Neuro

A patient is in the acute phase of an ischemic stroke. How long does the nurse know that this phase may last?

1-3 days

A patient is admitted via ambulance to the emergency room of a stroke center at 1:30 p.m. with symptoms that the patient said began at 1:00 p.m. Within 1 hour, an ischemic stroke had been confirmed and the doctor ordered tPA. The nurse knows to give this drug no later than what time?

4 pm

A nurse is instructing the spouse of a client who suffered a stroke about the use of eating devices the client will be using. During the teaching, the spouse starts to cry and states, "One minute he is laughing, and the next he's crying; I just don't understand what's wrong with him." Which statement is the best response by the nurse?

Emotional lability is common after a stroke, and it usually improves with time

A patient arrives to have an MRI done in the outpatient department. What information provided by the patient warrants further assessment to prevent complications related to the MRI?

I am trying to quit smoking and have a patch on

During a neurological assessment examination, the nurse assesses a patient for tactile agnosia. The nurse places a familiar door key in the patient's hand and asks him to identify the object with his eyes closed. The nurse documents his inability to identify the object and notes the affected area of the brain. Which of the following is the most likely affected area of the brain? You Selected:

Parietal lobe

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

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

The nurse is caring for an 82-year-old client diagnosed with cranial arteritis. What is the priority nursing intervention?

administer corticosteroid as ordered

A nurse is caring for a client with a brain tumor and increased intracranial pressure (ICP). Which intervention should the nurse include in the care plan to reduce ICP?

administer stool softeners

The nurse is caring for a client hospitalized with a severe exacerbation of Myasthenia Gravis. When administering medications to this client what is a priority nursing action?

administer the medication at exact intervals ordered

A client has undergone a lumbar puncture as part of a neurological assessment. The client is put under the care of a nurse after the procedure. Which important postprocedure nursing intervention should be performed to ensure the client's maximum comfort?

encourage the client to drink liberal amounts of fluids to help restore the volume of cerebrospinal fluid

The nurse is caring for a client with aphasia. Which strategy will the nurse use to facilitate communication with the client?

establishing eye contact

A 64-year-old client reports symptoms consistent with a transient ischemic attack (TIA) to the health care provider in the emergency department. Which is the origin of the client's symptoms?

impaired cerebral circulation

A client is receiving an IV infusion of mannitol (Osmitrol) after undergoing intracranial surgery to remove a brain tumor. To confirm that this drug is producing its therapeutic effect, the nurse should consider which finding most significant?

increased urinary output

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; This indicates injury to the expressive speech center (Broca's area) which is located in the inferior portion of the frontal lobe. The sensory strip is located in the anterior parietal lobe.

A client is admitted with weakness, expressive aphasia, and right hemianopia. The brain MRI reveals an infarct. The nurse understands these symptoms to be suggestive of which of the following findings?

left sided cerebrovascular accident

A client on your unit is scheduled to have intracranial surgery in the morning. Which nursing intervention helps to avoid intraoperative complications, reduce cerebral edema, and prevent postoperative vomiting?

restrict fluids before surgery

Following a generalized seizure in a client, which nursing assessment is a priority for detailing the event?

seizure was 1 minute in duration including tonic-clonic activity

When should the nurse plan the rehabilitation of a patient who is having an ischemic stroke?

the day the patient has the stroke

A client with meningitis has a history of seizures. Which should the nurse do to safely manage the client during a seizure? Select all that apply.

turn the client to the side provide verbal reassurance

When communicating with a client who has sensory (receptive) aphasia, the nurse should:

use short simple sentences

Which phase of a migraine headache usually lasts less than 1 hour

aura

A nurse is caring for a client who requires intracranial pressure (ICP) monitoring. The nurse should be alert for what complication of ICP monitoring?

infection ; the catheter for measuring ICP can create a risk of infection

The nurse is taking care of a client with a history of headaches. The nurse takes measures to reduce headaches and administer medications. Which appropriate nursing interventions may be provided by the nurse to such a client?

apply warm or cool cloths to the forhead or back of the neck

The nurse enters the client's room and finds the client with an altered level of consciousness (LOC). Which is the nurse's priority concern?

airway clearance

signs of cushings triad

bradypnea hypertension bradycardia

Which occurs when reflexes are hyperactive when the foot is aburptly dorsiflexed

clonus

The Family Nurse Practitioner is performing the physical examination of a client with a suspected neurologic disorder. In addition to assessing other parts of the body, the nurse should assess for neck rigidity. Which method should help the nurse assess for neck rigidity correctly?

moving the head toward the chest

A client is admitted for evaluation of cerebral aneurysm. Which assessment finding is of greatest importance in prioritizing nursing care to this client?`

nausea; it needs to be controlled to prevent vomiting which can greatly increase intracranial pressure

While providing information to a community group, the nurse tells them the primary initial symptoms of a hemorrhagic stroke are:

severe headache and early changes in level of consciousness

A client with diabetes is hospitalized with a TIA. When planning this client's discharge teaching the nurse knows to include which of the following?

techniques to control blood sugar within normal ranges

What is one of the earliest signs of increased ICP

decreased LOC

The critical care nurse is giving report on a client they are caring for. The nurse uses the Glasgow Coma Scale (GCS) to assess the level of consciousness (LOC) of a female client and reports to the on-coming nurse that the client has an LOC of 6. What does an LOC score of 6 in a client indicate?

comatose; a normal response is 15. A score of 7 or less is considered comatose.

A patient recently noted difficulty maintaining his balance and controlling fine movements. The nurse explains that the provider will order diagnostic studies for the part of his brain known as the

cerebellum

A nurse is caring for a client who has returned to his room after a carotid endarterectomy. Which action should the nurse take first?

ask the client if he has trouble breathing; the nurse should first assess the client's breathing. A complication of a carotid endarterectomy is an incisional hematoma, which could compress the trachea causing breathing difficulty for the client.

While providing information to a community group, the nurse tells them the primary initial symptoms of a hemorrhagic stroke are:

atrial fibrillation

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

chewing ; this nerve is involved in the 5th cranial nerve which aids in chewing

During a class on stroke, a junior nursing student asks what the clinical manifestations of stroke are. What would be the instructor's best answer?

clinical manifestations of a stroke depends on the area of the cortex, the affected hemisphere, the degree of blockage, and the availability of the collateral circulation

The nurse finds the client thrashing about in bed and reporting a severe headache. The client tells the nurse that the pain is behind the client's right eye which is red and tearing. What type of headache does the nurse suspect?

cluster; a person with a cluster headache has pain on one side of the head, usually behind the eye, accompanied by nasal congestion, rhinorrhea, and tearing and redness of the eye

The critical care nurse is caring for a client with bacterial meningitis. The client has developed cerebral vasculitis and increased ICP. What neurologic sequelae might this client develop?

damage to the optic nerve

How often should neurologic assessments and vital signs be taken initially for the patient receiving tissue plasminogen activator (tPA)?

every 15 minutes

The nurse is caring for a client with mid-to-late stage of an inoperable brain tumor. What teaching is important for the nurse to do with this client?

explaining hospice and services

A client tells the nurse that they have transient ischemic attacks. The client reports having undergone a carotid artery surgery. In such a case, what important assessments should be performed by the nurse?

frequent neuro checks

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?

gingival hyperplasia

The nurse is educating a patient with a seizure disorder. What nutritional approach for seizure management would be beneficial for this patient?

high in protein and low in carbohydrate

The nurse practitioner advises a patient who is at high risk for a stroke to be vigilant in his medication regimen, to maintain a healthy weight, and to adopt a reasonable exercise program. This advice is based on research data that shows the most important risk factor for stroke is:

hypertension

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; an increase in blood pressure and decrease in pulse with respiratory failure may indicate increased ICP

What does the nurse recognize as the earliest sign of serious impairment of brain circulation related to increasing ICP?

lethargy and stupor

Which of the following is the initial diagnostic in suspected stroke?

noncontrast computed tomography (CT)

Which lobe of the brain is responsible for spatial relationships

parietal

A potential complication of a hemorrhagic stroke is interference with the ability of the arachnoid villi to absorb CSF. Therefore, fluid in the ventricles increase beyond the amount that is usually absorbed daily, which is:

350-375 mL; 500 mL of CSF is produced each day, but 125 to 150 mL is absorbed by the villi. When blood enters the system from trauma or hemorrhagic stroke, the villi become obstructed, CSF is not absorbed and hydrocephalus which is increased size of the ventricles may result.