Neuro Exam

The normal range of ICP

0-10 mmHg

The nurse knows that symptoms a/w a transient ischemic attack (TIA), usually a precursor of a future stroke usually subside in:

1 H

A common cause of increased ICP is cerebral edema & swelling that peaks how long after the injury?

2-3 days

Postcraniotomy cerebral edema is at a max how long after brain surgery:

24-72 Hrs

Metastatic brain lesions occur in what percentage of pts w/ cancer?

25%

A nurse assess the pt's LOC using the GCS. What score indicates severe impairment of neurological functioning?

3

The GCS is used determine the LOC. A score considered indicative of a coma is:

3

The avg time from onset to death for pts dx w/ ALS is:

3-5 yrs

The median survival time for pts w/ brain lesion metastasis when no surgery is performed and radiation therapy is used, is:

3-6 months

More than 50% of new victims of SCI are:

30 yrs of age or younger

The initial mortality rate for a stroke can be as high as:

30%

Comatose pts are mechanically ventilated to control ICP. Hypocapnia is a goal that can be achieved w/ a PaCO2 in the range of:

35-40 mmHg

Recovery of vital organ functions resulting from spinal shock can take up to:

4 months

To prevent decreased CPP after brain injury, the nurse knows that cerebral perfusion pressure must be at a minimum reading of:

60 mmHg

A pt is admitted to the hopsital w/ an ICP reading of 20 mmHg and a MAP of 90 mmHg. The nurse knows the CPP will be:

70 mmHg

A nurse assessing U/O as an indicator of diabetes insipidus knows that an hourly output of what volume over 2 hrs may be a positive indicator?

> 200 mL/hr

Nutritional considerations as part of the nursing care plan would include all of the following except:

Calcium should be avoided

Identify the bacteria NOT associated w/ the cause of septic meningitis

Cryptococcus neoformans

A stroke victim is experiencing memory loss and impaired learning capacity. The nurse knows that brain damage has most likely occurred in which lobe?

Frontal

Charles is started on chemo, which is aimed at restoring dopamingeric activities. An example of such a drug is:

Levodopa

The most effective drug currently used to control the tremor of parkinsonism is:

Levodopa

High doses of which drug have been found to reduce swelling and disability if given within 8 hrs of injury even tho its use is controversial?

Methylprednisolone sodium

Unconsciousness may have what type of origin:

Multisystem involvement

Loss of ANS fx below the level of the lesion causes what kind of shock?

Neurogenic

Most pts w/ hemorrhagic strokes are placed in bed in which position:

Semi-fowlers

Orthostatic hypotension is a common problem for SCI at the level of

T7

All of the following statements about the occurrence of head injuries are correct except:

The majority of injuries occur in females

Initial compensatory VS changes w/ IICP include all of the following except:

a decreased temp

The most frequently seen intracerebral brain neoplasm is:

a glioma

The nurse assess for the characteristic movement of Parkinson's disease, which is:

a pronation-supination of the hand and forearm that interferes w/ normal hand activities

Resp difficulty and paralysis of all 4 extremities occur w/ SCI

above c2

An indicator of elevated body temp in a head-injured pt is:

all of the above

Assessing the level of consciousness is an important nursing measure post-injury. Signs of IICP include:

all of the above

The nurse knows that Parkinson's disease, a progressive neurologic disorder is characterized by:

all of the above

Bacterial meningitis alters intracranial physiology, causing:

all of the above changes

A brain abscess is a collection of infectious material within the substance of the brain that is caused by:

all of the above mechanisms

Neurologic and neurosurgical approaches to pain relief would include:

all of the above mechanisms

The most common cause of cerebrovascular disease

arteriosclerosis

Nursing care activities for a pt w/ IICP would NOT include:

assisting the pt w/ isometric exercises

The most severe form of meningitis is considered to be:

bacterial

The highest incidence of brain tumors occurs during which decades of life?

between the fifth and seventh

The most common SE of t-Pa is:

bleeding

The etiology of an ischemic stroke would include:

cardiogenic emboli

SCI can be classified according to the area of spinal cord damage. Motor deficits in the upper rather than lower extremities, usually caused by edema in the cervical area, are classified as:

central cord syndrome

ICP can be increased by a:

change in all the above

The degree of neurological damage that occurs w/ an ischemic stroke depends on the:

combination of the above factors

The majority of ischemic strokes have what type of origin?

cryptogenic

The clinical manifestations of Parkinson's disease (bradykinesia, rigidity, and tremors) are directly r/t a decreased level of:

dopamine

Parkinsonian symptoms usually appear during which decade of life?

fifth

The most severe neurologic impairments are evidenced by abnormal body posturing defined as:

flaccid

The most common motor dysfunction of a stroke is:

hemiplegia

A nurse knows that a pt experiencing Cushing's triad would not exhibit:

tachycardia

A common complication of immobility in a SCI is

thrombophlebitis

A surgical intervention that can cause substantial remission of MG is:

thymectomy

80% of hemorrhagic strokes are primarily caused by:

uncontrolled HTN

The majority of cases of epilepsy occur in those:

younger than 20 yrs

A positive dx of MG can be reached using the following test:

anticholinesterase levels

A seizure characterized by LOC and tonic spasms of the trunk and extremities, rapidly followed by repetitive generalized clonic jerking is classified as a:

generalized seizure

A nutritional approach for seizure management includes a diet that is:

high in protein and low in carbohydrate

A cerebral hemorrhage located within the brain is classified as:

intracerebral hematoma

Irreversible neuro dysfx occurs when the CPP is:

less than 50

The earliest sign of serious impairment of brain circulation r/t an increasing ICP is:

lethargy & stupor

The first priority of tx for a pt w/ altered LOC is:

maintenance of a patent airway

As ICP rises, the nurse knows that she may be asked to give a commonly used osmotic diuretic:

mannitol

A pt is dx w/ an intracerebral tumor. The nurse knows that the dx may include all of the following except:

meningioma

The most common benign encapsulated brain tumor (representing 15% of primary brain tumors) is

meningioma

The primary cause (35%) of SCI is:

motor vehicle crashes

The majority of brain tumors are treated by:

neurosurgery

The initial dx test for a stroke, usually performed in the ED, is a

non contrast CT

Nursing care for a pt who is experiencing a convulsive seizure includes all of the following except:

opening the pt's jaw and inserting a mouth gag

Long-term use of antiseizure medication in women leads to an increased incidence of:

osteoporosis

The initial neurologic symptom of Guillain-Barre syndrome is:

paresthesia of legs

A classic dx system of hemorrhagic stroke is the patient's complaint of:

severe HA