Neuro Exam
The nurse is caring for a patient with amyotrophic lateral sclerosis (ALS). Which of the following is a characteristic of this disease?
ALS always progresses to respiratory dysfunction and death
A patient with a seizure disorde lacks knowledge about the side effects of phenytoin (Dilantin). What teaching provided from the nurse would be most appropriate?
Take medication with food to reduce GI upset.
AN 83 year old patient has had a stroke. He is right handed and has a history of hypertension and "little" strokes. He presents with right hemiplegia. To afford him the best visual field, the nurse should approach him:
from the left side
The assessment finding that mannitol therapy for cerebral edema is effective in a patient with increased ICP is:
increased urinary output
A patient has weakness on the right side and impaired reasoning after a CVA in the____
left hemisphere of the cerebrum
The instruction that is most helpful in teaching the family and patiennt who is in the rehabilitation phase after a CVA about altered sensation is to:
make frequent assessments for signs of pressure injury.
Following a myelogram the nurse should include in the postprocedure care assessment for:
sensation in lower extremities
The nurse is the characteristic gait of the person with Parkinson disease is a propulsive gait, which causes the patient to:
shuffle with arms flexed
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 conduction?
It is possibly a temporary condition and will clear.
A patient age 45, is to have a myelogram to confirm the presence of a herniated invertebral disk. Which nursing action should be planned with respect to the diagnostic test?
Obtain an allergy history before the test
A nurse is assisting in performing an angiogram for a patient with a head injury. What is the nurse's role when assisting with this procedure?
Obtaina baseline neurological assessmentbefore the procedure
A mill worker with injuries to the spinal cord is under care of a healthcare facility& is now anxious about the paralysis that he has experienced. WHat would be the consequence of a complete transection of the spinal cord?
Permanent paralysis below the level of injury
A nurse is caring for a 12 year old that has had multiple seizures since she was 5 years old. WHich of the following measures should the nurse employ when the patient is having a seizure?
Place a soft pad beneath the patient's head
What should the nurse do when the child arrives on the floor with the diagnosis of bacterial menigitis?
Place the child in respiratory isolation
A family member of a patient who has just suffered a tonic-clonic seizure is concerned about the patient's deep sleep. What is this behavior called?
Postictal period
A patient with multiple sclerosis has been prescribed the drug baclofen. What's the action of this drug?
Reduces spasticity
A nurse is caring for a patient with autonomic dysreflexia. The nurse has been ordered to monitor the patient's blood pressure regularly because it is dangerously elevated. The nurse should be aware that which of the following can result from autonomic dysreflexia?
Stroke
A nurse is caring for a patient who experiences cluster headaches. The nurseknows that the exact cause of cluster headaches is unknownand the pain is usually on one side and described as sharp, burning, and steady. What symptom also accompanies a cluster headache?
Tear formation
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 assessment?
Test the drainage for glucose
Mannitol is an osmotic diuretic that can be used to treat what condition?
Alzheimer's disease
The nurse is aware that when assessing a patient by the 4 score coma scale, the patient is assessed in 4 categories: eye response, brainstem reflexes, motor response, and respiration. How are these results reported?
As individual scores in each category
A nurse at a long-term care facility is caring for a patient with myasthenia gravis. What important teaching should the nurse provide to thispatient?
Avoid large crowds during cold and flu season
Which question is likely the most valid response from the patent who is being interviewed about a neurological problem?
"Can you describe the sensation you are having".
A college student is recovering from Guillian-Barre'. The student asks the nurse, "Will having the disease affect my ability to learn and function mentally?" Which response is appropriate?
"Guilliam-Barre' does not affect cognitive function."
The nurse is aware that the drug t-PA (Activase), a tissue plasminogen activator, must be given in ____hours of the onset of symptoms to have maximum benefit.
3
The nurse is providing genetic counseling to a young couple hoping to start a family. The husband has the Huntington's disease gene and does not want to pass the disease to his children. WHich of the following teaching points should the nurse include in the teaching plan for thsi couple?
A child with a parent who has HD has a 50/50 chance of inheriting it
The nurse is caring for a patient with a subdural hematoma. Which of the following is the usual cause of this condition?
A torn vein on the brain's surface
How would a nurse record the behavior when a patient with Alzheimer disease attempts to eat using a napkin rather than a fork?
Agnosia
A nurse is assisting the anesthesist in performing a lumbar puncture on a patient who is being tested for meningitis. What important factor should the nurse document before & after the procedure?
Ability to move all extremities
A patient that has had a stroke is taking warfarin. What is an important assessment finding associated with this medication that the nurse should immediately report to the physician?
Black, tarry stool
A patient is on the neurological unit after a sports injury resulting in a thoracic fracture. The nurse's assessment reveals an intact halo device, flushing of the face and upper chest area, goose bumps, and stuffy nose. What additional assessment would be most important at this time?
Blood pressure
What does the nurse know about the stroke patient who has expressive aphasia?
Can understand the spoken word, but can not speak.
The nurse is providing a continuing education program to teenagers about the nervous system. The nurse is reviewing the parts of the neuron with the students. Based on this information, the nurse asks a s tudent to describe the axon of a neuron. Which explanation by the studnet best describes an axon?
Carries impulses away from the neuron cell body
What are the two divisions of the nervous system?
Central & peripheral
What is the cardinal sign of increased intracranial pressure in a brain injured patient?
Decrease in the level of consciousness
What is the action of a benzodiazepine in the treatment of seizures?
Depresses the CNS which results in muscle relaxation & anticonvulsant activity
The nurse is preparing a patient who manifests with signs & symptoms of status epilepticus for a test to diagnose seizure activity. Which of the following would be the best test to diagnose this condition?
Electroencephalogram
A nurse is taking care of a patient who has sustained head trauma as a reuslt of a motor vehicle accident. The nursenotices fluid leakingfrom the nose and ears. Based on this infprmation what diagnostic test should be tested for immediately?
Glucose
The nurse is administering heparin to a patient who has had a CVA. Which of the following complications should the nurse monitor for in this patient?
Hemorrhage
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?
Hypotension
The nurse caring for a patient with meningitis knows that signs and symptoms of meningitis usually appear abruptly. Which of the following are signs of this condition?
Inability to extend legs out completely without pain. Fever. Neck stiffness.
A 13 year old patient is admitted to the pediatric unit with suspected meningitis. The nurse notices the patient cannot extend his legs completely without excruiating pain. The nurse correctly documents this as which sign?
Kernig's sign
The most reliable indicator of neurological status is:
Level of consciousness
The nurse is preparing mediactions for a patient who has Parkinson's disease. Which of the following is the medication of choice to help reduce the tremors and rigidity of Parkinson's disease?
Levodopa
What is the basic problem that prompts most of the early signs of Alzheimer's disease?
Memory loss that disrupts daily life
What is the fatty covering that increases the transmission rate of impulses, protects and insulates nerve fibers?
Myelin
The nurse explains that the spinal cord extends from the brainstem to the level of which vertebra?
Second lumbar
A patient is in which stage of Alzheimer disease when she demonstrates "sundowning"?
Second stage
What is the nurse aware of when assessing a person with a craniocerebral injury?
Signs and symptoms may not occur until several days after the trauma.
The nurse is caring for a 60 year old man who is diagnosed with a brain abcess. WHat is a primary cause of a brain abcess?
Sinus infection
Why is the patient with suspected Guillian-Barre' Syndrome (GBS) hospitalized immediately?
The disease can rapidly progress into respiratory failure
The nurse caring for patients with spinal cord injuries explains the physiology of the spinal cord to the student nurse. Which of the following accurately describes this organ?
The spinal cord is the communiation system between the brain and the body.
Which symptom is specific to migraine headaches?
They are preceded by an aura.
How would the nurse instruct a patient with Parkinson's disease to improve activity level?
To walk with hands clasped behind back to help balance.
A patient has recently suffered a stroke with left-sidedweakness and has problems with chockinh, especially when drinking thin liquids. WHat nursing interventions would be most helpful in assisting this patient?
Tuck the chin when swallowing
What is the cranial nerve that supplies most of the organs in the thoracic & abdominal cavities and carres motor fibers to glands that produce digestive juices and other secretions
Vagus nerve
The patient recovering from a CVA asks the purpose of warfarin (Coumadin). The best response by the nurse is:
prevents the formation of new clots
The nurse explains that the neural synapse refers to:
the space between the axon of one neuron and the dendrite of the next
What is the first sign of Bell's palsy?
Inability to wrinkle forehead and pucker lips on affected side
A nurse is caring for a patient that has had an accident. Which response produced by the sympathetic division of the autonomic nervous system should the nurse identify in the patient?
Involuntary urination of bowel movements
What are the effects of normal aging on the nervous system? (Select all that apply).
Slowed reflexes Loss of neuron Decrease in oxygen use Reduction of cerebral-blood flow
A nurse is caring for a patient with paraplegia. Which of the following measures should the nurse employ, when providing care?
Slowly increasing the angle of sitting up
Which of the following techniques are necessary for safely feeding a hemiplegic patient? (Select all that apply)
Checking the affected side of the mouth for food accumulation. Adding a thickening agent to liquids. Offering small bites of food.
A nurse is educating a patient and family about the neurological systemsas it relates to the stroke that the patient had. Which is a function of a neuron that the nurse needs to include in the client's teaching?
Conducts messages within the neurological system
Which intervention by the nurse would be most effective in the prevention of autonomic dysreflexia in a patient with a spinal cord injury?
Ensure the patency of the urinary catheter
A nurse is ordered to observe a female patient that's suspected to have meningitis for positive Brudinski's sign. Which of the following would the nurse document as a positive Brudzinski's sign?
Evidence of pain or resistance when the client lies on the back and brings her head forward toward the chest
The newly admitted patient to the ER 30 minutes ago after a fall off a ladder has gradually decreased in consciousness & has slowly reacting pupils, a widened pulse pressure, and verbal responses that are slow & unintelligable. What's the most appropriateposition 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 spatial position of his body? a. Agnosia b. Proprioception c. Apraxia d. Sensation
Proprioception
The patient fell to the floor due to a generalized seixure. What should the nurse do first to prevent injury?
Protect the head using a cradling method or pillow.
A patient with a spinal cord injury at T1 complains of stiffness of the nose & a headache. The nurse notes a flushing of the neck and "goose flesh". What should be the primary nursing interventionbased on these assessments?
Sit upright and check blood pressure
