Chapter 14: Care of a patient with a Neurologic disorder exam

A patient with a spinal cord injury of T1 complains of stiffness of the nose and headache. The nurse notes a flushing of the neck and " goose flesh ". What should be the primary nursing intervention based on these assessments?

D) Sit upright and check blood pressure

What is the nurse assessing when asking the patient, "who is the president of the united states?" during a level of consciousness assessment?

D) fund of knowledge

Which symptom is specific to migraine headaches?

D) they are preceded by an aura

what is the cardinal sign of increased intercranial pressure in a brain injured patient?

Decrease in the level of consciousness

The newly admitted patient to the emergency room 30 mins ago after a fall off a ladder has gradually decreased in consciousness and has slowly reacting pupils, a widening pulse pressue, and verbal responses that are slow and unintelligible. What is the most appropriate position for the patient?

Neck placed in a neutral position

As the result of a stroke, a patient has difficulty discerning the position of his body without looking at it. In the nurse's documentation, which would best describe the patient's inability to assess spinal position of his body?

Proprioception

How would the nurse instruct a patient with Parkinson disease to improve activity level?

To walk with hands clasped to back to help balance

The nurse explains that the triad of signs of Parkinson disease is _______ , _______and __________.

Tremor rigidity bradykinesia

A patient is in which stage of Alzheimer's when she demonstrates "sundowning" ?

second stage

Which question is likely to elicit the most valid response from the patient who is being interviewed about neurologic problem?

" Can you describe the sensations you are having?'

How would a nurse record behavior when a patient with Alzheimer disease attempt to eat using a napkin rather than a fork?

B) Agnosia (total loss of the ability to recognize familiar objects or people through sensory stimuli as a result of organic brain damage)

A frantic family member is distressed about the flaccid paralysis of her son following a spinal cord injury several hours ago. What does the nurse know about this condition?

B) It is possibly a temporary condition and will clear

An 83 year old patient has had a stroke. He is right-handed and has had a history of hypertension and "little" strokes. He presents with right hemiplegia. To afford him the best visual field, the nurse should approach him :

B) from the left side

The newly admitted patient to the emergency room after a motorcycle accident has serosanguineous drainage coming from the nose. what is the most appropriate nursing response to this assessement.

C) Gently wipe with and absorbent gauze

What is the nurse aware of when assessing a person with a craniocerebral injury?

C) Signs and symptoms may not occur until several days after the trauma

What is the basic problem that prompts most of the early signs of Alzheimer disease?

C) memory loss that disrupts daily life

Following a myelogram the nurse should include in the postprocedure care assessment for:

C) sensation in lower extremities

A patient, age 45, is to have a myelogram to confirm the presence of a herniated intervertebral disk. Which nursing action should be planned with respect to this diagnostic test?

obtain an allergy history before the test

What should the nurse do when the child arrives on the floor with a diagnosis of bacterial meningitis?

place child in respiratory isolation

What are the two divisions of the nervous system?

central nervous system and peripheral nervous system

Which of the following techniques are necessary for safely feeding a hemiplegic patient?

checking the affected side of the mouth for food accumulation offering small bites of food adding thickening agents to liquids

What is the reticular activating system essential to?

concentration wakefullness attention introspection

What is the cranial nerve that supplies most of the organs in the thoracic and abdominal cavities and also carries motor fibers to glands that produce digestive juices and other secretions?

vagus nerve

Which foods should the person who suffers from migraine headache avoid?

yogurt, caffeine, marinated foods

The nurse is aware that when assessing a patient by the FOUR score coma scale, the patient is assessed in the four categories: eye response, brainstem reflexes, motor response, and respiration. How are these results reported?

as individual scores in each category

A _______ is a diagnostic procedure used to identify lesions by observing the flow of radiopaque.

myelogram

What are surgical navigation systems?

A) Computerized devices that guide the surgeon

The nurse assures an anxious family member of a 92-year-old patient who is demonstrating signs of dementia that many causes of dementia are reversible and preventable. What is one example?

A) Hypotension

A family member of a patient who has just suffered a tonic-clonic seizures is concerned about the patient's deep sleep. What is the behavior called?

D) Postictal period ( a rest of period of variable length)

The nurse is aware that the characteristic gait of the person with parkinson's disease is a propulasive gait, which causes the patient to:

B) shuffle with arms flexed

A patient has recently suffered a stroke with left-sided weakness and has problems with chocking, especially when drinking thin liquids. What nursing interventions would be most helpful in assisting this patient to swallow safely?

B. Tuck chin when swallowing ( 90 degree angle with head up and chin slightly tucked

What Glascow coma scale rating would a patient receive who opens the eyes spontaneously but has incomprehensible speech and obey's command for movement?

D) 12

What does the nurse know about the stroke patient who has expressive aphasia?

D) Can understand the spoken word, but cannot speak

What are the effects of a normal aging on the nervous system?

Loss of neurons reduction of cerebral blood flow Lipofuscin Decrease in oxygen use

_______ Is/are responsible for the transmissin of impulses between synapses

Neurotransmitters

Involuntary rhythmic movement of the eyes, which may be horizontal, vertical, or mixed in the directional movement. The eye movement cannot be controlled by the patient

Nystagmus

Why is the patient with suspected Guillain-Barre syndrome hospitalized immediately?

The disease can rapidly progress into respiratory failure

The nurse is caring for a home health patient who had a spinal cord injury at C5 three years ago. The nurse bases the plan of care of the knowledge that the patient will be able to:

A) feed self with a setup and adaptive equipment

The nurse is aware that the drug t- PA ( Activase), tissue plasminogen activator, must be given in______hours of the onset of symptoms to have maximum benefit.

A) must be given 3 hours of the onset plan

What is the first sign on bell's palsy?

Inability to wrinkle forehead and pucker lips on affected side

what are the three signs of cushing response?

Widened pulse pressure. Bradycardia Increased systolic blood pressure.

Why are the drugs neostigmine (Prostigmin) and pyridostigme (Mestinon) helpful to the person with myasthenia gravia?

it promotes nerve impulse transmission

The waxy substance covers the neuron fibers and increases the rate of transmission of impulses is the _____.

myelin

The nurse explains that the two divisions of autonomic nervous system work to maintain homeostasis. Place in order the autonomic events

Extremely stressful or frightening event Sympathetic nervous system Heart rate and blood pressure rise, secretion of adrenaline Parasympathetic nervous system dominates Blood pressure, heart rate, and adrenaline output decrease

What is the purpose of a "drug holiday" in the treatment of Parkinson's disease?

restart drugs at a lower dosage with favorable results