Neuro Review Q's - Alicia Review 11/6

3

A 13-month-old child is undergoing lumbar puncture for confirmation of a diagnosis of bacterial meningitis. During the procedure the nurse notes that the spinal fluid is cloudy. Which would this finding indicate? 1. Healthy spinal fluid 2. Increased glucose level 3. Increased white blood cell (WBC) count 4. Rising number of red blood cells (RBCs)

3

A client develops bacterial meningitis. Which action is the priority nursing care? 1. Monitoring for signs of intracranial pressure 2. Adding pads to the side of the bed 3. Administering prescribed antibiotics 4. Administering glucocorticoids

13 Eye opening - spontaneous 4 - speech 3 - pain 2 - none 1 Verbal - oriented 5 - confused 4 - inappropriate 3 - incomprehensible 2 - none 1 Motor - obeying 6 - localizing 5 - withdrawal 4 - flexing 3 - extending 2 - none 1

A client is admitted to the hospital after an accident. The nurse uses the Glasgow Coma Scale (GCS) with the client. The client is alert and opens his or her eyes when there is a sound or when someone talks. When questions are asked, the client answers in a confused manner. The client obeys commands, such as being asked to move a leg. Which would be the client's total score?

3

A client is diagnosed with Parkinson disease and receives a prescription for levodopa therapy. Which mechanism of action would the nurse identify for this medication? 1. Blocks the effects of acetylcholine 2. Increases the production of dopamine 3. Restores the dopamine levels in the brain 4. Promotes the production of acetylcholine

2

A client with myasthenia gravis has been receiving neostigmine and asks about its action. Which information would the nurse consider when formulating a response? 1. Stimulates the cerebral cortex 2. Blocks the action of cholinesterase 3. Replaces deficient neurotransmitters 4. Accelerates transmission along neural sheaths

4

Pyridostigmine is prescribed for a client with myasthenia gravis. Why would the nurse instruct the client to take pyridostigmine about 1 hour before meals? 1. This timing limits first pass metabolism. 2. Taking it on an empty stomach increases absorption. 3. Taking it before meals decreases gastric irritation. 4. Taking it before meals improves the ability to chew.

2

The nurse assesses a client with a spinal cord injury at level T5. The client's blood pressure is 184/95 mm Hg, and the client presents with a flushed face and distended neck veins. Which action will the nurse take first? 1.Initiate oxygen via nasal cannula 2.Place the client in a sitting position 3.Palpate the abdomen 4.Administer sublingual nitroglycerin

2

The nurse in the emergency department is caring for a 9-year-old child with a suspected spinal cord injury sustained while falling off a bicycle. Which is the initial nursing action? 1. Placing the child's head on a pillow for support 2. Immobilizing the child's spine to limit additional injury 3. Logrolling the child to check for lacerations on the back 4. Moving the child onto a firm stretcher for transport to the radiography department

1

The nurse is providing discharge teaching to a client with a spinal cord injury, Which client statement indicates a correct understanding of how to prevent respiratory problems at home? 1. "I'll deep breath and cough hourly while I'm awake." 2. "I'll drink thinned fluids to prevent choking." 3. "I'll take cough medicine to prevent excessive coughing." 4. "I'll position myself on my right side so I don't aspirate."

4

The nurse is teaching the partner of a client diagnosed with Parkinson's disease. Which statement by the partner demonstrates understanding of the changes associated with this disease? 1. "His mask-like face makes it difficult to communicate, so I will use a white board." 2. "He should not socialize outside of the house due to uncontrollable drooling." 3. "This disease is associated with anxiety causing increased perspiration." 4. "He may have trouble chewing, so I will offer bite-sized portions."

1,3,4

The nurse performed a neurological assessment on a client, which included the Glasgow Coma Scale (GCS). Which components does the GCS assessment tool include? Select all that apply. One, some, or all responses may be correct. 1. Best verbal response 2. Best pupillary response 3. Best motor response 4. Best eye-opening response 5. Best cognitive response

4

The primary reason the nurse encourages a client with a spinal cord injury to increase oral fluid intake is to prevent which problem? 1. Dehydration 2. Skin breakdown 3. Electrolyte imbalances 4. Urinary tract infections

1

When assisting a client with Parkinson disease to ambulate, which instruction would the nurse provide the client? 1. Avoid leaning forward. 2. Hesitate between steps. 3. Rest when tremors are experienced. 4. Keep arms close to the center of gravity.

1 Eye opening - spontaneous 4 - speech 3 - pain 2 - none 1 Verbal - oriented 5 - confused 4 - inappropriate 3 - incomprehensible 2 - none 1 Motor - obeying 6 - localizing 5 - withdrawal 4 - flexing 3 - extending 2 - none 1

Which Glasgow Coma Scale score would the nurse give a client who does not open the eyes to any stimulus, only makes incomprehensible sounds and moans, and extends the arm at the elbow with adduction and internal rotation of the arm at the shoulder? 1. 5 2. 6 3. 7 4. 8

1

Which assessment is priority after checking airway for a client with a cervical spinal cord injury? 1. Level of consciousness 2. Sensory perception in all extremities 3.Presence and location of diaphoresis 4.Pain Assessment

2

Which instruction will the nurse give a client with migraine headaches who is starting triptan medication therapy? 1. "Check your pulse before and after administration." 2. "Report any chest discomfort to the health care provider." 3. "Wait for 1 hour after symptom onset to administer the medication." 4. "Stop taking the medication if you experience warm, flushing sensations."

2

Which intervention would the nurse perform first for a client with a spinal cord injury who is experiencing autonomic dysreflexia? 1. Assess for the cause. 2. Place the client in sitting position. 3. Check the client for fecal impaction. 4. Give an alpha blocker prophylactically.

4

Which priority intervention would the nurse perform immediately for a client with a spinal cord injury? 1. Monitor the urinary output. 2. Assess for other injuries. 3. Infuse lactated Ringer solution. 4. Immobilize and stabilize the cervical spine.