Neuro
The nurse will implement which of these nursing interventions for the patient with increased intracranial pressure? (Select all that apply.)
flexion of hips, waist, and neck place neck in neutral position suction prn teach pt to avoid valsalva maneuver
An 83-year-old patient has had a stroke. He is right-handed and has a history of hypertension and little strokes. He presents with right hemiplegia. To afford him the best visual field, the nurse should approach him:
from the left side
What is the nurse assessing when asking the patient, Who is the president of the United States? during a level of consciousness assessment?
fund of knowledge
What is the purpose of a drug holiday in the treatment of Parkinson disease?
restart drugs at a lower dosage with favorable results
A patient is in which stage of Alzheimer disease when she demonstrates sundowning?
second stage
Following a myelogram the nurse should include in the postprocedure care assessment for:
sensation in lower extremities
The nurse is aware that the characteristic gait of the person with Parkinson disease is a propulsive gait, which causes the patient to:
shuffle with arms flexed
What is the nurse aware of when assessing a person with a craniocerebral injury?
signs and symptoms may not occur until several days after the trauma
A patient with a spinal cord injury at T1 complains of stuffiness of the nose and a headache. The nurse notes a flushing of the neck and goose flesh. What should be the primary nursing intervention based on these assessments?
sit upright and check pressure
The nurse is aware that the drug t-PA (Activase), a tissue plasminogen activator, must be given in____hours of the onset of symptoms to have maximum benefit.
3hrs
a pt who has been experiencing recent seizure activity is preparing to have diagnostic testing performed. The hcp has explained that the test will provide a graphic recording of the electrical conduction activities of the brain. the pt understands the which test will be performed
EEG
.The newly admitted patient to the emergency room after a motorcycle accident has serosanguineous drainage coming from the nose. What is the most appropriate nursing response to this assessment?
gently wipe nose with absorbent gauze
The nurse assures an anxious family member of a 92-year-old patient who is demonstrating signs of dementia that many causes of dementia are reversible and preventable. What is one example?
hypotension
when teaching a pt about parkinsons disease which response would indicate the need for further education
if a miss occasional does the the medication it doesn't matter much
a 12 yr old has a history of generalized tonic-clonic seizures. The nurse educates the pt and his family by including which points?
it is not uncommon to lose consciousness during this type of seizure
The newly admitted patient to the emergency room 30 minutes ago after a fall off a ladder has gradually decreased in consciousness and has slowly reacting pupils, a widening pulse pressure, and verbal responses that are slow and unintelligible. What is the most appropriate position for the patient?
neck placed in a neutral position
the nurse is caring for a pt who suffered a cervical spinal cord injury. What injury can most likely be anticipated
tetraplegia
Why is the patient with suspected Guillain-Barre Syndrome (GBS) hospitalized immediately?
the disease can rapidly progress into respiratory failure
a pt is diagnosed with bells palsey as indicated by feeling of stiffness and a drawing sensation of the face, what is important to teach her about the disease
the eye susceptible to injury if the eyelid does not close
which symptom is specific to migraine headaches
they are preceded by an aura
How would a nurse record the behavior when a patient with Alzheimer disease attempts to eat using a napkin rather than a fork?
agnosia
a right handed patient has right sided hemiplegia and aphasia from a stroke. What is the most likely location of the lesion
left frontal lobe
What term most accurately describes age-related changes of the neurologic system?
long term memory is more affected by aging than is short term memory
What are the effects of normal aging on the nervous system? (Select all that apply.)
loss of neurons reduction of cerebral blood flow lipofuscin decrease in oxygen use
A patient is going for a diagnostic test. The nurse listens as the health care provider explains the procedure to the patient. The health care provider states that the test involves the use of differential signal characteristics of flowing blood to evaluate extracranial and intracranial blood vessels. In preparing to answer the patient's questions further, what diagnostic test will the nurse address?
magnetic reohance angiography
What is the autoimmune disease of the neuromuscular junction characterized by fluctuating weakness of certain muscle groups?
myasthenia gravis
Why are the drugs neostigmine (Prostigmin) and pyridostigmine (Mestinon) helpful to the person with myasthenia gravis?
promotes nerve impulse transmission
What is the first sign of Bells palsy?
Inability to wrinkle forehead and pucker lips on affected side
the nursing care plan for a pt with increased intercranial pressure will include what as the therapeutic position for the pt
maintain head of the bed at 30 degrees
during admission of a pt with severe head trauma to the ER what is the highest priority assessment for the nurse
patent airway
The nurse is caring for a patient with multiple sclerosis. What appropriate nursing care should be implemented?
encouraging a well balanced diet high in fiber and adequate fluids
A patient has recently suffered a stroke with left-sided weakness and has problems with choking, especially when drinking thin liquids. What nursing interventions would be most helpful in assisting this patient to swallow safely?
tuck chin when swallowing
What is the cranial nerve that supplies most of the organs in the thoracic and abdominal cavities and also carries motor fibers to glands that produce digestive juices and other secretions?
vagus nerve
a pt is admitted to the hospital with a diagnosis of TIA. The pt asks the nurse to explain what a TIA is, which statement by the nurse is most accurate
a TIA is often a precursor of a stroke
what are the divisions of the nervous system
central and peripheral
What is the earliest sign of increased intracranial pressure?
change in lvl of consciousness
the nurse is caring for a pt with a spinal cord injury who displays symptoms of autonomic dyflexia. what intervention should the nurse implement first?
check the bladder for distention
The nurse is caring for a patient who is being evaluated for a neurologic disorder. She is not able to comprehend the written or spoken word. Which term would the nurse use to document this problem?
receptive
How would the nurse instruct a patient with Parkinson disease to improve activity level?
to walk with hands clasped behind back to help balance
The nurse is aware that when assessing a patient by the FOUR score coma scale, the patient is assessed in four categories: eye response, brainstem reflexes, motor response, and respiration. How are these results reported?
as individual scores in each category
What does the nurse know about the stroke patient who has expressive aphasia?
can understand the spoken word, but cannot speak
Which of the following techniques are necessary for safely feeding a hemiplegic patient? (Select all that apply.)
checking the affected side of the mouth for food accumulated offering small bites of food adding a thickening agent to liquids
the pt has been diagnosed with bells palsy. this condition affects which cranial nerve?
cranial nerve 7
what is the cardinal sign of increased intercranial pressure in a brain injured pt
decrease in lvl of consciousness
the nursing assessment of an 80yr old who had a stroke found that she had difficulty swallowing. a videofluoroscopy with barium was preformed to rule out aspiration. The rehab team in the skilled nursing facility determined that she can eat soft diet with one-to-one supervision. which action is important
tipping the head toward the unaffected side while swallowing
the nurse is caring for a pt with myasthenia gravis. The pt asks the nurse about the causes of the disease. which response is correct.
antibodies attacking the acetylcholine receptors, damaging them, and reducing their number is the most likely cause
Which question is likely to elicit the most valid response from the patient who is being interviewed about a neurologic problem?
can you describe the sensations you are having
What neurotransmitter primarily affects motor function and is involved in gross subconscious movements of the skeletal muscles?
dopamine
The nurse is caring for a home health patient who had a spinal cord injury at C5 three years ago. The nurse bases the plan of care on the knowledge that the patient will be able to:
feed self with setup and adaptive equipment
The nurse is taking care of a patient who suddenly begins to have a seizure. What is the appropriate nursing response?
observe and record the seizure activity
What are the three signs of Cushing response? (Select all that apply.)
widened pulse pressure bradycardia increased systolic pressure
.What should the nurse do when the child arrives on the floor with the diagnosis of bacterial meningitis?
place the child in respiratory isolation
a male patient has been recently diagnosed with Parkinson disease. His wife asks the nurse numerous questions about the disease. What information is correct in addressing this wife's questions?
Parkinson's disease
What is the reticular activating system (RAS) essential to? (Select all that apply.)
concentration wakefulness attention introspection
What are surgical navigational systems?
computerized devices that guide the surgeon
a pt involved in a snowmobile accident. on admission to the ER, he is receiving 02 and is intubated. His glascow coma scalw score is 6. About 10min after arrival, he is note to having widened pulse pressure, increased systolic blood pressure, and bradycardia. which finding indicates to the nurse that late-stage increased ICP is present
1-Deeping respirations 2-tremor 3-rigidity
which sign or symptom of late stage increased intercranial pressure should the LPN be aware of?
1-increased systolic pressure 2-widing of pulse pressure 3-bradycardia
a 35 yr old pt is seen for complaints of headache, which she has experienced for the past month. Her hcp wants to rule out a brain tumor. What diagnostic tests will be most helpful
1-brain scan 2-PET scan 3-electroencephalography 4-MRI
what nursing intervention should the nurse include in the plan of care for a pt who has had a stroke with right sided hemiplgia and expressive aphasia
1-encourage self-help behaviors as much as possible such as feeding 2-perform ROM to affected extremities every shift 3-implement the use of a communication board for the pt to use as needed
a nurse in the ER of her community hospital is teaching a group of HS students how to prevent head and spine injuries. What should the nurse include in the presentation. (select all that apply)
1-use helmets 2-use helmets when doing contact sports 3-never drive or ride under the influence 4-wear seat belts
What Glasgow Coma Scale rating would a patient receive who opens the eyes spontaneously, but has incomprehensible speech and obeys commands for movement?
12
A frantic family member is distressed about the flaccid paralysis of her son following a spinal cord injury several hours ago. What does the nurse know about this condition?
it is possibly a temporary condition and will clear
a 13 yr old student is admitted to the ped unit with possible menegitis. The nurse finds that the pt cannot extend her legs completely without experiencing extreme pain. the nurse corectly documents this which sign
kernigs sign
when caring for a pt who has undergone a craniotomy, what is the primary nursing intervention
preventing ICP
What is the basic problem that prompts most of the early signs of Alzheimer disease?
memory loss that disrupts daily life
A patient, age 45, is to have a myelogram to confirm the presence of a herniated intervertebral disk. Which nursing action should be planned with respect to this diagnostic test?
obtain an allergy history before test
when reviewing the medical plan of treatment for a pt with Guillian-barre syndrome, which therapies are considered to be most therapeutic
plasmapheresis and intravenous immune globulin
A family member of a patient who has just suffered a tonic-clonic seizure is concerned about the patients deep sleep. What is this behavior called?
postictal period
As the result of a stroke, a patient has difficulty discerning the position of his body without looking at it. In the nurses documentation, which would best describe the patients inability to assess spatial position of his body?
proprioception
a pt experiencing TIA's is scheduled for a carotid endaterectomy. The pt asks the nurse what the procedure is, the nurse correctly responds with which response.
this procedure helps prevent a stroke by removing atherosclerotic plaques obstructing cerebral blood flow
which plan of care is considered beneficial for select patients who have experienced an ischemic stroke
thrombolytic such as tPA in the forst 3hrs
a 70 year old with back pain is scheduled to have a myelogram in the morning to rule out pathologic condition of the spine. in preparing him for the procedure, what statement by the nurse is accurate
we will ask if you have any numbness or tingling in the legs after the procedure
Which foods should the person who suffers from migraine headaches avoid? (Select all that apply.)
yogurt caffeine marinated foods
