Neuro Chapter 25

generalized absence seizure

A 7-year-old child comes to the clinic with her mother, who states that her daughter is doing poorly in school because she has some kind of "ADD" (attention deficit disorder). The nurse asks the mother what makes her think the child has ADD. The mother says that both at home and at school her daughter just zones out for several seconds and licks her lips. She states it happens at least four to six times an hour. She says this has been happening for about 1 year. After several seconds of lip licking, her daughter seems normal again. She states her daughter has been generally healthy with just normal childhood colds and ear infections. The client's parents are both healthy; no other family members have had these symptoms. What type of seizure disorder is most likely? Generalized absence seizure Simple partial seizure (Jacksonian) Complex partial seizure Generalized tonic-clonic seizure

determine the ability to differentiate hot and cold temperatures

A client cannot differentiate between sharp and dull pain sensations when a nurse tests with a safety pin. What is an appropriate action by the nurse? Strike a tuning fork and place it on the top of one foot Use a wisp of cotton to test light touch sensation Try another object and test only the upper dermatomes Determine the ability to differentiate hot and cold temperatures

Are you having any dizziness or lightheadedness

A client presents to the health care facility for a routine health checkup. The nurse learns that the client has a long history of cardiovascular disease, including hypertension and carotid artery disease. When assessing this client for potential problems in the nervous system, which question by the nurse is appropriate? "Are you having any dizziness or lightheadedness?" "Have you noticed any changes in your vision?" "Have you noticed any weakness in your muscles?" "Do you have trouble hearing people when they talk to you?"

parasympathetic

A client reports resting and skipping exercise during a holiday from work. Which part of the nervous system is controlling this client's behavior? cranial nerves central parasympathetic sympathetic

Ask the client to walk in a heel to toe fashion and watch for an unsteady gait

A client reports the feeling of being unsteady when walking. What is an appropriate action by the nurse to assess for a problem with gait and balance? Ask the client to walk in a heel-to-toe fashion and watch for an unsteady gait Have the client stretch out the arms and bring one finger at a time to the nose Instruct the client to walk across the floor and note the swinging of the arms Tell the client to stand with arms at the sides and note the presence of swaying

depth of respiration

A client sustains an injury to the brain stem. What is the most important assessment parameter that the nurse should perform for this client? Depth of respirations Movement of all extremities Level of consciousness Sensation in extremities

depression

A client visits the clinic and tells the nurse that he has not been feeling very well. The nurse observes that the client's speech is slow, the client has a disheveled appearance, and he maintains poor eye contact with the nurse. The nurse should further assess the client for schizophrenia. hallucinations. delirium. depression.

9 glossopharyngeal

A client who was injured by a fall at a construction site has been admitted to the hospital. He has suffered nerve damage such that his gag reflex is no longer intact, requiring him to receive intravenous total parenteral nutrition. Which nerve should the nurse suspect to be involved in this client's injury? Glossopharyngeal (IX) Hypoglossal (XII) Spinal accessory (XI) Vagus (X)

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A nurse assesses a client for pupillary response of the eyes and finds a unilateral dilated pupil that is unresponsive to light or accommodation. The nurse recognizes that which cranial nerve is responsible for the damage of pupillary response? II V III I

Walk across the room and back

A nurse is assessing a client for abnormalities of gait due to a concern that the client is at increased risk for a fall. Which instruction should the nurse give the client first? "Walk heel to toe." "Hop on one spot." "Walk across the room and back." "Walk on your toes then on your heels."

With dysarthria, words may be nasally, slurred, or indistinct, but the central symbolic aspect of language remains intact.

A nurse is conducting a health history with a client who has recently had a stroke. The nurse notes the client has slurred speech, although language is intact. Which disorder of speech is the nurse observing in this client? dysphonia aphonia aphasia dysarthria

Sudden numbness or weakness of the face Sudden confusion, trouble speaking, or understanding speech Sudden trouble seeing in one or both eyes Sudden trouble walking, dizziness, loss of balance or coordination Sudden severe headache with no known cause

A nurse is instructing a client who has recently experienced a transient ischemic attack (TIA) on warning signs of a stroke that the client should be aware of in case they occur and she needs to call 911. Which of the following should the nurse mention? Select all that apply. Sudden confusion, trouble speaking, or understanding speech Sudden trouble walking, dizziness, loss of balance or coordination Sudden numbness or weakness of the face Sudden trouble seeing in one or both eyes Sudden chest pain Sudden severe headache with no known cause

sympathetic nervous system

A nurse is preparing to offer a community education session on anxiety. Which part of the nervous system should the nurse include in the discussion? somatic nervous system peripheral nervous system sympathetic nervous system autonomic nervous system

Increased or brisk but not pathologic

A nurse is reviewing a client's health record while interviewing her. The nurse sees in the patient's record a score of 3+ on the biceps reflex test from her previous visit. The nurse understands that this finding indicates which of the following? Increased or brisk, but not pathologic Present but decreased Normal Exaggerated; indicator of possible upper motor neuron lesion

contact lenses

A nurse is testing a client's corneal reflex but notices that the reflex appears to be reduced. The client is otherwise alert and oriented with no signs of neurological degeneration. What is an appropriate action by the nurse? Ask the client about the presence of a contact lens Touch the cornea with a small piece of cotton Rinse the eye then attempt the test again Allow the client to blink a few times then repeat test

cerebellar ataxia

A nurse observes a client's gait and notes it to be wide-based and staggering. The Romberg test results were positive. The nurse recognizes this as what type of abnormal gait? Parkinsonian gait Cerebellar ataxia Spastic hemiparesis Steppage gait

Decreased sensation in the feet

During an admission assessment, the nurse notes that the client has diabetes with peripheral neuropathy. What finding would the nurse expect to find? Severe pain in legs Bluish discoloration Open sores on legs Decreased sensation in the feet

cerebellar ataxia

During the Romberg test, a client is unable to stand with his feet together and demonstrates a wide-based, staggering, unsteady gait. The nurse would identify this as which of the following? Cerebellar ataxia Scissors gait Parkinsonian gait Spastic hemiparesis

ask for facial expressions

How do you test cranial nerve 7?

12 cranial 31 spinal

How many pairs of cranial nerves and how many pairs of spinal nerves are found in the peripheral nervous system?

Right knee +2 and left knee +1

If the right patellar reflex is fine, but the left is diminished, then how would you grade them?

cranial nerve 3, 4, or 6

If there is a drooping eye lid on your patient what cranial nerve is most likely damaged?

the pyramidal (corticospinal tract) and the extrapyramidal tract

Motor impulses are conducted to the muscles by two descending neural pathways, what are they?

influences ability to read and understand and is the primary visual receptor center.

Occipital?

spinothalamic tract

Sensations of temperature, pain, and crude and light touch are carried by way of the spinothalamic tract. extrapyramidal tract. corticospinal tract. posterior tract.

the spinothalamic tract and the posterior columns

Sensory impulses travel to the brain by way of two ascending neural pathways, what are they?

hearing

Temporal

Weakness made worse with repeated effort and improved with rest suggests myasthenia gravis Myasthenia gravis is caused by a breakdown in the normal communication between nerves and muscles.

The client presents at the clinic with a complaint of weakness that is made worse with repeated effort and improves with rest. The client's complaint is consistent with what health problem? Lyme disease Parkinson disease Myasthenia gravis Ischemic stroke

thalamus and hypothalamus.

The diencephalon of the brain consists of the cerebellum and midbrain. pons and brainstem. thalamus and hypothalamus. medulla oblongata and cerebrum.

assess for nonverbal signs

The nurse has completed a Glasgow Coma Scale assessment and assigns the client a score of three. Which is the best way for the nurse to assess pain in this client? Assess for nonverbal signs. Use a verbal 0-10 rating scale. Utilize the FACES scale. Clients assigned this low score are pain free.

cerebellar disease

The nurse is assessing the client's coordination and finds that her movements are clumsy, unsteady, and inappropriately varying in their speed, force, and direction. The nurse notes that patient has dysmetria. What would the nurse know this patient has? Brainstem disease Cerebral disease Basal ganglia disease Cerebellar disease

ask the client to purse their lips

The nurse is assessing the neurologic system of an adult client. To test the client's motor function of the facial nerve, the nurse should note the presence of a gag reflex. ask the client to open the mouth and say "ah." observe the client swallow a sip of water. ask the client to purse the lips.

Delirium

The nurse is caring for a client in the hospital and identifies the client to be experiencing acute confusion after cardiac surgery. The nurse recognizes this as what? Delirium Hypoxia Amnesia Dementia

true

The nurse is tapping the spine for the level of vertebral pain. The nurse is testing the dermatomes. False True

temporal lobe herniation

The nurse observes the client's pupils as shown.Which is one dilated the other normal. What should the nurse suspect is occuring with the client? Structural damage in the midbrain Cocaine use Temporal lobe herniation Damage to the sympathetic pathways in the hypothalamus

document the findings

The nurse performs a neurological assessment and determines the Glasgow Coma Scale (GCS) score is 15. What is the nurse's best action? Re-assess in 15 minutes. Ask the client to open eyes on command. Notify the healthcare provider. Document the findings.

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The nurse plans to test which cranial nerve when testing an elderly patient's hearing status? VII VI V VIII

Cerebellar ataxia, a wide-based gait with staggering and lurching, is often due to alcohol intake or cerebral palsy. Spastic hemiparesis is usually caused by stroke, not alcohol intoxication.

The nurse working in the emergency department is assessing an intoxicated driver involved in a motor vehicle crash when the client insists on ambulating to the bathroom. The nurse escorts the client and calls for help while anticipating which abnormal gait in this client that places him at risk for falls? Scissors movement Sensory ataxia Spastic Hemiparesis Cerebellar ataxia

The CNS and PNS

The very complex neurologic system is responsible for coordinating and regulating all body functions?

controls respiratory rate, heart rate and force and blood pressure.

What are the functions of the medulla oblongata?

TMJ jaw clench and sensation of the skin on the head is tested

What are two tests for the 5th cranial nerve?

Regulation of internal autonomic functions Body position in space Conscious sensation

What functions are attributed to sensory impulses? (Select all that apply.) Body position in space Regulation of internal autonomic functions Cessation of cough reflex Conscious sensation Stimulation of sneezing

cerebellum becomes inflamed or damaged and you have a hard time controlling voluntary muscles.

What is cerebellar ataxia?

involuntary muscle contractions that cause repetitive or twisting movements.

What is dystonia?

rapid twitching of resting muscle, seen in lower motor neuron disease or fatigue

What is fasciculation?

cushions the brain and spinal cord, nourishes the CNS and removes waste

What is the function of CSF?

communication, emotions, intellect, reasoning, behavior, judgement

What is the functiuon of the frontal lobe?

tactile sensation

What should the nurse assess to test the function of the parietal lobe? tactile sensation communication impulses from the ear ability to read

impulses from the ear

What should the nurse assess to test the function of the temporal lobe? Communication Ability to read Tactile sensation Impulses from the ear

midbrain, pons and medulla oblongata

What three parts make up the brain stem

the toes will fan out

When assessing the plantar reflex, what is a positive Babinski response?

pain and light touch

When testing sensory function of the trigeminal nerve (CN V), which of the following sensations would the nurse assess? Proprioception and extinction Pain and light touch Vibration and stereognosis Dull touch and vibration

Swinging a single foot in a semi circle movement.

When the individual walks with a spastic hemiparesis gait, what does it look like?

can you tell me where you are right now

When the nurse is assessing a client's mental status as part of the neurological examination, which question would be most appropriate to ask? "Can you tell me about your mood today?" "Can you tell me where you are right now?" "Do you feel like crying often?" "Do you have a history of psychotic disorder?"

In the middle of the brain.

Where is the Diencephalon located?

use rapid wrist movement and strike the tendon

Which action by a nurse demonstrates the correct technique to use the reflex hammer? Tap the tendon gently to avoid pain and tingling Instruct the client to tense the muscles before striking Strike the tendon then palpate for a response Use rapid wrist movement and strike the tendon

1)diabetic amyotrophy 2)autonomic dysfunction 3) mononeuritis multiplex

Which of the following are types of diabetic neuropathies? (Select all that apply.) Gastroparesis Mononeuritis multiplex Diabetic amyotrophy Orthostatic hypotension Autonomic dysfunction

hypothalamus

Which part of the brain regulates water balance, appetite, vital signs, sleep cycles , pain perception and emotional status?

interprets tactile sensation, pain, temp, and two point discrimination

parietal lobe?

corpus callosum

the two hemispheres are joined by what structure?

grey matter

what are the lobes composed of?