Patho Exam 2 Ch 37

The parent of an infant who developed hydrocephalus while in utero is very concerned that the child will have significant intellectual dysfunction. The best response to the parent would be which of the following?

"Because the skull sutures are not fused there may be no brain damage."

A client has developed global ischemia of the brain. The nurse determines this is:

Inadequate to meet the metabolic needs of the entire brain.

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?

Amygdala.

The nurse assessing a patient with a traumatic brain injury assesses for changes in which of the following? Select all that apply.

Cognition, Level of consciousness, Motor function, and Sensory function.

A patient who is diagnosed with seizures describes feeling a strange sensation before losing consciousness. The family members report that the patient has been smacking their lips prior to having a seizure. Which type of seizure disorder presents with these symptoms?

Complex partial or focal seizure with impairment of consciousness.

A pathologist is examining the brain of a recently deceased client who was thought to have developed Alzheimer disease shortly before death. Which pathology findings would confirm the diagnosis?

Cortical atrophy in the temporal lobes.

The parents of an infant born with hydrocephalus are concerned about the size of the baby's head. The doctors are telling them that the infant needs the surgical placement of a shunt. The nurse caring for the infant in the neonatal intensive care unit explains that placement of a shunt will do which of the following?

Decrease the likelihood of further neurological deficits.

The chart of a client admitted because of seizures notes that the seizure activity began simultaneously in both cerebral hemispheres. The nurse should interpret this to mean that the client experienced which of the following?

Generalized seizure.

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?

Thrombolysis.

A client has sustained a severe, diffuse brain injury that resulted in seriously compromised brain function. The client is at greatest risk for:

Brain death.

Which of the following individuals would be most likely to experience global ischemia to his or her brain?

A man who has entered cardiogenic shock following a severe myocardial infarction.

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 tonic-clonic seizure.

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 nurse is caring for a client admitted to the emergency room with suspected meningitis. The nurse prepares to perform which nursing intervention upon physician orders, while diagnostic testing is being completed?

Administration of antibiotics.

An 85-year-old patient with a medical history of diabetes, thrombocytopenia, and hypertension is on the cardiac step-down unit following the development of atrial defibrillation with a heart rate of 120-140. The atrial fibrillation was successfully cardioverted to a normal sinus rhythm and the patient was preparing to be discharged from the hospital when suddenly the patient developed right-sided hemiplegia and dysphasia. The nurse understands that this patient has many modifiable risk factors for stroke including which of the following? Select all that apply.

Atrial fibrillation, Diabetes, and Hypertension.

Manifestations of brain tumors are focal disturbances in brain function and increased ICP. What causes focal disturbances manifested by brain tumors?

Brain edema and disturbances in blood flow.

A soccer player has been diagnosed with a brain contusion after being injured in a game. The best explanation of the injury by the nurse would be:

Bruising on the surface of the brain occurred.

Intracranial aneurysms that rupture cause subarachnoid hemorrhage in the client. How is the diagnosis of intracranial aneurysms and subarachnoid hemorrhage made?

CT scan.

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:

Decreased level of oxygen.

A patient with Alzheimer's disease (AD) is forgetful and has started to lose interest in social activities. Which of the following treatment routines would be beneficial for the patient?

Donepezil (Aricept).

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?

Encephalitis.

An emergency room nurse receives a report that a client's Glasgow Coma Scale (GCS) is 3. The nurse prepares to care for a client with which of the following?

Flaccid motor response.

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.

An adult client has been admitted to a rehabilitation center after hospital treatment for an ischemic stroke. Which aspect of the client's history would be considered to have contributed to his stroke?

The client's blood pressure has historically been in the range of 150s/90s.

The most common cause of ischemic stroke is:

Thrombosis.

A client who is being seen in the outpatient clinic reports a single episode of unilateral arm and leg weakness and blurred vision that lasted approximately 45 minutes. The client is most likely experiencing:

Transient ischemic attack (TIA).

T/F? Global or diffuse brain injury is manifested by changes in the level of consciousness.

True.

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?

"Did you sustain any injuries in the accident?"

A patient discharged from the hospital 5 days ago following a stroke has come to the emergency department with facial droop that progressed with hemiplegia and aphasia. The patient's spouse is extremely upset because the physician stated that the patient cannot receive thrombolytic medications to reestablish cerebral circulation and the spouse asks the nurse why. Which of the following is the nurse's most accurate response?

"Thrombolytics may cause cerebral hemorrhage."

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?

"You should remind the patient to shower."

A 20 year-old has been diagnosed with an astrocytic brain tumor located in the brainstem. Which of the following statements by the oncologist treating the client is most accurate?

"Your prognosis will depend on whether we can surgically resect your tumor."

According to the Glasgow Coma Scale, opening one's eyes to only painful stimuli would receive which score?

2.

A nurse is teaching a client newly diagnosed with a seizure disorder with a seizure disorder about medications. The most important information for the nurse to provide would be:

Antipileptic medications should never be discontinued abruptly.

What medication teaching should be done for a woman of childbearing age with seizure disorder?

Antiseizure drugs increase the risk for congenital abnormalities.

The nurse is caring for a client with a brain tumor when the client begins to vomit. Which intervention should the nurse do first?

Assess for other signs/symptoms of increased intracranial pressure.

Following a collision while mountain biking, the diagnostic work up of a 22 year-old male has indicated the presence of an acute subduraral hematoma. Which of the following pathophysiological processes most likely underlies his diagnosis?

Blood has accumulated between the man's dura and subarachnoid space.

A nurse is preparing for a course in cardiopulmonary resuscitation (CPR) and realizes that ventricular fibrillation quickly disrupts blood flow to the brain that causes which of the following in a matter of seconds?

Global ischemia.

Which symptoms would support the diagnosis of a stroke involving the posterior cerebral artery? Select all that apply.

Loss of central vision, and Repeating of verbal responses.

The emergency room doctor suspects a client may have bacterial meningitis. The most important diagnostic test to perform would be:

Lumbar puncture.

Hypoxic injury will result in which of the following effects on the brain?

Neuronal cell injury and death.

The nurse taking a report on a client coming into the emergency room plans care for a client with brain dysfunction based on which of the following symptoms?

Stupor.

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?

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:

The blood-brain barrier is disrupted, allowing fluid to escape into the extracellular fluid.