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
