Test 1 Questions

A health care provider needs help in identifying the precise location of a brain tumor. To measure brain activity, as well as to determine structure, the nurse expects the health care provider to order which of the following tests?

PET

Which of the following is the first-line therapy for myasthenia gravis (MG)?

Pyridostigmine bromide (Mestinon)

The nurse is assisting with administering a Tensilon test to a patient with ptosis. If the test is positive for myasthenia gravis, what outcome does the nurse know will occur?

Thirty seconds after administration, the facial weakness and ptosis will be relieved for approximately 5 minutes.

The brain stem holds the medulla oblongata. What is the function of the medulla oblongata

Transmits motor impulses from the brain to the spinal cord

The nurse is caring for a client who is experiencing increased intracranial pressure (ICP), resulting from a pituitary adenoma. The nurse should anticipate which intervention will likely be prescribed to help decrease this client's ICP?

Transphenoidal surgery

A nurse is performing a neurologic assessment on the client and notes a positive Romberg test. This test for balance is related to which of the following cranial nerves?

VIII (acoustic....hearing and equilibrium)

The nurse is performing a neurologic assessment on a client diagnosed with a stroke and cannot elicit a gag reflex. This deficit is related to which of the following cranial nerves?

X (vagus)

Which of the following neurotransmitters are deficient in myasthenia gravis?

acetylcholine

The nurse is caring for an 82-year-old client diagnosed with cranial arteritis. What is the priority nursing intervention?

administer corticosteroids

Which type of brain injury has occurred if the client can be aroused with effort but soon slips back into unconsciousness?

contusion

Which insult or abnormality can cause an ischemic stroke

drug use, cocaine use

Following a motorcycle accident, a client is brought to the emergency department with multiple fractures. Which assessment finding would be most significant in determining the client has also suffered a closed head injury with rising intracranial pressure?

lethargy

A client with a traumatic brain injury is showing early signs of increasing intracranial pressure (ICP). While planning care for this client, what would be the priority expected outcome?

maintain a patent airway

A client is weak and drowsy after a lumbar puncture. The nurse caring for the client knows that what priority nursing intervention should be provided after a lumbar puncture?

position patient flat for 3 hours

A nurse is teaching a client who was recently diagnosed with myasthenia gravis. Which statement should the nurse include in her teaching?

"This disease doesn't cause sensory impairment."

A client has a lower motor neuron lesion, the nurse would expect the client to exhibit...

-*decreased muscle tone* -flaccid paralysis -atrophy of affected muscle

Which are contraindications for the administration of tissue plasminogen activator (t-PA)? Select all that apply.

Intracranial hemorrhage Major abdominal surgery within 10 days

A nurse is caring for a client with lower back pain who is scheduled for myelography using metrizamide (a water-soluble contrast dye). After the test, the nurse should place the client in which position?

HOB elevated 45 degrees

To help assess a client's cerebral function, a nurse should ask:

have you noticed a change in your memory?

A patient is in the acute phase of an ischemic stroke. How long does the nurse know that this phase may last?

1-3 days

Cerebral edema peaks at which time point after intracranial surgery?

24 hours

A client with fungal encephalitis receiving IV amphotericin B reports fever, chills, and body aches. What action by the nurse is appropriate?

Administer diphenhydramine and acetaminophen per orders.

The nurse is caring for a patient with MS who is having spasticity in the lower extremities that decreases physical mobility. What interventions can the nurse provide to assist with relieving the spasms? Select all that apply.

Demonstrate daily muscle stretching exercises. Allow the patient adequate time to perform exercises Apply warm compresses to the affected areas.

Which of the following cranial nerves is responsible for salivation, tearing, taste, and sensation in the ear?

Facial

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

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

The nurse is caring for a client following an aneurysm coiling procedure. The nurse documents that the client is experiencing Korsakoff syndrome. Which set of symptoms characterizes Korsakoff syndrome?

Psychosis, disorientation, delirium, insomnia, and hallucinations

A patient having an acute stroke with no other significant medical disorders has a blood glucose level of 420 mg/dL. What significance does the hyperglycemia have for this patient?

This is significant for poor neurologic outcomes.

The nurse is assessing the pupils of a patient who has had a head injury. What does the nurse recognize as a parasympathetic effect?

constricted pupils

A patient has a severe neurologic impairment from a head trauma. What does the nurse recognize is the type of posturing that occurs with the most severe neurologic impairment?

flaccid

During assessment of a patient who has been taking dilantin for seizure management for 3 years, the nurse notices one of the side effects that should be reported. What is that side effect?

gingival hyperplasia

Excessive levels of which neurotransmitter has been implicated in amyotrophic lateral sclerosis (ALS)?

glutamate

A client has a 12-year history of migraine headaches and is frustrated over how these headaches impact lifestyle. The nurse discusses the potential triggers of the client's migraines. Which is not a potential trigger to migraines?

seasonal changes

A client with a malignant brain tumor comes to the clinic for a follow up. During the visit, the client asks the nurse, "Why am I so tired all the time?" When responding to the client, which information would the nurse include as possible causes? Select all that apply.

tumor, treatment being used, stress

A client is scheduled for a transsphenoidal hypophysectomy to remove a pituitary tumor. Preoperatively, the nurse should assess for potential complications by:

performing capillary glucose testing every 4 hours.

Neurological level of spinal cord injury refers to which of the following?

The lowest level at which sensory and motor function is normal

The nurse is performing the physical examination of a client with a suspected neurologic disorder. In addition to assessing other parts of the body, the nurse should assess for neck rigidity. Which method should help the nurse assess for neck rigidity correctly?

moving the head and chin toward the chest

The nurse is caring for a client with a spinal cord injury. What test reveals the level of spinal cord injury?

neuro exam

The intensive care unit has four clients received from a violent motor vehicle accident. When assessing the clients, which client would the nurse assess first?

pt with basilar fracture

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

-Pain radiating down posterior thigh

The nurse is caring for a client in the clinic who has come in to have an EMG done. How would the nurse prepare the client for this test?

-tell client to expect some discomfort (needle electrodes inserted into muscle)

A client with a traumatic brain injury has developed increased intracranial pressure resulting in diabetes insipidus. The expected treatment would consist of which of the following?

-vasopressin (also give fluids, replace lytes)

A patient is diagnosed with amyotrophic lateral sclerosis, also known as ALS or Lou Gehrig's disease. The nurse understands that the symptoms of the disease will begin in what way?

Weakness starting in the muscles supplied by the cranial nerves

Corticosteroids are used in the treatment of brain tumors for which of the following clinical manifestations? Select all that apply.

Cerebral edema Headache Altered level of consciousness

Which of the following are disease-modifying agents used in the treatment of multiple sclerosis (MS)? Select all that apply.

Interferon beta-1a (Rebif) Interferon beta-1b (Betaseron) Interferon beta-1a (Avonex) Glatiramer acetate (Copaxone)

Which of the following are clinical manifestations associated with increased intracranial pressure (ICP)? Select all that apply.

Seizures Nausea with or without vomiting Papilledema Headache

The nurse is caring for a client who is to have a lumbar puncture. What are the lowest vertebrae that contain the spinal cord?

second lumbar vertebrae

A frontal lobe brain abscess produces which manifestation?

seizures

A nurse is assessing a client with Parkinson's disease. Which of the following would the nurse expect to find?

slowing of activity

The nurse is providing discharge instructions for a client who was admitted to the oncology unit due to dehydration and anorexia after chemotherapy treatment. What information should the nurse provide to the client to promote improve the client's nutritional intake at home?

take pain meds before meal

A client has a 12-year history of cluster headaches. After the client describes the characteristics of the head pain, the nurse begins to discuss its potential causes. What would the nurse indicate that the origin of the headaches is:

unknown

A client is diagnosed with a brain angioma. When providing care to this client, the nurse would be especially vigilant in monitoring for signs and symptoms of which of the following?

hemorrhagic stroke

A client is admitted for scheduled gamma-knife radiosurgery, in the treatment of a brain tumor. Which nursing measure is primary in the postsurgical care of this client?

assess neuro findings

The nurse is planning care of a client admitted to the neurologic rehabilitation unit following a cerebrovascular accident. Which nursing intervention would be of highest priority?

include client in plan of care nd goal setting

A nurse assesses a patient who has been diagnosed with having a pituitary adenoma that is pressing on the third ventricle. The nurse looks for the associated sign/symptom. What is that sign/symptom?

increased ICP

A nurse is caring for a client with a diagnosis of trigeminal neuralgia. Which activity is altered as a result of this diagnosis?

chewing

A rapid, jerky, involuntary, and purposeless movement of the extremities or facial muscles is

chorea

While making your initial rounds after coming on shift, you find a client thrashing about in bed complaining of a severe headache. The client tells you the pain is behind his right eye which is red and tearing. What type of headache would you suspect this client of having?

cluster

The critical care nurse is caring for a client with bacterial meningitis. The client has developed cerebral vasculitis and increased ICP. What neurologic sequelae might this client develop?

damage to the optic nerve

Decerebrate posturing as a response to pain indicates...

dysfunction to brainstem

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

encourage the client to repeat sounds of the alphabet

A client with a spinal cord injury says he has difficulty recognizing the symptoms of urinary tract infection (UTI). Which symptom is an early sign of UTI in a client with a spinal cord injury?

fever and change in urine clarity

A client with tetraplegia has a spinal cord injury (SCI) at C4. He experiences severe orthostatic hypotension with any elevation of his head. Which of the following interventions will the nurse employ to reduce the hypotension?

Apply anti-embolytic stockings prior to elevation of the head.

Which anticholinergic agent is used to control tremor and rigidity in Parkinson disease?

Benztropine Mesylate

The nurse educator is providing information to a group of nurses regarding different types of brain tumors. The nurse is correct in explaining that total surgical resection of a glioblastoma multiforme (GBM) is not possible for which reason?

The presence of finger-like tentacles produced by the tumor.

A patient comes to the emergency department with severe pain in the face that was stimulated by brushing the teeth. What cranial nerve does the nurse understand can cause this type of pain?

V (Trigeminal...facial sensation, corneal reflex, mastication)

In planning care for a patient with an extrapyramidal disorder, the nurse recognizes that a major difference between Parkinson's disease and Huntington's disease is the development of ________ in clients with advanced Huntington's disease.

hallucinations and delusions