin before respirations cease. The client is not obtaining sufficient oxygen and the depth of breathing is assisted by the ventilator. The health care provider will determine changes in the ventilator settings

A client who is regaining consciousness after a craniotomy becomes restless and attempts to pull out the IV line. Which nursing intervention protects the client without increasing the intracranial pressure (ICP)? 1. Place in a jacket restraint. 2. Wrap the hands in soft "mitten" restraints. 3. Tuck the arms and hands under the drawsheet. 4. Apply a wrist restraint to each arm.

2. Wrap the hands in soft "mitten" restraints. It is best for the client to wear mitts, which help prevent the client from pulling on the IV without causing additional agitation. Using a jacket or wrist restraint or tucking the client's arms and hands under the drawsheet restrict movement and add to feelings of being confined, all of which would increase her agitation and increase ICP.

The client has sustained a severe closed head injury and the neurosurgeon is determining if the client is "brain dead." Which data support that the client is brain dead? 1. When the client's head is turned to the right, the eyes turn to the right. 2. The electroencephalogram (EEG) has identifiable waveforms. 3. There is no eye activity when the cold caloric test is performed. 4. The client assumes decorticate posturing when painful stimuli are applied.

3 *3. The cold caloric test, also called the oculovestibular test, is a test used to determine if the brain is intact or dead. No eye activity indicates brain death. If the client's eyes moved, that would indicate that the brainstem is intact.* 4. Decorticate posturing after painful stimuli are applied indicates that the brainstem is intact; flaccid paralysis is the worse neurological response when assessing a client with a head injury.

The nurse is caring for the following clients. Which client would the nurse assess first after receiving the shift report? 1. The 22-year-old male client diagnosed with a concussion who is complaining someone is waking him up every two (2) hours. 2. The 36-year-old female client admitted with complaints of left-sided weakness who is scheduled for a magnetic resonance imaging (MRI) scan. 3. The 45-year-old client admitted with blunt trauma to the head after a motorcycle accident who has a Glasgow Coma Scale score of 6. 4. The 62-year-old client diagnosed with a cerebrovascular accident (CVA) who has expressive aphasia.

3 1. A client with a head injury must be awakened every two (2) hours to determine alertness; decreasing level of consciousness is the first indicator of increased intracranial pressure. 2. A diagnostic test, MRI, would be an expected test for a client with left-sided weakness and would not require immediate attention. *3. The Glasgow Coma Scale is used to determine a client's response to stimuli (eye-opening response, best verbal response, and best motor response) secondary to a neurological problem; scores range from 3 (deep coma) to 15 (intact neurological function). A client with a score of 6 should be assessed first by the nurse.*

The client with a closed head injury has clear fluid draining from the nose. Which action should the nurse implement *first*? 1. Notify the health-care provider immediately. 2. Prepare to administer an antihistamine. 3. Test the drainage for presence of glucose. 4. Place 2 × 2 gauze under the nose to collect drainage.

3 1. Prior to notifying the HCP, the nurse should always make sure that all the needed assessment information is available to discuss with the HCP. 2. With head injuries, any clear drainage may indicate a cerebrospinal fluid leak; the nurse should not assume the drainage is secondary to allergies and administer an antihistamine. *3. The presence of glucose in drainage from the nose or ears indicates cerebrospinal fluid, and the HCP should be notified immediately once this is determined.* 4. This would be appropriate, but it is not the first intervention. The nurse must determine where the fluid is coming from.

the spouse of a client who has been in a long term care facility for a few months due to brain injury that caused a vegetative state asks the nurse why the client is still being fed through the gastrostomy tube. what is the nurses best response? 1) "it is mandated by law to do so" 2) "the client will recover from this state" 3) "to avoid aspiration into the lungs" 4) "feeding the client allows for comfort"

3) "to avoid aspiration into the lungs"

a client is brought to the emergency department and is diagnosed with an ischemic stroke confirmed by CT scan. the most important treatment for this client would be to 1) monitor vital signs closely for improvement 2) prepare the client for emergency surgery 3) administer IV tissue plasminogen activator (tPA) 4) administer analgesics for the relief of pain

3) administer IV tissue plasminogen activator (tPA)

a client has suffered a stroke that has affected his speech. the physical has identified the client is having expressive aphasia. layer in the day the family asks the nurse to explain what this means. the most accurate response would be aphasia that is 1) manifested as impaired repetition and speech riddled with letter substitutions, despite good comprehension and fluency 2) nearly normal speech except for difficulty with findings singular words 3) characterized by an inability to communicate spontaneously with ease or translate thoughts or ideas into meaningful speech or writing 4) characterized by an inability to comprehend the speech of others or comprehend written material

3) characterized by an inability to communicate spontaneously with ease or translate thoughts or ideas into meaningful speech or writing

a clients emergency room report includes the presence of a countercoup injury. the nurse plans care for a client with which of the following? 1) closed head injury in there area of impact 2) open spinal cord injury with complete serving of neurons 3) closed head injury opposite the area of impact 4) infection resulting from exposed brain tissue

3) closed head injury opposite the area of impact

the nurse reading a clients lumbar puncture results notifies the physician of findings consistent with meningitis when which sign/ symptom is noted? 1) clear cerebrospinal fluid 2) increased glucose 3) large number of polymorphonuclear neutrophils 4) decreased protein count

3) large number of polymorphonuclear neutrophils

the nurse is assessing a client and notes the client is now displaying decerebrate posturing the position would be documented as 1) flexion of the arms wrists and fingers with abduction of the upper extremities internal rotation and plantar flexion of the lower extremities 2) active range of motion with increased strength in the upper extremities when painful stimulation applied 3) rigidity of the arms with palms of the hands turned away from the body and with stuffy extended legs and plantar flexion of the feet 4) prone position with arms placed above the head and legs elevated deep tendon reflexes showing hyperreflexa

3) rigidity of the arms with palms of the hands turned away from the body and with stuffy extended legs and plantar flexion of the feet

the MRA scan of a client with a suspected stroke reports ruptured berry aneurysm. the nurse plans care for a client with 1) lacunar infarct 2) encephalitis 3) subarachnoid hemorrhage 4) thrombotic stroke

3) subarachnoid hemorrhage

the most common cause of an ischemic stroke is which of the following? 1) vasospasm 2) cariogenic embolus 3) thrombosis 4) intracerebral arterial vasculitis

3) thrombosis

A client who had a serious head injury with increased intracranial pressure is to be discharged to a rehabilitation facility. Which of the following rehabilitation outcomes would be appropriate for the client? The client will: 1. Exhibit no further episodes of short-term memory loss. 2. Be able to return to his construction job in 3 weeks. 3. Actively participate in the rehabilitation process as appropriate. 4. Be emotionally stable and display pre-injury personality traits.

3. Actively participate in the rehabilitation process as appropriate. Recovery from a serious head injury is a long-term process that may continue for months or years. Depending on the extent of the injury, clients who are transferred to rehabilitation facilities most likely will continue to exhibit cognitive and mobility impairments as well as behavior and personality changes. The client would be expected to participate in the rehabilitation efforts to the extent he is capable. Family members and significant others will need long-term support to help them cope with the changes that have occurred in the client.

Which activity should the nurse encourage the client to avoid when there is a risk for increased intracranial pressure (ICP)? 1. Deep breathing. 2. Turning. 3. Coughing. 4. Passive range-of-motion (ROM) exercises.

3. Coughing. Coughing is contraindicated for a client at risk for increased ICP because coughing increases ICP. Deep breathing can be continued. Turning and passive ROM exercises can be continued with care not to extend or flex the neck.

Which of the following nursing interventions is appropriate for a client with an increased intracranial pressure (ICP) of 20 mm Hg? 1. Give the client a warming blanket. 2. Administer low-dose barbiturates. 3. Encourage the client to hyperventilate. 4. Restrict fluids.

3. Encourage the client to hyperventilate. Normal ICP is 15 mm Hg or less or 15 to 30 seconds or longer. Hyperventilation causes vasoconstriction, which reduces cerebrospinal fluid and blood volume, two important factors for reducing a sustained ICP of 20 mm Hg. A cooling blanket is used to control the elevation of temperature because a fever increases the metabolic rate, which in turn increases ICP. High doses of barbiturates may be used to reduce the increased cellular metabolic demands. Fluid volume and inotropic drugs are used to maintain cerebral perfusion by supporting the cardiac output and keeping the cerebral perfusion pressure greater than 80 mm Hg.

What should the nurse do first when a client with a head injury begins to have clear drainage from the nose? 1. Compress the nares. 2. Tilt the head back. 3. Give the client tissues to collect the fluid. 4. Administer an antihistamine for postnasal drip.

3. Give the client tissues to collect the fluid. The clear drainage must be analyzed to determine whether it is nasal drainage or cerebrospinal fluid (CSF). The nurse should not give the client tissues because it is important to know how much leakage of CSF is occurring. Compressing the nares will obstruct the drainage flow. It is inappropriate to tilt the head back, which would allow the fluid to drain down the throat and not be collected for a sample. It is inappropriate to administer an antihistamine because the drainage may not be from postnasal drip.

The nurse is enjoying a day at the lake and witnesses a water skier hit the boat ramp. The water skier is in the water not responding to verbal stimuli. The nurse is the first health-care provider to respond to the accident. Which intervention should be implemented first? 1. Assess the client's level of consciousness. 2. Organize onlookers to remove the client from the lake. 3. Perform a head-to-toe assessment to determine injuries. 4. Stabilize the client's cervical spine.

4 1. Assessment is important, but with clients with head injury the nurse must assume spinal cord injury until it is ruled out with x-ray; therefore, stabilizing the spinal cord is priority. 2. Removing the client from the water is an appropriate intervention, but the nurse must assume spinal cord injury until it is ruled out with x-ray; therefore, stabilizing the spinal cord is priority. 3. Assessing the client for further injury is appropriate, but the first intervention is to stabilize the spine because the impact was strong enough to render the client unconsciousness. *4. The nurse should always assume that a client with traumatic head injury may have sustained spinal cord injury. Moving the client could further injure the spinal cord and cause paralysis; therefore, the nurse should stabilize the cervical spinal cord as best as possible prior to removing the client from the water.*

the nurse is caring for a client admitted to the emergency room with suspected meningitis. the nurse prepares to perform which nursing intervention upon physician orders while diagnostic testing is being completed? 1) administration of TPN 2) administration of oxygen 3) adminstrationof pain medication 4) administration of antibiotics

4) administration of antibiotics

the spouse of a client admitted to the hospital after a motor vehicle accident reports the nurse that the client has become very drowsy. the nurse should 1) prepare the client for EEG testing 2) contact the physician 3) instruct the spouse not to let the client fall sleep until the physical has assessed the client 4) asses the client for additional signs/ symptoms of increased intracranial pressure

4) asses the client for additional signs/ symptoms of increased intracranial pressure

a teenage has been in a car accident and experienced an acceleration deceleration head injury. initially the client was stable but then started to develop neurological signs/ symptoms. the nurse caring for this client should be assessing for which type of possible complication 1) status epilepticus 2) TIAs and cerebrovascular infarction 3) momentary unconsciousness 4) brain contusions and hematoma

4) brain contusions and hematoma

A soccer player has been diagnosed with a brain contusion after being injured in a game. The best explanation of the injury by the nurse would be: 1) tearing of brain tissue occurred 2) hypoxia to the brain occured 3) transient neurogenic dysfunction caused by mechanical force to the brain occurred 4) busing on the surface of the brain occurred

4) busing on the surface of the brain occurred

an 80 year old client with a history of heavy alcohol use is being seen by his provider for drowsiness confusion and headache. his family states that the fell and hit his head several weeks ago. which type of hematoma does the provider suspect? 1) acute subdural 2) epidural 3) subacute subdural 4) chronic subdural

4) chronic subdural

the chart of a client admitted because of seizures notes the seizure actively began simulationeously in both cerebral hemispheres. the nurse should interrupt this to mean that the client experienced 1)focal seizure without impairment of consciousness 2) unknown type of seizure 3) focal seizure with impairment of consciousness 4) generalized seizure

4) generalized seizure

the emergency room doctor suspects a client may have bacterial meningitis. the most important diagnostic test to perform would be 1) CT of head 2) blood cultures 3) sputum culture 4) lumbar puncture

4) lumbar puncture

for which common manifestation of acute meningococcal meningitis should the school nurse be assessing students? 1) focal paralysis 2) papilledema 3) diplopia 4) petechiae

4) petechiae

a client's recent computed tomography (CT) scan has revealed the presence of hydrocephalus. which of the following treatment measures is most likely to resolve this health problem? 1) administration of hypertonic intravenous solution 2) lumbar puncture 3) aggressive diuresis 4) placement of a shunt

4) placement of a shunt

the nurse observes a new nurse performing the test for kerning sign on a client. the new nurse performs the test by providing resistance to flexion of the knees while the client is lying with the hip flexed at a right angle. the nurse should explain to the new nurse that 1) the client should be in a sitting position 2) the sign elected was the obturator sign 3) the sign elected was the budzinski sign 4) resistance should be provided with the knee in a flexed position

4) resistance should be provided with the knee in a flexed position

A client with a head injury regains consciousness after several days. Which of the following nursing statements is most appropriate as the client awakens? 1. "I'll get your family." 2. "Can you tell me your name and where you live?" 3. "I'll bet you're a little confused right now." 4. "You are in the hospital. You were in an accident and unconscious."

4. "You are in the hospital. You were in an accident and unconscious." It is important to first explain where a client is to orient him or her to time, person, and place. Offering to get the family and asking questions to determine orientation are important, but the first comments should let the client know where he or she is and what has happened. It is useful to be empathetic to the client, but making a comment such as "I'll bet you're a little confused" is not helpful and may cause anxiety.

Which of the following describes decerebrate posturing? 1. Internal rotation and adduction of arms with flexion of elbows, wrists, and fingers. 2. Back hunched over, rigid flexion of all four extremities with supination of arms and plantar flexion of feet. 3. Supination of arms, dorsifexion of the feet. 4. Back arched, rigid extension of all four extremities.

4. Back arched, rigid extension of all four extremities. Decerebrate posturing occurs in clients with damage to the upper brain stem, midbrain, or pons and is demonstrated clinically by arching of the back, rigid extension of the extremities, pronation of the arms, and plantar flexion of the feet. Internal rotation and adduction of arms with flexion of elbows, wrists, and fingers describes decorticate posturing, which indicates damage to corticospinal tracts and cerebral hemispheres.

The nurse is assessing a client with increasing intracranial pressure (ICP). The nurse should notify the health care provider about which of the following changes in the client's condition? 1. Widening pulse pressure. 2. Decrease in the pulse rate. 3. Dilated, fixed pupils. 4. Decrease in level of consciousness (LOC)

4. Decrease in level of consciousness (LOC) A decrease in the client's LOC is an early indicator of deterioration of the client's neurologic status. Changes in LOC, such as restlessness and irritability, may be subtle. Widening of the pulse pressure, decrease in the pulse rate, and dilated, fixed pupils occur later if the increased ICP is not treated.

3. Extreme cerebral edema may cause the brain to herniate into another compartment. Upward herniation from the infratentorial compartment against the aqueduct of Sylvius causes:

A) hydrocephalus.

1. The somatosensory system consists of three types of sensory neurons. The special somatic type of afferent sensory neurons has receptors that sense: A) Muscle position B) Visceral fullness C) Temperature D) Painful touch

A

10. Disorders of the pyramidal tracts, such as a stroke, are characterized by: A) Paralysis B) Hypotonia C) Muscle rigidity D) Involuntary movements

A

11. A clinician is assessing the muscle tone of a client who has been diagnosed with a lower motor neuron (LMN) lesion. Which of the following assessment findings is congruent with the client's diagnosis? A) Hypotonia B) Spasticity C) Tetany D) Rigidity

A

13. Which of the following peripheral nerve injuries will likely result in cellular death with little chance of regeneration? A) Nerve fibers destroyed close to the neuronal cell body B) Crushing injury where the nerve is traumatized but not severed C) Cutting injury where slow-regeneration axonal branches are located D) Incomplete amputation where tubular implants are used to fill in the gaps of nerves

A

15. A client's recent diagnosis of Parkinson disease has prompted his care provider to promptly begin pharmacologic therapy. The drugs that are selected will likely influence the client's levels of: A) Dopamine B) Acetylcholine C) Serotonin D) Adenosine

A

A

A patient is experiencing bilateral symmetrical muscle weakness and sensory changes of both feet and legs. What should the nurse expect to assess that determines the presence of Guillain-Barré syndrome (GBS)? A) Areflexia B) Hyporeflexia C) Hyperreflexia D) Hyperanalgesia

17. During physiology class, the instructor asks students to explain the pathology behind development of multiple sclerosis. Which student gave the most accurate description? A) The demyelination and subsequent degeneration of nerve fibers and decreased oligodendrocytes, which interfere with nerve conduction B) Muscle necrosis with resultant increase in fat/connective tissue replacing the muscle fibers C) Atherosclerotic destruction of circulation to the brain resulting in lactic acid buildup that affects nerve transmission D) Autoimmune disease where antibody loss of acetylcholine receptors at the neuromuscular junction causes decrease motor response

A

19. A client presents to the clinic complaining, "I have something in my eye." When questioned, the client admits to a scratching and burning sensation and light sensitivity. The health care provider suspects the client has developed: A) Conjunctivitis B) Retinal detachment C) Acute glaucoma D) Corneal edema

A

23. A client presents to the emergency department complaining of loss of part of his vision. An MRI with contrast reveals multiple aneurysms of the circle of Willis. The client is diagnosed with "bitemporal heteronymous anopia." For this client, what effect will this have on his vision? A) With both eyes open, the client has full binocular visual fields B) Bilateral loss of peripheral vision on both sides with a narrow binocular field C) Total, irreversible blindness D) Loss of a quarter of the visual field in both eyes

A

27. Motility along the length of the GI tract, controlling the function of each segment of the GI tract and integrating signals for absorption of nutrients primarily, is innervated by which portion of the enteric nervous system? A) Submucosal plexus B) Vasovagal C) Sympathetic D) Preganglionic

A

36. A client has had severe heart burn associated with persistent gastroesophageal reflux for many years. Which of the following statements made by the client leads the nurse to suspect the client is having a complication related to his reflux? The client is having: A) Difficulty in swallowing with feelings that food is "stuck" in the throat B) Burning sensation a half-hour after a meal C) Substernal chest pain that radiates to the shoulder and arm D) "Hoarseness" unrelieved by coughing or taking a drink of water

A

38. A 60-year-old male client has presented to his primary care provider to follow up with his ongoing treatment for peptic ulcer disease. What is the most likely goal of this client's pharmacologic treatment? A) Inhibiting gastric acid production B) Promoting hypertrophy of the gastric mucosa C) Increasing the rate of gastric emptying D) Increasing muscle tone of the cardiac sphincter

A

44. Which of the following clients should the nurse observe most closely for the signs and symptoms of paralytic ileus? A) A client who is first day postoperative following gallbladder surgery B) A client whose acute diarrhea has necessitated the use of antidiarrheal medications C) An obese client who refuses to ambulate because he complains of shortness of breath D) A client with a long-standing diagnosis of irritable bowel syndrome

A

48. A client's long-standing diagnosis of congenital hemolytic anemia often manifests itself with jaundice. What type of jaundice does this client most likely experience? A) Prehepatic B) Intrahepatic C) Posthepatic D) Infectious

A

60. Which of the following signs and symptoms is most suggestive of acute cholecystitis? A) Upper right quadrant or epigastric pain B) Fever and sudden abdominal distention C) Appearance of undigested fat in feces D) Nausea resulting in greenish vomitus

A

62. When explaining acute pancreatitis to a newly diagnosed client, the nurse will emphasize the pathogenesis begins with an inflammatory process whereby: A) Activated pancreatic enzymes escape into surrounding tissues, causing autodigestion of pancreatic tissue. B) The pancreas is irreversibly damaged and will not recover to normal functioning (chronic). C) The pancreas will hypertrophy (enlarge) to the point of causing bowel obstruction. D) Stones will develop in the common bile duct, resulting in acute jaundice.

A

When lecturing about heart attacks (myocardial infarctions), the instructor will emphasize the client may present with: Select all that apply. A) Substernal chest pain B) Neck pain C) Umbilicus pain D) Deep, right-sided abdominal pain E) Pain that radiates to the left arm

A) Substernal chest pain B) Neck pain E) Pain that radiates to the left arm

D

A patient seeks treatment for progressively deteriorating motor and sensory function. What question is essential for the nurse to ask when completing this patient's health history? A) "Have you been around any small children?" B) "When was the last time you had anything to eat?" C) "When was the last time you traveled out of the country?" D) "Have you recently experienced any lung or stomach infections?"

8. The demyelination and degeneration of nerve fibers characteristic of multiple sclerosis is the result of:

A) decreased oligodendrocytes.

When a person is stung on the index finger by a bee, the thalamus interprets the pain as: A) Somewhere on the hand B) A spot on the index finger C) Attributable to a bee stung D) Similar to a previous bee sting

A) Somewhere on the hand

A, B, C & E

A patient is admitted for diagnosis and treatment of Guillain-Barré syndrome (GBS). What should the nurse expect to assess during the acute stage of this syndrome? (Select all that apply.) A) Edema B) Paralysis C) Difficulty breathing D) Urinary incontinence E) Numbness and tingling

B

A patient is being prepared for a Tensilon test. What should the nurse ensure is available prior to the beginning of this test? A) Oxygen B) Atropine sulfate C) Intravenous fluids D) Nasogastric suction

Which of the following individuals has the highest chance of having a medulloblastoma?

A 4-year-old child who has become uncoordinated in recent months

Which of the following individuals has the highest chance of having a medulloblastoma? An 88-year-old man who has begun displaying signs and symptoms of increased ICP A 60-year-old woman who is soon to begin radiation therapy for the treatment of breast cancer A 4-year-old child who has become uncoordinated in recent months A 68-year-old man who is a smoker and has a family history of cancer

A 4-year-old child who has become uncoordinated in recent months

B

A client is diagnosed with myasthenia gravis. What should the nurse explain about this disease process? A) "Your nerve endings are worn out." B) "Your body does not recognize the neurotransmitter needed for movement." C) "Your body does not make enough of the neurotransmitter needed for movement." D) "Your nerves have lost their protective covering and impulses cannot reach body areas."

D

A patient with Guillain-Barré syndrome (GBS) asks how the illness develops. What should the nurse respond about the pathophysiology of the disorder? A) "An infection eats away at the nerve endings." B) "An infection enters the spinal cord and erodes the nerves at the roots." C) "The nerves are killed by infiltration of your body's white blood cells used to fight an infection." D) "After an infection your immune system created antibodies that affect the covering of the nerves."

A

A patient with Guillain-Barré syndrome (GBS) is receiving plasmapheresis. What finding should the nurse identify as being a complication of this treatment? A) Septicemia B) Flu-like symptoms C) Aseptic meningitis D) Acute renal failure

B

A patient with Guillain-Barré syndrome (GBS) loses respiratory function three weeks into the acute phase. When should the nurse expect respiratory function to return in this patient? A) During the plateau phase B) Early in the recovery stage C) At the end of the plateau stage D) At the end of the recovery stage

B

A patient with myasthenia gravis has lost 6 kg of weight over the last two months. What should the nurse suggest to improve this patient's nutritional status? A) Eat three large meals per day B) Plan medication doses to occur before meals C) Restrict drinking fluids prior to and during meals D) Increase the amount of fat and carbohydrates in meals

B

A patient with myasthenia gravis is experiencing sweating and pallor. After administering edrophonium (Tensilon), which finding suggests the patient is experiencing a cholinergic crisis? A) Clear vision B) Fasciculations C) Strong hand grasps D) Equal shoulder shrugs

A

A patient with progressively deteriorating lower extremity motor and sensory function is having a lumbar puncture. What finding suggests that this patient has Guillain-Barré syndrome (GBS)? A) Elevated protein level B) Elevated glucose level C) Reduction in white blood cell count D) Increased number of red blood cells

What happens during the depolarization phase of nerve cells?

A rapid change in polarity to one that is positive on the inside and the membrane becomes open to sodium.

A patient who experienced a traumatic head injury from a severe blow to the back of his head now lives with numerous function deficits, including an inability to maintain steady posture while he is in a standing position, although he is steadier when walking. Which of the following disorders most likely resulted from his injury? Cerebellar dystaxia Cerebellar tremor A lower motor neuron lesion A vestibulocerebellar disorder

A vestibulocerebellar disorder

17. A patient's recent diagnosis of Parkinson disease has prompted his care provider to promptly begin pharmacologic therapy. The drugs that are selected will likely influence the patient's levels of:

A) dopamine.

A patient who experienced a traumatic head injury from a severe blow to the back of his head now lives with numerous function deficits, including an inability to maintain steady posture while he is in a standing position, although he is steadier when walking. Which of the following disorders most likely resulted from his injury? Cerebellar dystaxia Cerebellar tremor A lower motor neuron lesion A vestibulocerebellar disorder

A vestibulocerebellar disorder

Which of the following people are at high risk for developing nonulcerative inflammation of the cornea? Select all that apply

A welder with inadequate eye protection A female who uses a tanning bed four to five times/week A ski patrol who works 12 hours/day in bright, sunny mountain top

24. Which of the following statements by the husband of a client with Alzheimer disease demonstrates an accurate understanding of his wife's medication regimen? A) "I'm really hoping these medications will slow down her mental losses." B) "We're both holding out hope that this medication will cure her Alzheimer's." C) "I know that this won't cure her, but we learned that it might prevent a bodily decline while she declines mentally." D) "I learned that if we are vigilant about her medication schedule, she may not experience the physical effects of her disease."

A) "I'm really hoping these medications will slow down her mental losses."

A client presents to a health clinic complaining of several vague symptoms. As the history/physical continues, the health care provider clearly thinks the client may have myasthenia gravis. Which statements by the client would correlate with this diagnosis? Select all that apply. A) "Sometimes I have double vision." B) "I have more energy in the morning but get worse as the day goes by." C) "Sometimes I have numbness/tingling on my face." D) "I had what felt like an electric shock race down the back of my leg when I bend my neck." E) "I feel like I don't have enough energy to chew my food sometimes."

A) "Sometimes I have double vision." B) "I have more energy in the morning but get worse as the day goes by." E) "I feel like I don't have enough energy to chew my food sometimes."

A client with a spinal cord injury at T8 would likely retain normal motor and somatosensory function of her: A) Arms B) Bowels C) Bladder D) Perineal musculature

A) Arms

6. A teenager has been in a car accident and experienced acceleration-deceleration head injury. Initially, the client was stable but then started to develop neurological signs/symptoms. The nurse caring for this client should be assessing for which type of possible complication? A) Brain contusions and hematomas B) TIAs and cerebrovascular infarction C) Momentary unconsciousness D) Status epilepticus

A) Brain contusions and hematomas

4. A traumatic brain injury client has developed extreme cerebral edema. The nurse is monitoring the client closely for signs of brain herniation. Which clinical manifestations would correlate to upward herniation of the midbrain from the infratentorial compartment? Select all that apply. A) Deep coma B) Rhythmic movement of arms and legs C) Respiratory rate of 8 with intermittent sighs D) Intracranial bleeding from nose and ears E) Bilateral small, fixed pupils

A) Deep coma C) Respiratory rate of 8 with intermittent sighs E) Bilateral small, fixed pupils

The family of a multiple sclerosis client asks, "What psychological manifestations may we expect to see in our mother?" The health care provider informs them to expect which of the following? Select all that apply. A) Depression B) Hallucinations C) Delirium D) Inattentiveness E) Forgetfulness

A) Depression D) Inattentiveness E) Forgetfulness

A client works as a data entry worker for a large company. The client goes to employee health with pain in the wrist/hand. The nurse suspects that it is carpal tunnel syndrome based on which of the following assessment findings? Select all that apply. A) Describes numbness/tingling in the thumb and first digit B) States his forearm feels funny (paresthesia) C) Loss of tendon reflexes on the affected extremity D) Precision grip weakness in the affected hand E) Pain interferes with sleeping

A) Describes numbness/tingling in the thumb and first digit D) Precision grip weakness in the affected hand E) Pain interferes with sleeping

Which of the following interventions would be considered a nonpharmacologic method of pain control? Select all that apply. A) Distraction by knitting B) Guided imagery C) Biofeedback D) OTC acetaminophen

A) Distraction by knitting B) Guided imagery C) Biofeedback

A client's recent diagnosis of Parkinson disease has prompted his care provider to promptly begin pharmacologic therapy. The drugs that are selected will likely influence the client's levels of: A) Dopamine B) Acetylcholine C) Serotonin D) Adenosine

A) Dopamine

23. The health care provider for a client with degenerative Alzheimer-type dementia recognizes the client has moved from the initial stage to the moderate stage based on which of the following clinical manifestations? Select all that apply. A) Extreme confusion and disorientation B) Incontinence of urine and bowel C) Need for direct supervision for ADLs D) Social withdrawal from all family and friends E) Inability to problem solve simple tasks

A) Extreme confusion and disorientation C) Need for direct supervision for ADLs E) Inability to problem solve simple tasks

A sudden traumatic complete transection of the spinal cord results in what type of injury below the site? A) Flaccid paralysis B) Vasoconstriction C) Deep visceral pain D) 3+ tendon reflexes

A) Flaccid paralysis

While explaining the somatosensory cortex to a group of nursing students, the instructor asks, "What is involved in the final processing of somatosensory information?" The correct response includes: Select all that apply. A) Full localization B) Autonomic nervous system C) Discrimination of intensity D) Interpretation of somatosensory stimuli E) Pacinian corpuscle receptors

A) Full localization C) Discrimination of intensity D) Interpretation of somatosensory stimuli

8. A high school senior sustained a concussion during a football game. Which of the following signs and symptoms would indicate the presence of postconcussion syndrome in the days and weeks following his injury? A) Headaches and memory lapses B) Recurrent nosebleeds and hypersomnia C) Unilateral weakness and decreased coordination D) Neck pain and decreased neck range of motion

A) Headaches and memory lapses

A clinician is assessing the muscle tone of a client who has been diagnosed with a lower motor neuron (LMN) lesion. Which of the following assessment findings is congruent with the client's diagnosis? A) Hypotonia B) Spasticity C) Tetany D) Rigidity

A) Hypotonia

7. Following a head injury, a client is diagnosed with a possible intracranial epidural hematoma. During the initial assessment, the client suddenly becomes unconscious. Other clinical manifestations that correlate with this diagnosis may include: A) Ipsilateral pupil dilation B) Ipsilateral hemiparesis C) Diffuse venous bleeding from the nose D) Increased head circumference with hydrocephalus

A) Ipsilateral pupil dilation

The somatosensory system consists of three types of sensory neurons. The special somatic type of afferent sensory neurons has receptors that sense: A) Muscle position B) Visceral fullness C) Temperature D) Painful touch

A) Muscle position

Which of the following peripheral nerve injuries will likely result in cellular death with little chance of regeneration? A) Nerve fibers destroyed close to the neuronal cell body B) Crushing injury where the nerve is traumatized but not severed C) Cutting injury where slow-regeneration axonal branches are located D) Incomplete amputation where tubular implants are used to fill in the gaps of nerves

A) Nerve fibers destroyed close to the neuronal cell body

Disorders of the pyramidal tracts, such as a stroke, are characterized by: A) Paralysis B) Hypotonia C) Muscle rigidity D) Involuntary movements

A) Paralysis

What pain theory proposes that pain receptors share pathways with other sensory modalities and that different activity patterns of the same neurons can be used to signal painful or nonpainful stimuli? A) Pattern B) Specificity C) Gate control D) Neuromatrix

A) Pattern

More complex patterns of movements, such as throwing a ball or picking up a fork, are controlled by which portion of the frontal lobe? A) Premotor cortex B) Primary motor cortex C) Reflexive circuitry D) Supplementary motor cortex

A) Premotor cortex

Following his annual influenza vaccination, a client begins to feel achy, like he has developed the flu. An hour later, the client is rushed to the emergency department. Diagnosis of Guillain-Barré syndrome was made based on which of the following assessment findings? Select all that apply. A) Rapid deterioration of respiratory status B) Lack of any physical pain C) Flaccid paralysis of limbs D) BP 90/62 E) Pale, cool, dry skin

A) Rapid deterioration of respiratory status C) Flaccid paralysis of limbs D) BP 90/62

A family brings their father to his primary care physician for a checkup. Since their last visit, they note their dad has developed a tremor in his hands and feet. He also rolls his fingers like he has a marble in his hand. The primary physician suspects the onset of Parkinson disease when he notes which of the following abnormalities in the client's gait? A) Slow to start walking and has difficulty when asked to "stop" suddenly B) Difficulty putting weight on soles of feet and tends to walk on tiptoes C) Hyperactive leg motions like he just can't stand still D) Takes large, exaggerated strides and swings arms/hands wildly

A) Slow to start walking and has difficulty when asked to "stop" suddenly

Following an automobile accident that resulted in a traumatic amputation of the right lower leg, the client complains of feeling tingling, heaviness, and shooting pain in the amputated limb. The health care providers treat phantom limb pain by which of the following interventions? Select all that apply. A) TENS of the large myelinated afferents innervating the area B) Hypnosis C) Relaxation techniques D) Warm, moist compresses E) Use of mirrors to visualize the limb is no longer there

A) TENS of the large myelinated afferents innervating the area B) Hypnosis C) Relaxation techniques

During physiology class, the instructor asks students to explain the pathology behind development of multiple sclerosis. Which student gave the most accurate description? A) The demyelination and subsequent degeneration of nerve fibers and decreased oligodendrocytes, which interfere with nerve conduction B) Muscle necrosis with resultant increase in fat/connective tissue replacing the muscle fibers C) Atherosclerotic destruction of circulation to the brain resulting in lactic acid buildup that affects nerve transmission D) Autoimmune disease where antibody loss of acetylcholine receptors at the neuromuscular junction causes decrease motor response

A) The demyelination and subsequent degeneration of nerve fibers and decreased oligodendrocytes, which interfere with nerve conduction

15. A client has been diagnosed with a cerebral aneurysm and placed under close observation before treatment commences. Which of the following pathophysiologic conditions has contributed to this client's diagnosis? A) Weakness in the muscular wall of an artery B) Impaired synthesis of clotting factors C) Deficits in the autonomic control of blood pressure D) Increased levels of cerebrospinal fluid

A) Weakness in the muscular wall of an artery

Unlike disorders of the motor cortex and corticospinal (pyramidal) tract, lesions of the basal ganglia disrupt movement: A) Without causing paralysis B) Posture and muscle tone C) And cortical responses D) Of upper motor neurons

A) Without causing paralysis

12. A high school senior sustained a concussion during a football game. Which of the following signs and symptoms would indicate the presence of postconcussion syndrome in the days and weeks following his injury?

A) Headaches and memory lapses

11. A clinician is assessing the muscle tone of a patient who has been diagnosed with a lower motor neuron (LMN) lesion. Which of the following assessment findings is congruent with the patient's diagnosis?

A) Hypotonia

20. Which of the following statements by the husband of a patient with Alzheimer disease demonstrates an accurate understanding of his wife's medication regimen?

A) I'm really hoping these medications will slow down her mental losses.

15. A patient has been diagnosed with a cerebral aneurysm and placed under close observation before treatment commences. Which of the following pathophysiologic conditions has contributed to this patient's diagnosis?

A) Weakness in the muscular wall of an artery

20. A patient with a spinal cord injury at T8 would likely retain normal motor and somatosensory function of her:

A) arms.

10. The moderate stage of the progressive degenerative Alzheimer-type dementia is manifested by behaviors that include:

A) confusion.

A client presents to the emergency department complaining of loss of part of his vision. An MRI with contrast reveals multiple aneurysms of the circle of Willis. The client is diagnosed with "bitemporal heteronymous anopia." For this client, what effect will this have on his vision?

A)With both eyes open, the client has full binocular visual field

51. Clients with chronic autoimmune hepatitis may display which of the following clinical manifestations upon physical exam? Select all that apply. A) Enlarged liver B) Jaundice C) Bacterial meningitis D) Nuchal rigidity E) Edematous joints

A,B

28. The client chews an apple and starts the swallowing process. As the food bolus enters the back of the mouth and swallowing is initiated, the nurse knows that the client's motor impulses are being carried out by which of the following cranial nerves? Select all that apply. A) Trigeminal (V) B) Vagus (X) C) Hypoglossal (XII) D) Abducent (VI)

A,B,C

58. An ultrasound (US) of a client with intermittent pain reveals gallbladder sludge. Which of the following client history items are likely factors in the US result? Select all that apply. A) Had lap band surgery 2 years ago and lost 100 pounds B) Recent pregnancy with a 6-month-old child at home C) Current prescription for a medicine to lower cholesterol D) A runner training for a marathon E) Works in surgery with long periods of standing in one place

A,B,C

43. Which of the following signs/symptoms would lead the nurse to suspect the post-op client has developed a mechanical bowel obstruction? Select all that apply. A) Sluggish to absent bowel sounds B) Increase in abdominal distention C) Nausea and vomiting D) Rectal bleeding E) Continuous abdominal pain

A,B,C,E

40. The ulcerative colitis client should be assessed by the health care provider for which of the following clinical manifestations? Select all that apply. A) Persistent diarrhea B) Steatorrhea C) Stool containing blood (hematochezia) D) External hemorrhoids E) Prolapsed colon

A,C

50. A client with hepatitis B asks the nurse, "How did I get this hepatitis?" The nurse responds that the mode of transmission is predominantly by: Select all that apply. A) Intravenous drug use B) Fecal-oral route C) Unprotected sexual intercourse D) Sharing oral secretions by kissing E) Inhalation of airborne droplets

A,C

53. A client is admitted with late manifestations of cirrhosis. Which of the following clinical manifestations confirm this diagnosis? Select all that apply. A) Hepatomegaly felt on deep palpation B) Diffuse liver fibrosis with large, palpable lumps C) GI bleeding related to esophageal varices D) Acute renal failure with electrolyte imbalances E) Splenomegaly with bleeding tendencies

A,C,E

39. While assessing a client diagnosed with inflammatory bowel diseases, the nurse should assess for systemic manifestations that may include: Select all that apply. A) Autoimmune anemia B) Rheumatoid arthritis C) Thrombocytopenia D) Lactose intolerance E) Mouth ulcerations

A,D

47. A newborn is admitted to the hospital with a high bilirubin level of 13 mg/dL. The assessment data related to this lab value includes: Select all that apply. A) Yellowish discoloration of the skin B) Colicky, intermittent pain associated with formula feeding C) Xanthomas D) Yellowing of the sclera of the eye E) Dark-colored urine

A,D,E

49. A client has been diagnosed with cholestasis and is experiencing pruritus. The nurse caring for this client should be educating the client about reduced bile flow that will interfere with intestinal absorption of which of the following vitamins? Select all that apply. A) Vitamin A B) Vitamin B C) Vitamin C D) Vitamin D E) Vitamin K

A,D,E

Which of the following factors may adversely affect bone healing and therefore place the client at risk for long-term problems? Select all that apply.

A. Delayed union at the fracture site within a period considered the normal healing time C. History of uncontrolled diabetes mellitus with associated circulatory problems

A clinic nurse plans care for a newly diagnosed osteoarthritis client. Which of the following items should this client be provided with educational materials? Select all that apply.

A. How to use a cane or walker if hip/knees joints are involved C. Splints to protect and rest the involved joint D. Use of heat and cold when appropriate for muscle spasms and pain

A client presents to a health clinic complaining of several vague symptoms. As the history/physical continues, the health care provider clearly thinks the client may have myasthenia gravis. Which statements by the client would correlate with this diagnosis? Select all that apply. A. "Sometimes I have double vision." B. "I have more energy in the morning but get worse as the day goes by." C. "Sometimes I have numbness/tingling on my face." D. "I had what felt like an electric shock race down the back of my leg when I bend my neck." E. "I feel like I don't have enough energy to chew my food sometimes."

A. "Sometimes I have double vision." B. "I have more energy in the morning but get worse as the day goes by." E. "I feel like I don't have enough energy to chew my food sometimes."

A teenager has been in a car accident and experienced acceleration-deceleration head injury. Initially, the client was stable but then started to develop neurological signs/symptoms. The nurse caring for this client should be assessing for which type of possible complication? A. Brain contusions and hematomas B. TIAs and cerebrovascular infarction C. Momentary unconsciousness D. Status epilepticus

A. Brain contusions and hematomas

A traumatic brain injury client has developed extreme cerebral edema. The nurse is monitoring the client closely for signs of brain herniation. Which clinical manifestations would correlate to upward herniation of the midbrain from the infratentorial compartment? Select all that apply. A. Deep coma B. Rhythmic movement of arms and legs C. Respiratory rate of 8 with intermittent sighs D. Intracranial bleeding from nose and ears E. Bilateral small, fixed pupils

A. Deep coma C. Respiratory rate of 8 with intermittent sighs E. Bilateral small, fixed pupils

Which of the following interventions would be considered a nonpharmacologic method of pain control? Select all that apply. A. Distraction by knitting B. Guided imagery C. Biofeedback D. OTC acetaminophen

A. Distraction by knitting B. Guided imagery C. Biofeedback

A client's recent diagnosis of Parkinson disease has prompted his care provider to promptly begin pharmacologic therapy. The drugs that are selected will likely influence the client's levels of: A. Dopamine B. Acetylcholine C. Serotonin D. Adenosine

A. Dopamine

While explaining the somatosensory cortex to a group of nursing students, the instructor asks, "What is involved in the final processing of somatosensory information?" The correct response includes: Select all that apply. A. Full localization B. Autonomic nervous system C. Discrimination of intensity D. Interpretation of somatosensory stimuli E. Pacinian corpuscle receptors

A. Full localization C. Discrimination of intensity D. Interpretation of somatosensory stimuli

Disorders of the pyramidal tracts, such as a stroke, are characterized by: A. Paralysis B. Hypotonia C. Muscle rigidity D. Involuntary movements

A. Paralysis

Which of the following signs and symptoms is most indicative of Meniere disease

A. Rotary vertigo and tinnitus

When a person is stung on the index finger by a bee, the thalamus interprets the pain as: A. Somewhere on the hand B. A spot on the index finger C. Attributable to a bee stung D. Similar to a previous bee sting

A. Somewhere on the hand

When lecturing about heart attacks (myocardial infarctions), the instructor will emphasize the client may present with: Select all that apply. A. Substernal chest pain B. Neck pain C. Umbilicus pain D. Deep, right-sided abdominal pain E. Pain that radiates to the left arm

A. Substernal chest pain B. Neck pain E. Pain that radiates to the left arm

Which of the following physiologic principles would be considered a function of the somatic nervous system? A. The act of typing a report using a computer keyboard B. Withdrawing the hand after touching a hot surface C. The patellar reflex "knee jerk" activated by tapping the patellar tendon abdominal viscera D. The beginning of depolarization in the cardiac conduction of impulses

A. The act of typing a report using a computer keyboard

Which of the following clients are at risk for developing osteomalacia? Select all that apply.

A: A person who lives in a colder region of the northwest who doesn't get out much during the winter months for fear of falling C. A female client whose father had a genetic predisposition to primary hyperparathyroidism resulting in increased calcium resorption from the bone E. An elderly female who "can't stand to drink milk" and refuses calcium supplements since she has a history of kidney stones

After numerous trips to the physician's office, a client is diagnosed with diffuse scleroderma based on which of the following clinical manifestations? Select all that apply.

A: difficulty swallowing resulting in weight loss due to malabsorption B: hands turn bluish pruple when getting items out of the freezer E: spider veins on the face and chest

Which of the following lab results may be associated with metastatic bone disease? Select all that apply.

A: high serum calcium levels B: elevated alkaline phosphatase

A client works as a data entry worker for a large company. The client goes to employee health with pain in the wrist/hand. The nurse suspects that it is carpal tunnel syndrome based on which of the following assessment findings? Select all that apply.

A: precision grip weakness in the affected hand C: describes numbness/tingling in the thumb and first digit E: pain interferes with sleeping

A traumatic brain injury client has developed extreme cerebral edema. The nurse is monitoring the client closely for signs of brain herniation. Which clinical manifestations would correlate to upward herniation of the midbrain from the infratentorial compartment? Select all that apply.

A: respiratory rate of 8 with intermittent sighs C: deep coma D: bilateral small, fixed pupils

A health care provider suspects a female client (who has had vague complaints over the past several months) may be developing systemic lupus erythematosus (SLE). Which clinical manifestations would correlate with this diagnosis? Select all that apply.

A: tendon rupture C: chest pain that increases with each deep breath E: arthralgia

seizures

Abnormal behavior caused by an electrical discharge from neurons in the cerebral cortex. signs and symptoms that vary according to the site of neuronal discharge in the brain Manifestations generally include sensory, motor, autonomic, or psychic phenomenon Proposed Causes: genetic mutations Alterations in cell membrane permeability or distribution of ions across the neuronal cell membranes. Decreased inhibition of cortical or thalamic neuronal Neurotransmitter imbalances such as acetylcholine excess

The nurse is caring for a client admitted to the emergency room with suspected meningitis. The nurse prepares to perform which nursing intervention upon physician orders, while diagnostic testing is being completed?

Administration of antibiotics

risk factors and deficits of stroke

Age, sex, race, Family history HTN, Smoking, DM, a-fib, Asymptomatic carotid stenosis Sickle cell disease, Hyperlipidemia Motor deficits are the most common followed by language, sensation and cognition Dysarthria and Aphasia

An otherwise-healthy patient has been referred to a pain clinic because she claims to experience exquisite pain from the friction of her clothes on her torso. This patient is likely to be diagnosed with which of the following health problems

Allodynia

Global and focal brain injuries manifest differently. What is almost always a manifestation of a global brain injury?

Altered level of consciousness

For seizure disorders that do not respond to anticonvulsant medications, the option for surgical treatment exists. What is removed in the most common surgery for seizure disorders?

Amygdala

The nurse is caring for a client with a brain tumor when the client begins to vomit. Which intervention should the nurse do first?

Assess for other signs/symptoms of increased intracranial pressure.

A nurse is teaching a client newly diagnosed with a seizure disorder. Which statement is most important for the nurse to provide regarding antiepileptic medications?

Antiepileptic medications should never be discontinued abruptly

A nurse is teaching a client newly diagnosed with a seizure disorder. Which statement is most important for the nurse to provide regarding their antiepileptic medications?

Antiepileptic medications should never be discontinued abruptly.

What medication teaching should be done for a woman of childbearing age with a seizure disorder?

Antiseizure drugs increase the risk for congenital abnormalities.

A client with a spinal cord injury at T8 would likely retain normal motor and somatosensory function of her

Arms

A family brings their elderly mom to the emergency department. The client had a short period of time where she was confused, had slurred speech and appeared to have a weak arm. Now she is back to her normal self. Suspecting a transient ischemic attacks (TIAs), the health care provider will order diagnostic testing looking for:

Atherosclerotic lesions in cerebral vessels

An older adult is brought to the emergency department after experiencing some confusion, slurred speech, and a weak arm. Now the client is back to acting normally. Suspecting a transient ischemic attack (TIA), the health care provider prescribes diagnostic testing looking for which cause of this episode?

Atherosclerotic lesions in cerebral vessels

12. An elderly client has been brought to his primary care provider by his wife, who is concerned about his recent decrease in coordination. Upon assessment, his primary care provider notes that the client's gait is wide-based, unsteady, and lacking in fluidity, although his muscle tone appears normal. This client requires further assessment for which of the following health problems? A) Muscle atrophy B) Cerebellar disorders C) Impaired spinal reflexes D) Lower motor neuron lesions

B

2. A woman has cut her finger while dicing onions in the kitchen, causing her to drop her knife in pain. Which of the following components of this pain signal was transmitted by a third-order neuron? The neurons: A) Between the woman's finger and her spinal cord B) Between the thalamus and the cortex C) Between the CNS and the thalamus D) Of the efferent pathway that causes muscle contraction

B

29. In the stomach, chyme is churned by peristalsis into the antrum, which contracts, reverses the flow, and allows more churning. Because the pylorus is contracted during antral contraction, gastric content empties into the duodenum: A) During bile secretion B) Between contractions C) During opening of the pyloric sphincter D) Under gaseous pressure

B

3. While playing outside in the snow, a young child complained of painful fingertips since he would not keep his gloves on. In the emergency department, the nurse knows this painful sensation is a result of which transmission of proprioceptive somatosensory information? A) Reflexive networks B) Type C dorsal root ganglion neurons C) Anterolateral pathway D) Myelinated type B trigeminal sensory neurons

B

35. A teenager who has a history of achalasia will likely complain of which of the following clinical manifestations? A) Excessive heartburn following a high-fat meal of French fries B) Feeling like there is food stuck in the back of the throat C) Projectile vomiting across the room unrelated to meals D) Vomiting large amounts of bright red emesis

B

5. Nociceptors are sensory receptors that are activated by: A) Cortisol B) Noxious stimuli C) Pressure and touch D) Sudden movements

B

52. A client is suspected of having the onset of alcoholic liver disease. The nurse should be assessing for which of the following manifestations related to the necrosis of liver cells? A) Tremors of the hands B) Rapid onset of jaundice C) Long muscle group atrophy D) Development of multiple skin nodules

B

54. Both prehepatic and posthepatic causes of portal hypertension include the formation of: A) Fibrous nodules B) Venous thrombosis C) Collateral circulation D) Portosystemic shunts

B

9. A client with trigeminal neuralgia usually complains of excruciating pain. Which of the following activities may trigger an acute pain attack? Select all that may apply. A) Brushing the teeth with lukewarm water B) Working in the office that has an air duct located directly overhead C) One's significant other lightly stroking their face D) Applying lipstick E) Walking outside on a windy day

B,C,E

While lecturing to a group of physiology students, the instructor asks, "What metabolic factors cause vasodilation of cerebral vessels thereby increasing cerebral blood flow to the brain?" The student with the best response would be: A. Increased oxygen saturation B. Increased carbon dioxide level C. Decreased serum sodium level D. Decreased hydrogen ion concentration

B. Increased carbon dioxide level

A client with chronic low back pain presents to the clinic. In addition to a detailed pain assessment, which of the following questions would be appropriate to ask? Select all that apply. A) "Do you have trouble making water?" B) "Can you financially afford your medicine?" C) "What kind of stressors are you experiencing?" D) "Do you consider yourself a good driver?" E) "Are you having trouble sleeping?"

B) "Can you financially afford your medicine?" C) "What kind of stressors are you experiencing?" E) "Are you having trouble sleeping?"

Which of the following clients may be experiencing the effects of neuropathic pain? A) A girl whose playground accident resulted in an arm fracture B) A man with pain secondary to his poorly controlled diabetes C) An elderly woman with a stage III pressure ulcer D) A man whose pain is caused by gastric cancer

B) A man with pain secondary to his poorly controlled diabetes

A woman has cut her finger while dicing onions in the kitchen, causing her to drop her knife in pain. Which of the following components of this pain signal was transmitted by a third-order neuron? The neurons: A) Between the woman's finger and her spinal cord B) Between the thalamus and the cortex C) Between the CNS and the thalamus D) Of the efferent pathway that causes muscle contraction

B) Between the thalamus and the cortex

The nurse is caring for a spinal cord injury client. Assessment reveals shallow breath sounds with a very weak cough effort. The nurse correlates this with which level of injury on the spinal column? A) C2 B) C5 C) T1 D) T10

B) C5

An elderly client has been brought to his primary care provider by his wife, who is concerned about his recent decrease in coordination. Upon assessment, his primary care provider notes that the client's gait is wide-based, unsteady, and lacking in fluidity, although his muscle tone appears normal. This client requires further assessment for which of the following health problems? A) Muscle atrophy B) Cerebellar disorders C) Impaired spinal reflexes D) Lower motor neuron lesions

B) Cerebellar disorders

A client who has had a spinal injury now has sensory changes on the distal forearm and fourth and fifth fingers. The nurse can predict that this client has experienced an injury to the: Select all that apply. A) Cervical (C) 7 B) Cervical (C) 8 C) Thoracic (T) 1 dorsal root D) Thoracic (T) 2 dorsal root

B) Cervical (C) 8 C) Thoracic (T) 1 dorsal root

Stretch-sensitive receptors in the skin (Ruffini end organs, Pacinian corpuscles, and Merkel cells) help signal postural information and are processed through the: A) Third-order neurons B) Dorsal column-medial lemniscus pathway C) Anterolateral pathway D) Posterior column of the spinal cord

B) Dorsal column-medial lemniscus pathway

Which of the following principles should underlie the pain control strategy in the care of a child with a diagnosis of cancer? A) Opioids should be avoided in order to prevent liver and kidney insult. B) Dosing and timing should aim for a steady serum level of the prescribed drug. C) Doses of analgesia should be given only when the client's pain becomes severe. D) Drugs from numerous classifications should be used to maximize pain control.

B) Dosing and timing should aim for a steady serum level of the prescribed drug

10. While lecturing to a group of physiology students, the instructor asks, "What metabolic factors cause vasodilation of cerebral vessels thereby increasing cerebral blood flow to the brain?" The student with the best response would be: A) Increased oxygen saturation B) Increased carbon dioxide level C) Decreased serum sodium level D) Decreased hydrogen ion concentration

B) Increased carbon dioxide level

Nociceptors are sensory receptors that are activated by: A) Cortisol B) Noxious stimuli C) Pressure and touch D) Sudden movements

B) Noxious stimuli

17. Common manifestations of acute meningococcal meningitis, a highly contagious and lethal form of meningitis, include: A) Diplopia B) Petechiae C) Papilledema D) Focal paralysis

B) Petechiae

5. A client's recent computed tomography (CT) scan has revealed the presence of hydrocephalus. Which of the following treatment measures is most likely to resolve this health problem? A) Aggressive diuresis B) Placement of a shunt C) Administration of hypertonic intravenous solution D) Lumbar puncture

B) Placement of a shunt

A client with laryngeal dystonia has gotten to the point that people on the telephone cannot understand her. She has heard about getting Botox injections into her vocal cords. The nurse will teach about the actions of Botox. Which is the most accurate description? This drug: A) Will slow the decline in muscle strength and function B) Produces paralysis of the larynx muscles by blocking acetylcholine release C) Prevents the depolarizing effect of the neurotransmitters D) Inhibits the peripheral metabolism of dopamine

B) Produces paralysis of the larynx muscles by blocking acetylcholine release

While playing outside in the snow, a young child complained of painful fingertips since he would not keep his gloves on. In the emergency department, the nurse knows this painful sensation is a result of which transmission of proprioceptive somatosensory information? A) Reflexive networks B) Type C dorsal root ganglion neurons C) Anterolateral pathway D) Myelinated type B trigeminal sensory neurons

B) Type C dorsal root ganglion neurons

A client with trigeminal neuralgia usually complains of excruciating pain. Which of the following activities may trigger an acute pain attack? Select all that may apply. A) Brushing the teeth with lukewarm water B) Working in the office that has an air duct located directly overhead C) One's significant other lightly stroking their face D) Applying lipstick E) Walking outside on a windy day

B) Working in the office that has an air duct located directly overhead C) One's significant other lightly stroking their face E) Walking outside on a windy day

12. An elderly patient has been brought to his primary care provider by his wife who is concerned about his recent decrease in coordination. Upon assessment, his primary care provider notes that the patient's gait is wide-based, unsteady, and lacking in fluidity, although his muscle tone appears normal. This patient requires further assessment for which of the following health problems?

B) Cerebellar disorders

15. Which of the following disorders of neuromuscular function typically has the most rapid onset?

B) Guillain-Barré syndrome

19. Restoration of the integrity of myelin sheaths would likely result in a slowing or stopping of the progression of:

B) Multiple sclerosis (MS)

11. A patient's recent computed tomography (CT) scan has revealed the presence of hydrocephalus. Which of the following treatment measures is most likely to resolve this health problem?

B) Placement of a shunt

5. The cardinal symptoms of Parkinson disease include:

B) bradykinesia.

7. Metabolic factors that increase cerebral blood flow include:

B) increased carbon dioxide level.

9. Common manifestations of acute meningococcal meningitis, a highly contagious and lethal form of meningitis, include:

B) petechiae.

4. A client who has had a spinal injury now has sensory changes on the distal forearm and fourth and fifth fingers. The nurse can predict that this client has experienced an injury to the: Select all that apply. A) Cervical (C) 7 B) Cervical (C) 8 C) Thoracic (T) 1 dorsal root D) Thoracic (T) 2 dorsal root

B,C

6. A client with chronic low back pain presents to the clinic. In addition to a detailed pain assessment, which of the following questions would be appropriate to ask? Select all that apply. A) "Do you have trouble making water?" B) "Can you financially afford your medicine?" C) "What kind of stressors are you experiencing?" D) "Do you consider yourself a good driver?" E) "Are you having trouble sleeping?"

B,C,E

Neurotrophic factors contribute to the maintenance of homeostasis by promoting the growth and survival of neurons. Which of the following clients may be experiencing an alteration in neurotrophin levels? Select all that apply. A. A 92-year-old who fell and fractured the hip getting out of a shower B. A 55-year-old who is exhibiting clinical manifestations of early-onset Alzheimer disease C. A 38-year-old recently diagnosed with multiple sclerosis following initial complaint of vision loss as he was driving to work D. A 44-year-old with a family history of Huntington disease who is exhibiting jerky, uncontrollable movements

B. A 55-year-old who is exhibiting clinical manifestations of early-onset Alzheimer disease D. A 44-year-old with a family history of Huntington disease who is exhibiting jerky, uncontrollable movements

A woman has cut her finger while dicing onions in the kitchen, causing her to drop her knife in pain. Which of the following components of this pain signal was transmitted by a third-order neuron? The neurons: A. Between the woman's finger and her spinal cord B. Between the thalamus and the cortex C. Between the CNS and the thalamus D. Of the efferent pathway that causes muscle contraction

B. Between the thalamus and the cortex

The pathophysiologic effects of spina bifida are due to: A. Malformation of the brain and spinal column causing spinal fluid to pool at the base of the spine B. Failure of one or more neural arches to close within the vertebral column of the neural tube C. Cystic lesions growing into the dorsal root ganglia D. Hypertrophy of the primary vesicles, which eventually causes the excess fluid to bulge in weakened structures

B. Failure of one or more neural arches to close within the vertebral column of the neural tube

A client has been brought to the emergency department following an overdose of insulin that resulted in unconsciousness. When explaining the rationale for this to the family, the nurse will emphasize that neurons: A. Store glycogen within the brain cavity B. Must rely on glucose from the blood to meet their energy needs C. Require many amino acids in order to produce enough energy to function properly D. Can cause the liver to convert triglycerides into energy if needed quickly

B. Must rely on glucose from the blood to meet their energy needs

Nociceptors are sensory receptors that are activated by: A. Cortisol B. Noxious stimuli C. Pressure and touch D. Sudden movements

B. Noxious stimuli

A client's recent computed tomography (CT) scan has revealed the presence of hydrocephalus. Which of the following treatment measures is most likely to resolve this health problem? A. Aggressive diuresis B. Placement of a shunt C. Administration of hypertonic D. intravenous solution E. Lumbar puncture

B. Placement of a shunt

A client with laryngeal dystonia has gotten to the point that people on the telephone cannot understand her. She has heard about getting Botox injections into her vocal cords. The nurse will teach about the actions of Botox. Which is the most accurate description? This drug: A. Will slow the decline in muscle strength and function B. Produces paralysis of the larynx muscles by blocking acetylcholine release C. Prevents the depolarizing effect of the neurotransmitters D. Inhibits the peripheral metabolism of dopamine

B. Produces paralysis of the larynx muscles by blocking acetylcholine release

A client presents to a health clinic complaining of several vague symptoms. As the history/physical continues, the health care provider clearly thinks the client may have myasthenia gravis. Which statements by the client would correlate with this diagnosis? Select all that apply.

B: "I have more energy in the morning but get worse as the day goes by" C: "Sometimes I have double vision" E: "I feel like I don't have enough energy to chew my food sometimes"

The health care provider for a client with degenerative Alzheimer-type dementia recognizes the client has moved from the initial stage to the moderate stage based on which of the following clinical manifestations? Select all that apply.

B: extreme confusion and disorientation C: need for direct supervision for ADLs D: social withdrawal from all family and friends E: inability to problem solve simple tasks

Following his annual influenza vaccination, a client begins to feel achy, like he has developed the flu. An hour later, the client is rushed to the emergency department. Diagnosis of Guillain-Barré syndrome was made based on which of the following assessment findings? Select all that apply.

B: flaccid paralysis of limbs C: BP 90/62 E: rapid deterioration of respiratory status

A 16 year old boy present to the office with complaints of low back pain after lifting heavy boxes. In discussing with him proper body mechanics to prevent future injuries, the clinician should advise which of the following? • Hold boxes away from your body at arm's length • Bend your knees and face the object straight on • Keep your feet firmly together • Bend and twist simultaneously as you twist

Bend your knees and face the object straight on

aneuysmal subarachnoid hemorrhage

Bleeding into the subarachnoid space Causes: Congenital defect Acute increases in ICP Cigarette smoking Hypertension Excessive alcohol intake

A teenager has been in a car accident and experienced an acceleration-deceleration head injury. Initially, the client was stable but then started to develop neurological signs/symptoms. The nurse caring for this client should be assessing for which type of possible complication?

Brain contusions and hematomas

A client has sustained a severe, diffuse brain injury that resulted in seriously compromised brain function. The client is at greatest risk for:

Brain death

Manifestations of brain tumors are focal disturbances in brain function and increased ICP. What causes the focal disturbances manifested by brain tumors?

Brain edema and disturbances in blood flow

Which area of the brain is responsible for respiration?

Brain stem

When the suspected diagnosis is bacterial meningitis, what assessment techniques can assist in determining if meningeal irritation is present?

Brudzinski sign and Kernig sign

A soccer player has been diagnosed with a brain contusion after being injured in a game. The best explanation of the injury by the nurse would be:

Bruising on the surface of the brain occurred.

Neurotoxins such as the botulism organism can produce paralysis by what mechanism?

By blocking release of acetylcholine

infections of the CNS

By structure Meninges: meningitis Brain parenchyma: encephalitis Spinal cord, myelitis Brain and spinal cord: encephalomyelitis By type of invading organism: Bacterial, viral, or other

16. A client is devastated to receive a diagnosis of amyotrophic lateral sclerosis (ALS). The symptomatology of this disease is a result of its effects on upper and lower motor neurons. The health care provider caring for this client will focus on which priority intervention for this client? A) Ability to turn from side to side, thereby preventing skin breakdown B) Ability to empty bladder completely, thereby preventing autonomic dysreflexia C) Respiratory ventilation assessment and prevention of aspiration pneumonia D) Assessment of lower extremities to prevent deep vein thrombosis

C

20. During accommodation, pupillary dilation partially compensates for the reduced size of the retinal image by: A) Thickening the lens B) Contracting the ciliary muscle C) Increasing light entering the pupil D) Narrowing the palpebral opening

C

25. A client has been diagnosed with an incompetent pyloric sphincter. This client is experiencing a lot of abdominal pain and nausea. When this client vomits, the nurse should expect what type of secretions will be in the basin? A) Green, stringy emesis B) Bright red, bloody emesis C) Thick, brownish, foul-smelling emesis D) Clear mucous-looking emesis

C

26. A client who has had his gallbladder (GB) removed asks the nurse, "Why do I feel sick every time I go through a drive-in fast-food restaurant and order burgers and fries?" The nurse bases the response knowing that: A) The restaurant may have "bad" grease in their fryer. B) Without a GB, the size of the client's stomach has been decreased. C) Bile from the GB is needed to breakdown lipids. D) When the GB is removed, the pancreatic duct is also removed.

C

31. When discussing digestion with a group of nursing students, the instructor asks, "Where does the digestion of our food begin?" The most accurate student response would be A) The stomach with its hydrochloric acid production B) The duodenum with common bile duct secretions C) The mouth with ptyalin and amylase breaking down starches D) The jejunum, where peristaltic waves begin

C

33. When explaining absorption to a client, the nurse mentions that a number of substances require a specific carrier or transport system. An example the nurse could use relates to the transport of amino acids and glucose, which requires the presence of which of the following for absorption to occur? A) Potassium B) Phosphate C) Sodium D) Calcium

C

46. The role Kupffer cells play in removing harmful substances or cells from the portal blood as it moves through the venous sinusoids is known as: A) Filters B) Channels C) Phagocytes D) Cytotoxic cells

C

55. A client presents to the emergency department vomiting large amounts of bright red blood. The client has a history of alcohol abuse, and the physician suspects esophageal varices. The drug that is used to reduce splanchnic and hepatic blood flow and portal pressures is: A) Propranolol, a β-adrenergic blocking agent B) Lisinopril, an ACE inhibitor C) Ocetrotide, a long-acting synthetic analog of somatostatin D) Famotidine, a histamine-2 blocker to decrease stomach acid

C

56. A major factor in the development of hepatic encephalopathy is: A) Hypersplenism B) High sodium level C) Neurotoxin accumulation D) Steroid hormone deficiency

C

59. Which of the following factors is most strongly associated with the pathogenesis of gallstones? A) Excess serum ammonia and urea levels B) Portal hypertension C) Abnormalities or stasis of bile D) High-cholesterol diet

C

61. The client has right upper quadrant pain caused by acute choledocholithiasis. The health care provider suspects the common bile duct is obstructed, based on which of the flowing lab values? A) Albumin 2.0 g/dL (low) B) Amylase 150 unites/L (high) C) Bilirubin 15 mg/dL (high) D) Serum calcium level 7 mg/dL (low)

C

8. An otherwise healthy client has been referred to a pain clinic because she claims to experience exquisite pain from the friction of her clothes on her torso. This client is likely to be diagnosed with which of the following health problems? A) Visceral pain B) Hypoalgesia C) Allodynia D) Primary hyperalgesia

C

An elderly patient has been brought to his primary care provider by his wife who is concerned about his recent decrease in coordination. Upon assessment, his primary care provider notes that the patient's gait is wide-based, unsteady, and lacking in fluidity, although his muscle tone appears normal. This patient requires further assessment for which of the following health problems?

Cerebellar disorders

18. A family brings a client to the emergency department with increasing lethargy and disorientation. They think the client had a seizure on the drive over to the hospital. The client has been sick with a "cold virus" for the last few days. On admission, the clients' temperature is 102°F. Which other clinical manifestations may lead to the diagnosis of encephalitis? A) Petechia over entire body B) BP 100/72 C) Impaired neck flexion resulting from muscle spasm D) Appearance of red-purple discolorations on the skin that do not blanch on applying pressure

C) Impaired neck flexion resulting from muscle spasm

Among the treatments for multiple sclerosis (MS), which medication will reduce the exacerbation of relapsing-remitting MS? A) Long-term corticosteroid administration B) Mitoxantrone, an antineoplastic agent C) Interferon-β, a cytokine injection D) Baclofen, a muscle relaxer

C) Interferon-β, a cytokine injection

A 44-year-old woman has sought care for the treatment of headaches that have been increasing in severity and frequency and has been subsequently diagnosed with migraines. Which of the following teaching points should her care provider emphasize? A) "Weight loss and exercise are very important components of your treatment." B) "Stopping all of your current medications, even temporarily, should provide some relief." C) "It would be helpful for you to take control of your diet, sleep schedule, and stress levels." D) "Your headaches are likely a result of a nerve disorder and, unfortunately, cannot be treated successfully."

C) "It would be helpful for you to take control of your diet, sleep schedule, and stress levels."

19. Which of the following individuals has the highest chance of having a medulloblastoma? A) An 88-year-old man who has begun displaying signs and symptoms of increased ICP B) A 60-year-old woman who is soon to begin radiation therapy for the treatment of breast cancer C) A 4-year-old child who has become uncoordinated in recent months D) A 68-year-old man who is a smoker and has a family history of cancer

C) A 4-year-old child who has become uncoordinated in recent months

An otherwise healthy client has been referred to a pain clinic because she claims to experience exquisite pain from the friction of her clothes on her torso. This client is likely to be diagnosed with which of the following health problems? A) Visceral pain B) Hypoalgesia C) Allodynia D) Primary hyperalgesia

C) Allodynia

While talking about their migraine headaches, two women have found that they have some common triggers for their migraines, which may include: Select all that apply. A) Nonpharmacologic treatments like yoga B) Piercings of their nose and cheeks C) At the time of their menstrual cycle D) When drinking white wine E) Consuming chocolate

C) At the time of their menstrual cycle E) Consuming chocolate

11. An elderly male client has been brought to the emergency department after experiencing stroke-like symptoms a few hours ago, and has been subsequently diagnosed with an ischemic stroke. The care team is eager to restore cerebral perfusion despite the likely death of the brain cells directly affected by the stroke. What is the rationale for the care team's emphasis on restoring circulation? A) Failure to restore blood flow creates a severe risk for future transient ischemic attacks. B) Necrosis will continue unabated throughout the brain unless blood flow is restored. C) Cells of the penumbra may be saved from hypoxic damage if blood flow is promptly restored. D) Unless blood flow is restored, the client faces the risk of progressing to hemorrhagic stroke.

C) Cells of the penumbra may be saved from hypoxic damage if blood flow is promptly restored.

The client has a traumatic complete spinal cord transection at the C5 level. Based on this injury, the health care worker can expect the client to have control of which body function/part? A) Bladder B) Finger flexion C) Diaphragm D) Trunk muscle

C) Diaphragm

20. Following surgery for a large malignant brain tumor, the nurse should anticipate discussing which further treatment option with the family that may ensure that any remaining cancer cells will be killed? A) Chemotherapy B) Immunotherapy C) Gamma knife radiation D) Stem cell transplant

C) Gamma knife radiation

13. A client's emergency magnetic resonance imaging (MRI) has been examined by the physician and tissue plasminogen activator (tPA) has been administered to the client. What was this client's most likely diagnosis? A) Status epilepticus B) Subarachnoid hemorrhage C) Ischemic stroke D) Encephalitis

C) Ischemic stroke

A client with a diagnosis of myasthenia gravis has required a mastectomy for the treatment of breast cancer. The surgery has been deemed a success, but the client has gone into a myasthenic crisis on postoperative day 1. Which of the following measures should the care team prioritize in this client's immediate care? A) Positioning the client to minimize hypertonia and muscle rigidity B) Seizure precautions with padded side rails and bed in lowest height C) Respiratory support and protection of the client's airway D) Monitoring the client for painful dyskinesias

C) Respiratory support and protection of the client's airway

A client is devastated to receive a diagnosis of amyotrophic lateral sclerosis (ALS). The symptomatology of this disease is a result of its effects on upper and lower motor neurons. The health care provider caring for this client will focus on which priority intervention for this client? A) Ability to turn from side to side, thereby preventing skin breakdown B) Ability to empty bladder completely, thereby preventing autonomic dysreflexia C) Respiratory ventilation assessment and prevention of aspiration pneumonia D) Assessment of lower extremities to prevent deep vein thrombosis

C) Respiratory ventilation assessment and prevention of aspiration pneumonia

A client with a diagnosis of lung cancer has developed bone metastases resulting in severe and protracted pain. Which of the following assessment components should the nurse prioritize when assessing the client's pain? A) The appearance of grimacing, guarding, or wincing B) The presence of changes in vital signs that correspond to pain C) The client's subjective report of the character and severity of pain D) The results of a detailed neurologic assessment

C) The client's subjective report of the character and severity of pain

25. A client with a long history of cigarette smoking and poorly controlled hypertension has experienced recent psychomotor deficits as a result of hemorrhagic brain damage. The client's psychomotor deficits are likely the result of: A) Alzheimer disease B) Frontotemporal dementia (FTD) C) Vascular dementia D) Wernicke-Korsakoff syndrome

C) Vascular dementia

17. Which of the following individuals has the highest chance of having a medulloblastoma?

C) A 4-year-old child who has become uncoordinated in recent months

13. An elderly male patient has been brought to the emergency department after experiencing stroke-like symptoms a few hours ago, and has been subsequently diagnosed with an ischemic stroke. The care team is eager to restore cerebral perfusion despite the likely death of the brain cells directly affected by the stroke. What is the rationale for the care team's emphasis on restoring circulation?

C) Cells of the penumbra may be saved from hypoxic damage if blood flow is promptly restored.

14. A patient's emergency magnetic resonance imaging (MRI) has been examined by the physician and tPA has been administered to the patient. What was this patient's most likely diagnosis?

C) Ischemic stroke

14. A patient with a diagnosis of myasthenia gravis has required a mastectomy for the treatment of breast cancer. The surgery has been deemed a success, but the patient has gone into a myasthenic crisis on postoperative day one. Which of the following measures should the care team prioritize in this patient's immediate care?

C) Respiratory support and protection of the patient's airway

6. The patient has a traumatic complete spinal cord transection at the C5 level. Intact motor and somatosensory function will include ______ control.

C) diaphragm

18. A patient is devastated to receive a diagnosis of amyotrophic lateral sclerosis (ALS). The symptomatology of this disease is a result of its effects on:

C) upper and lower motor neurons.

19. A patient with a long history of cigarette smoking and poorly controlled hypertension has experienced recent psychomotor deficits as a result of hemorrhagic brain damage. The patient's psychomotor deficits are likely the result of:

C) vascular dementia.

While explaining to a group of nursing students the difference between benign and malignant bone tumors, the instructor will emphasize that a benign tumor: Select all that apply.

C. May cause the client to have a pathological fracture D. May be asymptomatic and detected incidentally

An elderly male client has been brought to the emergency department after experiencing stroke-like symptoms a few hours ago, and has been subsequently diagnosed with an ischemic stroke. The care team is eager to restore cerebral perfusion despite the likely death of the brain cells directly affected by the stroke. What is the rationale for the care team's emphasis on restoring circulation? A. Failure to restore blood flow creates a severe risk for future transient ischemic attacks. B. Necrosis will continue unabated throughout the brain unless blood flow is restored. C. Cells of the penumbra may be saved from hypoxic damage if blood flow is promptly restored. D. Unless blood flow is restored, the client faces the risk of progressing to hemorrhagic stroke.

C. Cells of the penumbra may be saved from hypoxic damage if blood flow is promptly restored.

Drugs like diazepam (Valium), a benzodiazepine, exert their action on ion channels. These drugs do not open the GABA-operated ion channel, but they: A. Modulate the release from axon terminals B. Modulate the peripheral sympathetic nerves and can have both a transmitter and modulator function C. Change the effect that GABA has when it binds to the channel at the same time as the drug D. Play a necessary role in the long-term survival of presynaptic neurons

C. Change the effect that GABA has when it binds to the channel at the same time as the drug

Which cranial nerves that have their origin in the pons assist with the manipulation of the jaw during chewing and speech? Select all that apply. A. Cranial nerve I B. Cranial nerve III C. Cranial nerve VI D. Cranial nerve VII E. Cranial nerve VIII

C. Cranial nerve VI D. Cranial nerve VII E. Cranial nerve VIII

The nurse working in an emergency room is caring for a client who is exhibiting signs and symptoms of a stroke. What does the nurse anticipate that the physician's orders will include?

CT scan

A 60-year-old woman has been recently diagnosed with multiple sclerosis, a disease in which the oligodendrocytes of the client's central nervous system (CNS) are progressively destroyed. Which physiologic process within the neurologic system is most likely to be affected by this disease process? A. Oxygen metabolism B. Neurotransmitter synthesis C. Nerve conduction D. Production of cerebrospinal fluid

C. Nerve conduction

A client with a diagnosis of lung cancer has developed bone metastases resulting in severe and protracted pain. Which of the following assessment components should the nurse prioritize when assessing the client's pain? A. The appearance of grimacing, guarding, or wincing B. The presence of changes in vital signs that correspond to pain C. The client's subjective report of the character and severity of pain D. The results of a detailed neurologic assessment

C. The client's subjective report of the character and severity of pain

The nurse is caring for a client with a spinal cord injury. Assessment reveals shallow breath sounds with a very weak cough effort. The nurse correlates this with which level of injury on the spinal column?

C5

The nurse is caring for a spinal cord injury client. Assessment reveals shallow breath sounds with a very weak cough effort. The nurse correlates this with which level of injury on the spinal column?

C5

A client presents to the orthopedic clinic for evaluation since the primary care provider thinks the client may have rheumatoid arthritis (RA). Which statement by the client correlates with the diagnosis of RA? Select all that apply.

C: "I'm having a hard time opening doors since it hurts so bad" D: "Look how my hand is deformed. My doctor calls it "hyperextension"'. E: "Look, I didn't button all my shirt buttons...it just hurts too much and look at the swelling in my hands"

compensatory mechanisms

CSF and blood volume compensate for changes in ICP -initial increase in ICP is buffered by movement of CSF to spinal subarachnoid space and increased reabsorption

Intracranial aneurysms that rupture cause subarachnoid hemorrhage in the client. How is the diagnosis of intracranial aneurysms and subarachnoid hemorrhage made?

CT scan

ischemic stroke

Caused by an interruption of blood flow in a cerebral vessel and are the most common type of strokes, accounting for 70% to 80% of all strokes

hemorrhagic stroke

Caused by bleeding into brain tissue usually from a blood vessel rupture caused by hypertension, aneurysms, arteriovenous malformations, head injury, or blood dyscrasias

A client who has been living with Alzheimer's disease and spouse are at the doctor's office and the spouse asks the nurse why the patient cannot remember much of anything from the past. The best response by the nurse is that Alzheimer's disease affects which of the following

Cells located in the hippocampus

An elderly male patient has been brought to the emergency department after experiencing stroke-like symptoms a few hours ago, and has been subsequently diagnosed with an ischemic stroke. The care team is eager to restore cerebral perfusion despite the likely death of the brain cells directly affected by the stroke. What is the rationale for the care teams emphasis on restoring circulation?

Cells of the penumbra may be saved from hypoxic damage if blood flow is promptly restored

An elderly male client has been brought to the emergency department after experiencing stroke-like symptoms a few hours ago, and has been subsequently diagnosed with an ischemic stroke. The care team is eager to restore cerebral perfusion despite the likely death of the brain cells directly affected by the stroke. What is the rationale for the care team's emphasis on restoring circulation?

Cells of the penumbra may be saved from hypoxic damage if blood flow is promptly restored.

An elderly male patient has been brought to the emergency department after experiencing stroke-like symptoms a few hours ago, and has been subsequently diagnosed with an ischemic stroke. The care team is eager to restore cerebral perfusion despite the likely death of the brain cells directly affected by the stroke. What is the rationale for the care team's emphasis on restoring circulation? Failure to restore blood flow creates a severe risk for future transient ischemic attacks. Necrosis will continue unabated throughout the brain unless blood flow is restored. Cells of the penumbra may be saved from hypoxic damage if blood flow is promptly restored. Unless blood flow is restored, the patient faces the risk of progressing to hemorrhagic stroke.

Cells of the penumbra may be saved from hypoxic damage if blood flow is promptly restored.

An elderly patient has been brought to his primary care provider by his wife who is concerned about his recent decrease in coordination. Upon assessment, his primary care provider notes that the patient's gait is wide-based, unsteady, and lacking in fluidity, although his muscle tone appears normal. This patient requires further assessment for which of the following health problems? Muscle atrophy Cerebellar disorders Impaired spinal reflexes Lower motor neuron lesions

Cerebellar disorders

An elderly patient has been brought to his primary care provider by his wife who is concerned about his recent decrease in coordination. Upon assessment, his primary care provider notes that the patient's gait is wide-based, unsteady, and lacking in fluidity, although his muscle tone appears normal. This patient requires further assessment for which of the following health problems? Muscle atrophy Cerebellar disorders Impaired spinal reflexes Lower motor neuron lesions

Cerebellar disorders

The intracranial volume that is most capable of compensating for increasing intracranial pressure is the:

Cerebrospinal fluid

The nurse is conducting a community education program on concussions. The nurse evaluates that the participants understand the education when they state that which of these offers the brain protection from external forces?

Cerebrospinal fluid

Which intracranial volume is most capable of compensating for increasing intracranial pressure?

Cerebrospinal fluid

A client who has had a spinal injury now has sensory changes on the distal forearm and fourth and fifth fingers. The nurse can predict that this client has experienced an injury to the: Select all that apply.

Cervical (C) 8 Thoracic (T) 1 dorsal root

A 55 year old female present with complaints of pain and parasthesisa in the left ulnar aspext of the forearm, thumb, and middle finger following a C6 and C7 nerve root dermatomal pattern. This is known as _________? - Peripheral polyneuropathy - Cervical radiculopathy - Brachial plexus neuritis - Thoracic outlet syndrome

Cervican radiculopathy Cervical root compresssion of C6 and C7 causes cervical rediculopathy. Brachial plexus neuritis present with dysfunction franging from momentary parasthesias to completely flail extremities and is usuallly caused by injuries to the C5 and C6 nerve roots. Peripheral polyneuropathy is associated with distal sensorimotor parasthesia and diminished deep tendon reflexes. Thoracic outlet syndrome is caused by compression of the brachial plexus and/or sublcavian vessles as they exit the space b/w the superior shoulder girdle and the first rib. Symptoms are color changes in the hand and sensory changes and weakness in the 4th and 5th fingers.

Drugs like diazepam (Valium), a benzodiazepine, exert their action on ion channels. These drugs do not open the GABA-operated ion channel, but they:

Change the effect that GABA has when it binds to the channel at the same time as the drug

A client has suffered a stroke that has affected his speech. The physician has identified the client as having expressive aphasia. Later in the day, the family asks the nurse to explain what this means. The most accurate response would be aphasia that is:

Characterized by an inability to easily communicate spontaneously or translate thoughts or ideas into meaningful speech or writing

The nurse is working in the emergency room. One client's presenting symptoms include the worst headache ever, nuchal rigidity, and nausea. Another client's presenting symptoms include fever, stiff back, and positive Kernig sign. Which client should the nurse assess first?

Client with the worst headache, nuchal rigidity, and nausea

A client's emergency room report includes the presence of a contrecoup injury. The nurse plans care for a client with which of the following?

Closed head injury opposite the area of impact

The nurse assessing a client with a traumatic brain injury assesses for changes in which neurologic component? Select all that apply.

Cognition Level of consciousness Motor function Sensory function

A clinician is assessing the muscle tone of a client who has been diagnosed with a lower motor neuron (LMN) lesion. Which of the following assessment findings is congruent with the client's diagnosis?

Hypotonia

A patient with a history of a seizure disorder has been observed suddenly and repetitively patting his knee. After stopping this repetitive action, the patient appears confused and is oriented to person and place but not time. What type of seizure did this patient most likely experience?

Complex partial seizure

A patient with a history of a seizure disorder has been observed suddenly and repetitively patting his knee. After stopping this repetitive action, the patient appears confused and is oriented to person and place but not time. What type of seizure did this patient most likely experience? Simple partial seizure Atonic seizure Myoclonic seizure Complex partial seizure

Complex partial seizure

postconcussion syndrome

Concussion refers to "an immediate and transient loss of consciousness accompanied by a brief period of amnesia after a blow to the head." Recovery usually takes place in 24 hours Mild symptoms may persist for months: Headache, Irritability, Insomnia Poor concentration and memory

levels of conciousness

Confusion Delirium lethargy: drowsy, responds then falls back asleep -Obtundation: opens eyes and looks at you but is slow and confused (decreased alertness of/to environment) -Stupor: response to verbal stimuli slow or absent, responds to pain but lapses back to unresponsive without stimuli (unaware of environment) -Coma: unarousable, eyes closed, no pain response Brain death Persistent Vegetative State: coma like with open eye but no awareness

Status epilepticus

Continual seizures, Do not stop spontaneously Many types If untreated or not stopped can lead to death due to respiratory failure

The nurse knows that which treatment plan listed below is most likely to be prescribed after a computerized tomography (CT) scan of the head reveals a new-onset aneurysmal subarachnoid hemorrhage?

Craniotomy and clipping of the affected vessel

A 16 year old male presents wo the clinical after sustaining a football injury to his right knee. The clinican elicits a positive anterior/posterior drawer sign. The test indicates an injury to the _____? - Crucial ligament - Lateral Meniscus - Collateral ligament - Medial meniscus

Cruciate ligament - positive anterior/posterior drawer signs indicate injury to the anterior cruciate ligament and posterior cruciate ligament, respectively. The drawer and Lachman tests are utilized to assess for cruciate ligament injury

14. A client who experienced a traumatic head injury from a severe blow to the back of his head now lives with numerous function deficits, including an inability to maintain steady posture while he is in a standing position, although he is steadier when walking. Which of the following disorders most likely resulted from his injury? A) Cerebellar dystaxia B) Cerebellar tremor C) A lower motor neuron lesion D) A vestibulocerebellar disorder

D

18. A recently injured (3 months ago) client with a spinal cord injury at T4 to T5 is experiencing a complication. He looks extremely ill. The nurse recognizes this as autonomic dysreflexia (autonomic hyperreflexia). His BP is 210/108; skin very pale; gooseflesh noted on arms. The priority nursing intervention would be to: A) Check the mouth/throat for pustules and redness B) Check the jugular vein for distention C) Assess calves of legs for redness, warmth, or edema D) Scan his bladder to make sure it is empty

D

21. A client develops fever, headache, and burning/itching in the periorbital area. After a few days, a vesicular rash appears around the eyelid margins. The health care provider will likely prescribe: A) Topical antimicrobial for infection caused by overuse of contact lens DB) Oral antibiotics to treat chlamydial infection C) Topical mast cell stabilizer to treat allergies D) Antiviral medication for herpes zoster ophthalmicus

D

22. Diabetic and hypertensive retinopathy are both characterized by the appearance of: A) Macular edema B) Cloudy corneas C) Microinfarctions D) Intraretinal hemorrhages

D

24. One of the causes of conductive hearing loss is: A) Sudden loud noise B) Ototoxic medication C) Auditory nerve damage D) Excess middle ear fluid

D

30. While assessing a client who is experiencing diarrhea caused by Clostridium difficile, the nurse should anticipate hearing: A) Normal bowel sounds B) Hypoactive bowel sounds C) Absence of bowel sounds D) Hyperactive bowel sounds

D

32. Which of the following clients likely faces the greatest risk of a gastrointestinal bleed? A) A man whose hypertension requires him to take a diuretic, an ACE inhibitor, and a β- adrenergic blocker B) A client who is taking a broad-spectrum antibiotic to treat a urinary tract infection C) A client with a history of anxiety who takes benzodiazepines several times daily D) A client who takes aspirin with each meal to control symptoms of osteoarthritis

D

34. A child who is experiencing the signs and symptoms of influenza has vomited frequently over the last 24 hours. While discussing vomiting with a group of nursing students, the instructor asks, "What site in the neurologic system is responsible for vomiting?" Which student response is most accurate? A) Myenteric plexus B) Intramural plexus C) Vagus nerve D) Chemoreceptor trigger zone

D

37. Acute gastritis refers to a transient inflammation of the gastric mucosa that is most commonly associated with: A) Diarrhea B) Food allergies C) Gastric reflux D) Alcohol intake

D

41. The nurse caring for a client with diverticulitis should assess for which of the following clinical manifestations? A) Frequent rectal bleeding B) Increased abdominal distention C) Large-volume diarrhea D) Lower left quadrant pain

D

42. A 66-year-old woman has been diagnosed with diverticular disease based on her recent complaints and the results of a computed tomography (CT) scan. Which of the client's following statements demonstrates an accurate understanding of this diagnosis? A) "From now on, I'm going to stick to an organic diet and start taking more supplements." B) "I think this might have happened because I've used enemas and laxatives too much." C) "I've always struggled with heartburn and indigestion, and I guess I shouldn't have ignored those warning signs." D) "I suppose I should try to eat a bit more fiber in my diet."

D

45. A teenager has been diagnosed with failure to thrive. The health care providers suspect a malabsorption syndrome. In addition to having diarrhea and bloating, the client more than likely has what hallmark manifestation of malabsorption? A) Feeling there is incomplete emptying of the bowel B) Abdominal distention C) Esophageal reflux with heartburn D) Fatty, yellow-gray, foul-smelling stools

D

57. Hepatocellular cancer usually has a poor prognosis due in part to which of the following factors? A) Surgical options do not exist because removal of all or part of the liver is a threat to health. B) Liver cancer typically metastasizes at a much earlier stage than other cancers. C) Liver tumors are poorly differentiated due to the low density of hepatic tissue. D) The nonspecific symptomatology of liver cancer leads to a diagnosis at a late stage.

D

7. A hospital client has been reluctant to accept morphine sulfate despite visible signs of pain. Upon questioning, the client reveals that he is afraid of becoming addicted to the drug. How can a member of the care team best respond to the client's concern? A) "You might become addicted, but there are excellent resources available in the hospital to deal with that development." B) "You should likely prioritize the control of your pain over any fears of addiction that you have." C) "If you start needing higher doses to control your pain, then we'll address those concerns." D) "There's only a minute chance that you will become addicted to these painkillers."

D

The family of a multiple sclerosis client asks, "What psychological manifestations may we expect to see in our mother?" The health care provider informs them to expect which of the following? Select all that apply.

Depression Inattentiveness Forgetfulness

A hospital client has been reluctant to accept morphine sulfate despite visible signs of pain. Upon questioning, the client reveals that he is afraid of becoming addicted to the drug. How can a member of the care team best respond to the client's concern? A) "You might become addicted, but there are excellent resources available in the hospital to deal with that development." B) "You should likely prioritize the control of your pain over any fears of addiction that you have." C) "If you start needing higher doses to control your pain, then we'll address those concerns." D) "There's only a minute chance that you will become addicted to these painkillers."

D) "There's only a minute chance that you will become addicted to these painkillers."

A client who experienced a traumatic head injury from a severe blow to the back of his head now lives with numerous function deficits, including an inability to maintain steady posture while he is in a standing position, although he is steadier when walking. Which of the following disorders most likely resulted from his injury? A) Cerebellar dystaxia B) Cerebellar tremor C) A lower motor neuron lesion D) A vestibulocerebellar disorder

D) A vestibulocerebellar disorder

Pain assessment is likely to be most challenging when providing care for which of the following older adult clients? A) A 90-year-old client who takes multiple medications for cardiac and respiratory conditions B) A 77-year-old man who has sustained burns on the lower part of his body C) An 82-year-old woman who has been diagnosed with diabetes and an anxiety disorder D) An 87-year-old man with vascular dementia and other health problems like heart failure

D) An 87-year-old man with vascular dementia and other health problems like heart failure

12. A family brings their elderly mom to the emergency department. The client had a short period of time where she was confused, had slurred speech and appeared to have a weak arm. Now she is back to her normal self. Suspecting a transient ischemic attacks (TIAs), the health care provider will order diagnostic testing looking for: A) Aneurysm leakage B) Cause of minor residual deficits C) Diffuse cerebral electrical malfunctions D) Atherosclerotic lesions in cerebral vessels

D) Atherosclerotic lesions in cerebral vessels

1. When trying to explain the difference between vasogenic versus cytotoxic cerebral edema, the physiology instructor mentions that cytotoxic edema displays which of the following functions in the brain? Select all that apply. A) Impaired blood-brain barrier that allows water/proteins to leave vessels and go into the interstitial space B) Mainly allows edema to form in the white mater of the brain C) May cause herniation by displacing a cerebral hemisphere D) Causes ischemia to build up lactic acid due to anaerobic metabolism E) Allows cells to increase volume to the point of rupture, damaging neighboring cells

D) Causes ischemia to build up lactic acid due to anaerobic metabolism E) Allows cells to increase volume to the point of rupture, damaging neighboring cells

2. The intracranial volume that is most capable of compensating for increasing intracranial pressure is the: A) Brain cell tissue B) Intravascular blood C) Surface sulci fluid D) Cerebrospinal fluid

D) Cerebrospinal fluid

14. A client has suffered a stroke that has affected his speech. The physician has identified the client as having expressive aphasia. Later in the day, the family asks the nurse to explain what this means. The most accurate response would be aphasia that is: A) Characterized by an inability to comprehend the speech of others or to comprehend written material B) Nearly normal speech except for difficulty with finding singular words C) Manifested as impaired repetition and speech riddled with letter substitutions, despite good comprehension and fluency D) Characterized by an inability to easily communicate spontaneously or translate thoughts or ideas into meaningful speech or writing

D) Characterized by an inability to easily communicate spontaneously or translate thoughts or ideas into meaningful speech or writing

Complex regional pain syndrome is characterized by: A) Repetitious dermatome pain attacks B) Trigeminal neuralgia with facial tics C) Severe limb pain after amputation D) Disproportionate pain with mobility

D) Disproportionate pain with mobility

21. A client with a history of a seizure disorder has been observed suddenly and repetitively patting his knee. After stopping this repetitive action, the client appears confused but is oriented to person and place but not time. What type of seizure did this client most likely experience? A) Tonic-clonic seizure B) Atonic seizure C) Myoclonic seizure D) Focal seizure with impairment to consciousness

D) Focal seizure with impairment to consciousness

Knowing that she is a carrier for Duchene muscular dystrophy (DMD), a pregnant woman arranged for prenatal genetic testing, during which her child was diagnosed with DMD. As her son develops, the woman should watch for which of the following early signs that the disease is progressing? A) Impaired sensory perception and frequent wounds B) Spasticity and hypertonic reflexes C) Muscle atrophy with decreased coordination D) Frequent falls and increased muscle size

D) Frequent falls and increased muscle size

3. A late indicator of increased intracranial pressure is: A) Tachycardia B) Right-sided heart failure C) Narrow pulse pressure D) High mean arterial pressure

D) High mean arterial pressure

9. Following a head injury on the football field, the medical team is assessing the player for injury. One of the earliest signs of decreased level of consciousness to assess for would be: A) Stupor B) Lethargy C) Delirium D) Inattention

D) Inattention

16. Which of the following pathophysiologic processes occurs in cases of bacterial meningitis? A) Infection in the cerebrospinal fluid causes vasoconstriction and cerebral hypoxia. B) Trauma introduces skin-borne pathogens to the cerebrospinal fluid. C) Infection in the cerebrospinal fluid causes spinal cord compression and neurologic deficits. D) Inflammation allows pathogens to cross into the cerebrospinal fluid.

D) Inflammation allows pathogens to cross into the cerebrospinal fluid.

Opioid receptors are highly concentrated in which region of the CNS and produce pain relief through the release of endogenous opioids? A) The enkephalins B) Primary afferent neurons C) Thalamus D) Periaqueductal gray (PAG) region

D) Periaqueductal gray (PAG) region

22. A client has started having uncontrolled seizures that are not responding to usual medications. Nursing working with the client must pay special attention to which of the following priority aspects of this clients care? Assessment of: A) ECG for arrhythmias B) Urine output and continence C) Ability to grasp hands and squeeze on command D) Respiratory status and oxygen saturation

D) Respiratory status and oxygen saturation

While teaching a class of nursing students about spinal cord injury, the instructor mentions that male SCI clients will be able to have a sexual response if their injury is at which level on the spinal column? A) T12 B) S1 C) L2 D) S4

D) S4

A recently injured (3 months ago) client with a spinal cord injury at T4 to T5 is experiencing a complication. He looks extremely ill. The nurse recognizes this as autonomic dysreflexia (autonomic hyperreflexia). His BP is 210/108; skin very pale; gooseflesh noted on arms. The priority nursing intervention would be to: A) Check the mouth/throat for pustules and redness B) Check the jugular vein for distention C) Assess calves of legs for redness, warmth, or edema D) Scan his bladder to make sure it is empty

D) Scan his bladder to make sure it is empty

. Which of the following characteristics differentiates a migraine with aura from a migraine without aura? A) Gastrointestinal involvement in the hours leading up to the headache B) A decrease in mood and affect prior to the headache C) Lack of response to nonpharmacologic treatments D) Visual symptoms that precede the headache

D) Visual symptoms that precede the headache

16. A patient who experienced a traumatic head injury from a severe blow to the back of his head now lives with numerous function deficits, including an inability to maintain steady posture while he is in a standing position, although he is steadier when walking. Which of the following disorders most likely resulted from his injury?

D) A vestibulocerebellar disorder

18. A patient with a history of a seizure disorder has been observed suddenly and repetitively patting his knee. After stopping this repetitive action, the patient appears confused and is oriented to person and place but not time. What type of seizure did this patient most likely experience?

D) Complex partial seizure

13. Knowing that she is a carrier for Duchene muscular dystrophy (DMD), a pregnant woman arranged for prenatal genetic testing, during which her child was diagnosed with DMD. As her son develops, the woman should watch for which of the following early signs that the disease is progressing?

D) Frequent falls and increased muscle size

16. Which of the following pathophysiologic processes occurs in cases of bacterial meningitis?

D) Inflammation allows pathogens to cross into the cerebrospinal fluid.

3. Myasthenia gravis is characterized by muscle weakness caused by antibody-mediated destruction of:

D) acetylcholine receptors.

1. The intracranial volume that is most capable of compensating for increasing intracranial pressure is the:

D) cerebrospinal fluid.

2. A late indicator of increased intracranial pressure is:

D) high mean arterial pressure.

6. The earliest signs of decreased level of consciousness include:

D) inattention.

4. Coup and contrecoup cerebral contusion caused by blunt head trauma against a fixed object results in:

D) permanent brain tissue damage.

4. A patient has wrist inflammation causing compression of the median nerve in the carpal tunnel. Manifestations of this syndrome include:

D) precision grip weakness.

8. Transient ischemic attacks (TIAs) are characterized by ischemic cerebral neurologic deficits that:

D) resolve within one hour of onset.

10. Autonomic dysreflexia (autonomic hyperreflexia) is characterized by:

D) vasospasms and hypertension.

What happens during the depolarization phase of nerve cells? A. It is an undisturbed period of the action potential during which the nerve is not transmitting impulses. B. The cell membrane decreases its permeability to sodium. C. The neurons are stimulated to fire. D. A rapid change in polarity to one that is positive on the inside and the membrane becomes open to sodium.

D. A rapid change in polarity to one that is positive on the inside and the membrane becomes open to sodium.

A client who experienced a traumatic head injury from a severe blow to the back of his head now lives with numerous function deficits, including an inability to maintain steady posture while he is in a standing position, although he is steadier when walking. Which of the following disorders most likely resulted from his injury? A. Cerebellar dystaxia B. Cerebellar tremor C. A lower motor neuron lesion D. A vestibulocerebellar disorder

D. A vestibulocerebellar disorder

A family brings their elderly mom to the emergency department. The client had a short period of time where she was confused, had slurred speech and appeared to have a weak arm. Now she is back to her normal self. Suspecting a transient ischemic attacks (TIAs), the health care provider will order diagnostic testing looking for: A. Aneurysm leakage B. Cause of minor residual deficits C. Diffuse cerebral electrical malfunctions D. Atherosclerotic lesions in cerebral vessels

D. Atherosclerotic lesions in cerebral vessels

1 / 1 pts The intracranial volume that is most capable of compensating for increasing intracranial pressure is the: A. Brain cell tissue B. Intravascular blood C. Surface sulci fluid D. Cerebrospinal fluid

D. Cerebrospinal fluid

1. The intracranial volume that is most capable of compensating for increasing intracranial pressure is the:

D. Cerebrospinal fluid

Since catecholamines can be degraded by enzymes, the medication category usually prescribed to treat a Parkinson disease client, thereby controlling this interaction, is: A. Dopamine B. β-Adrenergic blocker C. Epinephrine D. Monoamine oxidase (MAO) inhibitor

D. Monoamine oxidase (MAO) inhibitor

Opioid receptors are highly concentrated in which region of the CNS and produce pain relief through the release of endogenous opioids? A. The enkephalins B. Primary afferent neurons C. Thalamus D. Periaqueductal gray (PAG) region

D. Periaqueductal gray (PAG) region

Which of the following processes is most likely to occur as a result of a spinal reflex? A. Peristalsis of the small and large bowel B. Control of oculomotor function in changing light levels C. Pain sensation from a potentially damaging knee movement D. Withdrawal of a hand from a hot stove element

D. Withdrawal of a hand from a hot stove element

The nurse is caring for a 31-year-old trauma victim admitted to the neurologic intensive care unit. While doing the initial assessment, the nurse finds that the client is flexing the arms, wrists, and fingers. There is adduction of the upper extremities with internal rotation and plantar flexion of the lower extremities. How would the nurse describe this in the notes?

Decorticate posturing

The nurse observes that the upper extremities of a client with a brain injury are abducted while the lower extremities are internally rotated. The nurse communicates which terminology during hand-off reporting?

Decorticate posturing

The parents of an infant born with hydrocephalus are concerned about the size of the baby's head. The doctors are telling them that the infant needs the surgical placement of a shunt. The nurse caring for the infant in the neonatal intensive care unit explains that placement of a shunt will do which of the following?

Decrease the likelihood of further neurological deficits

The health care provider is concerned that a client may be at risk for problems with cerebral blood flow. The most important data to assess would be

Decreased level of oxygen

The health care provider is concerned that a client may be at risk for problems with cerebral blood flow. The most important data to assess would be:

Decreased level of oxygen

The nurse is caring for a trauma victim with head injury. Which factor will affect the cerebral blood flow?

Decreased level of oxygen

The client has a traumatic complete spinal cord transection at the C5 level. Based on this injury, the health care worker can expect the client to have control of which body function/part?

Diaphragm

Which of the following interventions would be considered a nonpharmacologic method of pain control? Select all that apply.

Distraction by knitting Guided imagery Biofeedback

Stretch-sensitive receptors in the skin (Ruffini end organs, Pacinian corpuscles, and Merkel cells) help signal postural information and are processed through the:

Dorsal column-medial lemniscus pathway

Which of the following principles should underlie the pain control strategy in the care of a child with a diagnosis of cancer?

Dosing & timing should aim for a steady serum level of the drug that is chosen.

A & B

During an assessment the nurse suspects that patient should be evaluated for myasthenia gravis. What did the nurse assess to make this clinical determination? (Select all that apply.) A) Ptosis B) Diplopia C) Abdominal pain D) Left leg weakness E) Epigastric burning

A child is being seen in the emergency department (ED) after ingesting crayons with lead in them. He is disoriented and having seizures. The provider suspects he has which of the following?

Encephalitis

Which type of hematoma usually results from a tear in an artery associated with a skull fracture?

Epidural hematoma

Excessive activity of the excitatory neurotransmitters and their receptor-mediated effects is the cause of which type of brain injury?

Excitotoxic

stroke warning signs : FAST

Face: droop? Arm: one arm drift down? Speech: slurred? Time: call 911 if any of these signs

hemodynamic effects of av malformation

First, blood is shunted from the high-pressure arterial system to the low-pressure venous system without the buffering advantage of the capillary network The draining venous channels are exposed to high levels of pressure, predisposing them to rupture and hemorrhage Second, the elevated arterial and venous pressures divert blood away from the surrounding tissue, impairing tissue perfusion

A client who is diagnosed with seizures describes feeling confused after experiencing a seizure. The family members report that the client has been smacking his lips prior to having a seizure. The client most likely experienced which type of seizure?

Focal

A client with a history of a seizure disorder has been observed suddenly and repetitively patting his knee. After stopping this repetitive action, the client appears confused—he is oriented to person and place but not time. What type of seizure did this client most likely experience?

Focal seizure with impairment to consciousness

seizure classification

Focal seizure: Seizure begins in a specific or focal area of one cerebral hemisphere Generalized seizure: Begins simultaneously in both cerebral hemispheres.

Knowing that she is a carrier for Duchene muscular dystrophy (DMD), a pregnant woman arranged for prenatal genetic testing, during which her child was diagnosed with DMD. As her son develops, the woman should watch for which of the following early signs that the disease is progressing?

Frequent falls and increased muscle size

Knowing that she is a carrier for Duchene muscular dystrophy (DMD), a pregnant woman arranged for prenatal genetic testing, during which her child was diagnosed with DMD. As her son develops, the woman should watch for which of the following early signs that the disease is progressing? Impaired sensory perception and frequent wounds Spasticity and hypertonic reflexes Muscle atrophy with decreased coordination Frequent falls and increased muscle size

Frequent falls and increased muscle size

Knowing that she is a carrier for Duchene muscular dystrophy (DMD), a pregnant woman arranged for prenatal genetic testing, during which her child was diagnosed with DMD. As her son develops, the woman should watch for which of the following early signs that the disease is progressing? Impaired sensory perception and frequent wounds Spasticity and hypertonic reflexes Muscle atrophy with decreased coordination Frequent falls and increased muscle size

Frequent falls and increased muscle size

Following surgery for a large malignant brain tumor, the nurse should anticipate discussing which further treatment option with the family that may ensure that any remaining cancer cells will be killed?

Gamma knife radiation

encephalitis

Generalized infection of the parenchyma of the brain or spinal cord, Local necrotizing hemorrhage Progressive degeneration of nerve cell bodies Prominent edema *Common causes are HSV and West Nile virus* Characterized by nuchal rigidity, headache, & fever. Transmission: Ingestion, Mosquito, Rabid animal

The chart of a client admitted because of seizures notes that the seizure activity began simultaneously in both cerebral hemispheres. The nurse should interpret this to mean that the client experienced which of the following?

Generalized seizure

A clinician is assessing the muscle tone of a patient who has been diagnosed with a lower motor neuron (LMN) lesion. Which of the following assessment findings is congruent with the patient's diagnosis? Hypotonia Spasticity Tetany Rigidity

Hypotonia

Which of the following disorders of neuromuscular function typically has the most rapid onset? Duchenne muscular dystrophy (DMD) Guillain-Barré syndrome Parkinson disease Myasthenia gravis

Guillain-Barré syndrome

Which of the following disorders of neuromuscular function typically has the most rapid onset? Duchenne muscular dystrophy (DMD) Guillain-Barré syndrome Parkinson disease Myasthenia gravis

Guillain-Barré syndrome

A high school senior sustained a concussion during a football game. Which of the following signs and symptoms would indicate the presence of postconcussion syndrome in the days and weeks following his injury?

Headaches and memory lapses

A high school senior sustained a concussion during a football game. Which of the following signs and symptoms would indicate the presence of postconcussion syndrome in the days and weeks following his injury? Headaches and memory lapses Recurrent nosebleeds and hypersomnia Unilateral weakness and decreased coordination Neck pain and decreased neck range of motion

Headaches and memory lapses

A high school student sustained a concussion during a football game. The school nurse will educate the family about postconcussion syndrome and ask them to watch for and report which manifestations of its presence?

Headaches and poor concentation

A 49 year old female present with low back pain radiating into the right leg. An X-ray of the lumbosacral spine is WNL. which of the folloing diagnoses do you explore further? - Herniated nucleus pulposus - Scoliosis - Osteoarthritis - Compression fracture

Herniated nucleus pulposus A plain xray will not show a herniated nucleus pulposus or a muscle straing. it will show spondylolisthesis, scoliosis, osteoarthritis, and spinal stenosis. Note that xrays of the spain are not indicated in low back pain unless the cause of the pains is thought to be body in origin or traumatic in nature or theres is a need to rule out systemic disease.

The nurse planning a community education class on brain tumors and their prevention should include which risk factors in the presentation? Select all that apply.

High dose irradiation exposure Acquired immune suppression

A clinician is assessing the muscle tone of a patient who has been diagnosed with a lower motor neuron (LMN) lesion. Which of the following assessment findings is congruent with the patient's diagnosis? Hypotonia Spasticity Tetany Rigidity

Hypotonia

The nurse is planning an inservice on hypoxia versus ischemia in brain-injured clients. The nurse should include which of the following?

Hypoxia produces a generalized depressive effect on the brain

The nurse is planning an inservice on hypoxia versus ischemia in brain-injured clients. The nurse should include which of the following?

Hypoxia produces a generalized depressive effect on the brain.

Which of the following statements by the husband of a patient with Alzheimer disease demonstrates an accurate understanding of his wifes medication regimen?

Im really hoping these medications will slow down her mental losses

Following a head injury, a client is diagnosed with a possible intracranial epidural hematoma. During the initial assessment, the client suddenly becomes unconscious. Other clinical manifestations that correlate with this diagnosis may include:

Ipsilateral pupil dilation

A family brings a client to the emergency department with increasing lethargy and disorientation. They think the client had a seizure on the drive over to the hospital. The client has been sick with a "cold virus" for the last few days. On admission, the client's temperature is 102°F (38.9°C). Which other clinical manifestations may lead to the diagnosis of encephalitis?

Impaired neck flexion resulting from muscle spasm

Neurotransmitters are small molecules that exert their actions through specific proteins, called receptors, embedded in the postsynaptic membrane. Where are neurotransmitters synthesized?

In the axon terminal

Following a head injury on the football field, the medical team is assessing the player for injury. One of the earliest signs of decreased level of consciousness to assess for would be:

Inattention

While lecturing to a group of physiology students, the instructor asks, "What metabolic factors cause vasodilation of cerebral vessels thereby increasing cerebral blood flow to the brain?" The student with the best response would be:

Increased carbon dioxide level

While lecturing to a group of physiology students, the instructor asks, "What metabolic factors cause vasodilation of cerebral vessels, thereby increasing cerebral blood flow to the brain?" The best student response would be:

Increased carbon dioxide level

Which of the following pathophysiologic processes occurs in cases of bacterial meningitis?

Inflammation allows pathogens to cross into the cerebrospinal fluid

Which of the following pathophysiologic processes occurs in cases of bacterial meningitis? Infection in the cerebrospinal fluid causes vasoconstriction and cerebral hypoxia. Trauma introduces skin-borne pathogens to the cerebrospinal fluid. Infection in the cerebrospinal fluid causes spinal cord compression and neurologic deficits. Inflammation allows pathogens to cross into the cerebrospinal fluid.

Inflammation allows pathogens to cross into the cerebrospinal fluid.

meningitis

Inflammation of the pia mater, arachnoid, CSF-filled subarachnoid space. Inflammation spreads rapidly dt CSF circulation. 2 types Bacterial, viral Bacterial: Most by S.pneumoniae or N. meningitidis *Neonates caused by Group B Strep- which is why we do GBS testing at the end of pregnancy- if the pregnant woman is positive we treat her when she goes into labor to prevent the baby from becoming infected* Characterized by nuchal rigidity, photophobia, Feve, chills, HA, back, abdominal, extremity pains; n/vomiting Tx is immediate- delayed treatment can result in poor outcomes

Among the treatments for multiple sclerosis (MS), which medication will reduce the exacerbation of relapsing-remitting MS?

Interferon-B, a cytokind injection

Among the treatments for multiple sclerosis (MS), which medication will reduce the exacerbation of relapsing-remitting MS?

Interferon-β, a cytokine injection

clinical manifestations of brain tumors ependymomas meningiomas primary CNS lymphomas

Intracranial tumors give rise to focal disturbances in the brain function and increased ICP. Focal disturbances occur because of brain compression, tumor infiltration, disturbances in blood flow and brain edema. General s/s: Headache, nausea, vomiting, mental changes, papilledema, visual disturbances, alterations in sensory and motor function, and seizures.

Generalized convulsive status epilepticus is a medical emergency caused by a tonic-clonic seizure that does not spontaneously end, or recurs in succession without recovery. What is the first-line drug of choice to treat status epilepticus?

Intravenous lorazepam

Following a head injury, a client is diagnosed with intracranial epidural hematoma. During the initial assessment, the client suddenly becomes unconscious. What additional clinical manifestations correlate with this diagnosis?

Ipsilateral pupil dilation

A client's emergency magnetic resonance imaging (MRI) has been examined by the physician and tissue plasminogen activator (tPA) has been administered to the client. What was this client's most likely diagnosis?

Ischemic stroke

A patient's emergency magnetic resonance imaging (MRI) has been examined by the physician and tPA has been administered to the patient. What was this patient's most likely diagnosis?

Ischemic stroke

A patient's emergency magnetic resonance imaging (MRI) has been examined by the physician and tPA has been administered to the patient. What was this patient's most likely diagnosis? Status epilepticus Subarachnoid hemorrhage Ischemic stroke Encephalitis

Ischemic stroke

A patients emergency magnetic resonance imaging (MRI) has been examined by the physician and tPA has been administered to the patient. What was this patients most likely diagnosis?

Ischemic stroke

The valgus stress trest, varus stress test, Lachman test, and thumb sign are all considered standard tests to check the integrity of the ligaments of the knee. Which of the following would the clinician choose to assess the anterior cruciate ligament (ACL), which is the most commonly involved structure in severe knee injury? - Lachman test - Varus stress test - Thumb Sign - Valgus stress test

Lachman test assesses the ACL

The emergency room doctor suspects a client may have bacterial meningitis. The most important diagnostic test to perform would be:

Lumbar puncture

Since catecholamines can be degraded by enzymes, the medication category usually prescribed to treat a Parkinson disease client, thereby controlling this interaction, is:

Monoamine oxidase (MAO) inhibitor

Restoration of the integrity of myelin sheaths would likely result in a slowing or stopping of the progression of: Amyotrophic lateral sclerosis (ALS) Multiple sclerosis (MS) Duchenne muscular dystrophy (DMD) Paralysis caused by Clostridium botulinum

Multiple sclerosis (MS)

Restoration of the integrity of myelin sheaths would likely result in a slowing or stopping of the progression of: Amyotrophic lateral sclerosis (ALS) Multiple sclerosis (MS) Duchenne muscular dystrophy (DMD) Paralysis caused by Clostridium botulinum

Multiple sclerosis (MS)

The somatosensory system consists of 3 types of sensory neurons. The special somatic type of afferent sensory neurons has receptors that sense

Muscle Position

The nurse is caring for an older adult client with hemiplegia following a stroke. While planning the client's care, the nurse knows the client is at risk for developing which condition?

Muscle atrophy

A 48 year old male presents with acute low back pain in the right that increases when standing and bending. Upon physical exam, lower extremity muscle strength is 5/5 and straight leg raise test is negative. Which of the following is the most likely diagnosis? - Herniated nucleus pulposus - Osteoarthritis - Muscle Strain - Spondyloisthesis

Muscle strain Muscle strain is usually located in the low back and is unilateral in location. The onset is acute and pain increases with standing and bending and decreases with sitting. the straight leg raises test and plain xray are both negative

A conservative approach is recommended in the inital approach to the managment of low back pain. which of the following would be an appropriate treatment plan for a 32 year old obese male (BMI 33) diagnosed with an acute lumbar strain. - Epidural steroid injections (ESI) - Surgery - Bedrest - NSAIDS

NSAIDS It has been proven that rest has little to no effect on the resolution of LBP. Pts should do whatever activities are tolerable. Almost 90% of cases resolve wihtin 1-6 wks this inisital management should include non-pharmacologic (massage, heat, etc.) pharmacological ( NSAIDS and short term use of muscle relaxants) and activity. Surgery and ESI are not inidicated in the initial managment of LBP

A 60-year-old woman has been recently diagnosed with multiple sclerosis, a disease in which the oligodendrocytes of the client's central nervous system (CNS) are progressively destroyed. Which physiologic process within the neurologic system is most likely to be affected by this disease process?

Nerve conduction

Which of the following peripheral nerve injuries will likely result in cellular death with little chance of regeneration?

Nerve fibers destroyed close to the neuronal cell body

Which peripheral nerve injury will likely result in cellular death with little chance of regeneration?

Nerve fibers destroyed close to the neuronal cell body

A 55 year old patient is able to complete ROM against gravity with some resistance. The NP would assign which of the following numerical grades to this manual muscle testing description? - 2 - 3 - 5 - 4

Normal muscle strength and function and complete ROM against gravity w/ full or normal resistance would be given a numerical grade of 5. Complete ROM against gravity with some resistance is given a 4 and described as good muscle strength. Complete ROM against graviatiy is indiciatve of fair muscle strength and graded at a 3. A grade of 2, denoting poor muscle strength, is given for complete ROM with gravity eliminated.

Nociceptors are sensory receptors that are activated by:

Noxious stimuli

A client has developed hydrocephalus and asks the nurse what may have caused this to occur. The best response would be:

Overproduction of cerebrospinal fluid

Disorders of the pyramidal tracts, such as a stroke, are characterized by:

Paralysis

seizure classification list

Partial Seizures -Simple partial seizures -Complex partial seizures -Partial seizures evolving to secondarily generalized seizures Unclassified Seizures -Inadequate or incomplete data Generalized Seizures -Absence seizures -Atonic seizures -Myoclonic seizures -Tonic seizures -Tonic-clonic seizures

A nurse assesses a patient with a cerebral infarct for sensation. Which of the following results indicates that second-order neurons are intact?

Patellar reflex +2

What pain theory proposes that pain receptors share pathways with other sensory modalities and that different activity patterns of the same neurons can be used to signal painful or nonpainful stimuli?

Pattern

Opioid receptors are highly concentrated in which region of the CNS and produce pain relief through the release of endogenous opioids?

Periaqueductal gray (PAG) region

A client's recent computed tomography (CT) scan has revealed the presence of hydrocephalus. Which of the following treatment measures is most likely to resolve this health problem?

Placement of a shunt

A client's recent computed tomography (CT) scan has revealed the presence of hydrocephalus. Which treatment measure is most likely to resolve this health problem?

Placement of a shunt

A patient's recent computed tomography (CT) scan has revealed the presence of hydrocephalus. Which of the following treatment measures is most likely to resolve this health problem? Aggressive diuresis Placement of a shunt Administration of hypertonic intravenous solution Lumbar puncture

Placement of a shunt

A patients recent computed tomography (CT) scan has revealed the presence of hydrocephalus. Which of the following treatment measures is most likely to resolve this health problem?

Placement of a shunt

Guillain-Barré syndrome is characterized by which of the following forms of neuron damage?

Polyneuropathy

As a client explains to the nurse what occurred prior to the onset of seizure activity, the client describes perceiving a feeling or warning that the seizure would occur. The nurse documents the perceived warning as which of the following?

Prodrome

A client with laryngeal dystonia has gotten to the point that people on the telephone cannot understand her. She has heard about getting Botox injections into her vocal cords. The nurse will teach about the actions of Botox. Which is the most accurate description? This drug:

Produces paralysis of the larynx muscles by blocking acetylcholine release

There are two types of nervous tissue cells. One type is neurons, and the other type is the supporting cells. What is the function of the supporting cells?

Protect the nervous system and provide metabolic support for the neurons

Following a car accident in which the driver did not have his seatbelt on, the client is diagnosed with a traumatic brain injury requiring emergent craniotomy for severe cerebral edema. Which assessments should the nurse report immediately since they correspond to a supratentorial herniation progressing to midbrain involvement? Select all that apply.

Pupils fixed at ~ 5 mm in diameter Respiration rate of 40 breaths/min Decerebrate posturing following painful stimulation of the sternum

A client seeks medical care when he wrecks his care because of poor eyesight. At the time of admission, his blood glucose level was 390 mg/dL. The client is diagnosed with diabetes (type 2). The ophthalmologist must perform an urgent intravitreal injection. The nurse explains this to the client by stating the doctor will

Put a needle with syringe into your eyeball and inject some medication to decrease active bleeding

Following a car accident that has resulted in partial amputation of the lower limbs, the client's body has implemented a compensatory mechanism releasing antidiuretic hormone (ADH) into the blood stream, causing retention of water and vasoconstriction of blood vessels. This is accomplished as a result of:

Rapid axonal transport of ADH from the hypothalamus into the posterior pituitary

A 62 year old woman present to the clinic with low back pain. She states she has developed episodes of fecal incontinence and numbness in her right leg over the last week. Upon examination the clinician notes decreased perianal sensation to pinprick. What should the clinician do next? - Send the pt for electromyelography (EMG) testing - Prescribe physical therapy for 6 weeks - Order a MRI - Refer the patient to the emergency room

Refer the patient to the emergency room Cauda equina is characterized by loww of bowel/bladder control or saddle-pattern anesthesia (perineum). If left untrested, compresssion can cause ischemia and premamnent nerve damage leading to incontinence and paralysis. the pt should be immediately referred to the ER.

The nursing assistant reports to the registered nurse that a client with a brain tumor has a blood pressure of 180/100 and a pulse of 50. Which of the following is the correct nursing intervention?

Report to physician the client's signs of increased intracranial pressure.

A client has started having uncontrolled seizures that are not responding to usual medications. Nurses working with the client must pay special attention to which priority aspects of this client's care? Assessment of:

Respiratory status and oxygen saturation

A client has started having uncontrolled seizures that are not responding to usual medications. Nursing working with the client must pay special attention to which of the following priority aspects of this clients care? Assessment of:

Respiratory status and oxygen saturation

A patient with a diagnosis of myasthenia gravis has required a mastectomy for the treatment of breast cancer. The surgery has been deemed a success, but the patient has gone into a myasthenic crisis on postoperative day one. Which of the following measures should the care team prioritize in this patient's immediate care? Positioning the patient to minimize hypertonia and muscle rigidity Seizure precautions Respiratory support and protection of the patient's airway Monitoring the patient for painful dyskinesias

Respiratory support and protection of the patient's airway

A patient with a diagnosis of myasthenia gravis has required a mastectomy for the treatment of breast cancer. The surgery has been deemed a success, but the patient has gone into a myasthenic crisis on postoperative day one. Which of the following measures should the care team prioritize in this patient's immediate care? Positioning the patient to minimize hypertonia and muscle rigidity Seizure precautions Respiratory support and protection of the patient's airway Monitoring the patient for painful dyskinesias

Respiratory support and protection of the patient's airway

A parent brought her 8-year-old child to the emergent care center to be examined following a fall off a playground set, resulting in a head injury. On discharge, the nurse explains to the parent that some symptoms may continue, including the inability to remember what happened before the fall. Which term best describes the diagnosis?

Retrograde amnesia

While teaching a class of nursing students about spinal cord injury, the instructor mentions that male SCI clients will be able to have a sexual response if their injury is at which level on the spinal column?

S4

A 13 year old obeses (BMI aboe the 95th percentile) boy repoerts low-grade left knee pain for the past 2 months. He denies antecedent trauma but admits frequent "horseplay" with his friends. The pain has progressivley worsened and he is now unable to bear weight at all on his left leg. His current complaints inclused left groin, thigh, and medial knee pain and tenderness. His examination demonstrates negative drawer, Lachman, and McMurray tests; left hip with decreased internal rotation and abduction; and external hip rotation with knee flexion. Based on the above scenario, the clinican should suspect which of the following? - A left meniscal tear - A slipped capital femoral epiphysis (SCFE) - A left anterior cruciated ligament (ACL) tear - Osgood-Schlatter disease

SCFE is a displacement of the femoral head relative to the femoral neck that occurs through the physis (growth plate) of the femur. The vast majority of clients with this condition are obese as the added wieght increases shear stress across the physis. the mean age at diagnsosi is 12 for females and 13.5 for males. Surgery is often required via in situ pin fixation (single screw) to stabilize the growth plate

A 10 year olf male presnt to the clinica after jumpting of a 2-foot wall, twisting his foor and ankle upon landing. His ankle xray demonstrates a fracture of the distal tibia, over the articular surface, through the epiphysis and physis. Based on the Salter-Harris classification of growht plate injuries, the clinican knows that this is a _____? - Salter-Harris II fx - Salter-Harris III fx - Salter-Harris IV fx - Salter-Harris V fx

Satler-Harris III fracture Salter Harris classification system of grwoth plate injuries divides most growth plate injuries into 5 categories based on damage: - SH I fx travels through the phyis. - SH II fx travels through the metaphysis and physis - SH III fx travels through the epiphysis and physis - SH IV fx travels through the metaphsyis, epiphysis, and physis - SH V fx involves compression injury of the physis

The emergency department nurse is caring for a patient who fell and had a head injury. Which of the following assessments would be noted during the early stage of intracranial pressure increase?

Stable Vital Signs

Epilepsy

Seizures may be caused by alterations in cell membrane permeability or distribution of ions across the neuronal cell membranes decreased inhibition of cortical/thalamic neuronal activity structural changes alter the excitability of neurons Neurotransmitter imbalances such as an acetylcholine excess or γ-aminobutyric acid (GABA, an inhibitory neurotransmitter) deficiency have been proposed as causes Certain epilepsy syndromes have been linked to specific genetic mutations causing ion channel defects

A family brings their father to his primary care physician for a checkup. Since their last visit, they note their dad has developed a tremor in his hands and feet. He also rolls his fingers like he has a marble in his hand. The primary physician suspects the onset of Parkinson disease when he notes which of the following abnormalities in the patient's gait?

Slow to start walking and has difficulty when asked to "stop" suddenly

When a person is stung on the index finger by a bee, the thalamus interprets the pain as:

Somewhere on the hand

convulsion

Specific seizure involving the entire body

The vertebral column provides protection of which parts of the body? Select all that apply.

Spinal cord Spinal nerves Supporting structures

Following an automobile accident that resulted in a traumatic amputation of the right lower leg, the client complains of feeling tingling, heaviness, and shooting pain in the amputated limb. The health care providers treat phantom limb pain by which of the following interventions? Select all that apply.

TENS of the large myelinated afferents innervating the area • Hypnosis • Relaxation techniques

Which lobe of the brain performs functions of perception, long-term memory, and recognition of auditory stimuli?

Temporal lobe

A 28 year old male present to the clinic for follo-up from the emergency department, where he was seen for right forearm pain 3 days ago. He works as a carpenter and is right hand dominant. He states he was diagnosed with right forearm tendinitis and is not sure what this means. As part of treaching, the clinician explains that the condition is caused by inflammation of one or more of the tendons. Which of the following describes tendons? - The ropelike bundles of collagen fibrils that connect bone to bont - the collagen fibers that connect muscle to bone - the fibrocartilaginous disks that separate bony surfaces - The pouches of synovial fluid that cushion bone and other joint structures

Tendons are the collagen fibers that connect muscle to bone.

Which of the following physiologic principles would be considered a function of the somatic nervous system?

The act of typing a report using a computer keyboard

An adult client has been admitted to a rehabilitation center after hospital treatment for an ischemic stroke. Which aspect of the client's history would be considered to have contributed to his stroke?

The client's blood pressure has historically been in the range of 150s/90s.

During physiology class, the instructor asks students to explain the pathology behind development of multiple sclerosis. Which student gave the most accurate description?

The demyelination and subsequent degeneration of nerve fibers and decreased oligodendrocytes, which interfere with nerve conduction

A client is being treated for the ingestion of a neurotoxin that interferes with the depolarization phase of action potentials. What physiologic process will be disrupted?

The inflow of sodium ions

A neuron has been hyperpolarized. How will this affect the excitability of the neuron?

The neuron will have a membrane potential farther from the threshold.

A

The nurse is planning care for a patient with Guillain-Barré syndrome (GBS). Which intervention will help with neuropathic pain? A) Administer gabapentin B) Turn and reposition every two hours C) Apply sequential compression devices D) Perform passive range of motion several times a day

A

The nurse is reading the results of a single-fiber electromyography completed on a patient suspected of having myasthenia gravis. Which information would validate this patient's diagnosis? A) Increased jitter B) Nerve compression C) Increased antibodies D) Decreased muscle response

A

The nurse is reviewing discharge instructions for a patient with myasthenia gravis. What should the nurse emphasize regarding medications? A) Keep extra doses of medication in the car B) Store extra doses of medication in the refrigerator C) Take an extra dose of medication before leaving the house D) Pack prescribed medications in a suitcase before flying on an airplane

A, C & D

The nurse is reviewing orders written for a patient with myasthenia gravis. Which medication order should the nurse question before administering? (Select all that apply.) A) Verapamil B) Furosemide C) Erythromycin D) Nicotine patch E) Warfarin sodium

D

The nurse notes that a patient with Guillain-Barré syndrome (GBS) sweats profusely. What should the nurse do about this finding? A) Place on a cooling blanket B) Notify the health-care provider C) Monitor body temperature every two hours D) Change linen and gown and keep comfortable

A, C, D & E

The nurse notes that a patient with myasthenia gravis is experiencing bulbar manifestations. On what should the nurse focus when assessing this patient? (Select all that apply.) A) Swallowing B) Eye opening C) Blood pressure D) Tongue movement E) Head and neck movement

A patient with a diagnosis of lung cancer has developed bone metastases resulting in severe and protracted pain. Which of the following assessment components should the nurse prioritize when assessing the patient's pain?

The patient's subjective report of the character & severity of pain

A 42 year old professional golfer complains of chronic back pain for many years. His workup reveals that it is not the result of degenerative disc problem. His back "goes out" about tsice per year, and he is out of work for about a week each time. Which of the following should the clinician advise? - Make and appt with a neurosurgeon ofr surgical consultation - Start on daily low-dose narcotic to take away the pain - Consider changing careers to something less physical - Being a Planned exercise program to strengthen back muscles

The pt amy benefit from a regular planned exercise program to strengthen his back muscles and attempt to reduce the probability of future episodes of back pain

Which of the following messages is most likely to be carried by general somatic afferent (GSA) neurons?

The sensation of cold when touching ice

A 55 year old female presnt to the clinical with complaints of left hand and wrist pain and swelling after a slip and fall on the ice yesterday. On examination, the clinican notes tenderness at the "antamocial snuffmox" this finding moste likely indicates which of the following? - Scaphoid fx - Ulnar styloid fx - Hamate fx - Radial head fx

There is tenderness over the "anatomical snuffbox" in a scaphoid (aka navicular) fx, the most common injurty of the carpal bones. Poor blood suppply puts the scaphoid boneat risk of avascular necrosis; therefore, wrist pain and tenderness in the anatomical snuff box, even w/o hx of antecedent trauma warrante a wrist xray

A client suffering a thrombotic stroke is brought into the emergency department by ambulance and the health care team is preparing to administer a synthetic tissue plasminogen activator for which purpose?

Thrombolysis

A patient suffering a thrombotic stroke is brought into the emergency department by ambulance and the health care team is preparing to administer a synthetic tissue plasminogen activator for which of the following purposes?

Thrombolysis

The most common cause of an ischemic stroke is which of the following?

Thrombosis

A client who is being seen in the outpatient clinic reports a single episode of unilateral arm and leg weakness and blurred vision that lasted approximately 45 minutes. The client is most likely experiencing:

Transient ischemic attack (TIA)

while playing outside in the snow, a young child complained of painful fingertips since he would not keep his gloves on. In the emergency department the nurse knows this painful sensation is a result of which transmission of proprioceptive somatosensory information ?

Type C dorsal root ganglian neurons

Which of the following characteristics differentiates a migraine with aura from a migraine without aura?

Visual symptoms that precede the headache.

A client has been diagnosed with a cerebral aneurysm and placed under close observation before treatment commences. Which pathophysiologic condition has contributed to this client's diagnosis?

Weakness in the muscular wall of an artery

A patient has been diagnosed with a cerebral aneurysm and placed under close observation before treatment commences. Which of the following pathophysiologic conditions has contributed to this patient's diagnosis?

Weakness in the muscular wall of an artery

A patient has been diagnosed with a cerebral aneurysm and placed under close observation before treatment commences. Which of the following pathophysiologic conditions has contributed to this patient's diagnosis? Weakness in the muscular wall of an artery Impaired synthesis of clotting factors Deficits in the autonomic control of blood pressure Increased levels of cerebrospinal fluid

Weakness in the muscular wall of an artery

A patient has been diagnosed with a cerebral aneurysm and placed under close observation before treatment commences. Which of the following pathophysiologic conditions has contributed to this patients diagnosis?

Weakness in the muscular wall of an artery

Which of the following individuals has the highest chance of having a medulloblastoma?

a 4-year-old child who has become uncoordinated in recent months

For many clients, the first indication that they have osteoporosis is:

a bone fracture

A client who experienced a traumatic head injury from a severe blow to the back of his head now lives with numerous function deficits, including an inability to maintain steady posture while he is in a standing position, although he is steadier when walking. Which of the following disorders most likely resulted from his injury?

a vestibulocerebellar disorder

The family of a multiple sclerosis client asks, "What psychological manifestations may we expect to see in our mother?" The health care provider informs them to expect which of the following? Select all that apply.

a. Depression d. Inattentiveness e. Forgetfulness

Following his annual influenza vaccination, a client begins to feel achy, like he has developed the flu. An hour later, the client is rushed to the emergency department. Diagnosis of Guillain-Barré syndrome was made based on which of the following assessment findings? Select all that apply.

a. Rapid deterioration of respiratory status c. Flaccid paralysis of limbs d. BP 90/62 Explanation:

When evaluating an ABG from a client with a subdural hematoma, the nurse notes the PaCO2 is 30 mm Hg. Which of the following responses best describes this result? a.) Appropriate; lowering carbon dioxide (CO2) reduces intracranial pressure (ICP). b.) Emergent; the client is poorly oxygenated. c.) Normal d.) Significant; the client has alveolar hypoventilation.

a.) Appropriate; lowering carbon dioxide (CO2) reduces intracranial pressure (ICP). Rationale: A normal PaCO2 value is 35 to 45 mm Hg. CO2 has vasodilating properties; therefore, lowering PaCO2 through hyperventilation will lower ICP caused by dilated cerebral vessels. Oxygenation is evaluated through PaO2 and oxygen saturation. Alveolar hypoventilation would be reflected in an increased PaCO2.

A client is admitted to the ER for head trauma is diagnosed with an epidural hematoma. The underlying cause of epidural hematoma is usually related to which of the following conditions?a.) Laceration of the middle meningeal artery b.) Rupture of the carotid artery c.) Thromboembolism from a carotid artery d.) Venous bleeding from the arachnoid space

a.) Laceration of the middle meningeal artery Rationale: Epidural hematoma or extradural hematoma is usually caused by laceration of the middle meningeal artery. An embolic stroke is a thromboembolism from a carotid artery that ruptures. Venous bleeding from the arachnoid space is usually observed with subdural hematoma

A client with subdural hematoma was given mannitol to decrease intracranial pressure (ICP). Which of the following results would best show the mannitol was effective? a.) Urine output increases b.) Pupils are 8 mm and nonreactive c.) Systolic blood pressure remains at 150 mm Hg d.) BUN and creatinine levels return to normal

a.) Urine output increases Rationale: Mannitol promotes osmotic diuresis by increasing the pressure gradient in the renal tubes. Fixed and dilated pupils are symptoms of increased ICP or cranial nerve damage. No information is given about abnormal BUN and creatinine levels or that mannitol is being given for renal dysfunction or blood pressure maintenance.

hydrocephalus

abnormal increase in csf volume in part or all of the ventricular system=enlargment of csf compartment types communicating: decreased absorption of csf noncommunicating: overproduction of csf

Myasthenia gravis is characterized by muscle weakness caused by antibody-mediated destruction of: periorbital muscles. thymus gland cells. skeletal muscle fibers. acetylcholine receptors.

acetylcholine receptors.

Myasthenia gravis is characterized by muscle weakness caused by antibody-mediated destruction of: periorbital muscles. thymus gland cells. skeletal muscle fibers. acetylcholine receptors.

acetylcholine receptors.

Neurons are characterized by the ability to communicate with other neurons and body cells through pulsed electrical impulses, or:

action potentials.

While explaining the physiology behind systemic sclerosis (scleroderma), the instructor states, "One of the hallmarks of scleroderma is:

activation of fibroblasts, resulting in fibrosis

A client is brought to the emergency department and is diagnosed with an ischemic stroke confirmed by CT scan. The most important treatment for this client would be to:

administer IV tissue plasminogen activator (tPA).

A client is experiencing severe pain in his back to the point of being immobile and running a temperature. The client also has swelling in his lower back (vertebrae). Following biopsy, the results show spinal tuberculosis. The nurse will anticipate explaining which priority intervention to this client?

administer the 4-drug antimicrobial medications

manifestations of global brain injury

alterations in sensory and motor function changes in level of conciousness rostral-to-caudal step wise progression: as the diencephalon, midbrain, pons, medulla are effected additional respiratory, pupillary, eye movement reflexes and motor signs become evident

global and focal brain injuries manifest differently. what is almost always a manifestation of a global brain injury?

altered level of consciousness

For seizure disorders that do not respond to anticonvulsant medications, the option for surgical treatment exists. What is removed in the most common surgery for seizure disorders?

amygdala

what medication teaching should be done for a women of childbearing age with a seizure disorder?

anti seizure drugs increase the risk for congenital abnormalities

A client with a spinal cord injury at T8 would likely retain normal motor and somatosensory function of her:

arms

A patient with a spinal cord injury at T8 would likely retain normal motor and somatosensory function of her: arms. bowels. bladder. perineal musculature.

arms.

A patient with a spinal cord injury at T8 would likely retain normal motor and somatosensory function of her: arms. bowels. bladder. perineal musculature.

arms.

The significant other of a client admitted to the hospital after a motor vehicle accident reports to the nurse that the client has become very drowsy. The nurse should:

assess the client for additional signs/symptoms of increased intracranial pressure.

A family brings their elderly mom to the emergency department. The client had a short period of time where she was confused, had slurred speech and appeared to have a weak arm. Now she is back to her normal self. Suspecting a transient ischemic attacks (TIAs), the health care provider will order diagnostic testing looking for:

atherosclerotic lesions in cerebral vessels

A family brings their elderly mom to the emergency department. The client had a short period of time where she was confused, had slurred speech and appeared to have a weak arm. Now she is back to her normal self. Suspecting a transient ischemic attacks (TIAs), the health care provider will order diagnostic testing looking for:

atherosclerotic lesions in cerebral vessels

A patient is admitted with a subacute subdural hematoma. The nurse realizes this patient will most likely be treated with: a.) Emergency craniotomy. b.) Elective draining of the hematoma. c.) Burr holes to remove the hematoma. d.) Removal of the affected cranial lobe.

b.) Elective draining of the hematoma.

A woman has cut her finger while dicing onions in the kitchen, causing her to drop her knife in pain. Which of the following components of this pain signal was transmitted by a third-order neuron?

between the thalamus and the cortex

When explaining to the client diagnosed with gout how the xanthine oxidase inhibitors work to help treat gout, the health care provider would include which of the following data? Allopurinol:

blocks the profuction of uric acid by the body

While taking a client history, which of the following findings may lead the nurse to suspect the client is at risk for development of osteonecrosis?

bone marrow ischemia due to radiation therapy for cancer

The cardinal symptoms of Parkinson disease include: hypotonia. bradykinesia. paresthesia. lack of sweating.

bradykinesia.

The cardinal symptoms of Parkinson disease include: hypotonia. bradykinesia. paresthesia. lack of sweating.

bradykinesia.

A teenager has been in a car accident and experienced acceleration-deceleration head injury. Initially, the client was stable but then started to develop neurological signs/symptoms. The nurse caring for this client should be assessing for which type of possible complication?

brain contusions and hematomas

types of hematomas

brain injuries can be catagorized as traumatic (concussion, contusion, diffuse axonal injury) *epidural: temporal area is fx, develops btw dura & skull *subdural: bleeding btw brain and dura dt tear in small bridging veins on surface of the cortex that connect down to dural sinuses -traumatic intracerebral hematomas: may be single or multiple, common in temporal or frontal may be associated with severe motion or a contusion that turned into a hematoma non-trumatic (stroke infection, tumor, seizure)

infants increased ICP

bulging fontanels cranial suture separation increased head circumference high pitched cry

Which of the following signs and symptoms of increased ICP after head trauma would appear first? a.) Bradycardia b.) Large amounts of very dilute urine c.) Restlessness and confusion d.) Widened pulse pressure

c.) Restlessness and confusion Rationale: The earliest symptom of elevated ICP is a change in mental status. Bradycardia, widened pulse pressure, and bradypnea occur later. The client may void large amounts of very dilute urine if there's damage to the posterior pituitary.

A client with a subdural hematoma becomes restless and confused, with dilation of the ipsilateral pupil. The physician orders mannitol for which of the following reasons? a.) To reduce intraocular pressure b.) To prevent acute tubular necrosis c.) To promote osmotic diuresis to decrease ICP d.) To draw water into the vascular system to increase blood pressure

c.) To promote osmotic diuresis to decrease ICP Rationale: Mannitol promotes osmotic diuresis by increasing the pressure gradient, drawing fluid from intracellular to intravascular spaces. Although mannitol is used for all the reasons described, the reduction of ICP in this client is a concern.

When trying to explain the difference between vasogenic versus cytotoxic cerebral edema, the physiology instructor mentions that cytotoxic edema displays which of the following functions in the brain? Select all that apply.

causes ischemia to build up lactic acid due to anaerobic metabolism allows cells to increase volume to the point of rupture, damaging neighboring cells

An elderly male client has been brought to the emergency department after experiencing stroke-like symptoms a few hours ago, and has been subsequently diagnosed with an ischemic stroke. The care team is eager to restore cerebral perfusion despite the likely death of the brain cells directly affected by the stroke. What is the rationale for the care team's emphasis on restoring circulation?

cells of the penumbra may be saved from hypoxic damage if blood flow is promptly restored

An elderly male client has been brought to the emergency department after experiencing stroke-like symptoms a few hours ago, and has been subsequently diagnosed with an ischemic stroke. The care team is eager to restore cerebral perfusion despite the likely death of the brain cells directly affected by the stroke. What is the rationale for the care team's emphasis on restoring circulation?

cells of the penumbra may be saved from hypoxic damage if blood flow is promptly restored

An elderly client has been brought to his primary care provider by his wife, who is concerned about his recent decrease in coordination. Upon assessment, his primary care provider notes that the client's gait is wide-based, unsteady, and lacking in fluidity, although his muscle tone appears normal. This client requires further assessment for which of the following health problems?

cerebellar disorders

An elderly client has been brought to his primary care provider by his wife, who is concerned about his recent decrease in coordination. Upon assessment, his primary care provider notes that the client's gait is wide-based, unsteady, and lacking in fluidity, although his muscle tone appears normal. This client requires further assessment for which of the following health problems?

cerebellar disorders

Severe head trauma from a coup-contrecoup injury may result in which type of brain injury?

cerebral hematoma

The intracranial volume that is most capable of compensating for increasing intracranial pressure is the:

cerebrospinal fluid

The intracranial volume that is most capable of compensating for increasing intracranial pressures is the:

cerebrospinal fluid

The intracranial volume that is most capable of compensating for increasing intracranial pressure is the: brain cell tissue. intravascular blood. surface sulci fluid. cerebrospinal fluid.

cerebrospinal fluid.

A client has suffered a stroke that has affected his speech. The physician has identified the client as having expressive aphasia. Later in the day, the family asks the nurse to explain what this means. The most accurate response would be aphasia that is:

characterized by an inability to communicate spontaneously with ease or translate thoughts or ideas into meaningful speech or writing

A client has suffered a stroke that has affected his speech. The physician has identified the client as having expressive aphasia. Later in the day, the family asks the nurse to explain what this means. The most accurate response would be aphasia that is:

characterized by an inability to communicate spontaneously with ease or translate thoughts or ideas into meaningful speech or writing.

A client has suffered a stroke that has affected his speech. The physician has identified the client as having expressive aphasia. Later in the day, the family asks the nurse to explain what this means. The most accurate response would be aphasia that is:

characterized by an inability to easily communicate spontaneously or translate thoughs or ideas into meaningful speech or writing

A client has suffered a stroke that has affected his speech. The physician has identified the client as having expressive aphasia. Later in the day, the family asks the nurse to explain what this means. The most accurate response would be aphasia that is:

characterized by an inability to easily communicate spontaneously or translate thoughts or ideas into meaningful speech or writing

A client presents to the emergency department following an accident where he fell off a chair. He reports hip numbness, increasing pain, and muscle cramping. The triage nurse suspects:

closed hip fracture

The moderate stage of the progressive degenerative Alzheimer-type dementia is manifested by behaviors that include:

confusion

The moderate stage of the progressive degenerative Alzheimer-type dementia is manifested by behaviors that include: confusion. incontinence. decreased level of consciousness. social withdrawal.

confusion.

A client has started having uncontrolled seizures that are not responding to usual medications. Nursing working with the client must pay special attention to which of the following priority aspects of this clients care? Assessment of:

d. Respiratory status and oxygen saturation

A recently injured (3 months ago) client with a spinal cord injury at T4 to T5 is experiencing a complication. He looks extremely ill. The nurse recognizes this as autonomic dysreflexia (autonomic hyperreflexia). His BP is 210/108; skin very pale; gooseflesh noted on arms. The priority nursing intervention would be to:

d. Scan his bladder to make sure it is empty

The nurse is caring for a client with head trauma. The client is flexing the arms, wrists, and fingers. There is adduction of the upper extremities with internal rotation and plantar flexion of the lower extremities. How would the nurse describe this in the notes?

decorticate posturing

A client suffering global cerebral ischemia a week after a suicide attempt by hanging is in the intensive care unit receiving treatment. The parent asks the nurse why it is necessary to keep the client paralyzed with medications and on the ventilator. The most appropriate response would be that these therapies:

decrease metabolic needs and increase oxygenation.

The demyelination and degeneration of nerve fibers characteristic of multiple sclerosis is the result of: decreased oligodendrocytes. corticospinal injuries. atherosclerotic destruction. oligodendrocytic infection.

decreased oligodendrocytes.

The demyelination and degeneration of nerve fibers characteristic of multiple sclerosis is the result of: decreased oligodendrocytes. corticospinal injuries. atherosclerotic destruction. oligodendrocytic infection.

decreased oligodendrocytes.

A traumatic brain injury client has developed extreme cerebral edema. The nurse is monitoring the client closely for signs of brain herniation. Which clinical manifestations would correlate to upward herniation of the midbrain from the infratentorial compartment? Select all that apply.

deep coma respiratory rate of 8 with intermittent sighs bilateral small, fixed pupils

The family of a multiple sclerosis client asks, "What psychological manifestations may we expect to see in our mother?" The health care provider informs them to expect which of the following? Select all that apply.

depression inattentiveness forgetfulness

A client works as a data entry worker for a large company. The client goes to employee health with pain in the wrist/hand. The nurse suspects that it is carpal tunnel syndrome based on which of the following assessment findings? Select all that apply.

describes numbness/tingling in the thumb and first digit precision grip weakness in the affected hand pain interferes with sleeping

The client has a traumatic complete spinal cord transection at the C5 level. Based on this injury, the health care worker can expect the client to have control of which body function/part?

diaphragm

The patient has a traumatic complete spinal cord transection at the C5 level. Intact motor and somatosensory function will include __ control. bladder finger flexion diaphragm trunk muscle

diaphragm

The patient has a traumatic complete spinal cord transection at the C5 level. Intact motor and somatosensory function will include ______ control. bladder finger flexion diaphragm trunk muscle

diaphragm

A client's recent diagnosis of Parkinson disease has prompted his care provider to promptly begin pharmacologic therapy. The drugs that are selected will likely influence the client's levels of:

dopamine

A patient's recent diagnosis of Parkinson disease has prompted his care provider to promptly begin pharmacologic therapy. The drugs that are selected will likely influence the patient's levels of: dopamine. acetylcholine. serotonin. adenosine.

dopamine.

A patient's recent diagnosis of Parkinson disease has prompted his care provider to promptly begin pharmacologic therapy. The drugs that are selected will likely influence the patient's levels of: dopamine. acetylcholine. serotonin. adenosine.

dopamine.

signs of increased ICP

early recognition preserves brain function *EARLY: change in LOC, irritable, confused, pupillary change and decreased GCS, vomiting, seizures, HA *LATE: difficult to arouse, coma, posturing, fixed/blown pupils, ecg change *Cushings triad: systolic HTN with widening pulse pressure, bradycardia and respiratory depression

common pathways of brain damage

effects of ischemia excitatory amino acid injury cerebral edema injury due to increased ICP

A child is being seen in the emergency department (ED) after ingesting crayons with lead in them. He is disoriented and having seizures. The provider suspects he has which of the following?

encephalitis

The health care provider for a client with degenerative Alzheimer-type dementia recognizes the client has moved from the initial stage to the moderate stage based on which of the following clinical manifestations? Select all that apply.

extreme confusion and disorientation need for direct supervision for ADLs inability to problem solve simple tasks

A sudden traumatic complete transection of the spinal cord results in ___ below the level of injury. flaccid paralysis vasoconstriction deep visceral pain 3+ tendon reflexes

flaccid paralysis

A sudden traumatic complete transection of the spinal cord results in _______ below the level of injury. flaccid paralysis vasoconstriction deep visceral pain 3+ tendon reflexes

flaccid paralysis

A sudden traumatic complete transection of the spinal cord results in what type of injury below the site?

flaccid paralysis

A client with a history of a seizure disorder has been observed suddenly and repetitively patting his knee. After stopping this repetitive action, the client appears confused but is oriented to person and place but not time. What type of seizure did this client most likely experience?

focal seizure with impairment to consciousness

A client with a history of a seizure disorder has been observed suddenly and repetitively patting his knee. After stopping this repetitive action, the client appears confused but is oriented to person and place but not time. What type of seizure did this client most likely experience?

focal seizure with impairment to consciousness

Disorders that affect cortical bone typically result in:

fractures of long bones

Knowing that she is a carrier for Duchene muscular dystrophy (DMD), a pregnant woman arranged for prenatal genetic testing, during which her child was diagnosed with DMD. As her son develops, the woman should watch for which of the following early signs that the disease is progressing?

frequent falls and increased muscle size

Following surgery for a large malignant brain tumor, the nurse should anticipate discussing which further treatment option with the family that may ensure that any remaining cancer cells will be killed?

gamma knife radiation

The chart of a client admitted because of seizures notes that the seizure activity began simultaneously in both cerebral hemispheres. The nurse should interpret this to mean that the client experienced:

generalized seizure

A high school student sustained a concussion during a football game. The school nurse will educate the family about postconcussion syndrome and ask them to watch for and report which manifestations of its presence?

headaches and poor concentration

A late indicator of increased intracranial pressure is:

high mean arterial pressure

A late indicator of increased intracranial pressure is: tachycardia. right-sided heart failure. narrow pulse pressure. high mean arterial pressure.

high mean arterial pressure.

Extreme cerebral edema may cause the brain to herniate into another compartment. Upward herniation from the infratentorial compartment against the aqueduct of Sylvius causes:

hydrocephalus

Extreme cerebral edema may cause the brain to herniate into another compartment. Upward herniation from the infratentorial compartment against the aqueduct of Sylvius causes: hydrocephalus. cardiac arrest. tissue infarction. intracranial bleeding.

hydrocephalus.

A clinician is assessing the muscle tone of a client who has been diagnosed with a lower motor neuron (LMN) lesion. Which of the following assessment findings is congruent with the client's diagnosis?

hypotonia

An elderly resident of an assisted-living facility has had his mobility and independence significantly impaired by the progression of his rheumatoid arthritis (RA). What is the primary pathophysiologic process that has contributed to this client's decline in health?

immunologically mediated joint inflammation

A family brings a client to the emergency department with increasing lethargy and disorientation. They think the client had a seizure on the drive over to the hospital. The client has been sick with a "cold virus" for the last few days. On admission, the client's temperature is 102°F. Which other clinical manifestations may lead to the diagnosis of encephalitis?

impaired neck flexion resulting from muscle spasm

A client has developed global ischemia of the brain. The nurse determines this is:

inadequate to meet the metabolic needs of the entire brain.

Following a head injury on the football field, the medical team is assessing the player for injury. One of the earliest signs of decreased level of consciousness to assess for would be:

inattention

The earliest signs of decreased level of consciousness include:

inattention

The earliest signs of decreased level of consciousness include: stupor. lethargy. delirium. inattention.

inattention.

Metabolic factors that increase cerebral blood flow include:

increased carbon dioxide level

While lecturing to a group of physiology students, the instructor asks, "What metabolic factors cause vasodilation of cerebral vessels thereby increasing cerebral blood flow to the brain?" The student with the best response would be:

increased carbon dioxide level

Metabolic factors that increase cerebral blood flow include: increased oxygen saturation. increased carbon dioxide level. decreased serum sodium level. decreased hydrogen ion concentration.

increased carbon dioxide level.

intracranial pressure: 0-15mm

increased icp is common cause of injury: can obstruct cerebral brain flow, destroy brain cells, displace brain tissue, damage structures -cranial activity: 10% blood 10% CSF 80% brain tissue monro-kellie hypothesis of normalization of icp *influenced normally by intrathoracic pressure (coughing) or intrabdominal pressure (valsalva)

A 55-year-old male client has reported joint pain in his feet. Which of the following blood work results should prompt further testing to rule out primary gout?

increased serum uric acid

The client has a fractured tibia. After the cast is applied, he is at high risk for compartment syndrome caused by:

inflammation

Which of the following pathophysiologic processes occurs in cases of bacterial meningitis?

inflammation allows pathogens to cross into the cerebrospinal fluid

The most common cause of C. botulinum in infants is:

ingestion of honey products containing C. botulinum spores.

injury from excitatory amino acids

injury to neurons caused by over-stimulation of receptors for specific amino acids that act as excitatory neurotransmitter -causes: stroke, hypoglycemic injury, trauma to chronic degeneretive disorders (Huntingtons/Alzheimers)

An intracranial epidural hematoma causes focal symptoms that can include:

ipsilateral pupil dilation

Following a head injury, a client is diagnosed with a possible intracranial epidural hematoma. During the initial assessment, the client suddenly becomes unconscious. Other clinical manifestations that correlate with this diagnosis may include:

ipsilateral pupil dilation

Following a head injury, a client is diagnosed with a possible intracranial epidural hematoma. During the initial assessment, the client suddenly becomes unconscious. Other clinical manifestations that correlate with this diagnosis may include:

ipsilateral pupil dilation

An intracranial epidural hematoma causes focal symptoms that can include: ipsilateral pupil dilation. ipsilateral hemiparesis. diffuse venous bleeding. commuting hydrocephalus.

ipsilateral pupil dilation.

A client's emergency magnetic resonance imaging (MRI) has been examined by the physician and tissue plasminogen activator (tPA) has been administered to the client. What was this client's most likely diagnosis?

ischemic stroke

A client's emergency magnetic resonance imaging (MRI) has been examined by the physician and tissue plasminogen activator (tPA) has been administered to the client. What was this client's most likely diagnosis?

ischemic stroke

A patient's emergency magnetic resonance imaging (MRI) has been examined by the physician and tPA has been administered to the patient. What was this patient's most likely diagnosis?

ischemic stroke

Which of the following signs and symptoms should prompt a 29-year-old woman's primary care provider to assess for systemic lupus erythematosus (SLE)?

joint pain and increased creatinine and blood urea nitrogen

LOC examination technique

lethargy: speak in a loud voice obtundation: shake gently stupor: apply light painful stimuli (nail bed, pinch) coma: repeated painful stimuli

Which of the following peripheral nerve injuries will likely result in cellular death with little chance of regeneration?

nerve fibers destroyed close to the neuronal cell body

An adult female client visits with her health care provider about pain in her hand. She describes it as an audible grinding and cracking sound, especially in her thumb. "I had to buy an automatic jar opener...I just can't grasp and open a jar...it just hurts too badly." The health care provider suspects the client has a degenerative form of joint disease that is often evidenced by:

osteoarthritis

Following a knee replacement surgery, a nurse's next door neighbor asks, "I don't think I am healing right. Can you come look at my knee?" Upon assessment, the nurse notices the client is warm to touch and has a fever; the incision is inflamed and not well approximated with foul-smelling drainage around the incision line. At this point, the nurse tells the client she needs to go see her surgeon because the client may have:

osteomyelitis

The condition that contributes to the pathology of all metabolic bone diseases is:

osteopenia

A 77-year-old woman has been admitted to the geriatric medical unit of the hospital for the treatment of pneumonia. The nurse providing care for the client notes the presence of nasal calcitonin, vitamin D, and calcium chloride on the client's medication administration record. The nurse should conclude that this client likely has a history of:

osteoporosis

A client presents to a health care clinic reporting sudden onset of deep, localized pain and swelling in her proximal femur. The client is currently undergoing diagnostic workup for suspected lung cancer. The nurse suspects the client may have developed which of the following neoplasms of the skeletal system?

osteosarcoma

A feature of rheumatoid arthritis that differentiates it from other forms of inflammatory arthritis is the development of:

pannus tissue

Disorders of the pyramidal tracts, such as a stroke, are characterized by:

paralysis

Disorders of the pyramidal tracts, such as a stroke, are characterized by: paralysis. hypotonia. muscle rigidity. involuntary movements.

paralysis.

Disorders of the pyramidal tracts, such as a stroke, are characterized by: paralysis. hypotonia. muscle rigidity. involuntary movements.

paralysis.

Coup and contrecoup cerebral contusion caused by blunt head trauma against a fixed object results in:

permanent brain tissue damage

Coup and contrecoup cerebral contusion caused by blunt head trauma against a fixed object results in: diffuse axonal injuries. cerebrovascular infarction. momentary unconsciousness. permanent brain tissue damage.

permanent brain tissue damage.

Common manifestations of acute meningococcal meningitis, a highly contagious and lethal form of meningitis, include:

petechiae

Common manifestations of acute meningococcal meningitis, a highly contagious and lethal form of meningitis, include: diplopia. petechiae. papilledema. focal paralysis.

petechiae.

A client's recent computed tomography (CT) scan has revealed the presence of hydrocephalus. Which of the following treatment measures is most likely to resolve this health problem?

placement of a shunt

The nurse is assessing a client who has experienced a seizure. The client describes having a feeling or warning that the seizure would occur. Which term does the nurse use when documenting about this perceived warning?

podrome

A patient has wrist inflammation causing compression of the median nerve in the carpal tunnel. Manifestations of this syndrome include: little finger numbness. forearm paresthesia. loss of tendon reflexes. precision grip weakness.

precision grip weakness.

A patient has wrist inflammation causing compression of the median nerve in the carpal tunnel. Manifestations of this syndrome include: little finger numbness. forearm paresthesia. loss of tendon reflexes. precision grip weakness.

precision grip weakness.

More complex patterns of movements, such as throwing a ball or picking up a fork, are controlled by the __ cortex in the frontal lobe. premotor primary motor reflexive supplementary

premotor

More complex patterns of movements, such as throwing a ball or picking up a fork, are controlled by the ______ cortex in the frontal lobe. premotor primary motor reflexive supplementary

premotor

More complex patterns of movements, such as throwing a ball or picking up a fork, are controlled by which portion of the frontal lobe?

premotor cortex

A young adult male client presents to the orthopedic clinic complaining of "stiffening of the spine." The health care provider orders some diagnostic lab work. Which lab result leads the health care worker to diagnose ankylosing spondylitis?

presence of HLA-B27 allele marker

focal and diffuse brain injuries

primary brain injuries include focal (contusion, laceration, hemorrhage) diffuse (concussion, diffuse axonal injury) secondary brain injuries are often diffuse or multifocal including edema, infection and hypoxia

types of brain injuries

primary/direct: damage is caused by impact, include diffuse axonal injury and the focal lesions of laceration, contusion and hemorrhage secondary injuries: damage results from subsequent brain swelling, infection and cerebral hypoxia often diffuse or multifocal, including concussion, infection and hypoxic brain injury

A client with laryngeal dystonia has gotten to the point that people on the telephone cannot understand her. She has heard about getting Botox injections into her vocal cords. The nurse will teach about the actions of Botox. Which is the most accurate description? This drug:

produces paralysis of the larynx muscles by blocking acetylcholine release

Following his annual influenza vaccination, a client begins to feel achy, like he has developed the flu. An hour later, the client is rushed to the emergency department. Diagnosis of Guillain-Barré syndrome was made based on which of the following assessment findings? Select all that apply.

rapid deterioration of respiratory status flaccid paralysis of limbs BP 90/62

A 26-year-old woman has sought care for increasing pain at the back of her ankle and the bottom of her foot over the past 2 weeks. The client states that she is generally in good health, although she completed a course of antibiotics for a chlamydial infection 6 weeks earlier. This client's recent history suggests the possibility of:

reactive arthritis

The nurse observes a new nurse performing the test for Kernig sign on a client. The new nurse performs the test by providing resistance to flexion of the knees while the client is lying with the hip flexed at a right angle. The nurse should explain to the new nurse that:

resistance should be provided with the knee in a flexed position.

Transient ischemic attacks (TIAs) are characterized by ischemic cerebral neurologic deficits that:

resolve within one hour of onset

Transient ischemic attacks (TIAs) are characterized by ischemic cerebral neurologic deficits that: indicate aneurysm leakage. cause minor residual deficits. affect diffuse cerebral functions. resolve within one hour of onset.

resolve within one hour of onset.

A client has started having uncontrolled seizures that are not responding to usual medications. Nursing working with the client must pay special attention to which of the following priority aspects of this clients care? Assessment of:

respiratory status and oxygen saturation

A client with a diagnosis of myasthenia gravis has required a mastectomy for the treatment of breast cancer. The surgery has been deemed a success, but the client has gone into a myasthenic crisis on postoperative day 1. Which of the following measures should the care team prioritize in this client's immediate care?

respiratory support and protection of the client's airway

A client with a diagnosis of myasthenia gravis has required a mastectomy for the treatment of breast cancer. The surgery has been deemed a success, but the client has gone into a myasthenic crisis on postoperative day 1. Which of the following measures should the care team prioritize in this client's immediate care?

respiratory support and protection of the client's airway

A client is devastated to receive a diagnosis of amyotrophic lateral sclerosis (ALS). The symptomatology of this disease is a result of its effects on upper and lower motor neurons. The health care provider caring for this client will focus on which priority intervention for this client?

respiratory ventilation assessment and prevention of aspiration pneumonia

A parent brought her 8-year-old child to the emergent care center to be examined following a fall off a playground set, resulting in a head injury. On discharge, the nurse explains to the parent that some symptoms may continue, including the inability to remember what happened before the fall. Which term best describes the diagnosis?

retrograde amnesia

The nurse is assessing a client and notes the client is now displaying decerebrate posturing. The position would be documented as:

rigidity of the arms with palms of the hands turned away from the body and with stiffly extended legs and plantar flexion of the feet.

A recently injured (3 months ago) client with a spinal cord injury at T4 to T5 is experiencing a complication. He looks extremely ill. The nurse recognizes this as autonomic dysreflexia (autonomic hyperreflexia). His BP is 210/108; skin very pale; gooseflesh noted on arms. The priority nursing intervention would be to:

scan his bladder to make sure it is empty

A recently injured (3 months ago) client with a spinal cord injury at T4 to T5 is experiencing a complication. He looks extremely ill. The nurse recognizes this as autonomic dysreflexia (autonomic hyperreflexia). His BP is 210/108; skin very pale; gooseflesh noted on arms. The priority nursing intervention would be to:

scan his bladder to make sure it is empty

The distinguishing characteristic of chronic osteomyelitis is the presence of:

sequestrum bone

focal seizures

simple partial Seizures without impairment of consciousness or awareness Psychomotor Seizures with impairment of consciousness or awareness: Accompanied by automatisms: repetitive, nonpurposeful activities such as lip smacking, grimacing, patting, or rubbing clothing

A family brings their father to his primary care physician for a checkup. Since their last visit, they note their dad has developed a tremor in his hands and feet. He also rolls his fingers like he has a marble in his hand. The primary physician suspects the onset of Parkinson disease when he notes which of the following abnormalities in the client's gait?

slow to start walking and has difficulty when asked to "stop" suddenly

A family brings their father to his primary care physician for a checkup. Since their last visit, they note their dad has developed a tremor in his hands and feet. He also rolls his fingers like he has a marble in his hand. The primary physician suspects the onset of Parkinson disease when he notes which of the following abnormalities in the client's gait?

slow to start walking and has difficulty when asked to stop suddenly

signs and symptoms of cerebral aneurysm

small aneurysms are asymptomatic Large aneurysms may cause chronic headache, neurologic deficits, or both Other manifestations include signs of meningeal irritation, cranial nerve deficits, stroke syndrome, cerebral edema and increased ICP, and pituitary dysfunction Hypertension and cardiac dysrhythmias result from massive release of catecholamines triggered by the subarachnoid hemorrhage

What term is used to describe a level of consciousness during which a client responds only to vigorous and repeated stimuli and has minimal or no spontaneous movement?

stupor

tx and evaluation of brain tumors

surgery, irradiation, chemotherapy, MRI, CT, Electroencephalogram Visual field and fundoscopic examination Include physical and neurologic examinations

During physiology class, the instructor asks students to explain the pathology behind development of multiple sclerosis. Which student gave the most accurate description?

the demyelenation and subsequent degeneration of nerve fibers and decreased oligodendrocytes, which interfere with nerve conduction

During physiology class, the instructor asks students to explain the pathology behind development of multiple sclerosis. Which student gave the most accurate description?

the demyelination and subsequent degeneration of nerve fibers and decreased oligodendrocytes, which interfere with nerve conduction

A college baseball player has seen his season cut short by a rotator cuff injury. Rotator cuff injuries are frequent because of:

the inherenet instability of the shoulder

A client suffering a thrombotic stroke is brought into the emergency department by ambulance and the health care team is preparing to administer a synthetic tissue plasminogen activator for which purpose?

throbolysis

the most common cause of an ischemic stroke is which of the following?

thrombosis

what causes injury to the brain

traumas, tumors, stroke, metabolic derangements, degenerative disorders

A patient is devastated to receive a diagnosis of amyotrophic lateral sclerosis (ALS). The symptomatology of this disease is a result of its effects on: upper motor neurons. the vestibulocerebellar system. upper and lower motor neurons. neuromuscular junctions.

upper and lower motor neurons.

A patient is devastated to receive a diagnosis of amyotrophic lateral sclerosis (ALS). The symptomatology of this disease is a result of its effects on: upper motor neurons. the vestibulocerebellar system. upper and lower motor neurons. neuromuscular junctions.

upper and lower motor neurons.

Which medication would be recommended for myoclonic seizures?

valproic acid

A client with a long history of cigarette smoking and poorly controlled hypertension has experienced recent psychomotor deficits as a result of hemorrhagic brain damage. The client's psychomotor deficits are likely the result of:

vascular dementia

A patient with a long history of cigarette smoking and poorly controlled hypertension has experienced recent psychomotor deficits as a result of hemorrhagic brain damage. The patients psychomotor deficits are likely the result of:

vascular dementia

A patient with a long history of cigarette smoking and poorly controlled hypertension has experienced recent psychomotor deficits as a result of hemorrhagic brain damage. The patient's psychomotor deficits are likely the result of:

vascular dementia.

A patient with a long history of cigarette smoking and poorly controlled hypertension has experienced recent psychomotor deficits as a result of hemorrhagic brain damage. The patient's psychomotor deficits are likely the result of: Alzheimer disease. frontotemporal dementia (FTD). vascular dementia. Wernicke-Korsakoff syndrome.

vascular dementia.

cerebral edema

vasogenic edema: occurs with conditions that impair function of blood brain barrier and allow transfer of water and protein from vascular into interstitial space cytotoxic edema: involves an increase in intracellular fluid interstitial cerebral edema: edema of the central white matter as in hydrocephalus affecting the brain

Autonomic dysreflexia (autonomic hyperreflexia) is characterized by: severe spinal shock. tachycardia and pale skin. lack of sweat above injury level. vasospasms and hypertension.

vasospasms and hypertension.

Autonomic dysreflexia (autonomic hyperreflexia) is characterized by: severe spinal shock. tachycardia and pale skin. lack of sweat above injury level. vasospasms and hypertension.

vasospasms and hypertension.

A client has been diagnosed with a cerebral aneurysm and placed under close observation before treatment commences. Which of the following pathophysiologic conditions has contributed to this client"s diagnosis?

weakness in the muscular wall of an artery

Unlike disorders of the motor cortex and corticospinal (pyramidal) tract, lesions of the basal ganglia disrupt movement:

without causing paralysis

Unlike disorders of the motor cortex and corticospinal (pyramidal) tract, lesions of the basal ganglia disrupt movement:

without causing paralysis.

Unlike disorders of the motor cortex and corticospinal (pyramidal) tract, lesions of the basal ganglia disrupt movement: without causing paralysis. posture and muscle tone. and cortical responses. of upper motor neurons.

without causing paralysis.

Unlike disorders of the motor cortex and corticospinal (pyramidal) tract, lesions of the basal ganglia disrupt movement: without causing paralysis. posture and muscle tone. and cortical responses. of upper motor neurons.

without causing paralysis.

When trying to explain the difference between vasogenic versus cytotoxic cerebral edema, the physiology instructor mentions that cytotoxic edema displays which of the following functions in the brain? Select all that apply.

• Causes ischemia to build up lactic acid due to anaerobic metabolism • Allows cells to increase volume to the point of rupture, damaging neighboring cells

A client works as a data entry worker for a large company. The client goes to employee health with pain in the wrist/hand. The nurse suspects that it is carpal tunnel syndrome based on which of the following assessment findings? Select all that apply

• Describes numbness/tingling in the thumb and first digit • Precision grip weakness in the affected hand • Pain interferes with sleeping

Which of the following interventions would be considered a nonpharmacologic method of pain control? Select all that apply.

• Distraction by knitting • Guided imagery • Biofeedback

When lecturing about heart attacks (myocardial infarctions), the instructor will emphasize the client may present with: Select all that apply.

• Substernal chest pain • Neck pain • Pain that radiates to the left arm