Prep U-neuro

A patient had a carotid endarterectomy yesterday and when the nurse arrived in the room to perform an assessment, the patient states, "All of a sudden, I am having trouble moving my right side." What concern should the nurse have about this complaint?

A thrombus formation at the site of the endarterectomy

pt with sci has full head and neck control when injury is at

C5

A 37-year-old mother of three has just been diagnosed with a grade I meningioma. As part of patient education, the nurse tells the patient that:

Growth is slow and symptoms are caused by compression rather than tissue invasion.

A client is admitted reporting low back pain. How will the nurse best determine if the pain is related to a herniated lumbar disc?

Have the client lie on the back and lift the leg, keeping it straight.

The nurse is assisting with administering a Tensilon test to a patient with ptosis. If the test is positive for myasthenia gravis, what outcome does the nurse know will occur?

Thirty seconds after administration, the facial weakness and ptosis will be relieved for approximately 5 minutes.

pt had carotid endarterectomy yesterday, pt states all of a sudden I am having trouble moving my right side, what concern

a thrombus formation at the site of the site of the edarterectomy

failure to recognize familiar objects perceived by senses

agnosia

A nurse is assessing pain in a client who has a spinal cord injury. The client states that even a light touch to the legs will illicit severe pain. The client is describing which type of pain?

allodynia

pt with spinal cord injury, small touch to legs will illicit severe pain

allodynia

common se with tpa

bleeding

A nurse is caring for a client with lower back pain who is scheduled for myelography using metrizamide (a water-soluble contrast dye). After the test, the nurse should place the client in which position?

elevated 45 degrees

how often should you do a neuro assessment and vs for pt with tpa

every 15 min

A nurse is providing care to a client who has had a stroke. Which symptoms are consistent with left-sided stroke?

expressive aphasia, defects in the right visual fields, problems with abstract thinking

what s/s consistent with left sided stroke

expressive aphasia, defects in the right visual fiends, problems with abstract thinking

global aphasia, unable to perform which action

form words that are understandable or comprehend spoken words

During assessment of a patient who has been taking dilantin for seizure management for 3 years, the nurse notices one of the side effects that should be reported. What is that side effect?

gingivial hyperplasia

Excessive levels of which neurotransmitter has been implicated in amyotrophic lateral sclerosis (ALS)?

glutamate

when does basic rehab begin

immediately

pt with tia, what is origin of pt symptom

impaired cerebral circulation

The nurse is caring for a patient postoperatively after intracranial surgery for the treatment of a subdural hematoma. The nurse observes an increase in the patient's blood pressure from the baseline and a decrease in the heart rate from 86 to 54. The patient has crackles in the bases of the lungs. What does the nurse suspect is occurring?

increased icp

A nurse assesses a patient who has been diagnosed with having a pituitary adenoma that is pressing on the third ventricle. The nurse looks for the associated sign/symptom. What is that sign/symptom?

increased intracranial pressure

While assessing the client at the beginning of the shift, the nurse inspects a surgical dressing covering the operative site after the clients' cervical discectomy. The nurse notes that the drainage is 75% saturated with serosanguineous discharge. What is the nurse's most appropriate action?

inform the surgeon of the possibility of a dural leak

contraindication for tpa

intracranial hemorrhage

A client is receiving mitoxantrone for treatment of secondary progressive multiple sclerosis (MS). This client should be closely monitored for

leukopenia and cardiac toxicity

A client was undergoing conservative treatment for a herniated nucleus pulposus, at L5 - S1, which was diagnosed by magnetic resonance imaging. Because of increasing neurologic symptoms, the client undergoes lumbar laminectomy. The nurse should take which step during the immediate postoperative period?

logroll the pt from side to side

The nurse is called to attend to a patient having a seizure in the waiting area. What nursing care is provided for a patient who is experiencing a convulsive seizure? Select all that apply.

loosen tight clothing, position on side, provide privacy

s/s korsakoff syndrome

psychosis, disorientation, delirium, insomnia, hallucinations

A client is experiencing functional urinary incontinence. The nurse interprets this to mean which of the following?

pt does not reach toilet before experiencing voiding

The nurse is caring for a patient with Huntington's disease in the long-term care facility. What does the nurse recognize as the most prominent symptom of the disease that the patient exhibits?

rapid, jerky, involuntary movements

triggers for migraine

red wine, menstruation, exposure to flashing light

how does massage help pt with tension ha

relaxes musc

interventions to avoid bleeding in brain

report changes in neuro status, 30 degrees, avoid activites that cause valsalva

brain dead criteria

coma, absence of brain stem reflexes, apnea

A nurse is performing passive range of motion to a client's upper extremities. The nurse touches the client's thumb to each fingertip on the same hand. The nurse is performing which of the following?

opposition

A client is receiving hypothermic treatment for uncontrolled fever related to increased intracranial pressure (ICP). Which assessment finding requires immediate intervention?

shivering

A patient is diagnosed with a spinal cord tumor and has had a course of radiation and chemotherapy. Two months after the completion of the radiation, the patient complains of severe pain in the back. What is pain an indicator of in a patient with a spinal cord tumor?

spinal metastasis

A female client reports to a nurse that she experiences a loss of urine when she jogs. The nurse's assessment reveals no nocturia, burning, discomfort when voiding, or urine leakage before reaching the bathroom. The nurse explains to the client that this type of problem is called:

stress incontinence

Which condition occurs when blood collects between the dura mater and arachnoid membrane?

subdural hematoma

what occurs when blood collects between dura and arachnoid

subdural hematoma

A patient has been diagnosed with a brain tumor, a glioblastoma multiforme. The nurse met with the family after the diagnosis to help them understand that:

surgery can improve survival time but results are not guaranteed

autonomic dysreflexia occurs with spical cord injuries above which level

t6

if warfarin is contraindicated for stroke, what is best option

aspirin

Which nursing intervention is the priority for a client in myasthenic crisis?

assessing resp effort

Which drug should be available to counteract the effect of edrophonium chloride?

atropine

The nurse teaches the client diagnosed with Huntington disease that it is transmitted as which type of genetic disorder?

autosomal dominant

A nurse suspects that a client has Huntington disease based on which assessment finding?

chorea

pt fell and had loc, regained consciousness within hour after arrival at ed. what would nurse suspect

concussion

what drug should nurse question for pt with hemorrhagic stroke

heparin sodium

The nurse is caring for a client with a ventriculostomy. Which assessment finding demonstrates effectiveness of the ventriculostomy?

increased is 12

Which nutritional deficiency may delay wound healing?

lack of vit c

A client with possible bacterial meningitis is admitted to the ICU. What assessment finding would the nurse expect for a client with this diagnosis?

neck flexion produces flexion of the knees and hips

Which lobe of the brain is responsible for spatial relationships?

parietal

muscular hypertonicity in a weak muscle with increased resistance to stretch

spasticity

The nurse has just received report on a client in the ED being transferred to the acute stroke unit with a diagnosis of a right hemispheric stroke. Which findings does the nurse understand is indicative of a right hemispheric stroke?

spatial-perceptual deficits

pt with right hemispheric stroke, what findings are indicative

spatial-perceptual deficits

blindness in the right of left half of the visual field in both eyes

homonymous hemianopsia

A patient with a brain tumor is complaining of headaches that are worse in the morning. What does the nurse know could be the reason for the morning headaches?

increased intracranial pressure

The nurse is caring for a client with Guillain-Barré syndrome. Which assessment finding would indicate the need for oral suctioning?

increased pulse, adventitious breath sounds

A client has been diagnosed with a frontal lobe brain abscess. Which nursing intervention is appropriate?

initiate seizure precautions

A client with increased intracranial pressure has a cerebral perfusion pressure (CPP) of 40 mm Hg. How should the nurse interpret the CPP value?

low

When changing the dressing on a pressure ulcer, a nurse notes necrotic tissue on the edges of the wound. Which action should the nurse anticipate that the physician will order?

debridement

A client with a traumatic brain injury has already displayed early signs of increasing intracranial pressure (ICP). Which of the following would be considered late signs of increasing ICP?

decerebrate posturing and loss of corneal reflex

The nurse is caring for a client with increased intracranial pressure (ICP) after surgical resection of a brain tumor. The nurse recognizes the client is demonstrating late signs of ICP when which sign is observed?

irregular respirations

imaging indicate an embolis partially obstructing right carotid artery, what kind of stroke

ischemic

An older adult experienced a cerebrovascular disease 6 weeks ago and is currently receiving inpatient rehabilitation. The nurse is coaching the client to contract and relax her muscles while keeping her extremity in a fixed position. Which type of exercise is the client performing?

isometric

Which of the following is standard test for early diagnosis of herpes simplex virus (HSV)-1 encephalitis?

polymerase chain reaction

The nurse reviews the patient's drug regimen for treatment of a brain tumor. She explains to the patient why one of the following drugs would not be prescribed, even though it might have therapeutic benefits. Which drug would not be prescribed for this patient? 1. paclitaxel 2. coumadin 3. decadron 4. dilantin

coumadin

what will pt do to maintain skin integrity

diet high in protein, vit, and cal

The nurse is completing an assessment on a client with myasthenia gravis. Which of the following historical recounting provides the most significant evidence regarding when the disorder began?

drooping eyelids

A client with Parkinson's disease has been receiving levodopa as treatment for the past 7 years. The client comes to the facility for an evaluation and the nurse observes facial grimacing, head bobbing, and smacking movements. The nurse interprets these findings as which of the following?

dyskinesia

pt with paraplegia asks why exercises are done to LE every day

help prevent development of contractures

A nurse is assessing a patient's urinary output as an indicator of diabetes insipidus. The nurse knows that an hourly output of what volume over 2 hours may be a positive indicator?

more than 200 ml/hr

The nurse is seeing a client who has just been diagnosed with a grade I meningioma. The nurse is correct when stating what information about the client's diagnosis? 1. surgical intervention is not effective 2. this tumor has a poor prognosis 3. this type invades brain tissue quickly 4. grade 1 is most common type

grade 1 is the most common type of this tumor

stroke victim with memory loss and impaired learning capacity, which lobe

frontal

A nurse is preparing to administer an antiseizure medication to a client. Which of the following is an appropriate antiseizure medication?

lacimatal

what factors pose a threat to thrombolytic therapy

inr greater than 2Which is a contraindication for the administration of tissue plasminogen activator (t-PA)?

The nurse is caring for a client who has sustained a spinal cord injury (SCI) at C5 and has developed a paralytic ileus. The nurse will prepare the client for which of the following procedures?

insertion of an ng tube

cerebral hemorrhage located within the brain, what is this classified as

intracerebral hematoma

What is the only known risk factor for brain tumors?

ionizing radiation

what intervention helps control ICP 1. keep neck in neutral position 2. avoid sedation 3. cluster procedures together 4. keep bed flat

keep neck in neutral position

Which is a late sign of increased intracranial pressure (ICP)?

altered resp pattern

A client who recently experienced a stroke tells the nurse that he has double vision. Which nursing intervention is most appropriate?

alternatively patch one eye every 2 hours

A patient is diagnosed with amyotrophic lateral sclerosis, also known as ALS or Lou Gehrig's disease. The nurse understands that the symptoms of the disease will begin in what way?

weakness starting in the muscles supplied by the cn

Which medication classification should be avoided in the treatment of brain tumors?

anticoags

The nurse is advising a client with multiple sclerosis on methods to minimize spasticity and contractures. Which of the following techniques would the nurse instruct the client to perform?

apply warm packs

The nurse is caring for a client diagnosed with Guillain-Barre syndrome. His spouse asks about recovery rates. The nurse can correctly relate which of the following?

approximately 60-75% of pt recover completely

inability to perform previously learned purposeful motor acts on a voluntary basis

apraxia

A client with a traumatic brain injury has developed increased intracranial pressure resulting in diabetes insipidus. The expected treatment would consist of which of the following?

vasopressin therapy

A nurse is caring for a client with a history of severe migraines. The client has a medical history that includes asthma, gastroesophageal reflux disease, and three pregnancies. Which medication does the nurse anticipate the physician will order for the client's migraines?

verapamil (calan)

primary symptom of ischemic stroke

wkns on one side of body and diff with speech

acute phase duration ischemic stroke

1-3 days

The nurse is caring for a client who was diagnosed with a glioma 5 months ago. Today, the client was brought to the emergency department by his caregiver because he collapsed at home. The nurse suspects late signs of rising intracranial pressure (ICP) when which blood pressure and pulse readings are noted? a. bp 90/50, hr 75 b. bp 130/80, hr 55 c. bp 150/90, hr 90 d. bp 175/45, hr 42

175/45, 42

A nurse is reviewing a patient's laboratory test results. Which serum albumin level would lead the nurse to suspect that the patient is at risk for pressure ulcers?

2.5 g/mL

Cerebral edema peaks at which time point after intracranial surgery?

24 hrs

The nurse is aware that burr holes may be used in neurosurgical procedures. Which of the following is a reason why a neurosurgeon may choose to create a burr hole in a patient?

aspiration of a brain abcess

A patient who has suffered a stroke begins having complications regarding spasticity in the lower extremity. What ordered medication does the nurse administer to help alleviate this problem?

baclofen

pt who suffered stroke begins having spasticity, what med

baclofen

The nurse is using a measurement tool to determine a patient's level of independence in activities of daily living, such as continence, toileting, transfers, and ambulation. What would be the appropriate tool for the nurse to use?

barthel index

post-intracranial surgery, most important to monitor

body temp

A nurse caring for a patient with head trauma will be monitoring the patient for Cushing's triad. What will the nurse recognize as the symptoms associated with Cushing's triad? Select all that apply.

bradycardia, bradypnea, htn

cushings triad

bradycardia, hypertension, bradypnea

What portion of the brain is most likely responsible for the inability to breathe?

brain stem

light head, speech disturbance, left side wkns, abnormal sound auscultated in artery leading to brain. what is this

bruitThe nurse in the neurologic ICU is caring for a client who sustained a severe brain injury. Which nursing measures will the nurse implement to help control intracranial pressure (ICP)?

procedure for epidural hematoma

burr holes

which subtype of stroke is due to afib

cardio embolic

what is the etiology of an ischemic stroke

cardiogenic emboli

pt comes to er w/ exploding headache past two hours, pt immediately seen by triage nurse who suspects stroke, which is possible based on the symptom

cerebral aneurysm

The nurse is caring for a client who underwent surgery to remove a spinal cord tumor. When conducting the postoperative assessment, the nurse notes the presence of a bulge at the surgical site. The nurse suspects the client is experiencing what complication from the surgery?

cerebrospinal fluid leakage

Which is the primary medical management of arthropod-borne virus (arboviral) encephalitis?

controlling seizures and increased intracranial pressure

A patient has been diagnosed with a lipoma. The nurse explains to the patient that this tumor is located in the part of the brain known as the:

corpus callosum

Nursing students are reviewing the various types of brain tumors. The students demonstrate understanding of the material when they identify which of the following as the most common type?

gliomas

A client in the emergency department has a suspected neurologic disorder. To assess gait, the nurse asks the client to take a few steps; with each step, the client's feet make a half circle. To document the client's gait, the nurse should use which term?

helicopod

A client is diagnosed with a brain angioma. When teaching the client about the risks associated with this type of brain tumor, the nurse would educate about signs and symptoms associated with which condition?

hemorrhagic stroke

Which is the most common cause of acute encephalitis in the United States?

herpes simplex virus

The nurse is assessing an older adult who is experiencing a new onset of weakness, fatigue, and musculoskeletal pain. Which information in the client's health history will the nurse identify to help determine the reason for the client's new symptoms?

history of polio in 1955

Which disease is a chronic, progressive, hereditary disease of the nervous system that results in progressive, involuntary dancelike movements and dementia?

huntingtons

Which of the following areas of the brain are responsible for temperature regulation?

hypothalamus

why is it beneficial to admin o2 to maintain high PaO2 for pt with SCI

hypoxemia can create/worsen neuro deficit of spinal cord

After undergoing surgery for removal of a spinal cord tumor, the client is placed in the side-lying position. The nurse places a pillow between the client's knees to prevent:

knee flexion

A 53-year-old man presents to the emergency department with a chief complaint of inability to form words, and numbness and weakness of the right arm and leg. Where would you locate the site of injury?

left frontoparietal region

what will help control ICP

maintain cerebral perfusion pressure from 50-70

The diagnosis of multiple sclerosis is based on which test?

mri

evaluate cerebellum what should you ask

problems with balance

A client has undergone surgery for a spinal cord tumor that was located in the cervical area. The nurse would be especially alert for which of the following?

resp dysfunction

A client is diagnosed with amyotrophic lateral sclerosis (ALS) in the early stages. Which medication would the nurse most likely expect to be prescribed as treatment? 1. riluzole 2. benztropine mesylate 3. amantadine 4. bromocriptine

riluzole

The nurse is providing care for a client who has limited mobility after a stroke. In order to assess the client for contractures, the nurse should assess the client's:

rom

The nurse is assessing a patient at risk for the development of a pressure ulcer. What laboratory test will assist the nurse in determining this risk?

serum albumin

primary symptoms of a hemorrhagic stroke

severe ha and early change in loc

Nursing intervention for a pt with receptive aphasia

speak slowly and clearly

A client with respiratory complications of multiple sclerosis (MS) is admitted to the medical-surgical unit. Which equipment is most important for the nurse to keep at the client's bedside?

suction machine with catheters

what would you do to monitor early signs of diabetes inspidus

take daily weights

pt with tbi, which finding is most concerning

temp increase 98-99.6

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

transports motor impulses from brain to spinal cord

bring back concussion if

vomiting

A nurse is discussing a lumbar puncture with a nursing student who observed the procedure. The student noticed that the cerebrospinal fluid was blood tinged and asks what that means. The correct reply is which of the following?

"It can mean a traumatic puncture or a subarachnoid bleed."

A nurse and nursing student are caring for a client recovering from a lumbar puncture yesterday. The client reports a headache despite being on bedrest overnight. The physician plans an epidural blood patch this morning. The student asks how this will help the headache. The correct reply from the nurse is which of the following?

"The blood will seal the hole in the dura and prevent further loss of cerebral spinal fluid."

what position should pt with head injury be at to enhance outcome

30 degree

A nurse is noting from a client's neurologic assessment findings that the client's motor impulses are interrupted from the brain to the spinal cord. It also appears that the client lacks sensory impulses from the peripheral sensory neurons to the brain. Which area has the deficit?

medulla oblongata

A nurse is reviewing the medical record of a client diagnosed with a primary brain tumor. The nurse identifies the type of tumor as one that is most commonly found in adults. Which type of tumor would the nurse most likely identify?

meningioma

Which diagnostic is most commonly used for spinal cord compression?

mri

A client seeks care for lower back pain of 2 weeks' duration. Which assessment finding suggests a herniated intervertebral disk?

pain radiating down from posterior thigh

A 55-year-old female client presents at the walk-in clinic complaining of feeling like a mask is on her face. While doing the initial assessment, the nurse notes the demonstration of a pill-rolling movement in the right hand and a stooped posture. Physical examination shows bradykinesia and a shuffling gait. What would the nurse suspect is the causative factor for these symptoms?

parkinsons

which reasons would nurse question use of tpa for pt with ischemic stroke 1. platelet count 95,000 2. prothrombin time 10 sec 3. systolic bp 198 4. diastolic bp 120 5. received low molecular weight heparin injections twice a day

platelet, systolic, diastolic, heparin

Which of the following tests confirms the diagnosis of myasthenia gravis (MG)?

tensilon test

A client diagnosed with Parkinson's disease has developed slurred speech and drooling. The nurse knows that these symptoms indicate which of the following?

the disease has entered the late stages

The nursing is assessing a client who has been diagnosed with a pituitary adenoma, but has not yet started treatment. The client reports having increased heart rate, hand tremors, difficulty sleeping, weight loss and hyperthermia. The nurse anticipates the client will require blood work to assess for overproduction of which hormone?

thyroid-stim hormone

pt hospitalized when presenting to ed with right sided wkns, within 6 hrs of being admitted, neuro deficits resolve to presymptomatic state what was cause

transient ischemic attack