NEURO UNIT 11

A patient arrives to have an MRI done in the outpatient department. What information provided by the patient warrants further assessment to prevent complications related to the MRI? "I am trying to quit smoking and have a patch on." "I have been trying to get an appointment for so long." "I have not had anything to eat or drink since 3 hours ago." "My legs go numb sometimes when I sit too long."

"I am trying to quit smoking and have a patch on."

The Glasgow Coma Scale is a common screening tool used for patients with a head injury. During the physical exam, the nurse documents that the patient is able to spontaneously open her eyes, obey verbal commands, and is oriented. The nurse records the highest score of: 20 15 10 5

15

A nurse notes on the electronic medical record of a post-lumbar puncture patient an abnormal CSF value. Which of the following is the minimal level that is an abnormal value? 140 mm H2O 160 mm H2O 190 mm H2O 210 mm H2O

210 mm H2O

Which term refers to the inability to coordinate muscle movements, resulting in difficulty walking? Agnosia Ataxia Spasticity Rigidity

Ataxia

Consists of sympathetic and parasympathetic nervous systems.Maintains homeostasis.

Autonomic nervous system

A nurse is assessing reflexes in a client with hyperactive reflexes. When the client's foot is abruptly dorsiflexed, it continues to "beat" two to three times before settling into a resting position. How should the nurse document this finding? Rigidity Flaccidity Clonus

Clonus

The physician has prescribed a somatosensory evoked responses (SERs) test for a client for whom the nurse is caring. The nurse is justified in suspecting that this client may have a history of what type of neurologic disorder? Hypothalamic disorder Demyelinating disease Brainstem deficit Diabetic neuropathy

Demyelinating disease

An 80-year-old man has been brought to the emergency department (ED) by his daughter, who states that her father has become confused and agitated over the past several days. The daughter expresses fear that her father is "getting senile" and states that this concern is what prompted her to seek care. The ED nurse and the other members of the care team should prioritize which of the following aspects of assessment? Assessing for cranial nerve defects Assessing the man's nutritional status Correlating the man's cognitive function with his motor function Differentiating delirium from dementia

Differentiating delirium from dementia

A trauma client in the ICU has been declared brain dead. What diagnostic test is used in making the determination of brain death? Magnetic resonance imaging (MRI) Electroencephalography (EEG) Electromyography (EMG) Computed tomography (CT)

EEG

A patient had a lumbar puncture 3 days ago in the outpatient clinic and calls the nurse with complaints of a throbbing headache. What can the nurse educate the patient to do for relief of the discomfort? Select all that apply. Limit the amount of fluid to decrease cerebral edema. Force fluids (unless contraindicated). Get plenty of bed rest. Take some over-the-counter analgesics. Walk around.

Force fluids (unless contraindicated). Get plenty of bed rest. Take some over-the-counter analgesics.

Which anatomic part supplies cerebrospinal fluid to the subarachnoid space and down the spinal cord on the dorsal surface? Third ventricle Fourth ventricle Lateral ventricle Arachnoid villus

Fourth ventricle

The sympathetic and parasympathetic nervous systems have a direct effect on the circulatory system. Stimulation of the parasympathetic nervous system (PNS) causes which of the following? Blood vessels in the heart muscle to dilate Heartbeat to decrease Blood pressure to increase Blood vessels in the skeletal muscles to dilate

Heartbeat to decrease

A gerontologic nurse educator is providing practice guidelines to unlicensed care providers. Because reaction to painful stimuli is sometimes blunted in older adults, what must be used with caution? Hot or cold packs Analgesics Anti-inflammatory medications Whirlpool baths

Hot or cold packs

The nurse has admitted a new client to the unit. One of the client's admitting orders is for an adrenergic medication. The nurse knows that this medication will have what effect on the circulatory system? Thin, watery saliva Increased heart rate Decreased BP Constricted bronchioles

Increased heart rate

The nurse is caring for a client with an upper motor neuron lesion. What clinical manifestations should the nurse anticipate when planning the client's neurologic assessment? Decreased muscle tone Flaccid paralysis Loss of voluntary control of movement Slow reflexes

Loss of voluntary control of movement

Which term describes the fibrous connective tissues that cover the brain and spinal cord? Meninges Dura mater Arachnoid mater Pia mater

Meninges

In the course of a focused neurologic assessment, the nurse is palpating the client's major muscle groups at rest and during passive movement. Data gleaned from this assessment will allow the nurse to describe which of the following aspects of neurologic function? Muscle dexterity Muscle tone Motor symmetry Deep tendon reflexes

Muscle tone

O O T T A F V G V A H

Olfactory/Sensory Optic/Sensory Oculomotor/motor Trochlear/motor trigeminal/both abducens/motor facial/both vestibochlear/sensory glossopharyngeal/both vagus/both accessory/motor hypoglossal/motor

The nurse is doing an initial assessment on a client newly admitted to the unit with a diagnosis of cerebrovascular disease. The client has difficulty copying a figure that the nurse has drawn and is diagnosed with visual receptive aphasia. What brain region is primarily involved in this client's deficit? Temporal lobe Parietal—occipital area Inferior-posterior frontal areas Posterior frontal area

Parietal—occipital area

The client in the ED has just had a diagnostic lumbar puncture. To reduce the incidence of a post-lumbar puncture headache, what is the nurse's most appropriate action? Position the client prone. Position the client supine with the head of bed flat. Position the client left side-lying. Administer acetaminophen as ordered.

Position the client prone.

A client with lower back pain is scheduled for myelography using metrizamide (a water-soluble contrast dye). After the test, the nurse should prioritize what action? Positioning the client with the head of the bed elevated 45 degrees Administering IV morphine sulfate to prevent headache Limiting fluids for the next 12 hours Helping the client perform deep breathing and coughing exercises

Positioning the client with the head of the bed elevated 45 degrees

A patient has suffered cerebellar trauma after falling off of a ladder. The patient has been stabilized and is now receiving care on a neurological unit. When planning this patient's care, what nursing diagnosis is most likely to result from an injury to this part of the brain? Risk for aspiration Risk for falls Risk for ineffective thermoregulation Risk for ineffective breathing pattern

Risk for falls

A patient comes to the emergency department with severe pain in the face that was stimulated by brushing the teeth. What cranial nerve does the nurse understand can cause this type of pain? III IV V VI

V

When completing a neurologic examination on a client, which question is most essential to evaluate the accuracy of the data? When, if any, was your last narcotic use? Do you have any history of forgetfulness? Have you been diagnosed with any mental health issues? Have you experienced any unusual sensations?

When, if any, was your last narcotic use?

A nurse uses the Glasgow Coma Scale (GCS) to assess the level of consciousness (LOC) of a 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? comatose somnolence stupor normal

comatose

The nurse is assessing the pupils of a patient who has had a head injury. What does the nurse recognize as a parasympathetic effect? Dilated pupils Constricted pupils One pupil is dilated and the opposite pupil is normal Roth's spots

constricted pupils

There are 12 pairs of cranial nerves. Only three are sensory. Select the cranial nerve that is affected with decreased visual fields. Cranial nerve I Cranial nerve II Cranial nerve III Cranial nerve IV

cranial nerve II

The nurse is caring for a post-lumbar puncture client who is experiencing an intense headache. If the physician chooses aggressive treatment, which nursing action is anticipated? hanging an intravenous solution drawing venous blood to perform a blood patch applying ice to the back of the neck offering caffeinated drinks

drawing venous blood to perform a blood patch

To assess a client's cranial nerve function, a nurse should assess: hand grip. orientation to person, time, and place. arm drifting. gag reflex.

gag reflex

External otitis: Otitis media:

inflammation of the ear canal (swimmers ear) inflammation of the middle ear, more common in children than adults

Axons in the central and peripheral nervous systems may, or may not, be myelinated. Those that are myelinated are called white nerve fibers; those that are not are called gray nerve fibers. What is the function of myelination? insulate electrical conduction decrease impulse conduction speed increase impulse conduction speed inconclusive function, still being investigated

insulate electrical conduction

A client is scheduled for a myelogram and the nurse explains to the client that this is an invasive procedure, which assesses for any lesions in the spinal cord. The nurse should explain that the preparation is similar to which of the following neurologic tests? Lumbar puncture MRI Cerebral angiography EEG

lumbar puncture

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? lumbar puncture echoencephalography nerve conduction studies

lumbar puncture

The family nurse practitioner is performing the physical examination of a client with a suspected neurologic disorder. In addition to assessing other parts of the body, the nurse should assess for neck rigidity. Which method should help the nurse assess for neck rigidity correctly? moving the head toward both sides lightly tapping the lower portion of the neck to detect sensation moving the head and chin toward the chest gently pressing the bones on the neck

moving the head and chin toward the chest

The nurse is caring for a comatose client. The nurse knows she should assess the client's motor response. Which method may the nurse use to assess the motor response? observing the reaction of pupils to light observing the client's response to painful stimulus using the Romberg test assessing the client's sensitivity to temperature, touch, and pain

observing the client's response to painful stimulus

The nurse is caring for a client who is to have a lumbar puncture. What are the lowest vertebrae that contain the spinal cord? coccyx second lumbar vertebrae eleventh thoracic vertebrae fifth lumbar vertebrae

second lumbar vertebrae

The nurse is assessing a client's level of consciousness. The nurse speaks the client's name, strokes the client's hand, and moves the client's shoulder. There is a delay, and then the client states, "What do you want?" Which level of conscious should the nurse document? conscious semi-comatose somnolent stuporous

somnolent

dysarthria diplopia agnosia apraxia

stutter double vision loss of comprehension inability to preform purposeful movements

The brain stem holds the medulla oblongata. What is the function of the medulla oblongata? transmits sensory impulses from the brain to the spinal cord controls striated muscle activity in blood vessel walls controls parasympathetic nerve impulses in the pons transmits motor impulses from the brain to the spinal cord

transmits motor impulses from the brain to the spinal cord

The nurse is assessing the client's pupils following a sports injury. Which assessment findings indicate a neurologic concern? Select all that apply. unequal pupils quick pupil reaction pinpoint pupils absence of pupillary response pupil reacts to light

unequal pupils pinpoint pupils absence of pupillary response

To help assess a client's cerebral function, a nurse should ask: "Have you noticed a change in your memory?" "Have you noticed a change in your muscle strength?" "Have you had any problems with coordination?" "Have you had any problems with your eyes?"

"Have you noticed a change in your memory?"

A client for whom the nurse is caring has positron emission tomography (PET) scheduled. In preparation, what should the nurse explain to the client? The test will temporarily limit blood flow through the brain. An allergy to iodine precludes getting the radio-opaque dye. The client will need to endure loud noises during the test. The test may result in dizziness or lightheadedness.

The test may result in dizziness or lightheadedness.

The nurse is planning the care of a client with Parkinson disease. The nurse should be aware that treatment will focus on what pathophysiologic phenomenon? Premature degradation of acetylcholine Decreased availability of dopamine Insufficient synthesis of epinephrine Delayed reuptake of serotonin

Decreased availability of dopamine

A patient who has been diagnosed with colon cancer is scheduled to undergo positron emission tomography (PET) to search for metastases. In preparation for this diagnostic procedure, what teaching point should the nurse provide to the patient? "Sound waves will be refracted throughout your body and a computer will analyze them." "A series of X-rays will be taken that will be combined to create a three-dimensional image your body." "It's very important that all metal objects be removed from your body before the test." "You'll be given a radioactive substance that will be measured during the test."

"You'll be given a radioactive substance that will be measured during the test."

he nurse is preparing to assess a client with neurologic dysfunction. What does accurate and appropriate assessment require? Select all that apply. The ability to select basic medications for the neurologic dysfunction Understanding of the tests used to diagnose neurologic disorders Knowledge of nursing interventions related to assessment and diagnostic testing Knowledge of the anatomy of the nervous system The ability to interpret the results of diagnostic tests

Understanding of the tests used to diagnose neurologic disorders Knowledge of nursing interventions related to assessment and diagnostic testing Knowledge of the anatomy of the nervous system

The nurse is preparing a child for a cisternal puncture to extract cerebrospinal fluid (CSF) for neurological diagnosis. To perform cisternal puncture, which of the following areas on the child's body should be shaved? The back of the neck The lateral aspect of the skull The lower abdomen The lower lumbar region

back of neck