EXAM 4 FINAL
The regulation of cerebral blood flow is accomplished through both autoregulation and local regulation. This allows for the brain to meet its metabolic needs. What is the low parameter for arterial blood pressure before cerebral blood flow becomes severely compromised?
60 mm Hg
A patient exhibiting problems with their thyroid has been scheduled for a radioactive scan. From the following list of patients, which would the nurse question as to whether this would be a safe procedure for this patient?
A young female patient who has been trying to get pregnant.
A psychiatrist is providing care for a 68-year-old female whose anxiety disorder is significantly decreased her quality-of-life. The nurse knows that the client will likely benefit from which of the following pharmacological therapies listed below?
A drug that influences gamma aminobutrytic acid or GABA levels
A psychiatrist is providing care for a 68 year-old female whose anxiety disorder is significally decreasing her quality of life. The nurse knows that the client will likely benefit from which of the following pharmacologic therapies listed below?
A drug that influences gamma-aminobutyric acid (GABA) levels
Which of the following individuals would most likely experience global ischemia to his or her brain?
A man who has suffered a severe myocardial infarction
During a flu shot clinic, one of the questions the student nurse asks relates to whether the patient has had Guillain-Barre? syndrome in their medical history. The patient asks, "What is that?" How should the nursing student reply?
"A type of paralysis that affects movement on both sides of the body that may even involve the respiratory muscles"
The nurse is working with a client with schizophrenia who has cognitive deficits. It is time for the client to get up and eat breakfast. Which statement by the nurse would be most effective in helping the client prepare for breakfast?
"First, wash your face and brush your teeth. Then put your clothes on."
A client with schizophrenia is prescribed a second-generation antipsychotic. The client's mother asks, "About how long will it take until we see any changes in his symptoms?" Which response by the nurse would be most appropriate?
"Generally, it takes about 1 to 2 weeks to be effective in changing symptoms."
One evening, a client with schizophrenia leaves the client's room and begins marching in the hall. When approached by the nurse, the client says, "God says I'm supposed to guard the area." Which response would be best?
"I understand you hear a voice. You and I are the only ones in the hall, and I don't hear a voice."
A toddler is displaying signs/symptoms of weakness and muscle atrophy. The pediatric neurologist suspects it may be a lower motor neuron disease called spinal muscular atrophy (SMA). The client's family asks how he got this. The nurse willrespond:
"This is a degenerative disorder that tends to be inherited as an autosomal recessive trait."
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."
The nurse enters the room of a client with schizophrenia the day after the client has been admitted to an inpatient setting and says, "I would like to spend some time talking with you." The client stares straight ahead and remains silent. Which would be the best response by the nurse?
"You don't need to talk right now. I'll just sit here for a few minutes."
The parents of a 3 year-old boy have brought him to a pediatrician for assessment of the boy's late ambulation and frequent falls. Subsequent muscle biopsy has confirmed a diagnosis of Duchenne muscular dystrophy. Which of the following teaching points should the physician include when explaining the child's diagnosis to his parents?
"Your son will be prone to heart problems and decreased lung function because of this."
The parents of a 3-year-old boy have brought him to a pediatrician for assessment of the boy's late ambulation and frequent falls. Subsequent muscle biopsy has confirmed a diagnosis of Duchenne muscular dystrophy. Which teaching point should the physician include when explaining the child's diagnosis to his parents?
"Your son will be prone to heart problems and decreased lung function because of this."
A nurse monitoring client medication needs to recognize side effects quickly and intervene promptly for which reason?
Alleviate the side effects and help client maintain adherence
A person experiences a brain injury and the medulla oblongata is affected. Which of the following would you LEAST expect to occur due to this injury?
Alterations in posture and balance
A boy has been reported to lack fear and not show any stress in dangerous situations. These symptoms suggest issues with which area of the brain?
Amygdala
During an acute phase of schizophrenia when the patient is experiencing Hallucinations and delusions, the nurse should anticipate that the position will prescribe which of the following medication categories listed below?
An antipsychotic like risperidone
The nurse is caring for client during an acute phase of schizophrenia who is experiencing hallucinations and delusions. What class of medication should the nurse anticipate the health care provider will prescribe?
An antipsychotic such as risperidone
A client has just been diagnosed with multiple sclerosis (MS). The nurse recognizes that the client's condition is a result of:
An immune-mediated response that is caused by the demyelinization of the myelin sheath of the white matter of the brain, spinal cord, and optic nerve
After assessing a client with schizophrenia, the nurse notes that the client exhibits signs and symptoms related to being unable to experience pleasure. The nurse documents this finding as what?
Anhedonia
A nurse educator is explaining basic neuroanatomy to a class of prospective nursing students. Which statement best conveys an aspect of the role of cerebrospinal fluid (CSF)?
CSF cushions the brain and provides a near-water medium for diffusion of nutrients
The nurse assesses the client with Huntington disease demonstrating irregular wriggling and writhing movements. The client is also having facial grimacing, raising the eyebrows, and rolling the eyes. How would the nurse document this finding
Chorea
When initially assessing a client with verbalization of back pain, the nurse would prioritize rapid assessment for which client?
Client with gradual onset of back pain and history of intravenous drug use
A nurse is developing a plan of care for a client diagnosed with delusional disorder. Which of the following would the nurse need to keep in mind?
Clients with delusional disorder typically have problems with medication adherence.
A nurse on a neurology unit is assessing a female brain-injured client. The client is unresponsive to speech, and her pupils are dilated and do not react to light. She is breathing regularly but her respiratory rate is 45 breaths per minute. In response to a noxious stimulus, her arms and legs extend rigidly. What is her level of impairment?
Coma
Patient has eyes -closed; state of unresponsiveness; often after brain injury; from which one cannot be roused no matter how vigorous the stimuli. Patients are neither awake or aware
Coma
A client had an arm cast fitted after suffering a right humeral fracture in a hockey game. The client reported a loss of sensation in the right hand, but sensation returned upon removal of the cast. Which was the most likely cause of the client's loss of sensation?
Compression lesion of the musculocutaneous nerve
A client has been diagnosed with amyotrophic lateral sclerosis, a disease resulting in the loss of efferent signals. Which aspect of neurologic function will be primarily affected by this client's condition?
Conduction of information away from CNS
Several months ago, a 20 year-old male suffered a spinal cord injury brought about by a snowboard trick gone wrong. The lasting effects of his injury include flaccid bowel and bladder and the inability to obtain an erection. While sensation has been completely preserved in his legs and feet, his motor function issignificantly impaired. What type of incomplete spinal cord injury has the man most likely experienced?
Conus medullaris syndrome
The nurse is caring for a 31-year-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
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 oxygen
The client with schizophrenia believes the student nurses are there to spy on the clients. The client is suffering from which symptom?
Delusions
The nurse is caring for an elderly client with hemiplegia following a stroke. While planning the client's care, the nurse knows the client is at risk for which of the following conditions?
Disuse atrophy
A geriatrician a social worker of facilitating a family meeting for the children and wife of a 79-year-old man has been diagnosed with Alzheimer's disease. What color treatment will the clinicians most likely prioritize and their interactions with the family?
Do use of medication such as Donepezil and rivastigmine to slow the progression of the disease
A client with schizophrenia is exhibiting hallucinations and delusions. The mental health nurse knows that these symptoms are associated with hyperactivity of which neurotransmitter?
Dopamine
After teaching a group of nursing students about neurotransmitters associated with schizophrenia, the nursing instructor determines that the education was successful when the students identify what as playing a role in the positive symptoms of schizophrenia?
Dopamine
If you're a woman has experience devastating consequences in her family and work life as a result of long-standing alcohol addiction. The levels and pathways of which the following neurotransmitters in her body are likely to differ from an individual without addiction?
Dopamine
A client with Parkinson disease presents with bradykinesia and an altered gait. These symptoms arise in response to the progressive deterioration of which structure in the brain?
Dopamine nigrostriatal system
A client diagnosed with schizophrenia is exhibiting disorganized behavior and imitating what the nurse is saying. What term is used to identify this behavior?
Echolalia
A client who sustained a complete C6 spinal cord injury 6 months ago has been admitted to the hospital for pneumonia. The nurse observes the client with diaphoresis above the level of C6 and the blood pressure is 260/140 mm Hg. What is the first intervention the nurse should provide?
Elevate the head of the bed.
A teenager, exposed to West Nile virus a few weeks ago while camping with friends, is admitted with headache, fever, and nuchal rigidity. The teenager is also displaying some lethargy and disorientation. The nurse knows which medical diagnosis listed below may be associated with these clinical manifestations
Encephalitis
When caring for a client with anemia and a decrease in red blood cells (RBCs), the nurse recognizes which of these hormones will stimulate the bone marrow to produce additional RBCs?
Erythropoietin
A client is diagnosed with schizoaffective disorder. Which would the nurse identify as supporting this diagnosis?
Evidence of hallucinations and delusions accompanied by major depression
A client has been taking haloperidol for 5 years when the client is admitted to the inpatient unit for relapse of symptoms of schizophrenia. Upon assessment, the client demonstrates akathisia, dystonia, a stiff gait, and rigid posture. The nurse correctly identifies these symptoms are indicative of what?
Extrapyramidal side effects
Which nursing intervention is the highest priority intervention for a nurse caring for a 26-year-old client diagnosed with benign paroxysmal positional vertigo?
Fall precautions
While discussing the regulation of hormone levels, the instructor gives an example of hormones regulated by feedback mechanisms. Which example of this regulation is best?
Following a meal that was high in carbohydrates, a person's blood glucose elevates, which stimulates the release of insulin from the pancreas.
During a late night study session, a pathophysiology student reaches out to turn the page of her textbook. Which of the following components of her nervous system contains the highest level of control of her arm and hand action?
Frontal lobe
The nursing student who is studying pathophysiology correctly identifies the condition that characteristically has an increase in the aqueous humor that fills the anterior and posterior chambers of the eye. What is this disease called?
Glaucoma
A client is having an upper endoscopy to determine the presence of a gastric ulcer. After the procedure is performed, the nurse instructs the client that he cannot have anything to eat or drink until the return of the gag reflex. Which nerve is the nurse testing for return of function?
Glossopharyngeal
Nutrition students are studying the nervous system, which has a high rate of metabolism. Which of the following is its major fuel source?
Glucose
The nurse measures a blood glucose level of 40 mg/dL for a client with diabetes type I. Why would it be important for the nurse to institute an intervention to elevate the glucose level in this client?
Glucose is not stored in the brain and is a major fuel source for brain function.
The unique clinical presentation of a 3 month old infant in the emergency department leads the care team to suspect botulism. Which of the following assessment questions posed to the parents is likely to be most useful in the differential diagnosis?
Have you ever given your child any honey or honey containing products?
A client has sustained damage to cranial nerve VIII. The nurse recognizes that the client may experience difficulty with:
Hearing
Not realizing that its surface was hot, a woman has quickly withdrawn her hand from the surface of a bowl that she was removing from a microwave. Which of the following phenomena has facilitated the rapid movement of her hand in response to the painful stimulus?
Her CNS has enacted a protective response received by neurons that innervate her arm muscles.
A 60-year-old male office worker presents to a clinic complaining of new-onset of lower back pain that has been worsening over the last 6 weeks. The nurse knows that which component of his physical assessment and history is most indicative ofa serious pathologic process (like aortic aneurysm or cancer)?
His onset of pain has been gradual and he has no prior history of lower back problems.
A 10 month-old infant has an enlarging head circumference and delayed overall development. She has a bulging anterior fontanel and her SF pressure is elevated. Based on these findings, answer the following questions: The disease most likely is
Hydrocephaly
A client is unable to stick out his tongue as a result of injury to cranial nerve XII. The nurse recognizes that the client has sustained as damage to which nerve?
Hypoglossal
I woman has a long running compulsion to repeatedly check if the doors are home are locked and has received a diagnosis of OCD. Her husband is at a loss to understand her rational behavior and I sought help from a therapist to deal with the effect that twice OCD is having on their daily lives. Which of the husbands following statements would require correction?
I'm glad this is something that's a result of life stressors and not associate with any dysfunction in her brain
A nurse working in a busy orthopedic clinic is asked to perform the Tinel sign on a client having problems in her hand/wrist. In order to test Tinel sign, the nurse should give the client which direction
I'm going to tap (percuss) over the median nerve in your wrist; tell me what sensation you feel while I am doing this. Does the sensation stay in the wrist or go anywhere else?
A nurse working in a busy orthopedic clinic is asked to perform the Tinel sign on a client having problems in her hand/wrist. In order to test Tinel sign, the nurse should give the client which direction?
I'm going to tap (percuss) over the median nerve in your wrist; tell me what sensation you feel while I am doing this. Does the sensation stay in the wrist or go anywhere else?
A 9 year-old girl has a diffuse collection of symptoms that are indicative of deficits in endocrine and autonomic nervous system control. She also suffers from persistent fluid and electrolyte imbalances. The nurse knows which of the following aspects of the nervous system listed below would her healthcare providers focus their diagnostic efforts?
Impaired function of her hypothalamus
The nurse is assessing a client diagnosed with myasthenia gravis (MG). The nurse would expect the assessment to include:
Inability to move eyes in multiple positions
The geriatrician providing care for a 74-year-old man with diagnosis of Parkinson disease has recently changed the client's medication regimen. What is the most likely focus of the pharmacologic treatment of the man's health problem?
Increasing the functional ability of the underactive dopaminergic system
The geriatrician providing care or a 74 year old man with diagnosis of Parkinson's. What is the most likely focus of the pharmacologic treatment of the man's health problem?
Increasing the functional ability of the underactive dopaminergic system
The geriatrician providing care for a 74 year-old man with diagnosis of Parkinson disease has recently changed the client's medication regimen. What is the most likely focus of the pharmacologic treatment of the man's health problem?
Increasing the functional ability of the underactive dopaminergic system.
The nurse should anticipate that she will need to teach the client newly diagnosed with multiple sclerosis how to give injections if which medication to assist with reducing exacerbations is prescribed?
Interferon beta
While assessing a critically ill patient in the emergency department, the nurse notes on the cardiac monitor an R-on-T premature ventricular beat which develops into ventricular tachycardia (VT). Immediately, the patient became unresponsive. The nurse knows that based on pathophysiologic principles, the most likely cause of the unresponsiveness is:
Interruption of the blood/oxygen supply to the brain.
The health care provider is performing a spinal tap on a client with suspected infection. The provider would perform the procedure at:
L3 or L4
A client has developed spinal shock. The most important assessment for the nurse to perform would be:
Loss of tendon reflexes
A client with an acute spinal cord injury is developing spinal shock. The nurse should perform which priority assessment?
Loss of tendon reflexes below the injury
A 10 month-old infant has an enlarging head circumference and delayed overall development. She has a bulging anterior fontanel and her SF pressure is elevated. Based on these findings, answer the following questions: One test which may detect the disease is
MRI
The nurse is aware that the primary function of the sympathetic nervous system is:
Maintenance of vital functions and responding when there is a critical threat to the integrity of the individual
Amblyopia, or lazy eye, occurs at a time when visual deprivation or abnormal binocular interactions occur in visual infancy. Whether amblyopia is reversible depends on which factor?
Maturity of the visual system at time of onset.
A 20-year-old college student presents to the campus medical clinic because of unshakable despondency in recent months and is diagnosed
Medication that inhibits the reuptake of serotonin in his pre-synaptic space.
Between-year-old college student has presented to his campus medical clinic because of his unshakable despondency in recent months. He's been diagnosed with depression based on assigned symptoms and history. The nurse knows that which of the following treatments will likely be prescribed for the student?
Medication that inhibits three uptake of serotonin in his presynaptic space
Patients have awareness at least some of the time and some response to stimuli. They can reach for objects and follow a moving object with their eyes.
Minimally conscious state
A client with a diagnosis of depression has been prescribed a medication that ultimately increases the levels of the neurotransmitter serotonin between neurons. Which of the following processes will accompany the actions of the neurotransmitter in a chemical synapse?
More neurotransmitters will cross the synaptic cleft and bond with postsynaptic receptors.
Lucy is suffering from right side paralysis and sensory loss. She cannot speak at all. Cerebral angiography and a CAT scan have shown no cerebral vascular defects but the CAT scan did reveal a left sided mass wedged between the diencephalon and the basal nuclei. Using your
Most likely, projection fibers cannot go through, and the thalamus is also blocked.
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
Antibiotics such as gentamicin can produce a disturbance in the body that is similar to botulism by preventing the release of acetylcholine from nerve endings. In persons with preexisting neuromuscular transmission disturbances, these drugs can be dangerous. What disease falls into this category
Myasthenia gravis
A client with schizophrenia is receiving antipsychotic therapy. The nurse understands that which is a medical emergency should it develop in the client?
Neuroleptic malignant syndrome
A client diagnosed with Parkinson disease is displaying the following manifestations: tremor, rigidity, and slowness of movement. The nurse would interpret these as:
Normal manifestations of Parkinson disease
A nurse provides care to a client with schizoaffective disorder during hospitalization for acute psychosis. Nursing interventions to help the client to establish trust with the health care team is best accomplished by what?
Offering reassurance in a soft, nonthreatening voice
Mr. Frank, a former stroke victim who had made a remarkable recovery, suddenly began to have problems reading. He complained of seeing double and also had problems navigating steps. He was unable to move his left eye downward and laterally. What is the site of the problem?
One the trochlear nerves (IV) must be responsible for this action
After being thrown off the back of a bull, a bull rider can move their arms but has loss of motor function in the lumbar and sacral segments of the spinal cord. This is referred to as:
Paraplegia
For which common manifestation of acute meningococcal meningitis should the school nurse be assessing students?
Petechiae
A nursing student having trouble moving their head from side to side is likely experiencing a problem with which type of neurons?
Pharyngeal efferent neurons.
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
Which treatment should take place immediately in a client experiencing autonomic dysreflexia?
Position the client in upright position, and correct the initiating stimulus.
Which of the following treatments should take place immediately in a patient experiencing autonomic dysreflexia?
Position the patient in upright position, and correct the initiating stimulus.
As part of a diagnostic work up of a 22-year-old male with recently diagnosed schizophrenia, and neurologist wants to examine the levels of metabolic activity in particular areas of the clients brain. Which of the following diagnostic procedures is a position most likely to order?
Positron a mission tomography or PET scan
When educating a patient about to undergo a pacemaker insertion, the nurse explains the normal phases of cardiac muscle tissue. During the repolarization phase, the nurse will stress that membranes must be repolarized before they can be re-excited. Within the cell, the nurse understands that:
Potassium channels open and while sodium channels close causing repolarization to the resting state.
A patient with Wernicke's aphasia would exhibit what issues upon examination? A.Is unable to recognize faces B.Has no expressions (negative affect) C.Production of slow, non-fluent speech devoid of meaning ("word salad") D.Has difficulty pronouncing multi-syllabic words E.Can understand what is being said, but is unable to produce any words
Production of slow, non-fluent speech devoid of meaning ("word salad")
On performing an autopsy on a 60 year old man, a medical student found that the man had no corpus callosum. Apparently the man had functioned well neurologically; his medical history reported no neural dysfunctions. What is the function of the corpus callosum? Explain why the lack of corpus callosum, although surprising at autopsy , did NOT affect the man functionally
Projection fibers are still able to communicate with or from the cerebral cortex; only emotional aspects may been have been affected
A client is asked to stand with feet together, eyes open, and hands by the sides. Then the client is asked to close the eyes while the nurse observes for a full minute. What assessment is the nurse performing
Proprioception
The parent of a toddler with Duchenne muscular dystrophy reports that the child has an increase in muscle size but a decrease in strength. The nurse documents this using which medical term?
Pseudohypertrophy
A nurse caring for a client with multiple sclerosis notes that the client has mood swings. Which cause can best explain this?
Psychological manifestation due to involvement of white matter of cerebral cortex
A 44 year-old female has been diagnosed with major depression. Which of the following neuroimaging findings is most congruent with the woman's diagnosis?
Reduced activity and gray matter volume in the prefrontal cortex
Which of the following is the period during repolarization when a portion of the recovery period is where the membrane can be excited, although only by a stronger-than-normal stimulus?
Relative refractory period
A student notices that at certain times during his studying for final exams, he's more awake and his ability to think as a higher level is happening easier. The nurse knows that this experience may be attributed to which of the following neurological functions?
Release of excitatory neurotransmitter such as glutamate
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 upper and lower motor neurons. The health care provider caring for this client will focus on which priority intervention for this client?
Respiratory ventilation assessment and prevention of aspiration pneumonia
A 45 year old diabetic male is experiencing erectile dysfunction. If his erectile dysfunction is caused by the nervous system, then the nurse can educate the patient that the venous blood supply to the penis is controlled by:
Sacral parasympathetic fibers.
A nurse is caring for a client diagnosed with schizophreniform disorder. The nurse demonstrates understanding of this disorder when identifying that the client is at risk for developing what?
Schizophrenia
A nurse is assessing a client who is reporting the sensation of "bugs crawling under the skin" and intense itching and burning. The client states, "I know bugs have invaded my body." There is no evidence to support the client's report. The nurse interprets this as which type of delusion?
Sensation
Which of the following complications of spinal cord injury is the most preventable in a paraplegic patient?
Skin breakdown
A patient with Wernicke's aphasia would exhibit what issues upon examination?
Slow, non-fluent speech devoid of meaning
A child is experiencing difficulty difficulty with chewing and swallowing. The nurse knowns that which of the following cells may be innervating specialized gut-related receptors that provide taste and smell? a. Special somatic afferent fibers b. General somatic afferents c. Special visceral afferent cells d. General visceral afferent neurons
Special visceral afferent cells
A child is experiencing difficulty with chewing and swallowing. The nurse knows that which of the following cells may be innervating specialized gut-related receptors that provide taste and smell?
Special visceral afferent cells
An adult who was sexually abused as a child has been displaying some stress. She seems to complain of increased medical problems and she is under more stress. The nurse would classify this as an example of
Stress diastasis theory
The nurse taking a report on a client coming into the emergency room plans care for a client with brain dysfunction based on which symptom?
Stupor
A child riding a bike falls and hits their head. The child was not wearing a helmet. In the emergency room, cerebrospinal fluid taken during a spinal tap reveals blood. The doctors diagnosed the child had torn cerebral veins as they pass to the superior sagittal sinus. What area of the body was the fluid taken?
Subarachnoid space
A baseball player is hit by a line drive on the temporal area of his skull. At the hospital the doctors give a CT scan which shows an accumulation of blood between the dura mater and arachnoid mater, creating pressure on the cerebrum. The hemorrhage from the fracture would be located in which space?
Subdural space
A toddler brought up in a chaotic non-nurturing environment may suffer neurological consequences of the parents do not achieve attachment with the child. The nurse knows that which of the following nervous system listed below is the first to respond to the safety needs of the child?
Sympathetic nervous system
The nurse notices the client with a shuffling gait walking in the hall. Which would not be included as a symptom of drug-induced parkinsonism?
Tachycardia
An 82-year-old male has been diagnosed with parkinson's disease. Which of the following clinical findings would be most closely associated with his Parkinson's
Temor, rigidity and bradykinesia
Stacey is involved in a car accident that caused her head to snap forward and backward forcefully. Although no external signs of injury were seen, her blood pressure suddenly dropped and she appeared paralyzed. How could this happen?
The Medulla must be involved and pyramidal tracts cannot decussate.
The nurse is aware that some drugs may be prevented from entering the brain as a function of:
The blood-brain barrier
Ralph sustained a leg injury in a bowling accident and had to use crutches. Unfortunately, he never took time to learn how to use them properly. After 2 weeks of use, he noticed his fingers were becoming numb. Then he noticed his arms were getting weaker and tingling. What could be his problem?
The brachial plexus which includes the axillary nerve is most likely affected
A clinician is conducting an assessment of a male client suspected of having a disorder of motor function. Which assessment finding would suggest a possible upper motor neuron (UMN) lesion?
The client displays increased muscle tone.
During a clinical assessment of a 68-year-old client who has suffered a head injury, it is suspected that a client has a sustained damage to her vagus (CN X) nerve. Which of the following assessment findings is most likely to lead to this conclusion?
The client has difficulty swallowing, has constipation and hypoactive bowel sounds.
The nurse is performing a test to determine a client's neurological function related to a suspected lesion in the parietal lobe. What would the nurse determine is a normal finding after assessment?
The client is able to determine correctly that the item placed in his hand is a paper clip.
A client has developed a tendency to have a back-and-forth tremor in his fingers as he reaches for an object. The client and his wife deny any changes to his cognition. Which signs/symptoms and diagnostic testing should primarily be the focus of the assessment?
The client's cerebellar function
After surviving an ischemic stroke, a 79-year-old male has demonstrated significant changes in his emotional behavior, with his family noting that he now experiences wide mood swings with exaggerated responses of empathy, anger, and sadness to situations. His care team would most likely attribute these responses to ischemic changes in which of the following brain structures?
The components of the client's limbic system
After surviving in as she McStroke, 79-year-old male has demonstrated significant changes in his emotional behavior, with his family noting that he now experience is wide mood swings with exaggerated responses of empathy anger and sadness to situations. His care team would most likely attribute these responses to ischemic changes in which of the following brain structures?
The components of the clients limbic system
A client has been recovering from a stroke for several weeks and has been reluctant to participate in physical therapy. As a result, the client has experienced disuse atrophy. The nurse should recognize that the client is experiencing the consequences of which physiologic process?
The diameter of the client's muscle cells has decreased
A nurse is providing education to a client newly diagnosed with Guillain-Barré syndrome. Which statement reflects accurate information about the course of the disease?
The disorder may present with rapid life-threatening symptoms or may present as a slow insidious process.
A client is being treated for the ingestion of a neurotoxin that interferes with the depolarization phase of action potentials. What physiologic process will be disrupted?
The inflow of sodium ions
After a spinal cord injury, a 22-year-old male has lost fine motor function of his fingers and thumb but is still able to perform gross motor movements of his hand and arm. Which of the following components of his white matter has most likely been damaged?
The outer layer (neolayer)
A client with schizophrenia is prescribed an antipsychotic medication. Which immediate side effects would the nurse include in the education plan for this medication?
The potential for sedation
The nurse is working with a client who has an addiction to cocaine. The nurse is aware that the high associated with cocaine is due to the inhibition of reuptake. What physiologic phenomenon is affected?
The resorption of the neurotransmitter to remove it from action
Chloe was in a very unhappy marriage with Tony. Eventually she remarried and is now quite happy with her new husband and life together. However, every time Chloe hears the lively tune Rudolf the Red Nose Raindeer" Chloe feels sad and even has tears in her eyes and she thinks of Tony. What part of her neural circuitry is responsible for this?
This illustrates the actions of the limbic system
Phil had to have his arm amputated after an accident. He tells you that he can sometimes still feel pain in his fingers even though the hand is gone. He says this is especially true when he bumps the stub of his arm where it is amputed. How can this be explained.
This illustrates what is sometimes called " Phantom limb" condition
An adult male has a new diagnosis Guillain- Barre syndrome. The nurse knows which of the following pathophysiological processes underlie the deficits that accompany the degeneration of myelin in his peripheral nervous system (PNS)?
Unless remyelination occurs, the axon will eventually die
An adult male has a new diagnosis of Guillain-Barre syndrome. The nurse knows which of the following pathophysiological processes underlie the deficits that accompany the degeneration of myelin in his peripheral nervous system (PNS)?
Unless remyelination occurs, the axon will eventually die.
A 70 year-old male has been diagnosed with a stroke that resulted in an infarct to his cerebellum. Which of the following clinical findings would be most closely associated with cerebellar insult?
Unsteady gait and difficulty speaking and swallowing
A client in the intensive care unit who has a brain tumor has experienced a sharp decline. The care team suspects that water and protein have crossed the blood-brain barrier and been transferred from the vascular space into the client's interstitial space. Which diagnosis best captures this pathophysiology?
Vasogenic edema
A patient in the intensive care unit who has a brain tumor has experienced a sharp decline. The care team suspects that water and protein have crossed the blood-brain barrier and been transferred from the vascular space into the client's interstitial space. Which of the following diagnoses best captures this pathophysiology?
Vasogenic edema
The patient has eyes open and may appear to focus, but is thought not to have true awareness either or self of the surrounding environment
Vegetative State
A 21 year old male is brought to the ED following a night of partying in his fraternity. His friends found him "asleep" and couldn't get him to respond. They cannot recall how many alcoholic beverages he drank the night before. While educating a student nurse and the roommates in the fraternity, the nurse begins by explaining that alcohol is:
Very lipid soluble and rapidly crosses the blood-brain barrier.
A client asks the nurse when during embryonic growth the nervous system develops. The best response would be:
Week 3
The nurse is caring for client who has been living with Parkinson disease for the past 10 years and is being treated with levodopa-carbidopa. The client often leaves the unit with family for extended periods. What should the nurse prioritize when teaching the client?
Your medication needs to be taken at equal intervals to reduce symptom fluctuation.
A 26 year-old female is resting after a 1-minute episode during which she lost consciousness while her muscles contracted and extremities extended. This was followed by rhythmic contraction and relaxation of her extremities. On regaining consciousness, she found herself to have been incontinent of urine. What has the woman most likely experienced?
a tonic-clonic seizure
A client diagnosed with schizophrenia is in anticholinergic crisis. The nurse would expect which finding to be noted upon assessment?
facial flushing
A gymnast on a balance beam would activate all but one of the listed areas of the medulla oblongata. Which one would NOT be activated? A.gracile nucleus B.gustatory nucleus C.vestibular nuclei D.inferior olivary nucleus E.pyramids
gustatory nucleus
A 10 month-old infant has an enlarging head circumference and delayed overall development. She has a bulging anterior fontanel and her SF pressure is elevated. Based on these findings, answer the following questions: This test may have shown which of the following:
constriction of the cerebral aqueduct
An infant has hydrocephalus. The CSF could not get out of the third ventricle. What passage was blocked?
Aqueduct of midbrain
A 22-year-old female college student is shocked to receive a diagnosis of myasthenia gravis. What are the etiology and most likely treatment for her health problem?
A decline in functioning acetylcholine receptors; treatment with corticosteroids and intravenous immunoglobulins
The nurse is providing teaching to a client diagnosed with schizoaffective disorder. The nurse should explain to the client that which is true about this disorder?
it is a mix of psychotic and mood symptoms.
A stroke patient has a lesion on their trigeminal ophthalmic branch. Which symptom would the patient exhibit? A.loss of sensation on the anterior 2/3 of the tongue B.loss of pain, temperature and touch sensation around the eye C.loss of the sense of smell D.paralysis of eye muscles E.loss of taste sensation to the posterior part of the tongue
loss of pain, temperature and touch sensation around the eye
A nurse caring for a patient in myasthenic crisis identifies a priority concern as:
maintenance of airway and respiration.
A week after beginning therapy with thiothixene, the client demonstrates muscle rigidity, a temperature of 103°F, an elevated serum creatinine phosphokinase level, stupor, and incontinence. The nurse should notify the physician because these symptoms are indicative of:
neuroleptic malignant syndrome.
A 10 month-old infant has an enlarging head circumference and delayed overall development. She has a bulging anterior fontanel and her SF pressure is elevated. Based on these findings, answer the following questions: This test may have shown enlargement of which of the following:
of the lateral and third ventricles
A patient shows no effect when a light shines in the right eye, but shining a light into the left eye causes both pupils (right and left) to constrict. This could be caused by a lesion on the __?__ nerve. A.optic B.abducens C.trochlear D.oculomotor E.trigeminal
optic
The nurse witnesses a client go into cardiac arrest. If the nurse delays intervention, when will the death of brain cells begin?
4-6 minutes
Which individual is likely to have the best prognosis for recovery from his or her insult to the peripheral nervous system?
A 32-year-old male who had his forearm partially crushed by gears during an industrial accident
A 22- ear old female college student is shocked to receive a diagnosis of myasthenia gravis. What are the etiology and most likely treatment for her health problem?
A decline in functioning acetylcholine receptors; treatment with corticosteroids and intravenous immunoglobulins
A client is having an edrophonium test. The client suddenly goes into respiratory arrest. Which priority medication should the nurse be prepared to administer?
Anticholinergic
Which one of the following is a manifestation of a serious condition that causes new-onset back pain in persons 50 years of age or older?
Aortic aneurysm
a 47- year old woman was diagnosed with amyotrophic lateral sclerosis 3 years ago and has experienced a progressive onset and severity of complications. She has been admitted to a palliative care unit due to her poor prognosis? What assessments and interventions should the nursing staff of the unit prioritize in their care?
Assessment of swallowing ability and respiratory status
A 47 year-old woman was diagnosed with amyotrophic lateral sclerosis three years ago and has experienced a progressive onset and severity of complications. She has been admitted to a palliative care unit due to her poor prognosis. What assessments and interventions should the nursing staff of the unit prioritize in their care?
Assessment of swallowing ability and respiratory status.
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 the normal self. 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 reveals that when in bed, changes in head position cause brief periods of vertigo, usually lasting less than 1 minute. Which condition is the client most likely experiencing?
Benign paroxysmal positional vertigo
A client with schizophrenia is being treated with olanzapine 10 mg daily. The client asks the nurse how this medicine works. The nurse explains that the mechanism by which the olanzapine controls the client's psychotic symptoms is believed to be what?
Blocking dopamine receptors in the brain.
A patient had damage to their frontal lobe leaving them unable to speak. What specific area was damaged? A.primary gustatory B.common integrative C.Wernicke's D.Broca's E.prefrontal cortex
Broca's
A client has been involved in a motor vehicle accident and has sustained spinal cord damage. The client has voluntary motor function loss on one side and a loss of pain and temperature sensation from the contralateral side below the level of the lesion. What type of cord syndrome does the nurse recognize the client has sustained?
Brown-Sequard syndrome
A 14-year-old girl has been thrown from the back of a pick-up truck. MRI shows complete cord injury at the level of C2. What is the main significance of an injury at this level of the spinal column?
Cannot breathe on own, needs ventilator assistance
A middle age woman is brought to the emergency room after a minor auto accident. Her gait is staggering and unsteady; her speech is slurred and she displays slight nystagmus. The police officer who brought her in says she has not been drinking. Her blood pressure is very high. Which of the following health problems most likely underlies her present state?
Cerebellar damage caused by a cerebrovascular accident
A middle-aged woman is brought to the emergency room after a minor auto accident. Her gait is staggering and unsteady, her speech is slurred, and she displays slight nystagmus. The police officer who brought her in says she has not been drinking. Her blood pressure is very high. Which of the following health problems most likely underlies her present state?
Cerebellar damage caused by a cerebrovascular accident
A soccer ball was hit your way. You see the area you want to kick it to at the same time you are preparing to plant your foot and kick the ball. What area allows you to compare intended movement with the actual movement?
Cerebellum
Select the laboratory blood test that would be a used to suggest a diagnosis of muscular dystrophy (MD).A. Rheumatoid factor
Creatine kinase
Parents of a 16-year-old male who has been behaving in an increasingly Bizzarre ways in recent months or distraught that he has been diagnosed with schizophrenia. What are the mothers following statements about her sons diagnosis demonstrates an accurate understanding of the disease?
This makes it even more worried about his younger brother and whether he might develop schizophrenia
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. This assessment is known as:
Tinel sign
Which of the following statements on the final diagnostic report regarding a computerized tomography or CT of the head with contrast with lead healthcare providers to diagnose a patient with Alzheimer's disease?
Too numerous to count beta amyloid deposits noted
Which of the following statements on the final diagnostics report regarding a computerized tomography (CT) of the head with contrast would lead healthcare providers to diagnose a patient with Alzheimer disease?
Too numerous to count beta-amyloid deposits noted
The nurse teaches a client about a new diagnosis of astrocytoma. Which statement indicates an accurate understanding?
Treatment is hard since glial cells support neurons and blood vessels in the brain.
As the nurse is performing a physical assessment of a client, the client begins to have seizure activity including loss of consciousness and limb jerking. The nurse's priority is to:
protect the client from injury.
A recently injured (3 months ago) client with a spinal cord injury at T4 to T5 is experiencing a complication. He looks extremely ill. The nurse recognizes this as autonomic dysreflexia (autonomic hyperreflexia). His BP is 210/108; skin very pale; gooseflesh noted on arms. The priority nursing intervention would be to:
scan his bladder to make sure it is empty.
The health care provider is assessing a client to differentiate a herniated disk from other causes of acute back pain. The most important test for the provider to perform would be:
straight leg test
The nurse is caring for a client who was diagnosed with schizoaffective disorder two years ago. Which of the following assessments should the nurse prioritize?
suicide.
Which individual is likely to have the best prognosis for recovery from his or her insult to the peripheral nervous system? An adult:
who had his forearm partially crushed by gears during an industrial accident.
