Neuro

Thrombolytic therapy should be initiated within what time frame of an ischemic stroke to achieve the best functional outcome?

3 hours

Which value indicates a normal intracranial pressure?

5 mm Hg (0-10 mm Hg)

Which Glasgow Coma Scale score is indicative of a severe head injury?

7 (3-8)

Myasthenia gravis occurs when antibodies attach which receptor sites?

Acetylcholine

The nurse is caring for a client who was involved in a motorcycle accident 7 days ago. Since admission the client has been unresponsive to painful stimuli. The client has a ventriculostomy placed upon admission tot he ICU. The current assessment findings include ICP of 14 with good waveforms, pulse 92, respirations per ventilator, temperature 102.7 F (rectal), urine output 320 mL in 4 hours, pupils pinpoint and briskly reactive, and hot, dry skin. Which is the priority nursing action?

Administer acetaminophen per orders.

A patient is suspected to have bacterial meningitis. What is the priority nursing intervention?

Administer prescribed antibiotics.

Which term refers to the failure to recognize familiar objects perceived by the senses?

Agnosia

Which term refers to the inability to recognize objects through a particular sensory system?

Agnosia

Which are risk factors for spinal cord injury?

Alcohol use Drug abuse Young age

Which of the following is the priority nursing intervention for a patient in myasthenic crisis?

Assessing respiratory effort

Which interventions would be recommended for a client with dysphagia?

Assist the client with meals Allow ample time to eat Test the gag reflex before offering foods or fluids

Which term refers to the inability to coordinate muscle movements, resulting difficulty walking?

Ataxia

Which drug should be available to counteract the fact of Tensilon?

Atropine

Which phase of a migraine headache usually lasts less than an hour?

Aura

Which positions is used to help reduce intracranial pressure?

Avoiding flexion of the neck with a cervical collar

Which of the following is anticholinergic agent used to control tremor and rigidity in Parkinson's disease?

Benzotropine Mesylate

Which signs are manifestations of the Cushing triad?

Bradycardia Hypertension Bradypnea

A nurse is caring for a patient diagnosed with Guillain-Barre syndrome. The patient states, "It's getting harder to take a deep breath." Which of the following actions by the nurse is most appropriate?

Call the physician and prepare for intubation.

Which is the earliest sign of increasing intracranial pressure?

Change in level of consciousness

Which insult or abnormality can cause an ischemic stroke?

Cocaine use

Which of the following manifestations is inconsistent with the diagnosis of Guillain-Barr syndrome?

Cognitive decline

A Glasgow Coma Scale score of 7 or less is generally interpreted as

Coma

Which structural and motor change is related to aging and may be assessed in geriatric lints during an exam of neurological function?

Decreased or absent DTRs

An osmotic diuretic such as mannitol is given to the client with increased intracranial pressure to

Dehydrate the brain and reduce the cerebral edema

The nurse is caring for a client with a history of TIAs and moderate carotid stenosis who has undergone a carotid endarterectomy. Which postop finding would cause the nurse the most concern?

Difficulty swallowing

The statements presented here match nursing interventions with nursing diagnoses. Which statements are appropriate for a client who has suffered a head injury?

Disturbed sleep pattern: Provide back rubs to the client Interrupted family process: encourage the family to join a support group Ineffective airway clearance: apply suction as indicated

A client diagnosed with a stroke is having difficulty forming words during communication. This would be appropriately documented as

Dysarthria

The nurse is caring for a client diagnosed with subarachnoid hemorrhage resulting from a leaking aneurysm. The client is awaiting surgery. Which nursing interventions would be appropriate for the nurse to implement?

Elevate the HOB 30 degrees Administer decussate per order Provide a dimly lit environment

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.

Which statement reflects nursing management of the client with expressive aphasia?

Encourage the client to repeat sounds of the alphabet.

Which activity should be avoided in clients with increased intracranial pressure?

Enemas

The nurse is preparing the patient for an acetylcholinesterase inhibitor test to rule out myasthenia gravis. Which of the following is the priority nursing action?

Ensure atropine is readily available

What safety actions does the nurse need to take for a client receiving oxygen therapy who is undergoing MRI?

Ensure that no client care equipment containing metal enters the room where the MRI is located.

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

Establishing eye contact

The patient with a brain tumor may be at increased risk for aspiration. The most important nursing intervention includes which of the following?

Evaluation of gag reflex and ability to swallow

Which of the following is the most common clinical manifestation of multiple sclerosis?

Fatigue

A client has been diagnosed as having global aphasia. The nurse recognizes that the client will be unable to perform which action?

Form words that are understandable or comprehend spoken words

Which cerebral lobe is the largest and controls abstract thought?

Frontal

Which is a nonmodifiable risk factor for ischemic stroke?

Gender

A client with a neurological disorder has difficulty swallowing. The nurse should take care with the client's diet because of a potential risk of imbalanced nutrition. Which measure may be taken by the nurse to ensure that the client's diet allows for easy swallowing?

Help the client sit upright when eating and feed slowly

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

Hemiplegia

Which term refers to the shifting of brain tissue from an area of high pressure to an area of low pressure?

Herniation

The nurse is assigned to care for clients with SCI on a rehabilitation unit. Which signs does the nurse recognize as clinical manifestations of autonomic dysreflexia?

Hypertension Nasal Congestion Diaphoresis

The nurse is caring for a client following a spinal cord injury who has a halo device in place. The client is preparing for discharge. Which statement by the client indicates the need for further instruction?

I can apply powder under the liner to help with sweating

The nurse has been educating a patient newly diagnosed with MS. Which of the following statements by the patient indicates an understanding of the education?

I will stretch daily as directed by the physical therapist.

A client arrives at the ED via ambulance following a motorcycle accident. The paramedics state the client was found unconscious at the scene but briefly regained consciousness during transport to the hospital. Upon initial assessment, the client's GCS score is 7. The nurse anticipates which action?

Immediate craniotomy

The statements presented here match nursing interventions with nursing diagnoses. Which statements are true for a client with a stroke?

Impaired swallowing: provide a pureed diet Impaired verbal communication: repeat words and instructions Disturbed sensory perception: stand on the client's unaffected side

A patient is receiving mitoxantrone for treatment of secondary progressive multiple sclerosis. The patient should be closely monitored for

Leukopenia and cardiac toxicity

Which of the following medications in the most effective agent in the treatment of parkinson's disease?

Levodopa

A client with a concussion is discharged after the assessment. Which instruction should the nurse give the client's family?

Look for signs of increased intracranial pressure.

A client with increased intracranial pressure has a CPP of 40 mm Hg. This CPP reading is considered

Low (70-100 mm Hg)

Health promotion efforts to decrease the risk for ischemic stroke involve encouraging a healthy lifestyle including

Low-fat, low-cholesterol diet and increased exercise.

The diagnosis of multiple sclerosis is based upon which of the following tests?

MRI

The nurse is caring for a client diagnosed with a hemorrhagic stroke. The nurse recognizes that which intervention is most important?

Maintaining a patent airway

Which are contraindications for the administration of t-PA?

Major abdominal surgery within 10 days Intracranial hemorrhage

Which term describes the fibrous connective tissues that cover the brain and spinal cord?

Meninges

Which is the most common cause of spinal cord injury?

Motor vehicle crashes

Which of the following is a chronic, degenerative, progressive disease of the CNS characterized by the occurrence of small patches of demyelination in the brain and spinal cord?

Multiple sclerosis

Which clinical manifestation would be exhibited by a client following a hemorrhagic stroke of the right hemisphere?

Neglect of the left side

Which is the initial diagnostic test for a stroke?

Noncontrast computed tomography

Which cranial nerve is responsible for muscles that move the eye and lids?

Oculomotor

Which lobe of the brain is responsible for spatial relationships?

Parietal

The nurse teaches the patient with which disorder his or her disease is due to decreased levels of dopamine int he basal ganglia of the brain?

Parkingson's Disease

Which of the following diseases is associated with decreased levels of dopamine due to destruction of pigmented neuronal cells in the substantial migration in the basal ganglia of the brain?

Parkingson's disease

Corticosteroids are used in the management of brain tumors to

Reduce cerebral edema

A client with CVA is prescribed medication to treat the disorder. The client wants to know what other measures may help reduce CVA. Which is an accurate suggestion for the client?

Reduce hypertension and high blood cholesterol

A client experiences a seizure while hospitalized for appendicitis. During the postictal phase, the client is yelling and swings a closed fist at the nurse. Which is the appropriate action by the nurse?

Reorient the client while gently holding their arms.

A client with neurological infection develops cerebral edema from SIADH. Which is an important nursing action for this client?

Restricting fluid intake and hydration.

A client is receiving hypothermic treatment for uncontrolled fever related to increased intracranial pressure. Which assessment finding requires immediate intervention?

Shivering

A client is treated for increased intracranial pressure. It is important for the client to avoid hypothermia because

Shivering in hypothermia can increase ICP

Which is a modifiable risk factor for transient ischemic attacks and ischemic strokes?

Smoking

Which of the following are the most commonly reported clinical manifestations of multiple sclerosis?

Spasticity Depression Fatigue Numbness Pain

Which is indicative of a right hemisphere stroke?

Spatial-perceptual deficits

Which statement reflects the nursing management of a client with receptive aphasia?

Speak slowly and clearly to assist the client in forming the sounds.

The nurse is caring for a client immediately following a spinal cord injury. Which is an acute complication of SCI?

Spinal shock

Which condition occurs when blood collects between the dura mater and arachnoid membrane?

Subdural hematoma

Which cerebral lobe contains the auditory receptive areas?

Temporal

The parents of a patient intubated due to the progression of Guillain-Barre syndrome ask if their child will die. What is the best response by the nurse?

There are no guarantees, but a large portion of people with Guillain-Barre syndrome survive.

A client with meningitis has a history of seizures. Which activity should the nurse do while the client is actively seizing?

Turn the client tot he side during a seizure and do not restrain movements.

Which method is used to help reduce intracranial pressure?

Using a cervical collar

A client has been diagnosed with a concussion and is to be released from the ED. The nurse teaches the family or friends who will be caring for the client to contact the physician or return to the ED if the client demonstrates which complaints?

Vomiting Slurred speech Weakness on one side of the body

The nurse is assessing the client's mental status. Which question will the nurse include in the assessment?

Who is the president of the US?

Which finding indicates increasing intracranial pressure in the client who has sustained a head injury?

Widened pulse pressure

The nurse is caring for a male client who has emerged from a coma following a head injury. The client is agitated. Which intervention will the nurse implement to prevent injury to the client?

Apply an external urinary sheath catheter

Which is the priority nursing diagnosis when caring for a client with increased ICP who has an intraventricular catheter?

Ineffective cerebral tissue perfusion

A patient has been brought to the ED with altered LOC, high fever, and a purpura rash on the lower extremities. The family states the patient was complaining of neck stiffness earlier in the day. What action should the nurse do first?

Initiate isolation precautions.

Which is a contraindication for the administration of tissue plasminogen activator (t-PA)?

Intracranial hemorrhage

The nurse in the neurologic ICU is caring for a client who sustained a sever brain injury. Which nursing measures will the nurse implement to help control intracranial pressure?

Maintain cerebral perfusion pressure from 50 to 70 mm Hg

Which stimulus is known to trigger an episode of autonomic dysreflexia in the client who has suffered a spinal cord injury?

Placing a blanket over the client

The nurse is caring for a client with dysphagia. Which intervention would be contraindicated while caring for this client?

Placing food on the affected side of the mouth

Which well-recognized sign of meningitis is exhibited when the patient's neck is flexed and flexion of the knees and hips is produced?

Positive Brudzinski sign

The nurse is caring for a client with traumatic brain injury. Which clinical finding observed during the reassessment of the client, causes the nurse the most concern?

Temperatur increases from 98.0 F to 99.6 F

Which is a late sign of increased intracranial pressure?

Altered respiratory patterns

The nurse reviews the physician's emergency department progress notes for the client who sustained a head injury and sees that the physician observed the Battle sign. The nurse knows that the physician observed which clinical manifestation?

An area of bruising over the mastoid bone

Which term refers to the inability to perform previously learned purposeful motor acts on a voluntary basis?

Apraxia

If warfarin is contraindicated as a treatment for stroke, which medication is the best option?

Aspirin

An unresponsive patient is brought to the ED by a family member. The family states, "We don't know what happened." Which of the following is the priority nursing intervention?

Assess for a patent airway.

A client is ordered to undergo CT of the brain with IV contrast. Before the test, the nurse should complete which action first?

Assess the client for medication allergies.

Which medication classification is used preoperatively to decrease the risk of postoperative seizures?

Anticonvulsants

Which of the following nursing interventions is appropriate for a patient with double vision in the right eye due to MS?

Apply an eye patch to the right eye

Which interventions are appropriate for a client with increased intracranial pressure?

Administering prescribed antipyretics Frequent oral care Maintaining aseptic technique with an intraventricular catheter.

Which of the following medication classifications should be avoided in the treatment of brain tumors?

Anticoagulants