K. Neurologic Function Med Surg
Which of the following terms refers to the inability to recognize objects through a particular sensory system?
Agnosia
A nurse is completing a neurological assessment and determines that the client has significant visual deficits. A brain tumor is considered. Considering the functions of the lobes of the brain, which area will most likely contain the neurologic deficit? a) Occipital b) Frontal c) Pariétal d) Temporal
Occipital
A client is scheduled for an EEG after having a seizure for the first time. Client preparation for this test should include which instruction?
"Avoid stimulants and alcohol for 24 to 48 hours before the test."
A nurse is discussing a lumbar puncture with a nursing student who observed the procedure. The student noticed that the cerebrospinal fluid was blood tinged and asks what that means. The correct reply is which of the following? a) "It can mean a traumatic puncture or a subarachnoid bleed." b) "It can mean a subarachnoid bleed or damage to the spinal cord." c) "It can mean the spinal cord was damaged or a traumatic pucture." d) "It can mean a bleed around the hypothalamus or damage from the needle."
"It can mean a traumatic puncture or a subarachnoid bleed." The needle is inserted below the level of the spinal cord, which prevents damage to the cord. The cerebral spinal fluid (CSF) should be clear and colorless. Pink or bloody CSF may indicate a subarachnoid bleed or local trauma from the puncture. The hypothalamus is located deep inside the brain and does not affect the color of the CSF.
A nurse is preparing a client for lumbar puncture. The client has heard about post-lumbar puncture headaches and asks how to avoid having one. The nurse tells the client that these headches can be avoided by doing which of the following after the procedure? a) "Ambulate as soon as possible." b) "Remain prone for 2 to 3 hours." c) "Remain on bedrest for 3 days." d) "Remain NPO for 6 hours."
"Remain prone for 2 to 3 hours." The headache is caused by cerebral spinal fluid (CSF) leakage at the puncture site. The supply of CSF in the cranium is depleted so that there is not enough to cushion and stabilize the brain. When the client assumes an upright position, tension and stretching of the venous sinuses and pain-sensitive structures occur. The headache may be avoided if the client remains prone for 2 to 3 hours after the procedure. Drinking plenty of fluids will help in replacing the CSF. Hydration is important for replacement of the CSF lost so remaining NPO is not an option unless it is for other reasons, then IV fluid replacement will be important. Ambulating right away will make the possibility of a headache more likely. It is not necessary to remain on bedrest for more than a few hours, unless a headache has occurred; then bedest for overnight is usually sufficient.
The nurse is completing a neurologic assessment and uses the whisper test to assess which of the following cranial nerves? a) Facial b) Olfactory c) Vagus d) Acoustic
Acoustic Clinical examination of the acoustic nerve can be done by the whisper test. Having the patient say "ah" tests the vagus nerve. Observing for symmetry when the patient performs facial movements tests the facial nerve. The olfactory nerve is tested by having the patient identify specific odors. (less)
Which of the following terms refers to the inability to coordinate muscle movements, resulting difficulty walking? a) Spasticity b) Agnosia c) Ataxia d) Rigidity
Ataxia
Lesions in the temporal lobe may result in which of the following types of agnosia? a) Tactile b) Auditory c) Visual d) Relationship
Auditory
A nurse is working in a neurologist's office. The physician orders a Romberg test. Which nursing action is correct? a) Have the client close his eyes and discriminate between dull and sharp. b) Have the client touch his nose with one finger. c) Have the client close his eyes and stand erect. d) Have the client close his eyes and jump on one foot.
Have the client close his eyes and stand erect.
A nurse is assisting during a lumbar puncture. How should the nurse position the client for this procedure?
Lateral recumbent, with chin resting on flexed knees
Low levels of the neurotransmitter serotonin lead to which of the following disease processes? a) Depression b) Parkinson's disease c) Myasthenia gravis d) Seizures
Depression A decrease of serotonin leads to depression. A decrease in the amount of acetylcholine causes myasthenia gravis. Parkinson's disease is caused by a depletion of dopamine. Decreased levels of GABA may cause seizures.
A nurse is working in a neurologist's office. The physician orders a Romberg test. Which nursing action is correct? a) Have the client close his eyes and stand erect. b) Have the client touch his nose with one finger. c) Have the client close his eyes and discriminate between dull and sharp. d) Have the client close his eyes and jump on one foot.
Have the client close his eyes and stand erect. In the Romberg test, the client stands erect with the feet close together and eyes closed. If the client sways and appears to fall, it is considered a positive Romberg test. All of the other options include components of neurologic tests, indicating neurologic deficits and balance.
Which of the following areas of the brain are responsible for temperature regulation?
Hypothalamus
A 53-year-old man presents to the emergency department with a chief complaint of inability to form words, and numbness and weakness of the right arm and leg. Where would you locate the site of injury? a) Right frontoparietal region b) Left basal ganglia c) Left temporal region d) Left frontoparietal region
Left frontoparietal region The patient is exhibiting signs of expressive aphasia with numbness/tingling and weakness of the right arm and leg. This indicates injury to the expressive speech center (Broca's area), which is located in the inferior portion of the frontal lobe. The motor strip is located in the posterior portion of the frontal lobe. The sensory strip is located in the anterior parietal lobe.
The pre-nursing class is learning about the nervous system in their anatomy class. What part of the nervous system would the students learn is responsible for digesting food and eliminating body waste? a) Parasympathetic b) Sympathetic c) Peripheral d) Central
Parasympathetic
Which lobe of the brain is responsible for spatial relationships? a) Occipital b) Temporal c) Frontal d) Parietal
Parietal The parietal lobe is responsible for spatial relationships. The frontal lobe also controls information storage or memory and motor function. The temporal lobe contains the auditory receptive area. The occipital lobe is responsible for visual interpretation.
The nurse is performing a neurological assessment of a client who has sustained damage to the frontal cortex. Which of the following deficits will the nurse look for during assessment?
The inability to tell how a mouse and a cat are alike
The brain stem holds the medulla oblongata. What is the function of the medulla oblongata?
Transmits motor impulses from the brain to the spinal cord
During recovery from a stroke, a client is given nothing by mouth to help prevent aspiration. To determine when the client is ready for a liquid diet, the nurse assesses the client's swallowing ability once per shift. This assessment evaluates: a) cranial nerves III and V. b) cranial nerves IX and X. c) cranial nerves VI and VIII. d) cranial nerves I and II.
cranial nerves IX and X. Swallowing is a motor function of cranial nerves IX and X. Cranial nerves I, II, and VIII don't possess motor functions. The motor functions of cranial nerve III include extraocular eye movement, eyelid elevation, and pupil constriction. The motor function of cranial nerve V is chewing. Cranial nerve VI controls lateral eye movement.
Which of the following are sympathetic effects of the nervous system? a) Decreased blood pressure b) Increased peristalsis c) Decreased respiratory rate d) Dilated pupils
Dilated pupils
Which lobe of the brain is responsible for concentration and abstract thought? a) Occipital b) Parietal c) Frontal d) Temporal
Frontal
What is the function of cerebrospinal fluid (CSF)?
It cushions the brain and spinal cord.
A client is diagnosed with a brain tumor. The nurse's assessment reveals that the client has difficulty interpreting visual stimuli. Based on these findings, the nurse suspects injury to which lobe of the brain? a) Frontal b) Parietal c) Temporal d) Occipital
Occipital
A Geriatric Nurse Practitioner is assessing older adults. The Nurse Practitioner knows that older adults sometimes have difficulty following directions during a neurologic examination or diagnostic procedure. What strategies can the Nurse Practitioner use to examine older clients? a) Spread the examination over 2 or 3 days b) Provide brief instructions, one step at a time c) Suggest a nurse or an examiner who is of their age d) Offer incentives such as sweets
Provide brief instructions, one step at a time
To evaluate a client's cerebellar function, a nurse should ask: a) "Have you noticed any changes in your muscle strength?" b) "Do you have any problems with balance?" c) "Do you have any trouble swallowing food or fluids?" d) "Do you have any difficulty speaking?"
"Do you have any problems with balance?" To evaluate cerebellar function, the nurse should ask the client about problems with balance and coordination. The nurse asks about difficulty speaking or swallowing to assess the functions of cranial nerves IX, X, and XII. Questions about muscle strength help her evaluate the client's motor system.
Which cranial nerve is tested by listening to a ticking watch?
Acoustic
The nurse is caring for a client with a significant allergy history to various medications and shellfish. Because the client needs to have a diagnostic study with contrast, which medication classification is anticipated? a) Antibiotic b) Antihistamine c) Cardio tonic d) Bronchodilator
Antihistamine
A nurse is preparing a client for a lumbar puncture. The client has heard about post-lumbar puncture headaches and asks what causes them. The nurse tells the client that these headaches are caused by which of the following?
Cerebral spinal fluid leakage at the puncture site
What part of the brain controls and coordinates muscle movement? a) Cerebellum b) Cerebrum c) Midbrain d) Brain stem
Cerebellum The cerebellum, which is located behind and below the cerebrum, controls and coordinates muscle movement.
The critical care nurse is giving report on a client she is caring for. The nurse uses the Glasgow Coma Scale (GCS) to assess the level of consciousness (LOC) of a female client and reports to the oncoming nurse that the client has an LOC of 6. What does an LOC score of 6 in a client indicate? a) Comatose b) Somnolence c) Normal d) Stupor
Comatose The GSC is used to measure the LOC. The scale consists of three parts: eye opening response, best verbal response, and best motor response. A normal response is 15. A score of 7 or less is considered comatose. Therefore, a score of 6 indicates the client is in a state of coma and not in any other state such as stupor or somnolence. The evaluations are recorded on a graphic sheet where connecting lines show an increase or decrease in the LOC.
The nurse is assessing the throat of a client with throat pain. In asking the client to stick out the tongue, the nurse is also assessing which cranial nerve? a) Cranial nerve V b) Cranial nerve XI c) Cranial nerve I d) Cranial nerve XII
Cranial nerve XII Assessment of the movement of the tongue is cranial nerve XII . Cranial nerve I is the olfactory nerve. Cranial nerve V is the trigeminal nerve responsible for sensation to the face and chewing. Cranial nerve XI is the spinal or accessory nerve responsible for head and shoulder and shoulder movement.
The nurse is caring for a client newly diagnosed with multiple sclerosis. The client indicates that there is so much to understand at one time. The client indicates understanding that there is a disruption in the covering of axons but does not remember what the covering is called. Which nursing action is correct?
Tell the client that the covering is called myelin and that you can discuss at the next meeting.
A client has sustained a head injury to the occipital area. He cannot identify a familiar object by looking at it. The nurse knows that this deficit is which of the following?
Visual agnosia
After a plane crash, a client is brought to the emergency department with severe burns and respiratory difficulty. The nurse helps to secure a patent airway and attends to the client's immediate needs, then prepares to perform an initial neurologic assessment. The nurse should perform an:
evaluation of the corneal reflex response.
Lower motor neuron lesions cause a) increased muscle tone. b) flaccid muscle paralysis. c) hyperactive and abnormal reflexes. d) no muscle atrophy.
flaccid muscle paralysis. Lower motor neuron lesions cause flaccid muscle paralysis, muscle atrophy, decreased muscle tone, and loss of voluntary control. Upper motor neuron lesions cause increased muscle tone. Upper motor neuron lesions cause no muscle atrophy. Upper motor neuron lesions cause hyperactive and abnormal reflexes.
A client presents to the Emergency Department status post seizure. The physician wants to know what the pressure is in the client's head. What test might be ordered on this client? a) Lumbar puncture b) Nerve conduction studies c) EMG d) Echoencephalography
Lumbar puncture
The nurse is assessing the client's pupils following a sports injury. Which of the following assessment findings indicates a neurologic concern? Select all that apply. a) Pinpoint pupils b) Pupil reacts to light c) Absence of pupillary response d) Unequal pupils e) Pupil reaction quick
• Pinpoint pupils • Absence of pupillary response • Unequal pupils
Which neurotransmitter demonstrates inhibitory action, helps control mood and sleep, and inhibits pain pathways?
Serotonin
Which of the following is a sympathetic nervous system effect? a) Decreased blood pressure b) Decreased peristalsis c) Constricted bronchioles d) Constricted pupils
Decreased peristalsis Sympathetic effects of the nervous system include decreased peristalsis, increased blood pressure, dilated pupils, and dilated bronchioles.
Which of the following is an age-related change in the nervous system?
Loss of neurons in the brain
If a patient has a lower motor neuron lesion, the nurse would expect which of the following upon physical assessment? a) Hyperactive reflexes b) Decreased muscle tone c) Muscle spasticity d) No muscle atrophy
Decreased muscle tone A patient with a lower motor neuron lesion would be expected to have decreased muscle tone. Those with upper motor neuron lesion would have hyperactive reflexes, no muscle atrophy, and muscle spasticity.
The client is waiting in a triage area to learn the medical status of his family following a motor vehicle accident. The client is pacing, taking deep breaths, and wringing the hands. Considering the effects in the body systems, what effects does the nurse anticipate in the liver? a) The liver will maintain a basal rate of functioning. b) The liver will produce a toxic by product in relation to stress. c) The liver will convert glycogen to glucose for immediate use. d) The liver will cease function and shunt blood to the heart and lungs.
The liver will convert glycogen to glucose for immediate use. When the body is under stress, the sympathetic nervous system is activated readying the body for action. The effect of the body is to mobilize stored glycogen to glucose to provide additional energy for body action.
The nurse has completed evaluating the cranial nerves of a patient. The nurse documents impairment of the right cervical nerves (CN IX and CN X). Based on these findings, the nurse will instruct the patient to complete which of the following? a) "When you walk, use your walker." b) "While you are in the hospital, wear your hearing aids." c) "Refrain from eating or drinking for now." d) "Have your husband bring in your glasses."
"Refrain from eating or drinking for now." Significant findings of CN IX (glossopharyngeal) include difficulty swallowing (dysphagia) and impaired taste, and significant findings of CN X (vagus) include weak or absent gag reflex, difficulty swallowing, aspiration, hoarseness, and slurred speech (dysarthria). Based on these findings the nurse should instruct the patient to refrain from eating and drinking and contact the health care provider. The other instructions are associated with abnormalities of CN II (optic) and CN VIII (acoustic).
Which of the following neurotransmitters are deficient in myasthenia gravis? a) GABA b) Dopamine c) Serotonin d) Acetylcholine
Acetylcholine A decrease in the amount of acetylcholine causes myasthenia gravis. A decrease of serotonin leads to depression. Parkinson's disease is caused by a depletion of dopamine. Decreased levels of GABA may cause seizures.
A client has sustained a head injury to the parietal lobe and cannot identify a familiar object by touch. The nurse knows that this deficit is a) Ataxia b) Astereognosis c) A positive Romberg d) Visual agnosia
Astereognosis Astereognosis is the inability to identify an object by touch. Visual agnosia is the loss of ability to recognize objects through visualizing them. The Romberg test has to do with balance. Ataxia is defined as incoordination of voluntary muscle action.
The physician's office nurse is caring for a client who has a history of a cerebral aneurysm. Which diagnostic test does the nurse anticipate to monitor the status of the aneurysm? a) Milligram b) Electroencephalogram c) Echoencephalography d) Cerebral angiography
Cerebral angiography The nurse would anticipate a cerebral angiography, which detects distortion of the cerebral arteries and veins . A milligram detects abnormalities of the spinal canal. An electroencephalogram records electrical impulses of the brain. An echoencephalography is an ultrasound of the structures of the brain
The nurse is employed in a neurologist's office, performing a history and assessment on a client experiencing hearing difficulty. The nurse is most correct to gather equipment to assess the function of which cranial nerve? a) Cranial nerve II b) Cranial nerve XI c) Cranial nerve VIII d) Cranial nerve VI
Cranial nerve VIII There are 12 pairs of cranial nerves. Cranial nerve VIII is the vestibulocochlear or auditory nerve responsible for hearing and balance. Cranial nerve II is the optic nerve. Cranial nerve VI is the abducens nerve responsible for eye movement. Cranial nerve XI is the accessory nerve and is involved with head and shoulder movement.
A female patient has undergone a lumbar puncture for a neurological assessment. The patient is put under the postprocedure care of a nurse. Which of the following important postprocedure nursing interventions should be performed to ensure maximum comfort to the patient? a) Keep the room brightly lit and play soothing music in the background b) Administer antihistamines according to the physician's prescription c) Help the patient take a brisk walk around the testing area d) Encourage a liberal fluid intake for the patient
Encourage a liberal fluid intake for the patient
The spinal cord is composed of 31 pairs of spinal nerves. How many pairs of thoracic nerves are contained within the spinal column? a) Twelve b) One c) Five d) Eight
Twelve
The nurse is performing a neurologic assessment on a client diagnosed with a stroke and cannot elicit a gag reflex. This deficit is related to which of the following cranial nerves? a) X b) VII c) VIII d) III
X CN X is the vagus nerve and has to do with the gag reflex, laryngeal hoarseness, swallowing ability, and the symmetrical rise of the uvula and soft palate. CN VII is the facial nerve and has to do with symmetry of facial movements and the ability to discriminate between the tastes of sugar and salt. The inability to close one eyelid indicates impairment of this nerve. CN VIII is the acoustic nerve. It has to do with hearing, air and bone conduction, and balance. CN III is the oculomotor nerve and has to do with pupillary response, conjugate movements, and nystagmus.
A nurse is evaluating a client's cranial nerves during a routine examination. To assess the function of cranial nerve XII (hypoglossal), the nurse should assess the client's ability to:
stick out the tongue and move it rapidly from side to side and in and out
The nurse is preparing a client for a neurological examination by the physician and explains tests the physician will be doing, including the Romberg test. The client asks the purpose of this particular test. The correct reply by the nurse is which of the following? a) "It is a test for balance." b) "It is a test for muscle strength." c) "It is a test for motor ability." d) "It is a test for coordination."
"It is a test for balance."
A client is scheduled for an EEG after having a seizure for the first time. Client preparation for this test should include which instruction? a) "Avoid thinking about personal matters for 12 hours before the test." b) "Avoid stimulants and alcohol for 24 to 48 hours before the test." c) "Don't eat anything for 12 hours before the test." d) "Don't shampoo your hair for 24 hours before the test."
"Avoid stimulants and alcohol for 24 to 48 hours before the test." For 24 to 48 hours before an EEG, the client should avoid coffee, cola, tea, alcohol, and cigarettes because these may interfere with the accuracy of test results. (For the same reason, the client also should avoid antidepressants, sedatives, and anticonvulsants.) To avoid a reduced serum glucose level, which may alter test results, the client should eat normal meals before the test. The hair should be washed before an EEG because the electrodes must be applied to a clean scalp. The client's thoughts don't affect the test results.
The nurse is assessing the mental status of a patient. Which of the following questions will the nurse include in the assessment?
"Who is the president of the United States?"
The nurse is completing a neurologic assessment and uses the whisper test to assess which of the following cranial nerves?
Acoustic
Which of the following occurs when reflexes are hyperactive when the foot is abruptly dorsiflexed? a) Ataxia b) Clonus c) Rigidity d) Flaccidity
Clonus Clonus occurs when the foot is abruptly dorsiflexed. It continues to "beat" two or three times before it settles into a position of rest. Sustained clonus always indicates the present of central nervous system disease and requires further evaluation. Ataxia is incoordination of voluntary muscle action. Rigidity is an increase in muscle tone at rest characterized by increased resistance to passive movement. Flaccid posturing is usually the result of lower brain stem dysfunction the patient has no motor function, is limp, and lacks motor tone
Which of the following neurotransmitters inhibit pain transmission? a) Dopamine b) Acetylcholine c) Serotonin d) Enkephalin
Enkephalin Enkephalins are neurotransmitters that inhibit pain transmission. Acetylcholine is an excitatory transmitter. Serotonin is an inhibitory transmitter that helps control mood and sleep. Dopamine usually is inhibitory affecting behavior and fine movement.
A comatose client is being cared for by a critical care nurse who documents that the client responds only to very painful stimuli by fragmentary, delayed reflex withdrawal. The nurse knows that reflexes in the body are centered where? a) In the medulla oblongata b) In the pons c) In the spinal cord d) In the midbrain
In the spinal cord
Which of the following terms is used to describe the fibrous connective tissue that covers the brain and spinal cord? a) Arachnoid mater b) Pia mater c) Meninges d) Dura mater
Meninges The meninges have three layers, the dura mater, arachnoid mater, and pia mater. The dura mater is the outmost layer of the protective covering of the brain and spinal cord. The arachnoid is the middle membrane of the protective covering of the brain and spinal cord. The pia mater is the innermost membrane of the protective covering of the brain and spinal cord.
Which of the following cerebral lobes contains the auditory receptive areas?
Temporal
The physician's office nurse is caring for a client who has a history of a cerebral aneurysm. Which diagnostic test does the nurse anticipate to monitor the status of the aneurysm? a) Electroencephalogram b) Echoencephalography c) Myelogram d) Cerebral angiography
Cerebral angiography The nurse would anticipate a cerebral angiography, which detects distortion of the cerebral arteries and veins . A myelogram detects abnormalities of the spinal canal. An electroencephalogram records electrical impulses of the brain. An echoencephalography is an ultrasound of the structures of the brain.
A nurse is caring for a client with deteriorating neurologic status. The nurse is performing an assessment at the beginning of the shift that reveals a falling blood pressure and heart rate, and the client makes no motor response to stimuli. Which documentation of neuromuscular status is most appropriate? a) Flaccidity b) Decorticate posturing c) Abnormal posture d) Weak muscular tone
Flaccidity The nurse would document flaccidity when the client makes no motor response to stimuli. Abnormal posturing and weak motor tone would be documented specifically as the nurse would assess. Decorticate posturing is when a client is stiff with bent arms and clenched fists with legs straight out.
Cranial nerve IX is also known as which of the following? a) Vagus b) Hypoglossal c) Glossopharyngeal d) Spinal accessory
Glossopharyngeal
The nurse is caring for a client in the emergency department with diagnosis of head trauma secondary to a motorcycle accident. The nurse aide is assigned to clean the client's face and torso . For which action, made by the nurse aide, would the nurse provide further instruction?
The nurse aide moved the client's head to clean behind the ears.
A patient is scheduled for standard EEG testing to evaluate a possible seizure disorder. Nursing interventions prior to the procedure include which of the following? a) Maintaining NPO status for 6 hours prior to the procedure b) Sedate the patient prior to the procedure, per order c) Withholding antiseizure medications for 24 to 48 hours prior to the exam d) Instructing the patient that standard EEG takes 2 hours
Withholding antiseizure medications for 24 to 48 hours prior to the exam Antiseizure agents, tranquilizers, stimulants, and depressants should be withheld 24 to 48 hours before an EEG because these medications can alter EEG wave patterns or mask the abnormal wave patterns of seizure disorders. To increase the chances of recording seizure activity, it is sometimes recommended that the patient be deprived of sleep on the night before the EEG. Coffee, tea, chocolate, and cola drinks are omitted in the meal before the test because of their stimulating effect. However, the meal is not omitted, because an altered blood glucose level can cause changes in brain wave patterns. The patient is informed that the standard EEG takes 45 to 60 minutes; a sleep EEG requires 12 hours.
A male patient is scheduled for an EEG. The patient asks about any diet-related prerequisites that he must take. Which of the following diet-related advice should the nurse provide to the patient? a) Avoid taking sedative drugs or drinks that contain caffeine for at least 8 hours prior to the test. b) Avoid eating food at least 8 hours prior to the test. c) Decrease the amount of minerals in the diet. d) Include increased amount of minerals in the diet.
Avoid taking sedative drugs or drinks that contain caffeine for at least 8 hours prior to the test. The patient is advised to refrain from taking sedative drugs or drinks that contain caffeine for at least 8 hours prior to the test because these may interfere with the EEG test result. The patient is not advised to increase or decrease the intake of minerals in the diet or to avoid eating food 8 hours before the test.
You are caring for a client in the clinic who has come in to have an EMG done. How would you prepare the client for this test? a) Tell the client the doctor will use fluoroscopy for this test. b) Tell the client they will have to lie flat afterwards. c) Tell the client to expect some discomfort. d) Tell the client the test is painless.
Tell the client to expect some discomfort. Tell the client to expect some discomfort when undergoing a lumbar puncture, myelogram, EMG, or nerve conduction studies. There is no fluoroscopy used for an EMG. It is not necessary to lie flat after an EMG.
A nurse is caring for a client with an injury to the central nervous system. When caring for a client with a spinal cord insult slowing transmission of the motor neurons, which deficits are anticipated? a) A delayed reaction in identification of information due to slowed passages of information to brain b) A delayed reaction in processing the information transferred from the environment c) A delayed reaction in cognitive ability to understand the relayed information d) A delayed reaction in response due to the interrupted impulses from the central nervous system
A delayed reaction in response due to the interrupted impulses from the central nervous system The central nervous system is composed of the brain and the spinal cord. Motor neurons transmit impulses from the central nervous system. A deficit in slowing transmission in this area would slow the response of transmission leading to a delay in reaction. Sensory neurons transmit impulses from the environment to the central nervous system, allowing identification of a stimulus. Cognitive centers of the brain interpret the information.
A nurse is caring for a client with lower back pain who is scheduled for myelography using metrizamide (a water-soluble contrast dye). After the test, the nurse should place the client in which position? a) Supine with feet raised b) Supine with the head lower than the trunk c) Head of the bed elevated 45 degrees d) Prone
Head of the bed elevated 45 degrees After a myelogram, positioning depends on the dye injected. When a water-soluble dye such as metrizamide is injected, the head of the bed is elevated to a 45-degree angle to slow the upward dispersion of the dye. The prone and supine positions are contraindicated when a water-soluble contrast dye is used. The client should be positioned supine with the head lower than the trunk after an air-contrast study.
A nurse is evaluating a client's cranial nerves during a routine examination. To assess the function of cranial nerve XII (hypoglossal), the nurse should assess the client's ability to: a) elevate the shoulders, both with and without resistance. b) smell and identify a nonirritating, aromatic odor. c) stick out the tongue and move it rapidly from side to side and in and out. d) read an eye chart from a distance of 20?.
stick out the tongue and move it rapidly from side to side and in and out. To test cranial nerve XII, which controls tongue movement, the nurse should instruct the client to stick out the tongue and move it rapidly from side to side and in and out. The nurse would ask the client to smell and identify a nonirritating, aromatic odor when testing the function of cranial nerve I, the olfactory cranial nerve. Asking the client to read an eye chart is part of assessing cranial nerve II, the optic cranial nerve. Having the client elevate the shoulders with and without resistance is part of assessing cranial nerve XI, the spinal accessory cranial nerve that innervates the sternocleidomastoid muscle and the upper portion of the trapezius muscle.
Which of the following safety actions will the nurse implement for a patient receiving oxygen therapy who is undergoing magnetic resonance imaging (MRI)? a) Note that no special safety actions need to be taken. b) Check the patient's oxygen saturation level using a pulse oximeter after the patient has been placed on the MRI table. c) Securely fasten the patient's portable oxygen tank to the bottom of the MRI table after the patient has been positioned on the top of the MRI table. d) Ensure that no patient care equipment containing metal enters the room where the MRI table is located.
Ensure that no patient care equipment containing metal enters the room where the MRI table is located.
A client presents to the emergency department status postseizure. The physician wants to know what the pressure is in the client's head. What test might be ordered on this client? a) Nerve conduction studies b) Echoencephalography c) Lumbar puncture
Lumbar puncture Changes in CSF occur in many neurologic disorders. A lumbar puncture (spinal tap) is performed to obtain samples of CSF from the subarachnoid space for laboratory examination and to measure CSF pressure. Echoencephalography records the electrical impulses generated by the brain. Nerve conduction studies measure the speed with which the nerve impulse travels along the peripheral nerve. Electromyography studies the changes in the electrical potential of muscles and the nerves supplying the muscles
A client is weak and drowsy after a lumbar puncture. The nurse caring for the client knows that what priority nursing intervention should be provided after a lumbar puncture? a) Assess the level of consciousness (LOC) and the pupil response of the client. b) Provide adequate caffeine-rich drinks to the client. c) Administer antihistamines to the client. d) Position the client flat for at least 3 hours.
Position the client flat for at least 3 hours. A client who has undergone a lumbar puncture should be positioned flat for at least 3 hours and given adequate fluids. These measures help restore the cerebrospinal fluid volume extracted from the client and are priority activities. The client is administered antihistamines to manage any allergic reactions that may occur from the test. The nurse should assess the LOC or the pupil response of the client after a lumbar puncture. Parenteral administration of caffeine sodium benzoate may offset cerebral vasodilation.
The nurse is instructing a community class when a student asks, "How does someone get super strength in an emergency?" The nurse is correct to instruct on the action of which system?
Sympathetic nervous system
After a plane crash, a client is brought to the emergency department with severe burns and respiratory difficulty. The nurse helps to secure a patent airway and attends to the client's immediate needs, then prepares to perform an initial neurologic assessment. The nurse should perform an: a) examination of the fundus of the eye. b) assessment of the client's gait. c) evaluation of the corneal reflex response. d) evaluation of bowel and bladder functions.
evaluation of the corneal reflex response. During an acute crisis, the nurse should check the corneal reflex response to rapidly assess brain stem function. Other components of the brief initial neurologic assessment usually include level of consciousness, pupillary response, and motor response in the arms and legs. If appropriate and if time permits, the nurse also may assess sensory responses of the arms and legs. Emergency assessment doesn't include fundus examination unless the client has sustained direct eye trauma. The client shouldn't be moved unnecessarily until the extent of injuries is known, making gait evaluation impossible. Bowel and bladder functions aren't vital, so the nurse should delay their assessment.
During a routine physical examination to assess a client's deep tendon reflexes, a nurse should make sure to: a) support the joint where the tendon is being tested. b) hold the reflex hammer tightly. c) tap the tendon slowly and softly. d) use the pointed end of the reflex hammer when striking the Achilles tendon.
support the joint where the tendon is being tested. The nurse should support the joint where the tendon is being tested to prevent the attached muscle from contracting. The nurse should use the flat, not pointed, end of the reflex hammer when striking the Achilles tendon. (The pointed end is used to strike over small areas, such as the thumb placed over the biceps tendon.) Tapping the tendon slowly and softly wouldn't provoke a deep tendon reflex response. The nurse should hold the reflex hammer loosely, not tightly, between the thumb and fingers so it can swing in an arc.
