CH 70
A client comes to the clinic for evaluation because of complaints of dizziness and difficulty walking. Further assessment reveals a staggering gait, marked muscle incoordination, and nystagmus. A brain tumor is suspected. Based on the client's assessment findings, the nurse would suspect that the tumor is located in which area of the brain?
Cerebellum
The nurse is caring for a client who has been hospitalized for investigation of a sudden change in gait due to loss of balance and coordination. A magnetic resonance imaging scan reveals the client has a brain tumor. On or close to which brain structure is the tumor most likely situated?
Cerebellum
The nurse is caring for a client who underwent surgery to remove a spinal cord tumor. When conducting the postoperative assessment, the nurse notes the presence of a bulge at the surgical site. The nurse suspects the client is experiencing what complication from the surgery?
Cerebrospinal fluid leakage
Which of the following outcomes would be most appropriate to include in the plan of care for a client diagnosed with a muscular dystrophy?
Client participates in activities of daily living using adaptive devices.
A 37-year-old mother of three has just been diagnosed with a grade I meningioma. As part of patient education, the nurse tells the patient that:
Growth is slow and symptoms are caused by compression rather than tissue invasion.
A client is admitted reporting low back pain. How will the nurse best determine if the pain is related to a herniated lumbar disc?
Have the client lie on the back and lift the leg, keeping it straight.
A client with spinal cord compression from a tumor must undergo diagnostic testing. Which of the following is the most likely procedure for this client?
Magnetic resonance imaging
Which diagnostic is most commonly used for spinal cord compression?
Magnetic resonance imaging (MRI)
The nurse explains to the client with projectile vomiting and severe headache that a medication is being prescribed to reduced edema surrounding the brain and lessen these symptoms. What medication is the nurse preparing to administer?
Mannitol
A client diagnosed with Huntington's disease has developed severe depression. What would be most important for the nurse to assess for?
Suicidal ideations
A client is scheduled for a laminectomy to repair a herniated intervertebral disk. When developing the postoperative care plan, the nurse should include which action?
Turning the client from side to side, using the logroll technique
What nursing intervention will best help the client with Huntington disease to increase nutrition? Select all that apply.
Use Relaxation techniques Take phenothiazine prior to meals
A client with post-polio syndrome displays fatigue and decreased muscle strength. How should the nurse best respond to the client?
"Intravenous immunoglobulin infusion may help you."
Which disease includes loss of motor neurons in the anterior horns of the spinal cord and motor nuclei of the lower brain stem?
Amyotrophic lateral sclerosis
Bone density testing in clients with post-polio syndrome has demonstrated
low bone mass and osteoporosis.
A client with cerebral metastasis suddenly experiences a seizure for which phenytoin 10 mg/kg intravenously is ordered as an initial loading dose. The client weighs 165 pounds. How many milligrams of phenytoin should the client receive? Enter the number ONLY.
750
The nurse is caring for a client hospitalized after a motor vehicle accident. The client has a comorbidity of Parkinson's disease. Why should the nurse closely monitor the condition and the drug regimen of a client with Parkinson's disease?
Drugs administered may cause a wide variety of adverse effects.
The nurse is caring for a client with mid-to-late stage of an inoperable brain tumor. What teaching is important for the nurse to do with this client?
Explaining hospice care and services
The nurse is caring for a patient with Huntington's disease in the long-term care facility. What does the nurse recognize as the most prominent symptom of the disease that the patient exhibits?
Rapid, jerky, involuntary movements
A client with a malignant glioma is scheduled for surgery. The client demonstrates a need for additional teaching about the surgery when he states which of the following?
"The surgeon will be able to remove all of the tumor."
A client with cerebral metastasis suddenly experiences a seizure for which phenytoin 10 mg/kg intravenously is ordered as an initial loading dose. The client weighs 132 pounds. How many milligrams of phenytoin should the client receive? Enter the number ONLY.
600
Impaired balance and uncontrolled tremors of Parkinson's disease is correlated with which neurotransmitter?
Dopamine
A patient has recently been diagnosed with an acoustic neuroma. The nurse helps the patient understand that:
Hearing loss usually occurs.
A patient is diagnosed with an aggressive, primary malignant brain tumor. The nurse is aware that the glioma:
Originated within the brain tissue.
Which of the following is a late symptom of spinal cord compression?
Paralysis
The nursing is assessing a client who has been diagnosed with a pituitary adenoma, but has not yet started treatment. The client reports having increased heart rate, hand tremors, difficulty sleeping, weight loss and hyperthermia. The nurse anticipates the client will require blood work to assess for overproduction of which hormone?
Thyroid-stimulating hormone
A client with a brain tumor is exhibiting papilledema. When reviewing the client's history, which information would the nurse correlate with this finding? Select all that apply.
Visual field deficit Double vision
A nurse is working on a surgical floor. The nurse must logroll a client following a:
laminectomy.
The nurse is providing end-of-life care to a client who was diagnosed with glioblastoma multiforme (GBM) 8 months ago. Despite a calm interaction with the client 1 hour ago, the client is now angry and yells, "Get out of my room and don't touch me anymore. I don't need your help!" How should the nurse respond?
"I can tell now is not the right time for me to come in and check on you. Please let me know when it is a better time for me to come back."
The nurse educator is teaching nursing students about various types of brain tumors. The instructor recognizes that teaching has been effective when students correctly identify a client whose lab work indicates excessively high levels of thyroid stimulating hormone would most likely be diagnosed with which type of tumor?
Pituitary adenoma
A client is admitted to the hospital with pneumonia. He has a history of Parkinson disease, which his family says is worsening. Which assessment should the nurse expect?
Impaired speech
A male client who has undergone a cervical discectomy is being discharged with a cervical collar. Which of the following would be most appropriate to include the client's discharge plan?
Keeping the head in a neutral position
A patient with a brain tumor is complaining of headaches that are worse in the morning. What does the nurse know could be the reason for the morning headaches?
Increased intracranial pressure
After undergoing surgery for removal of a spinal cord tumor, the client is placed in the side-lying position. The nurse places a pillow between the client's knees to prevent:
knee flexion.
The nurse is caring for a client who was diagnosed with a glioma 5 months ago. Today, the client was brought to the emergency department by his caregiver because he collapsed at home. The nurse suspects late signs of rising intracranial pressure (ICP) when which blood pressure and pulse readings are noted?
BP = 175/45 mm Hg; HR = 42 bpm
A client has just returned from surgery after undergoing a lumbar laminectomy. Which of the following would be most important to do when positioning the client in bed?
Using a logrolling motion to change positions
The nurse is providing health education to a client recently diagnosed with a brain tumor. During the appointment, the client states, "I'm really worried that I will have a seizure while I am at work or with my kids. Should I be concerned about this?" How should the nurse respond?
"There is a risk for seizures in people who have this diagnosis. What have you already discussed with your primary health care provider regarding management of seizures?"
A client who has just been diagnosed with mixed muscular dystrophy asks the nurse about the usual course of this disease. How should the nurse respond?
"You may experience progressive deterioration in all voluntary muscles."
The nurse is providing postoperative care for a client who just underwent surgery to remove a metastatic intramedullary tumor. On postoperative day 3, the client states, "I am really looking forward to going running again, it had become too difficult because of the loss of feeling in my feet." Which should the nurse address in the client's care plan?
Knowledge deficit
A patient is diagnosed with a spinal cord tumor and has had a course of radiation and chemotherapy. Two months after the completion of the radiation, the patient complains of severe pain in the back. What is pain an indicator of in a patient with a spinal cord tumor?
Spinal metastasis
