NSG 3280(Patho) Nclex Reviews For Exam 3

The dementia of Alzheimer disease is associated with structural changes in the brain, including: a. deposition of amyloid plaques in the brain. b. degeneration of basal ganglia. c. hypertrophy of frontal lobe neurons. d. significant aluminum deposits in the brain.

a. deposition of amyloid plaques in the brain.

Following a bone fracture, the earliest likely event to occur is: a. development of a blood clot beneath the periosteum. b. leukocyte infiltration into bone tissue. c. blood vessel growth at the fracture site. d. migration of osteoblasts to the fracture site.

a. development of a blood clot beneath the periosteum.

Muscular dystrophy includes a number of muscle disorders that are: a. genetically transmitted. b. easily prevented and managed. c. autoimmune in nature. d. demyelinating focused

a. genetically transmitted

One of the most common causes of acute pain is: a. headache. b. fibromyalgia. c. malignancy. d. trigeminal neuralgia.

a. headache

Autonomic dysreflexia is characterized by: a. hypertension and bradycardia. b. hypotension and shock. c. pallor and vasoconstriction above the level of injury. d. extreme pain below the level of injury.

a. hypertension and bradycardia

The nurse caring for an individual with vision impairment should be prepared to: a. keep the patient on bed rest to avoid injury. b. speak to the patient with a clear, loud voice. c. announcing himself or herself at all interactions. d. provide as much bright light as possible.

c. announcing himself or herself at all interactions.

Expected management of acute otitis media includes: a. surgical removal of debris in the middle ear. b. placement of ventilation tubes in the tympanic membrane. c. antibiotic therapy. d. adenoidectomy.

c. antibiotic therapy

Leakage of CS from the nose or ears is commonly associated with: a. epidural hematoma. b. temporal skull fracture. c. basilar skull fracture. d. cerebral aneurysm.

c. basilar skull fracture.

Dopamine precursors and anticholinergics are all used in the management of Parkinson disease because they: a. increase dopamine activity in the basal ganglia. b. induce regeneration of neurons in the basal ganglia. c. prevent progression of the disease. d. produce excitation of basal ganglia structures.

a. increase dopamine activity in the basal ganglia.

Which conditions are risk factors for the development of cerebral palsy? (Select all that apply.) a. Birth trauma b. Seizure disorder c. Kernicterus d. Prenatal maternal infection e. Scoliosis

A. Birth trauma C. Kernicterus D. Prenatal maternal infection

The stroke etiology with the highest morbidity and mortality is: a. intracranial hemorrhage. b. intracranial thrombosis. c. intracranial embolization. d. cardiac arrest.

a. intracranial hemorrhage

The initial treatment of an individual experiencing a seizure is concentrated on a. maintaining an airway. b. administering anticonvulsant medication. c. documenting the seizure pattern. d. obtaining an EEG.

a. maintaining an airway

Healing of a fractured bone with a poor alignment is called: a. malunion. b. nonunion. c. disunion d. delayed union

a. malunion

Which brain disorders are a cause of acute brain injury? (Select all that apply.) a. Seizure disorders b. Brain trauma c. Dementias d. Brain hemorrhage e. Central nervous system infections

B. Brain trauma D. Brain hemorrhage E. Central nervous system infections

Cerebral aneurysm is most frequently the result of: a. embolic stroke. b. subarachnoid hemorrhage. c. subdural hemorrhage. d. meningitis.

B. Subarachnoid hemorrhage

Most muscle strains are caused by A. a tear in an adjoining tendon. B. abnormal muscle contraction. C. muscle asymmetry. D. bleeding into the muscle.

B. abnormal muscle contraction.

The most important preventive measure for hemorrhagic stroke is: a. anticoagulation. b. blood pressure control. c. thrombolytics. d. management of dysrhythmias.

B. blood pressure control.

Which are common causes of acquired parkinsonism? (Select all that apply.) a. Degeneration of dopaminergic neurons b. History of infection c. History of intoxication d. History of trauma e. Seizure disorder

B. history of infection C. history of intoxication D. history of trauma

Bone healing may be impaired by A. excessive vitamin C. B. nicotine use. C. a high-protein diet. D. immobilization.

B. nicotine use.

A sudden onset of eye pain and impaired vision associated with pupil dilation is characteristic of: a. narrow-angle glaucoma. b. open-angle glaucoma. c. cataract. d. retinal detachment.

a. narrow angle glaucoma

It is recommended that women of childbearing age take folic acid daily for prevention of: a. neural tube defects. b. seizure disorders. c. cerebral palsy. d. hydrocephalus.

a. neural tube defects

The physiologic mechanisms involved in the pain phenomenon are termed: a. nociception. b. sensitization. c. neurotransmission. d. proprioception.

a. nociception

An example of inappropriate treatment for head trauma would be: a. head elevation. b. free water restriction. c. hypoventilation. d. bed rest.

C. Hypoventilation

A vestibular disorder that is manifested by the sensation of motion without actual motion is referred to as: a. equilibrium. b. nystagmus. c. vertigo. d. effusion.

C. Vertigo

The stage of spinal shock that follows spinal cord injury is characterized by: a. reflex urination and defecation. b. autonomic dysreflexia. c. absent spinal reflexes below the level of injury. d. motor spasticity and hyperreflexia below the level of injury.

C. absent spinal reflexes below the level of injury.

The most important determinant for prescribing therapy for acute stroke is: a. location of ischemia. b. thrombotic versus embolic cause. c. ischemic versus hemorrhagic cause. d. age of the patient.

C. ischemic versus hemorrhagic cause.

Pain with passive stretching of a muscle is indicative of: a. noncontractile tissue injury. b. contractile tissue injury. c. vascular insufficiency. d. skeletal muscle damage.

a. noncontractile tissue injury

Which disorder usually causes skeletal pain and involves significant bone demineralization from vitamin D deficiency? a. Osteomalacia b. Osteopenia c. Osteomyelitis d. Osteoporosis

a. osteomalacia

Hearing loss associated with aminoglycosides is known as: a. sensorineural. b. conductive. c. presbycusis. d. otosclerosis.

a. sensorineural

In the acute phase of stroke, treatment is focused on: a. stabilization of respiratory and cardiovascular function. b. risk factor modification. c. prevention of and contractures spasticity. d. neurologic rehabilitation.

a. stabilization of respiratory and cardiovascular function.

A condition of ocular misalignment that causes a cross-eyed appearance is referred to as: a. strabismus. b. amblyopia. c. cataract. d. retinopathy.

a. strabismus

The displacement of two bones in which the articular surfaces partially lose contact with each other is called: a. subluxation. b. subjugation. C. sublimation. d. dislocation.

a. subluxation

A unique characteristic feature of fibromyalgia is the presence of: a. tender point pain. b. head pain. c. contractures. d. muscle atrophy.

a. tender point pain

It is true that encephalitis is usually: a. because of a bacterial infection in the CNS. b. fatal. c. because of a viral infection in brain cells. d. asymptomatic.

c. because of a viral infection in brain cells.

A patient who experiences early symptoms of muscle twitching, cramping, and stiffness of the hands may be demonstrating signs of: a. Guillain-Barré syndrome. b. amyotrophic lateral sclerosis. c. Parkinson disease. d. hydrocephalus.

b. Amyotrophic lateral sclerosis

- is one of the most common complications of diabetes. a. Cataract b. Diabetic retinopathy c. Macular degeneration d. Glaucoma

b. Diabetic retinopathy

Ascending paralysis with no loss of sensation is characteristic of: a. multiple sclerosis. b. Guillain-Barré syndrome. c. myasthenia gravis. d. amyotrophic lateral sclerosis.

b. Guillain-Barré syndrome.

Which structures make up the middle ear? (Select all that apply.) a. Cerumen b. Malleus c. Incus d. Scala media e. Stapes

b. Malleus c. Incus e. Stapes

- is a form of spina bifida in which a saclike cyst filled with CSF protrudes through the spinal defect but does not involve the spinal cord. a. Spina bifida occulta b. Meningocele c. Myelomeningocele d. Meningomyelocele

b. Meningocele

Anticholinesterase inhibitors may be used to manage: a. muscular dystrophy. b. myasthenia gravis. c. fibromyalgia. d. rheumatoid arthritis.

b. Myasthenia gravis

A severe complication of elevated intracranial pressure is: a. Cushing reflex. b. brain herniation. c. burr hole. d. hydrocephalus.

b. brain herniation.

The gate control theory of pain transmission predicts that activity in touch receptors will: a. enhance perception of pain. b. decrease pain signal transmission in the spinal cord. c. activate opioid receptors in the CNS. d. increase secretion of substance P in the spinal cord.

b. decrease pain signal transmission in the spinal cord.

Steroids may be used in the management of acute exacerbation of symptoms in patients with multiple sclerosis because a. viral damage can be inhibited. b. demyelination is mediated by immune mechanisms. c. steroids reverse the progression of the disease. d. steroids inhibit synaptic degradation of neurotransmitters.

b. demyelination is mediated by immune mechanisms.

risk factor for osteoporosis is: a. endometriosis. b. early menopause. c. Late menopause d. Ovarien cysts

b. early menopause.

Modulation of pain signals is thought to be mediated by the release of: a. histamine. b. endorphins. c. cholecystokinin. d. glutamine.

b. endorphins.

In older women, osteoporosis is thought to be primarily because of: a. dietary inadequacies. b. estrogen deficiency. c. malabsorption syndrome. d. inactivity.

b. estrogen deficiency.

Secondary injury after head trauma refers to: a. brain injury resulting from the initial trauma. b. focal areas of bleeding. c. brain injury resulting from the body's response to tissue damage. d. injury as a result of medical therapy.

c. brain injury resulting from the body's response to tissue damage.

Myopia is as a result of an error of light refraction in which: a. light rays are scattered as they pass through the cornea. b. the focal point of an image is behind the retina. c. far vision is impaired. d. accommodation is impaired.

c. far vision is impaired.

Assessment of an extremity six hours after surgical alignment and casting demonstrates pulselessness and pallor. The priority action to take is to: a. increase the administration of his pain medication. b. initiate action to have the cast split or removed. c. note the increase in pain in the chart, and recheck the extremity in 30 minutes. d. elevate the extremity to relieve swelling.

b. initiate action to have the cast split or removed.

Opacification of the lens is commonly referred to as: a. hyperopia. b. glaucoma. c. presbyopia. d. cataract.

D. Cataract

Rupture of a cerebral aneurysm should be suspected if the patient reports: a. ringing in the ears. b. transient episodes of numbness. c. transient episodes of vertigo. d. sudden, severe headache.

D. sudden, severe headache

A college student living in a dormitory reports a stiff neck and headache and is found to have a fever of 102°F. This information is most consistent with: a. encephalitis. b. meningitis. c. skull fracture. d. cerebral ischemia.

b. meningitis

A patient presenting with a severe, pounding headache accompanied by nausea and photophobia is likely experiencing a - headache. a. tension b. migraine c. sinus d. chronic

b. migraine

Most sensory afferent pain fibers enter the spinal cord by way of the _ nerve roots a. anterior b. posterior c. C fiber d. anterolateral

b. posterior

The classic manifestations of Parkinson disease include: a. intention tremor and akinesia. b. rest tremor and skeletal muscle rigidity. c. ataxia and intention tremor. d. skeletal muscle rigidity and intention tremor.

b. rest tremor and skeletal muscle rigidity.

Manifestations of acute brain ischemia (Cushing reflex) are due primarily to a. parasympathetic nervous system activation. b. sympathetic nervous system activation. c. autoregulation of body systems. d. loss of brainstem reflexes.

b. sympathetic nervous system activation.

Complete healing of a bone fracture occurs when: a. no movement of the break is detectable. b. the callus has been completely replaced with mature bone. c. the fracture site and surrounding soft tissue are pain free. d. a cast is no longer required to stabilize the break.

b. the callus has been completely replaced with mature bone.

Ménière disease is characterized by: a. bilateral hearing impairment. b. vertigo in association with hearing loss. c. middle ear infection. d. ossification of bones in the middle ear.

b. vertigo in association with hearing loss.

Which treatment is helpful in neuropathic pain but not used for acute pain? a. Narcotic analgesics b. Nonsteroidal anti-inflammatory drugs and aspirin c. Anticonvulsants d. Nonnarcotic analgesics

c. Anticonvulsants

Which group of clinical findings indicates the poorest neurologic functioning? a. Spontaneous eye opening, movement to command, oriented to self only. b. Eyes open to light touch on shoulder, pupils briskly reactive to light bilaterally. c. Assumes decorticate posture with light touch, no verbal response. d. No eye opening, responds to painful stimulus by withdrawing.

c. Assumes decorticate posture with light touch, no verbal response.

A tool used to assess levels of consciousness is: a. magnetic resonance imaging (MRI). b. intracranial pressure (ICP) monitoring. c. Glasgow Coma Scale (GCS). d. central perfusion pressure (CPP).

c. Glasgow Coma Scale (GCS)

It is useful to conceptualize pain physiology according to the four stages because each stage provides an opportunity for: a. education. b. stimulation. c. intervention. d. documentation.

c. Intervention

Orthostatic hypotension may be a manifestation of: a. Alzheimer disease. b. multiple sclerosis. c. Parkinson disease. d. amyotrophic lateral sclerosis.

c. Parkinson disease

Myasthenia gravis is an autoimmune disease in which: a. neuronal demyelination disrupts nerve transmission. b. muscles become increasingly bulky but weakened. c. acetylcholine receptors are destroyed or dysfunctional. d. acetylcholine release from motor neurons is disrupted.

c. acetylcholine receptors are destroyed or dysfunctional.

Risk factors for hemorrhagic stroke include: a. atherosclerosis. b. dysrhythmias. c. acute hypertension. d. sedentary lifestyle.

c. acute hypertension.

The complication which is not likely to result from an open, transverse fracture of the tibia and fibula is: a. bone infection. b. fat emboli. c. air embolus. d. compartment syndrome.

c. air embolus

Which statement is true about the incidence of multiple sclerosis? a. The age of onset ranges from 20 to 40 years. b. MS is more common in men than women. c. There is a higher incidence of MS in military veterans. d. There is a higher rate of MS in African-Americans.

a. The age of onset ranges from 20 to 40 years.

The physiologic change most likely to lead to an increase in intracranial pressure is a. cerebral vasodilation. b. hypernatremia. c. respiratory hyperventilation. d. REM sleep.

a. cerebral vasodilation

Subarachnoid hemorrhage is usually managed with volume expansion and blood pressure support to enhance cerebral perfusion. This is necessary because subarachnoid hemorrhage predisposes to: a. cerebral vasospasm. b. hypotension. c. excessive volume loss. d. decreased intracranial pressure.

a. cerebral vasospasm.

A fracture in which bone breaks into two or more fragments is referred to as: a. Comminuted b. Open c. Greenstick d. Stress

a. comminuted

Rickets is characterized by soft, weak bones resulting from a deficiency of a. Calcium b. estrogen c. Phosphate d. Vitamin D

Vitamin D

A level of - on the Glasgow Coma Scale indicates likely fatal damage a. 3 b. 8 c. 12 d. 15

a. 3

Pain is thought of as: a. a subjective experience that is difficult to measure objectively. b. associated with changes in vital signs reflecting its intensity. c. experienced in the same way by all individuals. d. always the result of tissue damage that activates nociceptors.

a. A subjective experience that is difficult to measure objectively

What type of fracture generally occurs in children? a. Greenstick b. Stress c. Oblique d. Colles

a. Greenstick

- occurs when a brainstem impaired patient exhibits a persistent rhythmic or jerky movement in one or both eyes. a. Nystagmus b. Dysconjugate movement c. Ocular palsy d. Doll's eyes

a. Nystagmus

Intracranial pressure normally ranges from - mm Hg a. O to 15 b. 10 to 20 c. 15 to 25 d. 20 to 30

a. O to 15

The disease that is similar to osteomalacia and occurs in growing children is: a. rickets. b. osteosarcoma. c. Paget disease. d. osteopenia.

a. Rickets

What effect do demyelinating disorders such as multiple sclerosis have on neurotransmission? a. Slower rate of action potential conduction b. Increased rate of action potential conduction c. Facilitation of action potential initiation d. Faster rate of repolarization

a. Slower rate of action potential conduction

Before making a diagnosis of Alzheimer disease: a. a brain biopsy demonstrating organic changes is necessary. b. biochemical tests for aluminum toxicity must be positive. c. other potential causes of dementia must be ruled out. d. increased protein is found in a lumbar puncture.

c. other potential causes of dementia must be ruled out.

It is true that Bell palsy is a: a. permanent facial paralysis after stroke. b. severe neuropathic pain affecting the trigeminal nerve. c. paralysis of the muscles innervated by the facial nerve. d. herpetic outbreak in a facial dermatome.

c. paralysis of the muscles innervated by the facial nerve.

The first indication of brain compression from increasing intracranial pressure (ICP) may be: a. decorticate posturing. b. absence of verbalization. c. sluggish pupil response to light. d. Glasgow Coma Scale score of 13.

c. sluggish pupil response to light.

When dealing with an elderly patient with hearing loss, the nurse should: a. speak loudly so that the patient can hear better. b. stand to the side of the patient, speaking into the dominant ear. c. speak at a normal rate, rhythm, and volume. d. use long sentences and draw pictures.

c. speak at a normal rate, rhythm, and volume.

Slow pain sensation is transmitted primarily by: a. group la afferents. b. motor neurons. c. unmyelinated C fibers. d. A fibers

c. unmyelinated C fibers.

Referred pain may be perceived at some distance from the area of tissue injury, but generally felt: a. on the same side of the body. b. with slightly less intensity. c. within the same dermatome. d. within 10 to 15 cm area.

c. within the same dermatome.

What type of seizure usually occurs in children and is characterized by brief staring spells? a. Epileptic b. Idiopathic c. Partial d. Absence

d. Absence

Upper extremity weakness in association with degeneration of CNS neurons is characteristic: a. multiple sclerosis. b. Guillain-Barré syndrome. c. myasthenia gravis. d. amyotrophic lateral sclerosis.

d. Amyotrophic lateral sclerosis

Which neurologic disorder is commonly referred to as Lou Gehrig disease? a. Multiple sclerosis b. Parkinson disease c. Alzheimer disease d. Amyotrophic lateral sclerosis

d. Amyotrophic lateral sclerosis

- edema occurs when ischemic tissue swells because of cellular energy failure. a. Interstitial b. Osmotic c. Vasogenic d. Cytotoxic

d. Cytotoxic

The pathophysiology of ostomalacia involves: a. Increased osteoclasts activity b. collagen breakdown in the bone matrix. c. Crowding of cells in the osteoid d. Inadequate mineralization osteoid

d. Inadequate mineralization osteoid

Parkinson disease is associated with: a. demyelination of CNS neurons. b. a pyramidal nerve tract lesion. c. insufficient production of acetylcholine in the basal ganglia. d. a deficiency of dopamine in the substantia nigra.

d. a deficiency of dopamine in the substantia nigra.

People who have osteoporosis are at risk for: a. rhabdomyolysis. b. osteomyelitis. c. osteomalacia. d. bone fractures.

d. bone fractures.

A Type I open fracture is best described as a bone that is: a. broken in two or more pieces. b. cracked but not completely separated. c. broken along the long axis d. broken and protruding through the skin

d. broken and protruding through the skin

It is true that epidural bleeding is: a. associated with widespread vascular disruption. b. located between the arachnoid and the dura mater. c. usually because of venous leakage. d. characterized by a lucid interval immediately after injury.

d. characterized by a lucid interval immediately after injury.

Acceleration-deceleration movements of the head often result in polar injuries in which: a. injury is localized to the site of initial impact. b. widespread neuronal damage is incurred. c. bleeding from venules fills the subdural space. d. focal injuries occur in two places at opposite poles.

d. focal injuries occur in two places at opposite poles.

Seizures that involve both hemispheres at the outset are termed: a. partial. b. complex. c. focal. d. generalized.

d. generalized

It is true that a conductive hearing loss: a. cannot be corrected. b. is as a result of damage to hair cells in the inner ear. c. usually results from chronic exposure to loud noise. d. is because of dysfunction of outer and middle ear structures.

d. is because of dysfunction of outer and middle ear structures.

Clinical manifestations of a stroke within the right cerebral hemisphere include: a. cortical blindness. b. right visual field blindness. c. expressive and receptive aphasia. d. left-sided muscle weakness and neglect.

d. left-sided muscle weakness and neglect.

Nerve fibers of the - system have their cell bodies in the mucous membrane of the upper and posterior parts of the nasal cavity. a. visual b. auditory c. gustatory d. olfactory

d. olfactory

The primary reason that prolonged seizure activity predisposes to ischemic brain damage is that: a. neurons are unable to transport glucose. b. cardiovascular regulation is impaired. c. the brainstem is depressed. d. the lack of airway maintenance can lead to hypoxia.

d. the lack of airway maintenance can lead to hypoxia.

The - is the level of painful stimulation required to be perceived. a. perception b. tolerance c. expression d. threshold

d. threshold