NURS 261 Module 7: Neuro cognition - Ch. 34 practice questions

A nursing instructor is teaching a group of student nurses about athetosis movements in clients with Huntington's disease. Which statement made by the student nurse indicates effective learning? A. "Athetosis refers to twisting and writhing movements." B. "Athetosis refers to brief, irregular dancing-like movements." C. "When athetosis is severe, there are thrashing motions referred to as ballismus." D. "Antipsychotic medications, such as haloperidol, may be symptomatically beneficial to treat athetosis."

"Athetosis refers to twisting and writhing movements." Athetosis refers to the twisting and writhing movements that are two of the involuntary motor movements of Huntington's disease. Therefore, the statement made by the student is correct and indicates effective learning.

Which statement relates to multiple sclerosis? A. "It is a demyelinating disorder." B. "It is an autosomal dominant neurological disorder." C. "It is the progressive loss of dopamine-producing cells." D. "It is a progressive neurodegenerative disorder with the loss of upper and lower motor neurons."

A. "It is a demyelinating disorder." Multiple sclerosis is an autoimmune and demyelinating disorder.

Which instruction should the nurse provide to a client who is prescribed an anticholinergic drug for symptomatic relief of Parkinson's disease? A. "You should watch out for side effects such as dry mouth and double vision after taking the medication." B. "You will be able to perform daily activities at a normal pace after taking the medication." C. "You should stay away from exercise therapy during the course of medication." D. "You should remember that the medication may precipitate tremors during initiation of therapy."

A. "You should watch out for side effects such as dry mouth and double vision after taking the medication." Anticholinergic drugs will precipitate side effects such as dry mouth and double vision due to a decrease in cholinergic activity. The nurse should provide this information to the client to decrease panic in the client during the course of medication.

Which client is expected to have status epilepticus? A. A client who is experiencing a series of three tonic-clonic seizures B. A client who is experiencing rapid alternate contraction and relaxation of muscles C. A client who is experiencing seizure or appears to be starring into space for a few moments D. A conscious client with rhythmic jerking movements of the arms and legs

A. A client who is experiencing a series of three tonic-clonic seizures Status epilepticus is a seizure continuing for about 30 minutes or a series of three tonic-clonic seizures. Therefore, a client who is experiencing a series of three chronic seizures is expected to have status eplilepticus. Rapid alternate contraction and relaxation of muscles is seen in the case of a myoclonic seizure. A seizure where a client appears to be staring into space for a few moments is usually an absence seizure. A rhythmic jerking movement of the arms and legs where consciousness is usually preserved occurs in clonic seizures.

A patient is recently diagnosed with amyotrophic lateral sclerosis (ALS). She is asking about how the disease will affect her functioning. Which of the following is correct for the nurse to share? A. ALS does not affect cognition or sensation; it does affect your muscle contractions. B. ALS affects cognition, sensation, and muscle contraction. C. ALS does not affect muscle contraction, but does affect sensation. D. ALS affects muscle contraction and sensation, but not cognition.

A. ALS does not affect cognition or sensation; it does affect your muscle contractions.

While taking a patient's health history, the nurse hears the patient state that she can always tell when she is going to have a migraine. What term may the nurse use to describe this? A. Aura B. Postictal C. Ictal D. Chorea

A. Aura

A nurse is caring for a patient diagnosed with tension headaches. Which signs and symptoms would you expect? Select all that apply. A. Bilateral pain B. Mild to moderate pain C. Rhinorrhea D. Stabbing pain E. Headache preceded by an aura

A. Bilateral pain B. Mild to moderate pain

A patient has Parkinson's disease. Which are the most common clinical presentations of this disorder? Select all that apply. A. Bradykinesia B. Seizures C. Tremors D. Rigidity E. Bitemporal headaches

A. Bradykinesia C. Tremors D. Rigidity

A client with cluster headaches is prescribed dihydroergotamine. What signs in the client indicate the effectiveness of the therapy? Select all that apply. A. Decreased nasal discharge B. Reduced tearing from the eye C. Relaxed cervicothoracic muscle D. Reduced bradykinesia E. Normalized deep tendon reflexes

A. Decreased nasal discharge B. Reduced tearing from the eye Cluster headache results in rhinorrhea or stuffy nose. Administration of dihydroergotamine will relieve these symptoms, which is evident from decreased nasal discharge. Cluster headache is characterized by tears in the eyes due to pain. Administration of dihydroergotamine will decrease pain associated with cluster headache and result in reduced tears from the eyes.

A patient is suffering from an epileptic seizure. Which is the priority of the nurse during the seizure? A. Place the patient in restraints. B. Protect patient from injury. C. Place patient on right side and turn the patient's head. D. Insert patient's mouth guard.

B. Protect patient from injury.

The production of which neurotransmitter is disrupted in Parkinson's disease? A. Dopamine B. Acetylcholine C. Serotonin D. GABA

A. Dopamine

Which treatment option is recommended for rapid relief of symptoms associated with myasthenia gravis? A. Plasmapheresis B. Acetylcholinesterase inhibitors C. Aminoglycoside antibiotics D. Corticosteroids

A. Plasmapheresis

What supportive care should be provided to a client diagnosed with Guillain-Barré syndrome? Select all that apply. A. Provide mechanical ventilation B. Monitor hemodynamics continuously C. Provide physical and occupational therapy D. Administer antipsychotic medications as prescribed E. Provide speech therapy and swallowing interventions

A. Provide mechanical ventilation B. Monitor hemodynamics continuously C. Provide physical and occupational therapy Mechanical support should be provided to a client with Guillain-Barré syndrome as part of supportive care because of respiratory failure caused by paralysis of respiratory muscles. The hemodynamics should be continuously monitored in clients with Guillain-Barré syndrome because of the fluctuations in blood pressure caused by ascending paralysis. Physical and occupational therapy will improve the physical and psychological health of a client with Guillain-Barré syndrome.

A female patient is complaining that her migraines seem to be getting worse. The nurse wants to speak about some lifestyle management that may reduce the risk of migraines developing. Which of the following may the nurse share? Select all that apply. A. Reducing worry and stress B. Begin taking oral contraceptives C. Prevent drops in blood sugar D. Get adequate sleep E. Avoid foods with high nitrites

A. Reducing worry and stress B. Begin taking oral contraceptives C. Prevent drops in blood sugar D. Get adequate sleep E. Avoid foods with high nitrites

David is a retired football player who has been recently diagnosed with a neurological disorder. The first signs and symptoms included weakness of his extremities and speech changes. David's disease is progressing; he now experiences dysphagia and muscle spasticity. His treatment plan is designed to manage his symptoms, as there is no cure. What disorder does David have?

ALS

The nursing instructor is teaching a group of student nurses about the most important intervention for clients with myasthenic crisis. Which statement made by a student nurse indicates effective learning? A. "The most important intervention by the nurse in clients with myasthenia gravis is to constantly monitor the arterial blood gases." B. "The forced vital capacity and negative inspiratory force of the client should be monitored every 2 to 4 hours." C. "The client must be closely monitored in an intensive care unit for decreased heart rate." D. "Immunosuppressant agents should be completely withdrawn in clients who experienced a myasthenic crisis."

B. "The forced vital capacity and negative inspiratory force of the client should be monitored every 2 to 4 hours."

After a theoretical session about edrophonium (Tensilon) testing, the nursing instructor asks a student nurse to perform the test in a group of clients with different neurological disorders. Which client should the student nurse choose to perform the test? A. A client with multiple sclerosis B. A client with myasthenia gravis C. A client with Huntington's disease D. A client with Guillain-Barré syndrome

B. A client with myasthenia gravis Multiple sclerosis is diagnosed with the help of McDonald criteria. Edrophonium (Tensilon) testing determines the response of the muscle to the drug Tensilon. In myasthenia gravis, the muscles become weakened due to the impaired ability to respond to nerve signals. Therefore, this statement made by the student nurse indicates effective learning. Huntington's disease is diagnosed with the help of the presymptomatic blood test. Guillain-Barré syndrome is diagnosed only by clinical examinations.

The student nurse is performing a Babinski reflex test in a client to assess his or her neurologic system. Which is the correct interpretation by the student nurse? A. A negative Babinski reflex indicates an upper motor neuron disorder. B. A positive Babinski reflex, where the client has flaring of the toes in response to stimulation of the sole of the foot, indicates an upper motor neuron disorder. C. A positive Babinski reflex occurs when the toes of the client flex inwrd upon stimulation of the sole of the foot. D. A negative Babinski reflex occurs when there is flaring of the toes in response to stimulation of the sole of the foot.

B. A positive Babinski reflex, where the client has flaring of the toes in response to stimulation of the sole of the foot, indicates an upper motor neuron disorder.

A patient has developed progressive muscle weakness in the lower extremities that appears to be ascending. Deep tendon reflexes are also affected. The patient mentions she was ill several weeks ago. Which of the following organisms may the patient have been infected with prior to her current state? A. Escherichia coli B. Campylobacter jejuni C. Norovirus D. Staphylococcus aureus

B. Campylobacter jejuni

In a client with Guillain-Barré syndrome, the health-care provider has found that the possibility of performing plasmapheresis is low. Which other alternative treatment can be recommended to this client to produce the same effect as that of plasmapheresis? A. Corticosteroids B. Cerebrospinal fluid filtration C. Intravenous immunoglobulin D. None of the above

B. Cerebral spinal filtration Cerebral spinal filtration is an alternative treatment for plasmapheresis, which produces the same effect as that of plasmapheresis. Therefore, the primary health care provider will recommend it to a client with Guillain-Barré syndrome.

Which pathophysiological condition particularly activates the trigeminovascular system? A. Epilepsy B. Cluster headache C. Parkinson's disease D. Tension headache

B. Cluster headache Epilepsy is the abnormal electrical discharge of neurons in the brain. The trigeminovascular system is activated in cluster headache. In cluster headache, the client experiences stabbing and unilateral headache. Parkinson's disease is the progressive loss of dopamine-producing cells. Tension headache is pericranial and cervical muscle tension.

Which neurotransmitter dysfunction has been implicated in Tourette's syndrome? A. Serotonin B. Dopamine C. Acetylcholine D. None of the above

B. Dopamine Tourette's syndrome is associated with the dysfunction of dopaminergic receptors, which is an inherited neuropsychiatric disorder.

A patient is in the postictal period of a seizure. What is the patient likely to experience? A. Sense that a seizure is imminent B. Drowsiness and amnesia C. Tremors and convulsion D. Intense hyperactivity and restlessness

B. Drowsiness and amnesia

Which condition is associated with seizures? A. Myasthenia gravis B. Epilepsy C. Parkinson's disease D. Multiple sclerosis

B. Epilepsy

A patient believes he may have amyotrophic lateral sclerosis. What can the clinician say about the diagnostic procedure for this disease? A. A CT scan needs to be scheduled. B. No specific diagnostic laboratory tests or biomarkers exist for this disease. C. Measurement of antibodies for this disease is an essential part of the diagnosis. D. An electromyography test will provide a definitive diagnosis for this condition.

B. No specific diagnostic laboratory tests or biomarkers exist for this disease.

Which function is associated with the frontal lobe of the cerebral cortex? Select all that apply. A. Orientation B. Planning C. Reasoning D. Problem solving E. Visual processing

B. Planning C. Reasoning D. Problem solving

A patient has had recurrent seizures. The clinician wants to increase the sensitivity of the EEG. Which recommendation can the clinician make to the patient that may increase the sensitivity of the EEG? A. Ingest large amount of carbohydrate before the EEG B. Refrain from sleep as much as possible before the EEG C. Exercise excessively prior to the EEG D. Restrict fluid prior to the EEG

B. Refrain from sleep as much as possible before the EEG

A patient is diagnosed with myasthenia gravis. Which of the following does the nurse expect to be the patient's primary complaint? A. Repeated seizure activity B. Severe muscle fatigue C. Migraine D. Ice-pick headache

B. Severe muscle fatigue

A nurse will be caring for a patient recently diagnosed with Guillain-Barré syndrome. Which will the nurse expect to observe? A. Frequent seizures B. Symmetric muscle weakness beginning in lower extremities C. Tremors D. Paralysis of muscles of arms and chest

B. Symmetric muscle weakness beginning in lower extremities

The primary health-care provider is assessing a client who lost consciousness. Which assessment techniques would the nurse expect the primary health-care provider to order? Select all that apply. A. Hearing B. Vital signs C. Orientation D. Pupil response E. Glasgow Coma Scale

B. Vital signs D. Pupil response E. Glasgow Coma Scale

Kathy arrives at the physician's office with a primary complaint of headaches that awaken her at night. With further questioning, Kathy states that she also experiences headaches during the day. The pain is dull and throbbing, but she has noticed whenever she bends over to pick something up, the headache worsens. When the physician conducts a cranial nerve assessment, an abnormality in cranial nerve V on the right side of the face was noted. What condition may Kathy be experiencing?

Brain tumor headache

The nursing instructor is teaching a group of student nurses about the preventive therapy for migraine. Which client requires preventive therapy to be prioritized first? A. A client who experiences one or two migraine attacks per month. B. A young female client who stopped the use of oral contraceptives. C. A female client who is on therapy with vasodilators. D. A client who withdrew from consuming alcohol.

C. A female client who is on therapy with vasodilators. Vasodilators will precipitate the symptoms of migraine headache.

Which of the following characteristics has been associated with an increased risk for multiple sclerosis? Select all that apply. A. Male sex B. Tropical residence C. Age 18-48 years D. Northern European heritage E. Living in cooler climate

C. Age 18-48 years D. Northern European heritage E. Living in cooler climate

What is the cause of multiple sclerosis? A. Lack of dopamine production B. Sudden discharge of electrical activity in brain C. Autoimmune attack of myelin sheath of neurons D. Autoimmune attack of acetylcholine receptors

C. Autoimmune attack of myelin sheath of neurons

The nurse is caring for a client who had a head injury in a motor vehicle accident. The client complains of lack of coordination and imbalance since the accident. Which part of the cerebrum would the nurse suspect to have been damaged? A. Cerebrum B. Brain stem C. Cerebellum D. Diencephalon

C. Cerebellum The function of the cerebrum is associated with higher functions of the brain, such as thought and action. The function of the brain stem is associated with basic vital life functions. The cerebellum contributes to the coordination, precision, and accuracy of movement. Therefore, if the client complains of lack of coordination and imbalance, the nurse would suspect the cerebellum to have been damaged. The function of the diencephalon is associated with autonomic functions of the peripheral nervous system.

A client is diagnosed with narrowing of the spinal cord. Based on which test did the primary health-care provider confirm this diagnosis? A. Angiography B. Evoked potentials C. Computed tomography D. Electronystagmography

C. Computed tomography Angiography is a diagnostic test used to detect blockages of the arteries. Evoked potential is a diagnostic test used to measure the electrical signals to the brain generated by hearing, touch, or sight. The narrowing of the spinal cord is diagnosed with the help of computed tomography. Therefore, this test would help the primary healthcare provider in diagnosing the narrowing of the spinal cord in this client. Electronystagmography is a diagnostic test used to diagnose dizziness, balance disorders, and involuntary eye movement.

Which neurotransmitter is depleted in clients with Parkinson's disease? A. Acetylcholine B. Serotonin C. Dopamine D. Glutamate

C. Dopamine Depletion in the level of acetylcholine is associated with Alzheimer's disease. Serotonin levels are not decreased in clients with Parkinson's disease. Depletion of serotonin occurs in clients with severe depressive syndrome. Dopamine levels are decreased in clients with Parkinson's disease due to the progressive loss of dopamine-producing cells in the substantia nigra of the brain. Glutamate levels remain unaltered in clients with Parkinson's disease.

The student nurse is taught about lumbar puncture. Prioritize the steps performed by the student nurse to indicate effective learning. A. Clean the area and inject local anesthetic. B. Locate the site for puncture in the lower back. C. Instruct the client to lean forward while sitting on a table or bed. D. Insert a special needle into the spinal sac and remove a small amount of fluid.

C. Instruct the client to lean forward while sitting on a table or bed. Locate the site for puncture in the lower back. Clean the area and inject local anesthetic. Insert a special needle into the spinal sac and remove a small amount of fluid.

A nurse is explaining to a patient that her signs and symptoms are due to the degeneration of the protection sheath of her neurons, the myelin sheath. What disease does the patient have? A. Myasthenia gravis B. Parkinson's disease C. Multiple sclerosis D. Huntington's disease

C. Multiple sclerosis

Which type of epileptic seizure is characterized by a sudden lapse of consciousness for 5 to 30 seconds? A. Tonic seizure B. Clonic seizure C. Petit mal seizure D. Tonic-clonic seizure

C. Petit mal seizure Petit mal seizure, also known as absence seizure, is characterized by a sudden lapse of consciousness for 5 to 30 seconds.

Which diagnostic test is used to measure the brain and body activity during sleep? A. Myelography B. Thermography C. Polysomnogram D. Evoked potentials

C. Polysomnogram Myelography is used to diagnose spinal nerve injury. Thermography is used to measure small temperature changes in an organ or between two sides of the body. A polysomnogram is a diagnostic test used to measure the activities of the brain and body during sleep. Evoked potentials are used to measure the electrical signals to the brain generated by hearing, touch, or sight.

The nurse is discussing the interictal period with a group of student nurses. Which statement made by the student nurse indicates effective learning? A. "It is the episode of the seizure." B. "It is the time after the completion of the seizure." C. "It is measured when the brain activity is abnormal." D. "It is the phase between seizures when multiple seizures occur in a short time frame."

D. "It is the phase between seizures when multiple seizures occur in a short time frame."

Which statement by the student nurse indicates the need for further teaching about cerebrospinal fluid (CSF) analysis? A. "The CSF from the client is obtained by performing the lumbar puncture technique." B. "While taking the CSF, the client is asked to lie on one side, in a ball position with knees close to the chest." C. "An anesthetic injection is given on the lower back of the client between the two vertebras." D. "To lessen the after-effect of lumbar puncture, the client is asked to stand still."

D. "To lessen the after-effect of lumbar puncture, the client is asked to stand still."

A patient with Parkinson's disease is prescribed Levodopa. The patient's spouse asks about long-term usage of this medication. Which of the following may the nurse share? A. Over time the body's response to Levodopa increases, so the dosage is normally lowered. B. To maintain the effectiveness of Levodopa, it is best to cycle on and of the medication. C. Because of its toxic side effects, levodopa can only be used for 1 to 2 years. D. After several years of use, the effectiveness of Levodopa may decrease.

D. After several years of use, the effectiveness of Levodopa may decrease.

A client suffering from myasthenia gravis is admitted to the intensive care unit after being diagnosed with respiratory failure. Which factor could have precipitated this condition in the client? A. A tapered dose of immunosuppressants B. Microbial infection C. Surgery D. All of the above

D. All of the above "All of the above" is the correct answer because a tapered dose of immunosuppressant, microbial infection, and surgery all will increase the immune response and cause respiratory failure in a client with myasthenia gravis.

While reviewing the medication chart of a client, the nurse finds that the client is on a therapy to decrease the release of the excitatory neurotransmitter glutamate. Which disorder will the nurse suspect in the client? A. Myasthenia gravis B. Huntington's disease C. Guillain-Barré syndrome D. Amyotrophic lateral sclerosis

D. Amyotrophic lateral sclerosis Therapy to decrease the release of the excitatory neurotransmitter glutamate through medication such as riluzole helps in blocking the channels associated with the damaged neurons. Amyotrophic lateral sclerosis is a disorder characterized by a loss of upper and lower motor neurons. Therefore, the nurse would suspect the client for amyotrophic lateral sclerosis.

Which neurodegenerative disorder is due to an autoimmune response? A. Alzheimer's disease B. Epilepsy C. Parkinson's disease D. Multiple sclerosis

D. Multiple sclerosis

A patient wants an explanation as to how she developed myasthenia gravis. Which is the following is a proper response by the nurse? A. Myasthenia gravis has no known cause. B. Myasthenia gravis develops after an infection. It normally resolves on its own. C. Myasthenia gravis develops in response to poor lifestyle choices. D. Myasthenia gravis is an autoimmune disorder.

D. Myasthenia gravis is an autoimmune disorder.

Several months ago, Julianne had gastroenteritis. Since that infection resolved, she has been healthy until a few days ago when she started having weakness in her extremities. She is now having difficulty walking. After running diagnostic tests, her physician expects her to fully recover. What disorder does Julianne most likely have?

Guillain-Barré syndrome

The pathophysiology of Maggie's condition occurs in stages: neural hyperexcitability, cortical spreading depression, trigeminovascular complex activation, and continued sensitization of the trigeminovascular complex. She experiences throbbing pain, usually on the right side of her head. While in pain, she lays down in a dark, quiet room to not exacerbate the pain. What disorder causes Maggie's pain?

Migraine

Claire's diagnosis was confirmed after imaging studies showed the appearance of lesions of demyelination and cerebrospinal fluid tested positive for immunoglobulins. Her autoimmune disorder causes motor and sensory weakness. Claire is experiencing problems with her vision and is having trouble with balance. What disorder does Claire have?

Multiple sclerosis

Amber is surprised at how tired she has been feeling recently. Even the smallest activities appear to drain her energy. Lately, commuting to work is exhausting. She has even noted she has difficulty keeping her eyes open while reading. Amber makes an appointment with her physician. Her physician is especially concerned about Amber's complaint of not being able to keep her eyes open. The physician orders antibody tests. What condition does the physician suspect?

Myasthenia gravis

Michael's disorder initiates in substantia nigra of basal ganglia. His disorder causes slow movements and muscle rigidity. He often experiences a pill-rolling tremor. He is currently on dopamine replacement therapy. What disorder does Michael have?

Parkinson's disease

Dan, age 27, visits his primary care provider about a recent history of headaches. He says that when he gets a headache, he feels "restless" and the pain feels like an ice pick. He sometimes has a stuffy nose and notices that his right eye gets red. He never vomits. What disorder is consistent with Dan's signs and symptoms?

Trigeminal autonomic cephalgia