chpt. 44 test 5 med surge

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

Thyroid-stimulating hormone

female client admitted to med unit for cerebral metastasis from a primary site- when reviewing history which site most likely primary site?

lung

client diagnosed- acoustic neuroma- what manifestations? select all

tinnitus vertigo staggering gait

pt. newly diagnosed with primary brain tumor- pt. asks where his tumor came from- nurses response?

your tumor originated from cells within your brain itself

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

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

Which of the following is a late symptom of spinal cord compression?

Paralysis

The nurse in the oncology outpatient clinic receives a phone call from a family member of a client who was diagnosed with a metastatic spinal cord tumor. The family member informs the nurse that the client has been reporting increased back pain in the region of the tumor and dizziness. How should the nurse respond?

Tell the family member to get the client to hospital for emergency assessment

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

Grade 1 is the most common type of this tumor.

A patient diagnosed with a pituitary adenoma has arrived on the oncology unit. Based upon the nurse's initial assessment, the patient is most likely to exhibit:

Headache

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

Cerebrospinal fluid leakage

Which of the following diagnostic studies provides visualization of cerebral blood vessels?

Cerebral angiography

An acoustic neuroma is a benign tumor of which cranial nerve?

Eighth

37-man-experiencing loss of motor function and sensation- suspect spinal cord tumor- what diagnostic test?

MRI

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

Papilledema

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

Cushing disease can result from a functioning tumor

The nurse is seeing the mother of a client who states, "I'm so relieved because my son's doctor told me his brain tumor is benign." The nurse knows what is true about benign brain tumors?

They can affect vital functioning.

assessing pt. with acoustic neuroma- what symptoms likely to find during assessment?

loss of hearing, tinnitus, vertigo

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

Irregular respirations

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

Coumadin

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

anticoagulants

pt. been experiencing numerous episodes of unexplained headaches- vomiting- referred to testing to rule out brain tumor- what characteristic of pts. vomiting is most consistent with a brain tumor?

the pts. vomiting is unrelated to food intake

nurse conducting presentation about brain cancer- someone asks what causes brain tumors? Nurses best response?

the cause of most brain tumors is still really not known

care plan- brain metastases- appropriate nursing diagnosis- anxiety related to lack of control over health circumstances- nurse- include what intervention?

the patient will be encouraged to verbalize concerns related to the disease and its treatment

pt. diagnosed- pituitary adenoma- planning care- nurse aware effects of tumor will primarily depend on what variable?

the specific hormones secreted by the tumor

A client with a brain tumor experiences projectile vomiting. The nurse integrates understanding of this occurrence as resulting from which of the following?

Irritation of the medullary vagal centers

A client is about to be discharged after undergoing surgery for the treatment of a brain tumor and has a referral in place for medical and radiation oncology. Which component(s) should be included in the discharge teaching for this client? Select all that apply.

Medication regimen Appointments for chemotherapy or radiotherapy Adverse effects of chemotherapy or radiation and techniques for managing them Nutritional support

A 13-year-old patient is admitted to the pediatric unit with a suspected brain tumor. The nurse should understand that which diagnostic test is the most helpful in the diagnosis of brain tumors?

MRI

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

Cerebellum

The nurse is conducting a neurological assessment with a client who has increased intracranial pressure secondary to growth of brain tumor mass. What assessment tools can the nurse use to determine the client's neurological status? Select all that apply

Glasgow coma scale (GCS) Mini mental status examination (MMSE)

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

Increased ICP

nurse educator discussing Neoplasms-effects caused by compression and infiltration of normal tissue- physiologic changes that result can cause what pathophysiologic events?

Increased ICP focal neurologic signs altered pituitary function

The nurse educator is facilitating a class on neurological function with a group of nursing students. When discussing problems that can result from growing brain tumors, the nurse educator should include that clients can experience which neurologic deficits even after surgical resection? Select all that apply.

Paralysis Incontinence Aphasia

A client is diagnosed with a tumor of the temporal lobe. When developing the client's plan of care the nurse would plan interventions to address problems with which areas of functioning? Select all that apply.

Understanding language Emotions Memory

A client whose physical findings suggest a hyperpituitary condition undergoes an extensive diagnostic workup. Test results reveal a pituitary tumor, which necessitates a transsphenoidal hypophysectomy. The evening before the surgery, the nurse reviews preoperative and postoperative instructions given to the client earlier. Which postoperative instruction should the nurse emphasize?

You must avoid coughing, sneezing, and blowing your nose.

pt. with brain tumor exhibiting signs of cachexia- assessment nurse should prioritize?

assessment of nutritional status

pt. with inoperable brain tumor- told has short life expectancy- what aspects of assessment and care should nurse focus on?

pain management management of treatment complications assistance with self care administration of treatments

pt. diagnosed- cancer of lung- told metastasized to brain-what change in health status would nurse attribute to pts. metastatic brain disease?

personality changes

The nurse teaches the client that corticosteroids will be used to treat his brain tumor to

reduce cerebral edema

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

related to impaired balance

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

respiratory disfunction

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

"Intravenous immunoglobulin infusion may help you.

The nurse is caring for a client who has been hospitalized for investigation of a sudden change in gait due to loss of balance and coordination. A magnetic resonance imaging scan reveals the client has a brain tumor. On or close to which brain structure is the tumor most likely situated?

Cerebellum

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

Cerebral edema Headache Altered level of consciousness

A patient has been diagnosed with a lipoma. The nurse explains to the patient that this tumor is located in the part of the brain known as the:

Corpus callosum

male pt.-metastatic brain tumor- generalized seizure- begins vomiting- nurse should do what first?

turn the pt. on his side

admitted neurologic ICU- brain tumor- scheduled for tumor resection/removal- what assessment parameters should nurse include in initial assessment?

gag reflex

nurse- reading journal article about brain tumors-different types that can occur- intracerebral tumor? select all

glioblastoma astrocytoma medulloblastoma

While reviewing the nursing documentation on a patient on the neurological unit, the nurse notes that the patient complained of a headache several times over the previous shift. How can the nurse differentiate between a headache that is caused by a brain tumor and a headache that is caused by meningitis or encephalitis?

Assess for the presence of a fever.

Extensive diagnostic testing has resulted in a patient's diagnosis of a benign brain tumor. When providing care for this patient, the nurse should be cognizant of which of the following characteristics of benign brain tumors?

Benign brain tumors can slowly grow into an area of vital brain function

The nurse is providing discharge teaching for a client who was admitted to hospital after having complex partial seizures secondary to a glioma. The client has been prescribed levetiracetam to manage the seizures. What should the nurse include in the discharge teaching for this medication?

Driving a car should be avoided until the you know how this medication effects you

Nurses are performing hourly neurological assessments of a patient who is postoperative day 1 following spinal surgery that was performed to treat spinal cord compression (SCC). The nurse's most recent assessment shows a marked reduction in motor and sensory function. How should the nurse best follow-up this assessment finding?

Inform the care provider promptly about this sudden change.

Nurse inspects dressing covering op site- after cervical diskectomy- drainage 75% saturated with serosanguineous discharge- nurses most appropriate action

Inform the surgeon of the possibility of a dural leak

A nurse is reading a journal article about spinal cord tumors and metastasis from other primary sites. The nurse demonstrates understanding of the article when identifying which primary sites as commonly metastasizing to the spinal cord? Select all that apply.

Lung Breast Gastrointestinal tract

A nurse helps a patient recently diagnosed with a pituitary adenoma understand that:

Most tumors produce too much of one or more hormones

male- free clinic- complains of impotency- presence of hypogonadism- what diagnosis?

Prolactinoma

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

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

client exhibiting late signs of ICP- which finding would nurse assess? select all

hypertension bradycardia respiratory depression

The nurse is caring for a client who was diagnosed with a glioma 5 months ago. Today, the client was brought to the emergency department by his caregiver because he collapsed at home. The nurse suspects late signs of rising intracranial pressure (ICP) when which blood pressure and pulse readings are noted?

BP = 175/45 mm Hg; HR = 42 bpm

The nurse is assessing an older adult who is experiencing a new onset of weakness, fatigue, and musculoskeletal pain. Which information in the client's health history will the nurse identify to help determine the reason for the client's new symptoms?

History of Polio in 1955

The nurse is seeing a client who has just been diagnosed with a meningioma. The client states he is confused because the provider stated, "If you have to be diagnosed with a brain tumor, this is the least harmful." The client asks the nurse for clarification. How should the nurse respond?

I am unable to interpret what your provider meant by making that statement; however, it is true that meningiomas are slow growing tumors that are not typically fatal."

treatment of newly diagnosed brain tumor- pt. just exhibited seizure activity- nurses priority response?

Implement precautions to ensure the pts. safety

A patient with a brain tumor is complaining of headaches that are worse in the morning. What does the nurse know could be the reason for the morning headaches?

Increased ICP

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

MRI

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

Mannitol

The nurse educator is testing a group of nursing students about various types of brain tumors and their clinical manifestations. The students are correct when stating tumors located in the cerebellar region of the brain produce which symptoms? Select all that apply.

Staggering gait Muscle incoordination Abnormal eye movements

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

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

client diagnosed with brain tumor of parietal lobe- based on tumors location- which assessment will nurse likely note? select all

difficulty with reading problems with mathematical equations

nurse conducting assessment on pt. suspected of brain tumor-assessment reveals- headache- headache supports suspicion of brain tumor when pt. reports the headache occurs?

early in the morning

25- female- brain metastases- considering life expectancy- not receiving treatment- nurses most appropriate action?

ensure patient receives adequate palliative care

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

exploring hospice care and services

A nurse is reviewing a client's medical record and finds that the client has a spinal cord tumor that involves the vertebral bodies. The nurse identifies this as which type of spinal tumor

extradural

pt. recently diagnosed with cerebellar tumor- due to location- nurse should implement measures to prevent what?

falls

A 30-year-old female patient has been referred to a specialist by her primary care provider because she has recently developed fat pads at the base of her neck, an increasingly round face, and striae at various locations. The patient's signs of illness have been attributed to a brain tumor. What type of brain tumor is most likely to result in these changes to the woman's physical appearance?

Pituitary adenoma

The nurse educator is teaching nursing students about various types of brain tumors. The instructor recognizes that teaching has been effective when students correctly identify a client whose lab work indicates excessively high levels of thyroid stimulating hormone would most likely be diagnosed with which type of tumor?

Pituitary adenoma