Pharmacology Prep U Chapter 19 Nerves and the Nervous System

The nurse is caring for a client who is recovering in the hospital from a stroke. What statement by the client suggests a need for further education?

"I'm eager to start rehabilitation because I want new nerves to grow as quickly as possible."

A client is recovering from an ischemic stroke that caused a significant brain infarction and loss of neurons. The client's family member asks the nurse, "How long will it take before new brain cells replace the ones that died?" What is the nurse's best response?

"Unfortunately, the destruction of nerves is permanent and they're unable to reproduce."

Several substances act as neurotransmitters in the human body. Which is a neurotransmitter?

Acetylcholine

A client has dysfunction in his GABA neurotransmission. Which disorder would the client be likely to exhibit?

Anxiety disorders

The nurse is performing an assessment of a client's neurologic system. What nursing assessment best addresses the functioning of the client's limbic system?

Assessing the client's mood and affect

In response to a stimulus, a client's nerve has released a neurotransmitter. From what component of the nerve would the neurotransmitter be released?

Axon

A nurse is preparing to assess a patient's cerebellar function. What would the nurse expect to test?

Balance

Which would a nurse identify as a component of the hindbrain?

Brain stem

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 student to describe the axon of a neuron. Which explanation by the student best describes the axon?

Carries impulses away from the neuron cell body

A patient exhibiting an uncoordinated gait has presented at the clinic. The nurse knows that what brain structure has the function of balance and coordination?

Cerebellum

The carotids and the vertebrals deliver blood to which common vessel at the bottom of the brain?

Circle of Willis

What best describes the blood-brain barrier?

Defensive mechanism

Information has been received by a client's neuron and transmitted into the cell body. What component of the neurologic system performed this function?

Dendrite

What is responsible for carrying nerve impulses from the central nervous system to stimulate a muscle?

Efferent fibers

Which is considered a neurotransmitter and hormone released by the adrenal medulla?

Epinephrine

Dendrites route information away from the nerve cell while axons bring information to the nerve.

False

Which is the most primitive area of the brain and contains the brain stem?

Hindbrain

The nursing student knows that the function of the thalamus is most accurately described by which statement?

It relays motor impulses from the cerebral cortex to the spinal cord.

Which neurons transmit impulses from the CNS?

Motor

During which neurologic disease process do the Schwann cells become enlarged and block the nodes of Ranvier?

Multiple sclerosis

What would be identified as the basic unit of the nervous system?

Neuron

A nurse is reviewing the structure and function of the nervous system in preparation for working on a neurological floor. What characteristic of neurons should the nurse identify?

Neurons convey action potentials to other neurons without being in physical contact.

Which would be responsible for the transmission of an electrical impulse along a nerve axon?

Nodes of Ranvier

Which is an important function of serotonin?

Prevents depression

A client is diagnosed with a sleep disorder. Which neurotransmitter is most likely to be dysfunctional for this client?

Serotonin

A client is experiencing major depressive disorder. Which neurotransmitter is most likely implicated?

Serotonin

When levels of serotonin are high in the RAS, the system shuts off and what occurs?

Sleep

Which would be most important for an action potential to occur?

Sufficient strength of a stimulus

What areas are mainly responsible for coordinating internal and external responses?

Thalamus and hypothalamus

A client has suffered an injury to the limbic system. What assessment finding should the nurse attribute to this injury?

The client exhibits bizarre behavior and unpredictable emotions

A client's nerve cell is at rest. What is true of this nerve cell at this time?

The membrane is permeable to potassium ions

What statement best explains the central and peripheral nervous system?

The two main divisions that control the nervous system are the central and peripheral nervous system.

The neurologic nurse is aware that spinal nerves are classified as mixed nerves. This implies what characteristic of spinal nerves?

They contain both motor and sensory components

Which areas are responsible for speech comprehension?

Wernicke's area

Most acute CNS responses are caused by fast-acting neurotransmitters, which include:

acetylcholine, dopamine, norepinephrine, and serotonin.

The CNS structure involved in all higher order functions, including conscious processes containing both motor and sensory areas, is the:

cerebral cortex.

A 46-year-old male client sustained a closed head injury four hours ago. He now presents to the emergency department because he is having difficulty breathing. This is a result of swelling around the:

medulla oblongata

The CNS structure containing groups of neurons responsible for vital cardiac, respiratory, and vasomotor functions is the:

medulla oblongata.

Characteristics that allow neurons to communicate with other body cells include:

the ability to be stimulated and to convey electrical impulses.

How many segments does the spinal cord contain?

31

What would a nurse identify as being responsible for carrying information from the nerve to the effector cell?

Axon

What part of the brain controls and coordinates muscle movement?

Cerebellum

An elderly client arrives at a health care facility with reports of loss of sensation. The nurse understands that a change in which part of the brain is responsible for changes in the client's ability to perceive sensation?

Cerebral cortex

A client with a longstanding diagnosis of schizophrenia has taken haloperidol for several years and has recently developed tremors, a shuffling gait and repetitive motor movements. How should the nurse best interpret this change in the client's status?

Function of the client's extrapyramidal system has been altered

The physiology instructor is teaching the class about neurotransmitters and their functions. According to the instructor, what is regulated by serotonin receptors?

Mood

A client has had an injury to the cerebellum. The nurse is collecting data from the client and family to document in preparing an individualized nursing care plan. Which is the best description of the function of the cerebellum that has to be considered when collecting data from the client?

Responsible for muscle control

The nurse is working with a client who has been diagnosed with depression and the nurse has described the role that selective serotonin reuptake inhibitors (SSRIs) play in depression. The nurse should describe what effect on this neurotransmitter?

There are increased levels of serotonin in the synapses

Stimulation of a nerve results in:

depolarization

A client has taken a blow to the back of the head and the hindbrain is thought to have a lesion. What nursing assessments should the nurse include when monitoring for effects of a lesion in this region? (Select all that apply.)

• Blood pressure • Swallowing assessment • Respiratory assessment

What client has suffered an injury to the forebrain?

A client whose cerebrum has an infarct from a stroke

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 student to describe the axon of a neuron. Which explanation by the student best describes a synapse?

A junction or space between one neuron and dendrites of the next

A stroke has caused an infarct in a client's cerebral cortex. What deficit should the nurse anticipate?

Diminished processing of intellectual information

A client's left adrenal medulla has been injured in a motor vehicle accident. What is a possible implication of this injury?

Disruptions in the levels of norepinephrine and epinephrine

Which neurotransmitter is involved in the coordination of impulses?

Dopamine

Which substance is required for brain cell metabolism?

Glucose

After teaching a group of students about major divisions of the brain, the instructor determines that additional teaching is needed when the students identify what as part of the hindbrain?

Hypothalamus

A 10-year-old child has been playing soccer and sustains a closed head injury in a collision with another player. The parent states that the child was unconscious for 5 minutes. Upon admission to the emergency department, the child has difficulty breathing. What area of the brain will have developed cerebral edema?

Medulla oblongata

A client is brought to the emergency room following a motor vehicle accident in which the client sustained head trauma. The client reports blindness in the left eye. The nurse would be correct in documenting this abnormal finding as corresponding to which cerebral lobe?

Occipital

What occurs when the cell returns to the resting membrane potential?

Repolarization

A nurse is reading an article about sleep and arousal that includes a discussion of a neurotransmitter. Which neurotransmitter would most likely be discussed?

Serotonin

A signal has reached the terminus of a client's nerve and is in the space where the nerve is closest to the effector cell in a muscle. At what location is this signal?

Synapse

A client's neuron has repolarized. The nurse understands that this neuron:

now has more sodium ions outside its membrane

The nurse is providing an overview of the structure and function of the nervous system to a client with a new diagnosis of multiple sclerosis. The nurse describes how a stimulus normally travels down the axon of a nerve and stimulates an effector cell by:

releasing one or more neurotransmitters into the synapse.

The nurse is teaching a client with depression about the structure and function of the limbic system. The nurse should describe the roles of what neurotransmitters? (Select all that apply.)

• Serotonin • Epinephrine • Norepinephrine

After studying for a test on the brain and spinal cord, the students demonstrate understanding when they identify the spinal cord as being made up of how many pairs of nerves?

31

The neurological nurse is caring for a diverse group of clients. For which client would the role of the blood-brain barrier be most significant during treatment?

A client who has been diagnosed with an infection of brain tissue

Magnetic resonance imaging of a client's brain indicates a lesion in Wernicke's area. What assessment should the nurse perform when gauging the effects of this lesion?

Assess the client's ability to comprehend spoken instructions.

The nurse has admitted a client who has been diagnosed with multiple sclerosis. The nurse should choose assessments and interventions that address the effects of what pathophysiological process?

Distortions in the structure and function of Schwann cells

Serotonin produces arousal and decreases the sleep-wake cycle. True or false?

False

The nurse is planning the care of a client who has been diagnosed with a cerebellar disorder. What should the nurse prioritize in this client's plan of care?

Implement falls precautions

The nursing instructor is talking with their clinical group about the central nervous system. What should the instructor tell the students about the function of the spinal cord?

Serves as a conduit for impulses to and from the brain

The brain stem holds the medulla oblongata. What is the function of the medulla oblongata?

Transmits motor impulses from the brain to the spinal cord

After teaching a group of students about the functions of the nervous system, the instructor determines that the teaching was effective when the students identify that a function is:

control of body functions.

A nurse is reviewing the structure and function of the blood--brain barrier. This anatomical feature would have the greatest effect on what aspect of nursing care?

Administering antibiotics to treat brain infections

GABA plays an important role in preventing overexcitability.

True

The central nervous system consists of the brain and spinal cord.

True

Which are the properties of the neurotransmitter dopamine? Select all that apply.

• It is an adrenergic neurotransmitter. • It is essential for normal function of the brain. • It produces vasodilation in the periphery.

Which client is most directly exhibiting the function of afferent nerves?

A client who has winced with pain during an intramuscular injection

A client's recent history and neuroimaging results suggest a disorder involving the reticular activating system (RAS). What assessment should the nurse prioritize in this client's care?

Assessment of sleep-wake cycles

Nerve stimulation has caused the release of serotonin into many of a client's synaptic clefts, causing stimulation of the effector cell. How will the effector cell be returned to a resting state so that it can be stimulated again?

Serotonin will be reabsorbed by the axon of the presynaptic nerve

A patient reports depression and insomnia. A patient with these issues could have an abnormality of which neurotransmitter?

Serotonin

A client presented with signs and symptoms of hypothyroidism and subsequent diagnostic testing revealed low levels of thyrotropin-releasing hormone (TRH) and thyroid stimulating hormone. The care team should focus assessments and interventions on the client's:

hypothalamus

A client is acutely ill with a brain abscess and the family has questioned why the client is not receiving intravenous antibiotics. When providing education to the family, the nurse should explain:

the structure and function of the blood-brain barrier.

Place these events in neurotransmission in the correct sequence from first to last.

• Neurotransmitter molecules are released from synaptic vesicles. • Neurotransmitter molecules cross the synapse. • Neurotransmitter molecules bind to receptors in the cell membrane of the postsynaptic neuron. • Neurotransmitter molecules exert their effects on postsynaptic neurons.

A patient has sustained an injury to the cerebellum. Which area would be the primary area for assessment?

Coordination

Assessment of a client with a complex neurologic history reveals that the client follows instructions but is unable to produce clear speech despite making great effort to do so. The nurse recognizes that diagnostic imaging is likely to reveal a lesion in what location?

Broca's area