ati question neuro
A nurse is reinforcing teaching with a client about computed tomography (CT) scanning of the brain. Which of the following pieces of information should the nurse include?
"You'll have to lie very still on a long, narrow table during the test."
A nurse is reinforcing teaching with a client who is going to have an electroencephalogram (EEG) in the morning. Which of the following information should the nurse provide the client?
"Shampoo your hair before the procedure and don't use any styling products afterward."
A nurse is assisting with preparing a client for an electroencephalogram (EEG). When the client asks the nurse what this test does, which of the following responses should the nurse make?
"An EEG records the electrical activity of your brain cells."
A nurse is collecting data from a client who has encephalitis due to West Nile virus. Which of the following findings should the nurse expect? (Select all that apply.)
- stiff neck - photophobia - lethargy
A family of a spinal cord-injured client rushes to the nursing station, saying that the client needs immediate help. On entering the room, the nurse notes that the client is diaphoretic, with a flushed face and neck, and complains of a severe headache. The pulse is 40 beats per minute, and the blood pressure is 230/100 mm Hg. The nurse acts quickly, knowing that the client is experiencing which condition?
Autonomic dysreflexia
A nurse is reinforcing discharge teaching with a client who had a transient ischemic attack (TIA). The nurse should instruct the client to monitor which of the following parameters at home?
Blood pressure
A nurse in an urgent care clinic is collecting data from a client who sustained a fall. Which of the following findings should the nurse identify as an indication of a skull fracture?
Clear fluid coming from the nares
A nurse is collecting data from an older adult client for physiological changes that can occur with aging. Which of the following findings should the nurse expect?
Decreased sense of taste
A nurse in a rehabilitation center is collecting data from a client who is recovering from a left-hemisphere stroke. Which of the following findings should the nurse expect?
Difficulty with speech
Carbidopa-levodopa is prescribed for a client with Parkinson's disease, and the nurse monitors the client for adverse effects of the medication. Which sign/symptom indicates the client is experiencing an adverse effect?
Impaired voluntary movements
A client with Parkinson's disease is experiencing a Parkinsonian crisis. The nurse would immediately place the client where?
In a quiet, dim room with respiratory and cardiac support available
A nurse is assisting with the plan of care for a client following a stroke. Which of the following interventions should the nurse identify as the priority in the plan of care?
Monitor the client for increased intracranial pressure (ICP)
The nurse is planning care for a client in spinal shock. Which action would be least helpful in minimizing the effects of vasodilation below the level of the injury?
Moving the client quickly as one unit
Phenytoin, 100 mg orally three times daily, has been prescribed for a client for seizure control. The nurse reinforces instructions regarding the medication to the client. Which statement by the client indicates an understanding of the instructions?
"I will use a soft toothbrush to brush my teeth."
A nurse is assisting with preparing a client for an electroencephalogram (EEG). Which of the following directions should the nurse provide to the client?
"You'll begin by lying still with your eyes closed."
A nurse is reinforcing teaching about auras with a client who has a new diagnosis of simple partial seizures. Which of the following statements by the client indicates an understanding of the teaching?
"An aura is a sensory warning that a seizure is imminent."
A nurse is reinforcing teaching with a client who has a new diagnosis of migraine headaches about interventions to reduce pain at the onset of a migraine. Which of the following instructions should the nurse include in the teaching?
"Darken the lights."
A nurse is reinforcing teaching with a group of clients about transient ischemic attacks (TIAs). Which of the following information should the nurse include in the teaching
A TIA can precede an ischemic stroke
A nurse in an urgent care center is collecting data from a group of clients who all have an odor of alcohol on their breath and multiple injuries to the head and extremities. Which of the following clients should the nurse report first to the charge nurse?
A client who is difficult to arouse and is unable to respond to questions
A nurse is caring for a client who has moderate Alzheimer's disease. Which of the following actions should the nurse take?
Add gestures when speaking with the client
A nurse asks a client to stand with her feet together and her eyes open. After a few seconds, the nurse asks the client to close her eyes. If the client begins to fall, the nurse should interpret this finding as a positive Romberg test, indicating which of the following alterations?
Cerebellar dysfunction
The nursing instructor asks a nursing student about the points to document if the client has had a seizure. The instructor determines that the student needs to research seizures and related documentation points if the student states which assessment is important?
Client's diet in the 2 hours preceding seizure activity
A nurse is caring for a client who experienced a traumatic brain injury. Which of the following findings is an indication the client is experiencing increased intracranial pressure?
Dilated pupils
A nurse is collecting data from a client who has a head injury with a possible skull fracture. Which of the following findings should the nurse identify as an indication that the client might have a complication involving the eighth cranial nerve (CN VIII)?
Dizziness and hearing loss
A nurse is collecting data from a client who has a brain tumor. Which of the following findings indicates cranial nerve involvement?
Dysphagia
A nurse is reinforcing teaching about degenerative complications with the partner of a client who has a new diagnosis of Parkinson's disease. Which of the following manifestations is the priority?
Dysphagia
A nurse is assisting with the care of a client during the first 72 hours following a cerebrovascular accident (CVA). Which of the following actions should the nurse take?
Elevate the head of the bed by 25° to 30° with the client in a neutral midline position
A nurse is reviewing the laboratory results of a lumbar puncture (LP) for a client who has manifestations of bacterial meningitis. Which of the following findings is consistent with this diagnosis?
Elevated protein
A nurse is caring for a client who had a cerebrovascular accident (CVA). The client appears alert and engaged during the visit but does not respond verbally to questions. The nurse should document this finding as which of the following alterations?
Expressive aphasia
A nurse is caring for a client who had a stroke and has expressive aphasia. The nurse should identify that the stroke affected which of the following lobes of the client's brain?
Frontal
A nurse is preparing to test the function of cranial nerve X for a client. Which of the following assessment procedures should the nurse use?
Have the client open his mouth and say, "aah"
A nurse is assisting with the care of a client who has a cerebral lesion and develops hyperthermia. The nurse should identify that which of the following areas of the brain is affected?
Hypothalamus
A nurse is collecting data from a client who has increased intracranial pressure and has received intravenous mannitol. The nurse should identify that which of the following findings indicates a therapeutic effect of this medication?
Increased urine output
The nurse is caring for a client with increased intracranial pressure (ICP). Which change in vital signs would occur if ICP is rising?
Increasing temperature, decreasing pulse, decreasing respirations, increasing BP
The family of an unconscious client with increased intracranial pressure is talking at the client's bedside. They are discussing the gravity of the client's condition and wondering if the client will ever recover. How would the nurse interpret the client's situation?
It is possible the client can hear the family.
A nurse is collecting data from a client who is admitted to the facility for observation following a closed head injury. Which of the following data is the priority for the nurse to collect to detect a change in the client's neurological status?
Level of consciousness
A nurse is reinforcing teaching with the family of a client who has stage II Alzheimer's disease (AD). Which of the following pieces of information should the nurse include in the teaching?
Limit choices offered to the client
A nurse is caring for a client who is experiencing autonomic dysreflexia due to a C5 spinal cord injury. After checking the client's vital signs, which of the following actions should the nurse take next?
Place the client in a high-Fowler's position
A nurse is reinforcing discharge teaching with the family of a client who has a new diagnosis of a seizure disorder. The nurse should instruct the client's family to take which of the following actions first if a seizure occurs?
Protect the client's head
A nurse is caring for a client who has an impairment of cranial nerve II. The nurse should do which of the following to ensure the client's safety?
Provide an obstacle-free path for ambulation
During a neurological evaluation, a nurse asks how the client arrived at the appointment and with whom. Which of the following types of memory is the nurse testing?
Recall
A nurse is caring for a client who has dementia and is experiencing anxiety. Which of the following actions should the nurse take?
Redirect the client to a different activity with a small group of people
A nurse is reinforcing discharge teaching with a client who had a transient ischemic attack (TIA). Which of the following instructions should the nurse include?
Reduce dietary sodium
During a neurological evaluation, a nurse asks a client to name all of his children and state their ages and their birth dates. Which of the following types of memory is the nurse testing?
Remote
A nurse is collecting data from a client who has a high-thoracic spinal cord injury. The nurse should identify which of the following findings as a manifestation of autonomic dysreflexia?
Report of a headache
A nurse is assisting with the care of a client who has a brainstem injury. Which of the following physiological functions should the nurse monitor?
Respiratory effort
A home health nurse is interviewing the adult child of a client who has Alzheimer's disease. The child is the client's sole caregiver and reports feeling fatigued and overwhelmed. Which of the following referrals should the nurse make for the caregiver?
Respite care
A nurse is caring for a client who has a left intracranial hemorrhage from a stroke. Which of the following findings should the nurse expect?
Right-sided hemiplegia
A nurse is caring for a client who has a closed traumatic brain injury and is experiencing increased intracranial pressure (ICP). The nurse should identify that this elevated ICP is due to which of the following?
Rigid skull containing cranial contents
A nurse is caring for a client who has a closed head injury. The nurse should place the client in which of the following positions?
Semi-Fowler's
A nurse is collecting data from a client with recent head trauma who has a urine output of 600 mL/hr. The nurse suspects the client has manifestations of diabetes insipidus (DI). Which of the following laboratory values should the nurse plan to obtain to monitor for DI?
Specific gravity
A nurse is caring for a client who has receptive aphasia. Which of the following communication problems should the nurse expect to find when collecting data from this client?
The client is unable to understand words or sentences he hears.
A nurse is caring for a client who has a traumatic brain injury and assumes a decerebrate posture in response to noxious stimuli. Which of the following reactions should the nurse anticipate when drawing a blood sample?
The client rigidly extends his arms.
A nurse is collecting data from a client who is recovering from a recent stroke. Which of the following data is the nurse's priority to collect?
The client's ability to clear oral secretions
A nurse is collecting data from a client who has a closed head injury and is receiving mannitol for manifestations of increased intracranial pressure (ICP). Which of the following findings indicates the medication is having a therapeutic effect?
The client's urine output is 250 mL/hr.
A nurse is reinforcing teaching with a client who has a history of tonic-clonic seizures and is scheduled for a standard electroencephalogram (EEG). Which of the following instructions should the nurse include in the teaching?
Thoroughly shampoo the hair prior to the EEG
A nurse is caring for a client who begins to have a generalized tonic-clonic seizure while lying in bed. Which of the following actions should the nurse take?
Turn the client onto the side
A nurse is caring for a client who is experiencing a seizure while in bed. Which of the following actions should the nurse take?
Turn the client's head to the side
A nurse is collecting data from a client following a recent head injury. Which of the following findings should the nurse recognize as a manifestation of increased intracranial pressure?
Widened pulse pressure
The nurse is planning care for a client with hemiparesis of the right arm and leg. Where would the nurse plan to place objects needed by the client?
Within the client's reach, on the left side
A nurse responds to a call from an assistive personnel that a client has had a seizure and is unconscious. Which of the following data should the nurse collect first?
check airway patency
A nurse is collecting data from a client who recently experienced a head injury. Which of the following findings should the nurse identify as an indication of short-term memory impairment?
nability to locate eyeglasses
