NCLEX STYLE STUDY QUESTIONS - NEURO EXAM

To calculate the MAP:

(2 x Diastolic BP + Systolic BP) / 3

Phenytoin Therapeutic Range

10-20 mcg/mL

What is the MAP for a DBP of 72 and a SBP of 120

184

Which nursing diagnosis takes highest priority for a client with Parkinson's crisis? 1. Imbalanced nutrition: Less than body requirements 2. Ineffective airway clearance 3. Impaired urinary elimination 4. risk for injury

2. Ineffective airway clearance

Cerebral edema peaks at which time point after intracranial surgery?

24 hours

Ideally, t-PA should be started within _______ minutes of arriving at the ED

45

Normal CCP range

70-100

Normal CCP range is

70-100

SIADH symptoms include

Abrupt fever, headache, dizziness, nausea, and malaise

A client with a T4 level spinal cord injury (SCI) is complaining of a severe headache. The nurse notes profuse diaphoresis of the client's forehead and scalp. Which of the following does the nurse suspect?

Autonomic dysreflexia

The client has been brought to the emergency department by their caregiver. The caregiver says that she found the client diaphoretic, nauseated, flushed and complaining of a pounding headache when she came on shift. What are these symptoms indicative of?

Autonomic dysreflexia

After administration of nimodipine, monitoring of which vital sign is necessary?

Blood pressure

Before a patient undergoes a diagnostic test requiring a contrast agent, the nurse must check which lab values and why?

Blood urea nitrogen and creatinine to ensure kidneys will be able to excrete the contrast agent.

How does HR, BP, and RR change with cushings triad?

Bradycardia, HTN (widening pulse pressure), bradypnea

Post-lumbar puncture headaches are caused by

CSF leakage at the puncture site

Before doing a lumbar puncture, which test must be done?

CT Scan

Parkinson's medications include

Carbidopa and Levodopa

A lumbar puncture is performed on a child suspected of having bacterial meningitis. CSF is obtained for analysis. A nurse reviews the results of the CSF analysis and determines which of the following results would verify the diagnosis?

Cloudy CSF, elevated protein, and decreased glucose

Do not give sumatriptan to patients with

Coronary Artery Disease (CAD)

Diagnosis of encephalitis includes which tests?

EEG and CSF Examination

Three hours after injuring the spinal cord at the C6 level, a client receives high doses of methylprednisolone sodium succinate (Solu-Medrol) to suppress breakdown of the neurologic tissue membrane at the injury site. To help prevent adverse effects of this drug, the nurse expects the physician to order:

Famotidine (pepsid)

The most common cause of encephalitis is

HSV

Acyclovir (Antiviral Agent) is the medication of choice for

HSV related encephalitis

A patient is having a lumbar puncture and the physician has removed 20 mL of cerebrospinal fluid. What nursing intervention is a priority after the procedure?

Have the patient lie flat for 6 hours

Which is the most common motor dysfunction seen in clients diagnosed with stroke?

Hemiplegia

Nimodipine can cause ____tension

Hypotension

Mannitol is given to reduce

ICP

Apraxia

Inability to perform previously learned tasks

The nurse is caring for the client with increased intracranial pressure. The nurse would expect temperature, pulse, respirations, and blood pressure to change in which ways if ICP is rising?

Increased temperature, decreased pulse, decreased respirations, increased blood pressure

A nurse practitioner provides health teaching to a patient who has difficulty managing hypertension. This patient is at an increased risk of which type of stroke?

Intracerebral Hemorrhage

A client with a brain tumor experiences projectile vomiting. The nurse integrates understanding of this occurrence as resulting from

Irritation of the medullary vagal centers

After undergoing surgery for removal of a spinal cord tumor, the client is placed in the side-lying position. The nurse places a pillow between the client's knees to prevent:

Knee flexion

A patient was admitted to a rehabilitation unit for treatment of a spinal cord injury. The admitting diagnosis is central cord syndrome. During an admissions physical, the nurse expects to find:

Loss of motor power and sensation in the upper extremities

What type of diet should a patient have when taking levadopa?

Low protein

To calculate CCP (Cerebral Perfusion Pressure):

MAP - ICP

Sumatriptan is given to treat __________ and __________ headaches

Migraines; cluster

What nursing intervention is important when treating HSV related encephalitis and why?

Monitoring blood chemistry and urinary output to identify renal complications related to antiviral therapy

Cholinergic are given to patients with

Myasthenia Gravis

Manifestations of meningitis include:

Nuchal Rigidity, Positive Kernig's sign, Positive Brudzinski's sign, photophobia, and rash

Which of the following is a hallmark of spinal metastases?

Pain

A client seeks care for lower back pain of 2 weeks' duration. Which assessment finding suggests a herniated intervertebral disk?

Pain radiating down the posterior thigh

A client is undergoing rehabilitation following a stroke that left him with severe motor and sensory deficits. The client has been unable to ambulate since his accident, but has recently achieved the goals of sitting and standing balance. What is the client now able to use?

Parallel Bars

A nurse is planning care for a child with acute bacterial meningitis. Based on the mode of transmission of this infection, which precautions should be expected?

Respiratory isolation for at least 24 hours after the initiation of antibiotics

A patient with amyotrophic lateral sclerosis (ALS) asks if the nurse has heard of a drug that will prolong the patient's life. The nurse knows that there is a medication that may prolong the life by 3 to 6 months. To which medication is the patient referring?

Riluzole

When caring for a client with a head injury, a nurse must stay alert for signs and symptoms of increased intracranial pressure (ICP). Which cardiovascular findings are late indicators of increased ICP?

Rising BP and Bradycardia

The parietal lobe regulates ________ function.

Sensory

The nurse is aware that, when assessing a patient for symptoms of a brain tumor, the symptom most frequently found is:

Simple to generalized seizures

3 (potential) stages of a Spinal Cord Injury

Spinal Cord Injury (SCI), Spinal Shock, Autonomic Dysreflexia

Autonomic dysreflexia occurs with lesions above

T6

Problems with memory and learning would relate to which lobe of the brain?

Temporal

Concussion

Temporary loss of neurologic function with no apparent structural damage to the brain

homonymous hemianopsia

The loss of the right or left half of the field of vision in both eyes.

Which nutritional deficiency may delay wound healing?

Vitamin C

The earliest sign of an Increased ICP is

altered level of consciousness

Because of Phenytoin's narrow therapeutic range, drugs should be taken

at the same time daily

Hemianopsia

blindness in half the visual field

The only way to confirm CJD and vCJD is a

brain biopsy

Contusions

bruises

A patient with a GSC of 8 or lower is considered

comatose

Status Elipticus

continuous seizure activity

Pituitary Adenomas, along with other functioning tumors, can lead to

cushing disease

Levetiracetam is considered an CNS _______

depressant

The bottom number in a blood pressure reading is considered

diastolic

Dysarthria

difficulty forming words

t-PA works by

dissolving the blood clot that is blocking blood flow to the brain

Monro-Kellie hypothesis

due to limited space for expansion within the skull, an increase in any one of the cranial contents (brain tissue, blood, or cerebrospinal fluid) causes a decrease in the volume of the others

The Sympathetic Nervous System ("fight or flight") regulates the expenditure of

energy

cholinergic medications are used for

fluid retention

The broca area can be found in the ________ lobe

frontal

To assess a client's cranial nerve function, a nurse should assess

gag reflex

Two major side effect of Mannitol include

heart failure and pulmonary edema

It is important to administer O2 and maintain a high partial pressure of arterial oxygen (PaO2) as

hypoxemia can create or worsen a neurological deficit of the spinal cord

Expressive aphasia

inability to express oneself through speech or written words

Agnosia

inability to recognize objects

Receptive aphasia

inability to understand spoken or written words

Carbidopa helps prevent the breakdown of

levodopa

Phenytoin is given for ________ term protection against seizures

long

In Parkinson's Disease, you will notice _____ dopamine and _______ acetylcholine

low; high

To help assess a client's cerebral function, a nurse should ask if the patient has noticed a change in

memory

Verapamil and Metoprolol can be used to help treat

migraines

The most common arthropod-borne virus vector in the United States is the

mosquito

An EMG is useful in determining the presence of

neuromuscular disorders and myopathies

Focal seizures originate in

one hemisphere

Hemiplegia

one-sided paralysis

Hemiparesis

one-sided weakness

If increased ICP goes untreated, it may end up damaging the

optic nerve

A PET scan produces images of

organs functioning

Predisposing factors leading to development of a brain abscess includes

otitis media and rhinosinusitis

SCI at C4 or above can result in

paralysis of the diaphragm

A CCP of <50 results in

permanent neurologic damage

Gingival Hyperplasia is an expected side effect of

phenytoin

Levetiracetam is given to ____________________ for those who are high risk

prevent and treat seizures

SCI of T12 and above can effect

respiratory function

An EEG is useful for dx and evaluation of

seizure disorders, coma, or organic brain syndrome

Topamax can be used to treat ___________ and ____________

seizures; migraines

The broca's area is responsible for

speech

Migraines have ________ familiar tendencies

strong

Nimodipine is a calcium channel blocker used to manage

subarachnoid hemorrhages

Nursing management for CJD and vCJD is centered around

supportive and palliative care

The top number in a blood pressure reading is considered

systolic

True or False: Red, brown urine, sweat, and saliva is normal when taking Parkinson's medications

true

The occipital lobe is responsible for

visual interpretation and memory

Patients with hemorrhagic strokes often complain of the

worst headache of my life