Unit 8

Which structural change can contribute to mixed sensorimotor deficit?

Polyneuropathies involving demyelination of peripheral nerves

Guillain-Barre syndrome is characterized by which form of neuron damage?

Polyneuropathy

Multiple sclerosis is characterized by what type of neuron damage?

Polyneuropathy

Which treatment should take place immediately in ac lient experiencing autonomic dysreflexia?

Position the client in upright position, and correct the initiating stimulus.

Duchenne muscular dystrophy usually does not produce any signs or symptoms until age 2 or 3. What muscles are usually first to be affected in Duchenne muscular dystrophy?

Postural muscles of the hip and shoulder.

Select the laboratory blood test that would be used to suggest a diagnosis of muscular dystrophy (MD)

Creatine Kinase

An emergency room nurse receives a report that a client's Glasgow Coma Scale (GCS) is 3. The nurse prepares to care for a client with which of the following?

Flaccid motor response

Global and focal brain injuries manifest differently. What is almost always a manifestation of a global brain injury?

Altered level of consciousness.

Based on assessment parameters for motor response on the Glasgow Coma Scale, to which client should the nurse assign a score of 5?

Localizes pain

Guillain Barre syndrome is characterized by which form of neuron damage?

polyneuropathy

The nurse observes a new nurse performing the test for Kernig sign on a client. The new nurse performs the test by providing resistance to flexion of the knees while the client is lying with the hip flexed at a right angle. The nurse should explain to the new nurse that:

resistance should be provided with the knee in a flexed position.

The nurse is working in the ER. One client's presenting symptoms include the worst HA ever, nuchal rigidity, and nausea. Another client's presenting symptoms include fever, stiff back, and positive Kernig sign. Which client should the nurse assess first?

Client with the worse HA, nuchal rigidity, and nausea

A client with an acute spinal cord injury developing spinal shock. The nurse should perform which priority assessment?

Loss of tendon reflexes below the injury.

According to the Glasgow Coma Scale, opening one's eyes to only painful stimuli would receive which score?

2

Which statement accurately reflects the typical person afflicted with multiple sclerosis (MS)

A 25- year old woman

Which principle best explains symptoms of amyotrophic lateral sclerosis (ALS), including dysphagia, muscle weakness and spasticity, and dysphonia

ALS is caused by both upper and lower motor neuron disturbances.

A client has just been diagnosed with Multiple sclerosis. The nurse recognizes that the client's condition is a result of:

An immune mediated response that is caused by the demyelination of the myelin sheath of the white matter of the brain, spinal cord, and optic nerve

There are two main categories of glial tumors. One of the categories is?

Astrocytic

An older adult is brought to the emergency department after experiencing some confusion, slurred speech, and a weak arm. Now the client is back to acting normally. Suspecting a transient ischemic attack *TIA), the health care provider prescribes diagnostic testing looking for which cause of this episode?

Atherosclerotic lesions in cerebral vessels

A client who has been living with alzheimer disease and spouse are at the doctor's office and the spouse asks the nurse why the client cannot remember much of anything from the past. The best response by the nurse is that Alzheimer disease affects which part of the brain?

Cells located in the hippocampus

A older adult has had a recent decrease in coordination, with gait being described as wide- based, unsteady, and lacking in fluidity, although the client's muscle tone appear normal. This client requires further assessment for which condition that is involved with coordination of movement?

Cerebellar disorder

When the suspected diagnosis is bacterial meningitis, what assessment techniques can assist in determining if meningeal irritation is present?

Brudzinski sign and Kernig sign

Neurotoxins such as botulism organism can produce paralysis by what mechanism?

By blocking release of acetylcholine

The nurse expects that loss of respiratory effort occurs with a spinal injury at which level?

C1-3

The nurse working in an emergency room is caring for a client who is exhibiting signs and symptoms of a stroke. What does the nurse anticipate that the physician's orders will include?

CT scan

A client's emergency room report includes the presence of a contrecoup injury. The nurse plans care for a client with which of the following?

Closed head injury opposite the area of impact.

The nurse is caring for a 31 years old trauma victim admitted to the neurologic intensive care unit. While doing the initial assessment, the nurse finds that the client is flexing the arms, wrists, and fingers. There is adduction of the upper extremities with internal rotation and plantar flexion of the lower extremities. How would the nurse describe this in the notes?

Decorticate posturing.

Excessive activity of the excitatory neurotransmitters and their receptor- mediated effects is the cause of which type of brain injury?

Excitotoxic

The nurse is planning an inservice on hypoxia versus ischemia in brain-injured clients. The nurse should include which of the following?

Hypoxia produces a generalized depressive effect on the brain.

Which current multiple sclerosis drug treatments are designed to slow the progress of myelin degeneration?

Immunomodulators

A family brings a client to the emergency department with increasing lethargy and disorientation. They think the client had a seizure on the drive over to the hospital. The client has been sick with a "cold Virus" for the last few days. On admission, the client's temperature is 102*F. Which other clinical manifestations may lead to the diagnosis of encephalitis?

Impaired neck flexion resulting from muscle spasm.

Following a head injury, a client is diagnosed with intracranial epidural hematoma. During the initial assessment, the client suddenly becomes unconscious. What additional clinical manifestation correlate with this diagnosis?

Ipsilateral pupil dialation

Restoration of the integrity of myelin sheaths would likely result in a slowing or stopping of the progression of:

Multiple Sclerosis (MS)

The nurse is caring for an older adult client with hemiplegia following a stroke. While planning the client's care, the nurse knows the client is at risk for developing which condition?

Muscle atrophy

Which of the following diseases is associated with fewer acetylcholine receptors, resulting in a lower- amplitude endplate potential, muscle weakness and fatigability?

Myasthenia gravis

Which disease is though to be caused by antibody mediated loss of acetylcholine receptors int he neuromuscular junction?

Myasthenia gravis.

A client with a diagnosis of Myasthenia gravis underwent a mastectomy. The surgery was a success, but the client has gone into a myasthenic crisis on postop day 1. Which priority measure should the care team initiate immediately?

Respiratory support and protection of the clients airway.

The nurse is assessing a client and notes the client is now displaying decerebrate posturing. The position would be documented as:

Rigidity of the arms with palms of the hands turned away from the body and with stiffly extended legs and planter flexion of the feet.

A family brings their father to his prare physician for a checkup. Since their last visit, they note their dad has developed a tremor in his hands and feet. He also rolls his fingers like he has a marble in his hand. The primary physician suspects the onset of parkinson disease when he notes which abnormality in the client's gait?

Slow to start walking and has difficulty when asked to stop suddenly.

A nurse at a long- term care facility provides care for a client who has had recent transient ischemic attacks (TIAs). What significance should the nurse attach to the clients TIAs?

TIAs, by definition, resolve rapidly, but they constitute an increased risk for stroke.

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:

The blood- brain barrier is disrupted, allowing fluid to escape into the extracellular fluid.

A client discharged from the hospital 5 days ago following a stroke has come to the emergency department with facial droop that progressed with hemiplegia and aphasia. The client's spouse is extremely upset because the physician stated that the client cannot receive thrombolytic medications to reestablish cerebral circulation and the spouse asks the nurse why. What is the nurse's most accurate response?

Thrombolytics may cause cerebral hemorrhage

A client discharged from the hospital 5 days ago following a stroke has come to the emergency department with facial droop that progressed with hemiplegia and aphasia. The client's spouse is extremely upset because the physician stated the client cannot receive thrombolytic medications to reestablish cerebral circulation and the spouse asks the nurse why. What is the nurse's most accurate response?

Thrombolytics may cause cerebral hemorrhage

The health care provider is assessing a client for carpal tunnel syndrome. The health care provider performs light percussion over the median nerve at the wrist. The assessment is known as:

Tinel Sign

A client is devastated to receive a diagnosis of amyotrophic lateral sclerosis (ALS). The symptomatology of this disease is a result of its effects on which region of the brain?

Upper and lower motor neurons.

Autonomic dysreflexia (autonomic hyperreflexia) is characterized by which of the following?

Vasospasms and hypertension

The most common cause of C. Botulinum in infants is:

ingestion of honey products containing c. botulinum spores.