neuro exam study guide

The parents of a child recently diagnosed with cerebral palsy ask the nurse about the disorder. The nurses bases the response on the understanding that cerebral palsy is which type of condition?

A chronic disability characterised by impaired muscle movement and posture

When teaching patients who are at risk for Bell's palsy because of previous herpes simplex infection, which information should the nurse include?

Call the doctor if pain or herpes lesions occur near the ear

Following a thymectomy, a patient with myasthenia gravis receives the usual dose of pyridostigmine (Mestinon). An hour later, the patient complains of nausea and severe abdominal cramps. Which action should the nurse take first?

Notify the patient's health care provider.

When the nurse is assessing a patient with myasthenia gravis, which action will be most important to take?

Observe respiratory effort.

What are the three major symptoms (major triad) of Parkinson's disease? Select all that apply

tremors at rest rigidity Bradykinesia

When assessing a patient with newly diagnosed trigeminal neuralgia, the nurse will ask the patient about

triggers that lead to facial pain.

The nurse is conducting discharge teaching with parents of a preschool child with myelomeningocele, repaired at birth, who is being discharged from the hospital after a urinary tract infection (UTI). Which should the nurse include in the discharge instructions related to management of the child's genitourinary function (Select all that apply)?

Continue to perform the clean intermittent catheterizations (CIC) at home. Administer the oxybutynin chloride (Ditropan) as prescribed. Monitor for signs of a recurrent UTI.

The nurse is caring for an infant with myelomeningocele scheduled for surgical closure in the morning. Which interventions should the nurse plan for the care of the myelomeningocele sac?

Covered with a sterile, moist, nonadherent dressing

Which action will the nurse include in the plan of care when caring for a patient who is experiencing trigeminal neuralgia?

Assess intake and output and dietary intake.

The nurse is admitting a school-age child with suspected Guillain-Barré syndrome (GBS). Which nursing intervention is a priority in the care for this child?

Assessing respiratory efforts

A patient with amyotrophic lateral sclerosis (ALS) is hospitalized with pneumonia. Which nursing action will be included in the plan of care?

Assist with active range of motion.

A patient with multiple sclerosis (MS) is to begin treatment with glatiramer acetate (Copaxone). Which information will the nurse include in patient teaching?

How to draw up and administer injections of the medication

Which problem is most often associated with myelomeningocele?

Hydrocephalus

Spastic cerebral palsy is characterized by:

Hypertonicity and poor control of posture, balance, and coordinated motion.

A patient who has numbness and weakness of both feet is hospitalized with Guillain-Barré syndrome. The nurse will anticipate the need to teach the patient about

IV infusion of immunoglobulin (Sandoglobulin

A patient with Parkinson's disease has decreased tongue mobility and an inability to move the facial muscles. Which nursing diagnosis is of highest priority?

Imbalanced nutrition: less than body requirements

he parents of a child with cerebral palsy ask the nurse if any drugs can decrease their child's spasticity. The nurse's response should be based on knowing that:

Implantation of a pump to deliver medication into the intrathecal space to decrease spasticity has recently become available.

Which assessment findings should the nurse note in a school-age child with Duchenne's muscular dystrophy (DMD) (Select all that apply)?

Lordosis Gower's sign Waddling gait

A 28-year-old woman who has multiple sclerosis (MS) asks the nurse about risks associated with pregnancy. Which response by the nurse is accurate?

MS symptoms may be worse after the pregn

In a patient with myastenia gravis, what does rapid improvement of muscle stregnth after administration of edrophonium chloride (Tensilon) indicate?

Myastenic crisis or cholinergic crisis

The most common problem of children born with a myelomeningocele is:

Neurogenic bladder.

After teaching a patient about management of migraine headaches, the nurse determines that the teaching has been effective when the patient says

"I will try to lie down someplace dark and quiet when the headaches begin.

A patient seen at the health clinic with a severe migraine headache tells the nurse about having four similar headaches in the last 3 months. Which initial action should the nurse take?

Ask the patient to keep a headache diary.

A patient tells the nurse about using acetaminophen (Tylenol) several times every day for recurrent bilateral headaches. Which action will the nurse plan to take first?

Discuss the need to stop taking the acetaminophen

In order to reduce the symptoms of Parkinson's disease, what is L-Dopa converted to once it crosses the blood-brain barrier?

Dopamine

The nurses is admitting a patient Guillian-Barrésyndrome to the nursing unit. The patient has ascending paralysis to the level of the waistline. Knowing the complications of this disorder, the nurse should bring which most essential items into the patietn's room?

ECG telemetry monitoring electrodes and intubation tray

Which action should the nurse take when assessing a patient with trigeminal neuralgia?

Examine the mouth and teeth thoroughly.

A current recommendation to prevent neural tube defects is the supplementation of:

Folic acid for all women of childbearing age.

Which of these nursing actions for a patient with Guillain-Barré syndrome is most appropriate for the nurse to delegate to an experienced nursing assistant?

Passive range of motion to extremities q8hr

The nurse is admitting a child with Werdnig-Hoffmann disease (spinal muscular atrophy type 1). Which signs and symptoms are associated with this disease?

Progressive weakness and wasting of skeletal muscle

The nurse is caring for a neonate born with a myelomeningocele. Surgery to repair the defect is scheduled the next day. The most appropriate way to position and feed this neonate is to place him:

Prone, turn head to side, and nipple feed.

After reviewing a patient's cerebrospinal fluid analysis, which result will be most important for the nurse to communicate to the health care provider?

Protein 65 mg/dL (0.30 g/L)

A young boy has just been diagnosed with pseudohypertrophic (Duchenne's) muscular dystrophy. The management plan should include:

Recommending genetic counseling.

The patient is admitted to the hospital with a diagnosis of Guillian-Barré syndrome. Which past medical history finding makes the patient most at risk for this disease?

Respiratory or gastrointestinal infection during the previous month

The nurse notes in the patient's medical history that the patient has a positive Romberg test. Which nursing diagnosis is appropriate?

Risk for falls related to dizziness or weakness

A hospitalized 24-year-old patient with a history of cluster headache awakens during the night with a severe stabbing headache. Which action should the nurse take first?

Start the ordered PRN oxygen at 6 L/mi

Which physical therapy programs are most helpful to patients with Parkinson's disease? Check all that apply.

Stretching Gait retraining Exercises for balance message

Which finding should cause the nurse to suspect a diagnosis of spastic cerebral palsy?

Sudden jerking movement caused by stimuli

A patient with Parkinson's disease has a nursing diagnosis of impaired physical mobility related to bradykinesia. Which action will the nurse include in the plan of care?

Suggest that the patient rock from side to side to initiate leg movement.

A patient with multiple sclerosis (MS) has urinary retention caused by a flaccid bladder. Which action will the nurse plan to take?

Teach the patient how to use the Credé method.

he nurse in the neonatal intensive care unit is caring for an infant with myelomeningocele scheduled for surgical repair in the morning. Which early signs of infection should the nurse monitor on this infant (Select all that apply)?

Temperature instability Irritability Lethargy

The health care provider is considering the use of sumatriptan (Imitrex) for a patient with migraine headaches. Which information obtained by the nurse is most important to report to the health care provider?

The patient has a history of a recent acute myocardial infarction.

A patient is scheduled for a myelogram to confirm the presence of a herniated intervertebral disk. Which information obtained when admitting the patient is most important for the nurse to communicate to the health care provider before the procedure?

The patient has an allergy to shellfish.

Which information about a patient with MS indicates that the nurse should consult with the health care provider before giving the prescribed dose of fampridine (Ampyra)?

The patient has an increased creatinine level.

When caring for a patient who has Guillain-Barré syndrome, which assessment data obtained by the nurse will require the most immediate action

The patient has continuous drooling of saliva.

A patient has a new prescription for bromocriptine (Parlodel) to control symptoms of Parkinson's disease. Which information obtained by the nurse may indicate a need for a decrease in the dose?

The patient's blood pressure is 90/46 mm Hg.

Which equipment will the nurse obtain to assess vibration sense in a patient who has peripheral nerve dysfunction?

Tuning fork

Which information about a patient who is being treated with carbidopa/levodopa (Sinemet) for Parkinson's disease is most important for the nurse to report to the health care provider?

Uncontrolled head movement

A patient with Parkinson's disease is admitted to the hospital for treatment of an acute infection. Which nursing interventions will be included in the plan of care (select all that apply)?

Use an elevated toilet seat. Cut patient's food into small pieces. Place an arm chair at the patient's bedside.

The nurse is preparing to admit a newborn with myelomeningocele to the neonatal intensive care nursery. Which describes this newborn's defect?

Visible defect with an external saclike protrusion containing meninges, spinal fluid, and nerves

A patient is seen in the health clinic with symptoms of a stooped posture, shuffling gait, and pill rolling-type tremor. The nurse will anticipate teaching the patient about

antiparkinsonian drugs.

To assess the functioning of the trigeminal and facial nerves (CN V and VII), the nurse should

apply a cotton wisp strand to the cornea.

A patient has a lesion that affects lower motor neurons. During assessment of the patient's lower extremities, the nurse expects to find

flacidity

A patient is scheduled for a lumbar puncture. The nurse will plan to

help the patient to a side lying position before the procedure.

When obtaining a health history and physical assessment for a patient with possible multiple sclerosis (MS), the nurse should

inquire about any urinary tract problems.

A 24-year-old patient is hospitalized with the onset of Guillain-Barré syndrome. During this phase of the patient's illness, the most essential assessment for the nurse to carry out

observing respiratory rate and effort.

When teaching a patient with myasthenia gravis (MG) about management of the disease, the nurse advises the patient to

perform physically demanding activities in the morning

A patient with Bell's palsy refuses to eat while others are present because of embarrassment about drooling. The best response by the nurse to the patient's behavior is to

respect the patient's desire and arrange for privacy at mealtimes.

ropranolol (Inderal), a â-adrenergic blocker that inhibits sympathetic nervous system activity, is prescribed for a patient. The nurse monitors the patient for

slowed pulse

When performing a focused assessment on a patient with a lesion of the left posterior temporal lobe, the nurse will assess for

understanding of written and oral language.

When a patient is experiencing a cluster headache, the nurse will plan to assess for

unilateral eyelid swelling.