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A nurse is caring for a patient with a diagnosis of trigeminal neuralgia. Which activity is altered as a result of this diagnosis?

Chewing

The nurse is caring for a patient with an altered LOC. What is the first priority of treatment for this patient?

Maintenance of a patent airway Explanation: The first priority of treatment for the patient with altered LOC is to obtain and maintain a patent airway.

Which of the following is a chronic, degenerative, progressive disease of the central nervous system characterized by the occurrence of small patches of demyelination in the brain and spinal cord?

Multiple sclerosis

Which of the following is an inaccurate manifestation of Cushing's triad?

Tachycardia Explanation: Cushing's triad is manifested by bradycardia, hypertension, and bradypnea. Tachycardia is not a component of the triad.

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.)

• Hypertension • Bradypnea • Bradycardia

The nurse is caring for a patient newly diagnosed with a primary brain tumor. The patient asks the nurse where his tumor came from. What would be the nurse's best response?

"Your tumor originated from cells within your brain itself."

A patient is recovering from intracranial surgery performed approximately 24 hours ago and is complaining of a headache that the patient rates at 8 on a 10-point pain scale. What nursing action is most appropriate?

Administer morphine sulfate as ordered. Explanation: The patient usually has a headache after a craniotomy as a result of stretching and irritation of nerves in the scalp during surgery. Morphine sulfate may also be used in the management of postoperative pain in patients who have undergone a craniotomy. Prone positioning is contraindicated due to the consequent increase in ICP. Distraction would likely be inadequate to reduce pain and a hot pack may cause vasodilation and increased pain.

A client is transferred to the intensive care unit after evacuation of a subdural hematoma. Which nursing intervention reduces the client's risk of increased intracranial pressure (ICP)?

Administering a stool softener as ordered

A patient diagnosed with multiple sclerosis (MS) has been admitted to the medical unit for treatment of an MS exacerbation. Included in the admission orders is baclofen (Lioresal). What would be the expected outcome of this medication?

Decreased muscle spasms in the lower extremities Explanation: Baclofen, a GABA agonist, is the medication of choice in treating spasms. It can be administered orally or by intrathecal injection. It is not used to promote continence or to increase strength. Avonex and Betaseron reduce the appearance of new lesions on the MRI.

Which term refers to the shifting of brain tissue form an area of high pressure to an area of low pressure?

Herniation Explanation: Herniation refers to the shifting of brain tissue form an area of high pressure to an area of lower pressure. Autoregulation is an ability of cerebral blood vessels to dilate or constrict to maintain stable cerebral blood flow despite changes in systemic arterial blood pressure. Cushing's response is the brain's attempt to restore blood flow by increasing arterial pressure to overcome the increased ICP. The Monro-Kellie hypothesis is a theory that states that due to limited space for expansion within the skull, an increase in any one of the cranial contents causes a change in the volume of the others.

The nurse is caring for a patient on the neurological unit who is in status epilepticus. What medication does the nurse anticipate being given to halt the seizure?

IV diazepam Explanation: Status epilepticus (acute prolonged seizure activity) is a series of generalized seizures that occur without full recovery of consciousness between attacks. Medical management of status epilepticus includes IV diazepam (Valium) and IV lorazepam (Ativan), given slowly in an attempt to halt seizures immediately. Other medications (phenytoin, phenobarbital) are given later to maintain a seizure-free state.

A patient has been admitted to the neurologic unit for the treatment of a newly diagnosed brain tumor. The patient has just exhibited seizure activity for the first time. What is the nurse's priority response to this event?

Implement precautions to ensure the patient's safety.

Narcotic analgesics increase CSF pressure.

Narcotic analgesics depress the respiratory center and raise CSF pressure. Their use is contraindicated in clients with head trauma or increased ICP, unless administration is an absolute necessity. Narcotic analgesics are contraindicated in clients with head trauma or increased ICP because they depress the respiratory center and raise CSF pressure. Narcotic analgesics are contraindicated in clients with head trauma or increased ICP because they depress the respiratory center and raise CSF pressure. Narcotic analgesics are contraindicated in clients with head trauma or increased ICP because they depress the respiratory center and raise CSF pressure.

When educating a patient about the use of antiseizure medication, what should the nurse inform the patient is a result of long-term use of the medication in women?

Osteoporosis Explanation: Because of bone loss associated with the long-term use of antiseizure medications, patients receiving antiseizure agents should be assessed for low bone mass and osteoporosis. They should be instructed about strategies to reduce their risks of osteoporosis.

Which of the following medication classifications is utilized preoperatively to decrease the risk of postoperative seizures?

Anticonvulsants Explanation: Anticonvulsants are used to decrease the risk of postoperative seizures following cranial surgery. Diuretics, corticosteroids, and antianxiety medications may be used for the patient with increased ICP.

A nurse working on a medical-surgical floor walks into a patient's room to find the patient with an altered level of consciousness (LOC). Which of the following actions would be the first priority? a) Maintenance of a patent airway b) Assessment of pupillary light reflexes c) Positioning to prevent complications d) Determination of the cause

Maintenance of a patent airway Explanation: The most important consideration in managing the patient with altered LOC is to establish an adequate airway and ensure ventilation.

A patient is admitted to the hospital for management of an extrapyramidal disorder. Included in the physician's admitting orders are the medications levodopa, Cogentin, and Eldepryl. The nurse knows that most likely, the client has a diagnosis of ________.

Parkinson's disease Explanation: These drugs are commonly used in the medical management of Parkinson's disease. Although antiparkinson drugs are used in some clients with Huntington's disease, these drugs are commonly used in the medical management of Parkinson's disease. The listed medications are not used to treat a seizure disorder. The listed medications are not used to treat MS.

The nurse is caring for a patient who has undergone supratentorial removal of a pituitary mass. What medication would the nurse expect to administer prophylactically to prevent seizures in this patient? a) Prednisone b) Cafergot c) Phenytoin d) Dexamethasone

Phenytoin Explanation: Antiseizure medication (phenytoin, diazepam) is often prescribed prophylactically for patients who have undergone supratentorial craniotomy because of the high risk of seizures after this procedure. Prednisone and dexamethasone are steroids and do not prevent seizures. Cafergot is used in the treatment of migraines.

A male patient presents to the clinic complaining of a headache. The nurse notes that the patient is guarding his neck and tells the nurse that he has stiffness in the neck area. The nurse suspects the patient may have meningitis. What is another well-recognized sign of this infection?

Positive Kernig's sign

An osmotic diuretic, such as mannitol, is given to the patient with increased intracranial pressure (IICP) for which of the following therapeutic effects?

To dehydrate the brain and reduce cerebral edema Explanation: Osmotic diuretics draw water across intact membranes, thereby reducing the volume of brain and extracellular fluid. Antipyretics and a cooling blanket are used to control fever in the patient with IICP. Although mannitol is a type of diuretic, it is not used to increase urine output. Medications such as barbiturates are given to the patient with IICP to reduce cellular metabolic demands.

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.)

• Positioning the patient on his or her side with head flexed forward • Providing for privacy • Loosening constrictive clothing

A patient is being admitted to the Neuro ICU following an acute head injury. The patient has cerebral oedema. The nurse would expect to administer what priority medications to reduce cerebral oedema? a) Mannitol (Osmitrol) b) Lasix (Furosemide) c) Spirolactone (Aldactone) d) Hydrochlorothiazide (HydroDIURIL)

Mannitol (Osmitrol)

A patient with neurologic infection develops cerebral edema from syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following is an important nursing action for this patient?

Restricting fluid intake and hydration Explanation: Fluid restriction may be necessary if the patient develops cerebral edema and hypervolemia from SIADH. Antipyretics are administered to patients who develop hyperthermia. In addition, it is important to maintain adequate hydration in such patients. A patient with neurologic infection should be given tracheal suctioning and hyperoxygenation only when the patient develops respiratory distress

The nurse is caring for a patient diagnosed with an acute subdural hematoma following a craniotomy. The nurse is preparing to administer an IV dose of dexamethasone (Decadron). The medication is available in a 20-mL IV bag and ordered to be infused over 15 minutes. At what rate (mL/hr) will the nurse set the infusion pump?

80 mL/hr 20/15 × 60 = 80 mL/hr

A nurse is caring for an older patient with late-stage Parkinson's disease. The client's plan of care includes a nursing diagnosis, "Potential for Injury." Which of the following would not be included as a cause for this diagnosis? a) Shuffling gait b) Choreiform movements c) Uncontrolled movements d) Rigidity

Choreiform movements Explanation: Choreiform, described as uncontrollable writhing and twisting of the body, is a typical symptom associated with Huntington's disease. This is commonly seen in clients with Parkinson's disease. This is commonly seen in clients with Parkinson's disease. This is commonly seen in clients with Parkinson's disease.

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?

You selected: More than 200 mL/h Explanation: For patients undergoing dehydrating procedures, vital signs, including blood pressure, must be monitored to assess fluid volume status. An indwelling urinary catheter is inserted to permit assessment of renal function and fluid status. During the acute phase, urine output is monitored hourly. An output greater than 200 mL per hour for 2 consecutive hours may indicate the onset of diabetes insipidus.

A client is admitted to an acute care facility after an episode of status epilepticus. After the client is stabilized, which factor is most beneficial in determining the potential cause of the episode? a) Recent weight gain and loss b) Compliance with the prescribed medication regimen c) Recent stress level d) The type of anticonvulsant prescribed to manage the epileptic condition

Compliance with the prescribed medication regimen Explanation: The most common cause of status epilepticus is sudden withdraw of anticonvulsant therapy. The type of medication prescribed, the client's stress level, and weight change don't contribute to this condition.