patho 2 exam 1
A patient is having difficulty with sleeping and has also been experiencing marital difficulties over the past couple of months. The patient tells the nurse at the physician's office that all this started after he had a car accident earlier that year. Which of the following would be the most important question for the nurse to ask? a) "What is your normal routine before bedtime?" b) "Did you go to the hospital following the accident?" c) "How long have you been married?" d) "Did you sustain any injuries in the accident?"
"Did you sustain any injuries in the accident?" Postconcussion syndrome can interfere with daily living and also with relationships and can continue for months. The syndrome can include amnesia, insomnia, headache, difficulty concentrating, and irritability. In this situation, it would be very important to determine if the patient sustained a head injury to rule out postconcussion syndrome.
The adult child of a patient with end-stage Alzheimer's disease asks the nurse at the physician's office if Alzheimer's can be passed on to them. Which of the following is the nurse's most accurate response?
"Research supports a possible genetic link with an early onset."
The spouse of a patient diagnosed with Alzheimer's disease asks the nurse why the patient often neglects to take a shower. The spouse states that the patient was always diligent with hygiene in the past; however, over the past few months that has not been the case. Which of the following is the nurse's best response? a) "The patient would be fine without showering." b) "You should remind the patient to shower." c) "The patient is experiencing a temporary relapse." d) "The patient just does not care anymore."
"You should remind the patient to shower." The patient should be reminded to shower because most likely he or she has difficulty remembering to do so. In the moderate stage of Alzheimer's disease, which can last for several years, it is not unusual for hygiene to be neglected because the person may just not remember if he or she did or did not shower. There is no information in the question to support the remaining responses.
A nurse is caring for a patient who is 2 days postpartum. The patient asks the nurse how many hours of the day she should expect her infant to sleep. Which of the following is the most appropriate answer
16-20 hours
A first episode of depression that occurs after what age can be a precursor to dementia?
65
Alzheimer-type dementia follows a progressive course. What is the average length of survival after diagnosis?
8 to 10 years
Which of the following is the length of time a patient undergoes a complete sleep cycle
90-110 minutes
The patient tells a nurse that "many voices in his head are telling him what he should do." The nurse thinks he may be experiencing which of the following?
A hallucination
A 26 year-old female is resting after a one-minute episode during which she lost consciousness while her muscles contracted and extremities extended. This was followed by rhythmic contraction and relaxation of her extremities. On regaining consciousness, she found herself to have been incontinent of urine. What has the woman most likely experienced? a) An absence seizure b) A myoclonic seizure c) A complex partial seizure. d) A tonic-clonic seizure.
A tonic-clonic seizure. A tonic-clonic seizure often begins with tonic contraction of the muscles with extension of the extremities and immediate loss of consciousness. Incontinence of bladder and bowel is common. Cyanosis may occur from contraction of airway and respiratory muscles. The tonic phase is followed by the clonic phase, which involves rhythmic bilateral contraction and relaxation of the extremities. -A myoclonic seizure involves bilateral jerking of muscles, generalized or confined to the face, trunk, or one or more extremities. -Absence seizures are nonconvulsive and -complex partial seizures are accompanied by automatisms (aimless and apparently undirected behavior that is not under conscious control and is performed without conscious knowledge).
The family of an older adult reports increasing inability to perform basic activities of daily living. After evaluation, the client is diagnosed with Alzheimer's disease. What intervention will be implemented to slow cognitive decline?
Acetylcholinesterase inhibitors
The family of an older adult reports increasing inability to perform basic activities of daily living. After evaluation, the client is diagnosed with Alzheimer's disease. What intervention will be implemented to slow cognitive decline? a) Psychotherapy b) Acetylcholinesterase inhibitors c) Antioxidant therapy d) Lipid-lowering agents
Acetylcholinesterase inhibitors Cognitive function in Alzheimer's disease (AD) can be enhanced by the use of medications. The acetylcholinsterase inhibitors donepezil, rivastigmine, and galantamine all increase concentration of acetylcholine in the cerebral cortex. -There has been no demonstrated improvement of cognitive function with use of lipid-lowering statins or antioxidant nutritional supplement therapy. -Psychotherapy is appropriate for depression.
A patient who is hospitalized in the intensive care unit after having a myocardial infarction (MI) informs the nurse that he needs a sleeping pill because of the inability to sleep in that environment. The patient states that he has never had trouble sleeping before. Which type of insomnia does the nurse recognize the patient is having?
Acute insomnia
A client is brought to the emergency department and is diagnosed with an ischemic stroke confirmed by CT scan. The most important treatment for this client would be to: a) Prepare the client for emergency surgery b) Monitor vital signs closely for improvement c) Administer IV tissue-type plasmin activator (tPA) d) Administer analgesics for the relief of pain
Administer IV tissue-type plasmin activator (tPA) tPA administration is the treatment of choice for an ischemic stroke after confirmation that it is not a hemorrhagic stroke. Monitor vital signs and provide pain relief to prevent complications
A nurse has an 80-year-old female patient who states she is tired and ready to sleep at 7:00 PM each night and is ready to rise at 4:00 AM each morning. Which of the following symptoms is the patient exhibiting?
Advanced sleep phase syndrome
For seizure disorders that do not respond to anticonvulsant medications, the option for surgical treatment exists. What is removed in the most common surgery for seizure disorders? a) Amygdala b) Temporal neocortex c) Hippocampus d) Entorhinal cortex
Amygdala The most common surgery consists of removal of the amygdala and an anterior part of the hippocampus and entorhinal cortex, as well as a small part of the temporal pole, leaving the lateral temporal neocortex intact. Only a portion of the hippocampus and entorhinal cortex, and temporal pole are removed.
A nurse is teaching a client newly diagnosed with a seizure disorder about medications. The most important information for the nurse to provide would be: a) Antiepileptic medications should never be discontinued abruptly. b) Pregnant women should reduce the dose of medication they are taking. c) All antiepileptic medications should be taken with food. d) Children can build up a tolerance to the medication quickly.
Antiepileptic medications should never be discontinued abruptly. Consistency in taking seizure medications is essential to obtaining and maintaining therapeutic blood levels of the medication. Abrupt withdrawal can cause seizure recurrence. Monitoring and assessment of drug levels are important. Each prescribed drug will provide information regarding administration to provide client safety.
What medication teaching should be done for a woman of childbearing age with a seizure disorder? a) Antiseizure drugs do not interact with oral contraceptives. b) Antiseizure drugs increase the risk for congenital abnormalities. c) All women of childbearing age should be advised to take a vitamin C supplement. d) Some antiseizure drugs can interfer with vitamin K metabolism.
Antiseizure drugs increase the risk for congenital abnormalities. For women with epilepsy who become pregnant, antiseizure drugs increase the risk for congenital abnormalities and other perinatal complications. - Many of the antiseizure medications interact with oral contraceptives and can interfere with vitamin D metabolism. -All woman should be advised to take folic acid supplementation.
The nurse is caring for a patient in the intensive care unit who has been unable to sleep well for days. Which of the following symptoms may be associated with sleep deprivation? Select all that apply.
Anxiety Irritability Inability to concentrate
When does the most rapid brain development occur in human development?
Birth to 5 years
When assessing the motor system, on which of the following will the nurse focus? Select all that apply.
Body position Presence of involuntary muscle movement Muscle strength Coordination
A teenager has been in a car accident and experienced acceleration-deceleration head injury. Initially, the client was stable but then started to develop neurological signs/symptoms. The nurse caring for this client should be assessing for which type of possible complication? a) Brain contusions and hematomas b) Momentary unconsciousness c) TIAs and cerebrovascular infarction d) Status epilepticus
Brain contusions and hematomas Contusions (focal brain injury) cause permanent damage to brain tissue. The bruised, necrotic tissue is phagocytized by macrophages, and scar tissue formed by astrocyte proliferation persists as a crater. The direct contusion of the brain at the site of external force is referred to as a acceleration injury, whereas the opposite side of the brain receives the deceleration injury from rebound against the inner skull surfaces. As the brain strikes the rough surface of the cranial vault, brain tissue, blood vessels, nerve tracts, and other structures are bruised and torn, resulting in contusions and hematomas. -TIAs and cerebral vascular infarction (stroke) are often caused by atherosclerotic brain vessel occlusions that cause ischemic injuries. -In mild concussion head injury, there may be momentary loss of consciousness without demonstrable neurologic symptoms or residual damage, except for possible residual amnesia. -Status epilepticus is not related to this situation.
The nurse working in an emergency room is caring for a client who is exhibiting signs and symptoms of a stroke. What does the nurse anticipate that the physician's orders will include? a) CT scan b) MRI c) Intravenous antibiotics d) pain medication
CT scan The nurse should anticipate that the client will be ordered a CT scan to rule out hemorrhagic stroke that would preclude the administration of tissue plasminogen activator (tPA).
In the Korsakoff component of Wernicke-Korsakoff Syndrome, the patient would most likely exhibit which of the following?
Confabulation
The nurse knows that which of the following treatment plans listed below is most likely to be prescribed after a computerized tomography (CT) scan of the head reveals a new-onset aneurysmal subarachnoid hemorrhage? a) Craniotomy and clipping of the affected vessel. b) STAT administration of tissue-type plasminogen activator (tPA). c) Administration of a diuretic such as mannitol to reduce cerebral edema and ICP. d) Monitoring in ICU for signs and symptoms of cerebral insult.
Craniotomy and clipping of the affected vessel. Surgery for treatment of aneurysmal subarachnoid hemorrhage involves craniotomy and inserting a specially designed silver clip that is tightened around the neck of the aneurysm. Administration of tPA would exacerbate bleeding and a diuretic would not address the issue of bleeding. Monitoring alone would be an insufficient response given the severity of the problem.
A patient suffering global cerebral ischemia a week after a suicide attempt by hanging is in the intensive care unit receiving treatment. The parent asks the nurse why it is necessary to keep the patient paralyzed with medications and on the ventilator. The most appropriate response would be that these therapies do which of the following? a) Increase oxygen demands and metabolic needs b) Decrease the patient's ability to attempt suicide again c) Decrease metabolic needs and increase oxygenation d) Decrease intracranial fluid volumes and pressures
Decrease metabolic needs and increase oxygenation The general goal of treatment with global cerebral ischemia is to decrease metabolic needs and increase oxygenation to the injured cerebral tissue. Artificial ventilation provides appropriate oxygenation; keeping the patient paralyzed decreases the body's metabolic needs.
The health care provider is concerned that a client may be at risk for problems with cerebral blood flow. The most important data to assess would be: a) Decreased level of carbon dioxide b) Decreased hydrogen ions c) Decreased level of PCO2 d) Decreased level of oxygen
Decreased level of oxygen Regulation of blood flow to the brain is controlled largely by autoregulatory or local mechanisms that respond to the metabolic needs of the brain. Metabolic factors affecting cerebral blood flow include an increase in carbon dioxide and hydrogen ion concentrations; cerebral blood flow is affected by decreased O2 levels and increased hydrogen ions, carbon dioxide, and PCO2 levels.
A parent brings their 15-year-old adolescent into the clinic, stating "I cannot wake him up in the morning. He has been late for school several times and I do not know what to do any longer." Which of the following sleep syndromes is the nurse aware is common in adolescents?
Delayed sleep phase syndrome (DSPS)
Depression has various subclassifications distinguished by symptom patterns. Which is that key clinical manifestation of depression with psychotic features?
Delusions or hallucinations
The nurse is evaluating a client for possible signs of depression. What are clinical manifestations of major depressive disorder? Select all that apply.
Depressed mood Anhedonia Decreased concentration
The diagnosis of dementia is based on assessment of the presenting problem. The American Academy of Neurology practice parameters recommend screening for which disorder when assessing a client for dementia?
Depression
What are the most common mental health problems in the United States? Select all that apply.
Depression Anxiety Substance abuse
What clinical manifestations will the nurse ask the client about when she is evaluating the client for panic disorder? Select all that apply.
Dizziness Fainting Chest pain
What chemical in the body is associated with the need to continue to abuse addictive substances?
Dopamine
A child is being seen in the emergency department (ED) after ingesting crayons with lead in them. He is disoriented and having seizures. The provider suspects he has which of the following? a) Encephalitis b) Bacterial meningitis c) Viral meningitis d) Meningioma
Encephalitis Less frequent causes of encephalitis include ingesting toxic substances such as lead. -People experience neurologic disturbances such as lethergy, disorientation, seizures, focal paralysis, delirium and coma. - Bacterial and viral meningitis are caused by bacterial and viral infections. -Meningiomas are a type of brain tumor that are seen in the middle or later years of life.
The nurse is teaching clients about psychiatric disorders. What can the nurse include in her education to help reduce the stigma toward the client with a psychiatric disorder?
Encourage an understanding of the effect of the client's environment on brain functioning
The CT scan report identified that a client with a skull fracture has developed a hematoma that resulted from a torn artery. The report would be interpreted as: a) Epidural hematoma b) Intracranial hematoma c) Subdural hematoma d) Chronic subdural hematoma
Epidural hematoma An epidural hematoma is one that develops between the inner side of the skull and the dura, usually resulting from a tear in an artery, most often the middle meningeal, usually in association with a head injury in which the skull is fractured. -A subdural hematoma results from a torn vein; -chronic subdural hematoma is common in older persons: -brain atrophy causes the brain to shrink away from the dura and to stretch fragile bridging veins. - An intracranial hematoma occurs when a blood vessel ruptures within your brain or between your skull and your brain.
The underlying causative problem in Parkinsonism is which of the following?
Failure of dopamine release
Bradykinesia occurring in Parkinson's disease places the Parkinson's client most at risk for which of the following?
Falls and injury
Mental illness is ubiquitous among Americans with one in how many suffering from the consequences of a psychiatric disorder in any given year?
Four
A 66-year-old client reports to his doctor that he cannot fall asleep and if he does it does not last. The physical examination shows his blood pressure to be normal, he does not drink alcohol on a regular basis, and he is generally healthy. He is recently started taking prednisone and he takes 81 mg aspirin daily as well as nitroglycerine for his angina, when needed. Which statement about the client's sleep difficulties is most accurate?
He may be experiencing problems sleeping due to prednisone.
A college student has been experiencing frequent headaches that he describes as throbbing and complaining of difficulty concentrating while studying. Upon cerebral angiography, he is found to have an arteriovenous malformation. Which of the following pathophysiological concepts are likely responsible for his symptoms? a) Increased tissue perfusion at the site of the malformation. b) High pressure and local hemorrhage of the venous system. c) Hydrocephalus and protein in the cerebral spinal fluid. d) Localized ischemia with areas of necrosis noted on CT angiography.
High pressure and local hemorrhage of the venous system. Answer B is incorrect since arteriovenous malformation is associated with blood vessels and not the fluid within the ventricles of the brain. Answer D is incorrect in that there is blood flow to the area. Ischemia is associated with decreased arterial flow resulting in death to brain tissue. In arteriovenous malformations, a tangle of arteries and veins acts as a bypass between the cerebral arterial and venous circulation, in place of the normal capillary bed. However, the capillaries are necessary to attenuate the high arterial blood pressure before this volume drains to the venous system. As a result, the venous channels experience high pressure, making hemorrhage and rupture more likely; the lack of perfusion of surrounding tissue causes neurologic deficits such as learning disorders. Headaches are severe, and people with the disorder may describe them as throbbing (synchronous with their heartbeat). Increased tissue profusion means that more oxygenated blood is brought to the area which is not the case. The elevated arterial and venous pressures divert blood away from the surrounding tissue, impairing tissue perfusion.
A patient with memory loss is concerned about the possibility that it may be inherited. Which of the following disorders is an inherited dementia?
Huntington's disease
A nurse practitioner is evaluating a patient who is being increasingly forgetful and agitated and has been indiscriminately spending money over the past 6 months; the patient is concerned that reason may be Alzheimer's disease. The nurse explains that it may not be Alzheimer's disease, that there are many potentially reversible causes of dementia such as which of the following? Select all that apply.
Hypothyroidism Anticholinergic drugs Vitamin B12 deficiency
The nurse is planning an inservice on hypoxia versus ischemia in brain-injured clients. The nurse should include which of the following? a) Ischemia does not interfere with delivery of glucose. b) Ischemia denotes a deprivation of oxygen with maintained perfusion. c) Hypoxia denotes an interruption in blood flow. d) Hypoxia produces a generalized depressive effect on the brain.
Hypoxia produces a generalized depressive effect on the brain. Hypoxia denotes a deprivation of oxygen with maintained blood flow (perfusion), whereas ischemia is a situation of greatly reduced or interrupted blood flow. Hypoxia produces a generalized depressant effect on the brain. Ischemia interferes with delivery of oxygen and glucose as well as the removal of metabolic wastes.
Which current multiple sclerosis drug treatments are designed to slow the progress of myelin degeneration?
Immunomodulators
A nurse observes clusters of rapid eye movements (REMs) in a sleeping patient. Additional characteristics of the sleep cycle that this patient is experiencing include which of the following?
Increased cerebral activity
A nurse has just returned to her home on the East Coast of the United States after attending a nursing conference on the West Coast. Which of the following symptoms are related to circadian rhythm and may be experienced by the nurse? Select all that apply.
Insomnia Daytime sleepiness Decreased alertness and performance
Which of the following neurons connect sensory and motor neurons?
Interneurons
A nurse is caring for a patient who experiences a compelling urge to move limbs during the evening or night, with the condition worsening at rest and inactivity. Which of the following supplements can the nurse anticipate administering to this client?
Iron
A nurse is caring for a patient diagnosed with Alzheimer's disease who sleeps at irregular intervals, having no consistent sleep-wake cycle. The nurse suspects that the patient is experiencing which of the following?
Irregular sleep-wake rhythm
What is understood to be the cause of Huntington disease (HD)?
It is inherited as an autosomal dominant disorder.
Which of the following statements is true regarding schizophrenia?
It presents with disorganized positive and negative symptoms.
Anticonvulsive medications are used in the treatment of bipolar depression. What other drug is used to treat bipolar disorder?
Lithium
The emergency room doctor suspects a client may have bacterial meningitis. The most important diagnostic test to perform would be: a) Lumbar puncture b) Sputum culture c) CT of the head d) Blood cultures
Lumbar puncture The diagnosis of bacterial meningitis is confirmed with abnormal CSF findings. Lumbar puncture findings, which are necessary for accurate diagnosis, include a cloudy and purulent CSF under increased pressure. The other options do not confirm the diagnosis.
A patient who experienced a myocardial infarction two weeks ago reports awakening early, loss of appetite, difficulty sitting still or concentrating, and loss of interest in personal hobbies. What mental health disorder do these manifestations represent?
Major depression
What is the task of the prefrontal area of the brain?
Manage information
A patient is having an electroencephalogram (EEG) to determine if there is seizure activity or a sleep disturbance. The client states she has been having periods when she seems to be "unaware of surroundings" and "falling asleep when awake during the day." What does the nurse determine the EEG will be able to determine?
Measuring the combined activity among neurons to a given stimulus
What role do the basal ganglia play in cognition?
Monitor sensory information coming into the brain and apply it to information stored in the memory
Restoration of the integrity of myelin sheaths would likely result in a slowing or stopping of the progression of:
Multiple sclerosis (MS)
A parent has brought her 16-year-old child to the hospital clinic because the child can't seem to stay awake in class, as reported by the teachers. The parent states that the child usually sleeps 10-12 hours a night. The child does not remember sleeping in class; however, he describes vivid hallucinations that appear to occur at the times the teachers state the child is sleeping. Which sleep disorder does the admitting nurse suspect?
Narcolepsy
Hypoxic injury will result in which of the following effects on the brain? a) Can be focal or global with only one part of the brain being underperfused or all of the brain being compromised b) Depends on the brain's compensatory mechanisms and the extent of the swelling c) Neuronal cell injury and death d) Clouding of consciousness, bilaterally small pupils (approximately 2 mm in diameter) with a full range of constriction, and motor responses to pain that are purposeful or semipurposeful (localizing) and often asymmetric
Neuronal cell injury and death Neuronal cell injury and death is directly caused by hypoxic injury. The others are specific to several other brain injury types.
The spouse of a blind client calls the nurse practitioner to ask what is causing the client such a difficult time sleeping and what can be done. What might the client be suffering from, and which would be the most accurate response?
Non-24 hour sleep-wake syndrome; regulate wake and sleep times.
Psychiatric diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM) is based on which items? Select all that apply.
Objective symptoms Panel of mental health experts
A patient comes to the emergency department complaining of dizziness, rapid breathing, sweating, palpitations, and a feeling of dying. The patient has normal laboratory values and has had a cardiac workup. The symptoms persist for 30 minutes and then subside. Which of the following conditions is the patient exhibiting?
Panic disorder
A patient states, "I am the most famous rock star in the country and all the other stars are trying to kill me." What type of distorted thinking is the patient likely experiencing?
Paranoid
The nurse is providing client education to a client newly diagnosed with Parkinson's disease. The nurse most accurately describes the disease progression:
Parkinson's is a chronic condition and treatment aims to manage symptoms
Formulations of the serotonin reuptake inhibitors are the most widely used antidepressants. Which is a common selective serotonin reuptake inhibitor that is used?
Paroxetine (Paxil)
A nurse caring for a patient with obsessive-compulsive disorder (OCD) is evaluating the treatment regimen. Which of the following data indicate effective treatment?
Patient ordered and ate lunch at a new restaurant.
What are the precipitant factors that are likely to cause a relapse of addictive, abusive behavior? Select all that apply.
Physical stress Emotional stress Environmental triggers Easy access to the substance of choice
At the present time there is only one diagnosis in the DSM that has a causative factor. Which diagnosis has a causative factor?
Post traumatic stress disorder
There is some evidence that the most powerful predictor of psychosis and diagnosis of schizophrenia is what factor?
Poverty
The nurse practitioner is examining a client who delivered a healthy baby 2 weeks prior to the visit. The client is complaining of severe mood swings, anxiety, and just feeling down overall. The nurse practitioner asks the client about frequency and duration of sleep disturbances in an effort to determine interruption in which of the following sleep stages?
REM
Which is correct about Creutzfeldt-Jakob disease (CJD)?
Rare, rapidly progressive form of dementia
Nystagmus due to cerebellar dysfunction would most likely interfere with which activity?
Reading
The transmission of impulses at the neuromuscular junction is mediated by which of the following actions?
Release of neurotransmitter acetylcholine from autonomic nerve endings
Although there are over 40 neurotransmitters, those that are the most familiar and important for psychiatric disorders are all of the following except?
Renin
The adult child of a patient with end-stage Alzheimer's disease asks the nurse at the physician's office if Alzheimer's can be passed on to them. Which of the following is the nurse's most accurate response?
Research supports a possible genetic link with an early onset."
Many people have experienced some kind of traumatic event in their lives. While response to trauma varies with individuals, what is a generalized response in those who have experienced severe trauma in childhood?
Response later in adulthood which manifests itself in medical and mental issues
A 21-year-old male college student has just been brought to the emergency department by police. He is agitated and talking about how someone is going to find him and appears to experiencing hallucinations, though there is no evidence of substance use. His mother accompanies him and states that he has a history of similar episodes. The care team should screen this client for which disease?
Schizophrenia
A nurse enters a patient's room to administer medications and finds the patient resting in bed with eyes closed. The nurse checks the patient's name bracelet and calls the patient by name. The patient arouses easily and states, "I must have dozed off." Which of the following stages of sleep does the nurse recognize this patient was in?
Stage 1
The MRA scan of a client with a suspected stroke reports ruptured berry aneurysm. The nurse plans care for a client with which of the following? a) Encephalitis b) Subarachnoid hemorrhage c) Thrombotic stroke
Subarachnoid hemorrhage The rupture of a berry aneurysm leads to a subarachnoid hemorrhage.
The nurse is explaining how vasogenic brain edema occurs to a client's family. The most appropriate information for the nurse to provide would be: a) Normal physiologic circumstances result in decreased adsorption of CSF. b) There is a decrease in the amount of fluid volume in the brain. c) The blood-brain barrier is disrupted, allowing fluid to escape into the extracellular fluid. d) There is an increase in the production of cerebral spinal fluid volume.
The blood-brain barrier is disrupted, allowing fluid to escape into the extracellular fluid. Vasogenic brain edema occurs with conditions that impair the function of the blood-brain barrier and allow the transfer of water and protein from the vascular space into the interstitial space. Increased production of CSF and decreased absorption result in hydrocephalus. It occurs in conditions such as hemorrhage, brain injury, and infectious processes. (less
A 60-year-old office worker has presented to a clinic reporting recent episodes of lower back pain. Which component of the client's assessment and history would be most indicative or a serious pathologic process?
The client's onset of pain has been gradual and the client has no prior history of back problems
After surviving an ischemic stroke, a client has demonstrated significant changes in his emotional behavior, with his family noting that he now experiences wide mood swings and exaggerated responses of empathy, anger, and sadness to situations. His care team would most likely attribute these responses to ischemic changes in which brain structure?
The components of the client's limbic system
A patient suffering a thrombotic stroke is brought into the emergency department by ambulance and the health care team is preparing to administer a synthetic tissue plasminogen activator for which of the following purposes? a) Hemolysis b) Hemostasis c) Thrombolysis d) Thrombogenesis
Thrombolysis Synthetic tissue plasminogen activators work with the body's natural tissue plasminogen activators to convert plasminogen to plasmin, which breaks down clots to allow for the reestablishment of blood flow. There are two causes of strokes: hemorrhagic and thrombotic, with thrombotic strokes occurring much more frequently. Thrombolytics play a large role in increased outcomes seen with thrombotic strokes.
The most common cause of an ischemic stroke is which of the following? a) Thrombosis b) Cardiogenic embolus c) Intracerebral arterial vasculitis d) Vasospasm
Thrombosis Thrombi are the most common cause of ischemic strokes, usually occurring in atherosclerotic blood vessels.
The nurse is caring for an eighty-four-year-old female client who has been diagnosed with advanced sleep phase syndrome (ASPS). The nurse understands that treatment of this sleep disorder includes which of the following? (Select all that apply.)
Treatment depends on how disruptive the client perceives the problem to be. Treatment may focus on sleep schedule changes.
Vascular dementia differs from Alzheimer's disease because the main presenting symptom of vascular dementia is slow psychomotor function.
True
Global or diffuse brain injury is manifested by changes in the level of consciousness. a) False b) True
True Global brain injury nearly always results in altered levels of consciousness, ranging from inattention to stupor or coma.
What clinical manifestations will the nurse ask the client about when she is evaluating the client for panic disorder? Select all that apply.
Vascular dementia
Which of the following forms of progressive dementia is often a result of chronic alcoholism?
Wernicke-Korsakoff syndrome
A 60-year-old male is being treated for significant denervation and muscle fibre atrophy. His movements are still smooth and he has no cognitive defects. The nurse should recognize the signs and symptoms of:
a mixed UMN/LMN disorder.
The nurse is caring for a client who has been diagnosed with narcolepsy. The client reports hat his muscles become extremely weak when he becomes excited. The nurse understands that the client is describing which of the following?
cataplexy
The nurse has a patient who appears to be sleepwalking. Which of the following interventions would be most appropriate for the nurse to do?
lead the patient back to bed
Actigraphy can be used to diagnose sleep disturbances. The actigraph is worn on the wrist and is used most commonly with what?
sleep diary
The most common cause of ischemic stroke is: a) vasospasms. b) cryptogenesis. c) arterial vasculitis. d) thrombosis.
thrombosis. Ischemic stroke includes those caused by large artery thrombosis (20%), small artery thrombosis (25%), cardiogenic embolism (20%) and cryptogenic (undetermined cause)(30%), making thrombosis the most common cause (45%).
A patient has an abrupt onset of mental slowing and depression. Which of the following conditions in the patient's history would indicate vascular dementia as a cause of these changes? Select all that apply. a) Cigarette smoking b) Peptic ulcer c) Diabetes insipidus d) Cardiac dysrhythmias e) Cerebrovascular accident
• Cerebrovascular accident • Cardiac dysrhythmias • Cigarette smoking The hallmarks of vascular dementia are mental slowing and depression. They usually occur as a result of brain injury from hemorrhage or occlusion. Common disorders associated with this diagnosis are cerebrovascular accident, cardiac dysrhythmias, cigarette smoking, hypertension, hyperlipidemia, diabetes mellitus, and autoimmune disorders.
The nurse assessing a patient with a traumatic brain injury assesses for changes in which of the following? Select all that apply. a) Sensory function b) Level of consciousness c) Metabolic function d) Motor function e) Cognition
• Cognition • Level of consciousness • Motor function • Sensory function Brain injuries can cause changes in level of consciousness and alterations in cognition, motor, and sensory function; therefore, the nurse assessing a patient with a traumatic brain injury should assess for changes in these areas.
