patho chapter 16
The emergency room doctor suspects a client may have bacterial meningitis. The most important diagnostic test to perform would be: Sputum culture Lumbar puncture CT of the head Blood cultures
Lumbar puncture
The nurse would consider which factors when providing education regarding modifiable risk factors for stroke? Select all that apply. Monitoring diabetes mellitus Controlling blood pressure The early syptoms of an impending stroke Selecting low fat foods Avoiding excessive alcohol use
Monitoring diabetes mellitus Controlling blood pressure Selecting low fat foods Avoiding excessive alcohol use
Which symptoms would support the diagnosis of a stroke involving the posterior cerebral artery? Select all that apply. Denial of paralyzed side Contralateral hemiplegia Repeating of verbal responses Loss of central vision Aphasia
Repeating of verbal responses Loss of central vision
The emergency department nurse is caring for a client who fell and has a head injury. Which assessment would be noted during the early stage of increased intracranial pressure? Vomiting Nonreactive pupils Hemiplegia Stable vital signs
Stable vital signs
A client who is diagnosed with seizures describes feeling a strange sensation before losing consciousness. The family members report that the client has been smacking his lips prior to having a seizure. Which type of seizure disorder presents with these symptoms? Complex partial or focal seizure with impairment of consciousness Atonic seizure Generalized seizures Simple partial seizure or prodrome
Complex partial or focal seizure with impairment of consciousness
The CT scan report identified that a client with a skull fracture has developed a hematoma that resulted from a torn artery. The report would be interpreted as: Subdural hematoma Intracranial hematoma Epidural hematoma Chronic subdural hematoma
Epidural hematoma
A client's recent computed tomography (CT) scan has revealed the presence of hydrocephalus. Which treatment measure is most likely to resolve this health problem? Placement of a shunt Aggressive diuresis Lumbar puncture Administration of hypertonic intravenous solution
Placement of a shunt
A client has started having uncontrolled seizures that are not responding to usual medications. Nurses working with the client must pay special attention to which priority aspects of this client's care? Assessment of: Ability to grasp hands and squeeze on command Respiratory status and oxygen saturation Urine output and continence ECG for arrhythmias
Respiratory status and oxygen saturation
A client who is being seen in the outpatient clinic reports a single episode of unilateral arm and leg weakness and blurred vision that lasted approximately 45 minutes. The client is most likely experiencing: Lacunar infarct Cardiogenic embolic stroke Thrombotic stroke Transient ischemic attack (TIA)
Transient ischemic attack (TIA)
A nurse in the emergency room is assessing a client who appears very drowsy but is able to follow simple commands and respond to painful stimuli appropriately. Which documentation is most accurate regarding this client's level of consciousness? Lethargy Stupor Confusion Obtundation
Obtundation
A child has developed a benign brain tumor in the cerebellum and the floor of the third ventricle. The proper documentation for this type of tumor includes which terminology? Ependymomas Fibrillary astrocytomas Pilocytic astrocytomas Oligodendrogliomas
Pilocytic astrocytomas
Which medication would be recommended for myoclonic seizures? Carbamazepine Lamotrigine Valproic acid Gabapentin
Valproic acid
The family of a male client documented to be in a vegetative state excitedly reports to the nurse that the client has just opened his eyes for the first time. The best response by the nurse is: "Clients in a vegetative state often open and close their eyes." "I will come and assess the client." "That is a miracle." "That is a just a reflexive action."
"I will come and assess the client."
According to the Glasgow Coma Scale, opening one's eyes to only painful stimuli would receive which score? 3 1 4 2
2
Which individual has the highest chance of having a primary central nervous system lymphoma? A 24-year-old man with acquired immunodeficiency syndrome (AIDS) and behavioral and cognitive changes A 68-year-old man who is a smoker and has a family history of cancer A 60-year-old woman who is soon to begin radiation therapy for the treatment of breast cancer An 88-year-old man who has begun displaying signs and symptoms of increased ICP
A 24-year-old man with acquired immunodeficiency syndrome (AIDS) and behavioral and cognitive changes
The health care provider is concerned that a client may be at risk for problems with cerebral blood flow. The most important data to assess would be: Decreased level of carbon dioxide Decreased hydrogen ions Decreased level of oxygen Decreased level of PCO2
Decreased level of oxygen
Generalized convulsive status epilepticus is a medical emergency caused by a tonic-clonic seizure that does not spontaneously end, or recurs in succession without recovery. What is the first-line drug of choice to treat status epilepticus? Intravenous lorazepam Intramuscular diazepam Intramuscular cyproheptadine Intravenous cyclobenzaprine
Intravenous lorazepam
The nurse is explaining to a client's family how vasogenic brain edema occurs. The most appropriate information for the nurse to provide would be: There is an increase in the production of cerebrospinal fluid volume. There is a decrease in the amount of fluid volume in the brain. The blood-brain barrier is disrupted, allowing fluid to escape into the extracellular fluid. Normal physiologic circumstances result in decreased adsorption of CSF.
The blood-brain barrier is disrupted, allowing fluid to escape into the extracellular fluid.
A client is brought to the emergency department and is diagnosed with an ischemic stroke confirmed by CT scan. The most important treatment for this client would be to: monitor vital signs closely for improvement. administer analgesics for the relief of pain. prepare the client for emergency surgery. administer IV tissue plasminogen activator (tPA).
administer IV tissue plasminogen activator (tPA).