Neuro review quiz

A nurse is caring for a client who has global aphasia. Which of the following actions should the nurse take? A. Speak to the client about one idea at a time. B. Ask the client to multi-task. C. Limit questions to yes and no answers. D. Focus on a single form of communication.

A

A nurse is creating a plan of care for a client who has a history of tonic-clonic seizure disorder. Which of the following interventions should the nurse include? Select all that apply. A. Provide a suction setup at the bedside. B. Elevate the side rails near the head when the client is in bed. C. Place the bed in the lowest position. D. Keep an oxygen setup at the bedside. E. Furnish restraints at the bedside.

A, B, C, D

A client arrives in the emergency department with an ischemic stroke and is scheduled to receive tissue plasminogen activator (t-PA) administration. Which is the priority nursing assessment? A. Complete physical and history. B. Time of onset of current stroke. C. Current medications. D. Upcoming surgical procedures.

B

The client experiences shock following a spinal cord injury. This type of shock is classified as: A. hypovolemic B. neurogenic C. cardiogenic D. Anaphylactic

B

A client in the neuro ICU with a closed-head injury is exhibiting signs of a secondary injury. Which of the following should be included in this client's plan of care? (SATA) A. Keep client's neck flexed B. Keep HOB elevated 30 degrees C. Monitor serum potassium levels D. Preoxygenate prior to suctioning E. Clump activities to ensure adequate rest periods. F. Monitor hypotonic saline infusion

B, D

The nurse is concerned that a patient is experiencing a transient ischemic attack. What did the nurse most likely assess in this patient? (SATA) A. Sudden severe pain over the left eye B. Visual disturbance of one or both eyes C. Loss of sensation and reflexes in both legs D. Complete paralysis of the right arm and leg E. Numbness and tingling in the corner of the mouth

B, E

A 78 year old client is admitted to the emergency department with numbness and weakness of the left arm and slurred speech. Which nursing intervention is priority? A. Notify the speech pathologist for an emergency consult. B. Prepare to administer recombinant tissue plasminogen activator (rt-PA) C. Schedule for a STAT computer tomography (CT) scan of the head. D. Discuss the precipitating factors that caused the symptoms.

C

A client is admitted to the hospital complaining of increasing neurological changes. The nurse learns this client had fallen off of a ladder 2 weeks prior and sustained a mild concussion. Which of the following conditions might be occurring with this client? A. Subarachnoid hematoma B. Epidural hematoma C. Answer Subdural hematoma, chronic D. Acceleration injury

C

A nurse caring for a client who had a right-sided stroke and is exhibiting homonymous hemianopsia when eating. Which of the following actions should the nurse take? A. Provide a nonskid mat to alleviate plate movement. B. Encourage the client to use his right hand when feeding himself. C. Remind the client to look for food on the left side of the tray. D. Encourage the use of the wide grip utensils.

C

The nurse is documenting that a patient is demonstrating decorticate posturing. What does the statement indicate about the patient's physical posture? A. In supine position, spine extended, legs extended B. In prone position with arms and knees sharply flexed C. Arms close to sides, elbows and wrists flexed D. neck extended, arms extended and pronated, feet plantar flexed

C

A nurse is developing a plan of care for a client who has a spinal fracture and complete spinal cord transection at the level of C5. Which of the following rehabilitation goals should the nurse add to the client's plan of care? A. Ability to achieve independent transfer from bed to wheelchair. B. Independent control of bowel and bladder function. C. Use of a wheelchair with a chin or mouth stick. D. Ability to self-feed with the use of adaptive equipment.

D

A nurse is presenting discharge instructions to a client who has multiple sclerosis (MS). The client reports symptoms of diplopia, dysmetria, and sensory change. Which of the following nursing statements are appropriate? A. Wear an eye patch on the right eye at all times. B. Plan to relax in a hot tub spa each day. C. Engage in a vigorous exercise program D. Implement a schedule to include periods of rest.

D