Neuro Section 2 Exam

39. A patient in the plateau stage of GBS is frustrated because there has been no improvement in manifestations för 5 days. Which explanation does the nurse provide to the patient?

The manifestations can last up to 2 weeks.

40. The nurse is visiting the home of a patient who is being treated for Bell palsy. Which statement by the patient indicates that care instructions need to be reviewed by the nurse?

"Alternating heat and cold therapy is helping the swelling."

42. The nurse is collecting ago. The patient has a good understanding up-to-date data from a patient who was diagnosed with MS 15 years of the disease and manages to maintain a relatively high level of functioning. Which statement by the patient prompts the nurse to seek additional information?

"I love to work in my flower beds during the summer months."

30. A patient diagnosed with Guillain-Barré syndrome (GBS) asks how the disease developed since the patient rarely has an illness. Whhh nursing response is the most accurate?

"It may be an autoimmune reaction to a virus."

9. A patient began experiencing manifestations of a stroke at 0800 hours. By which time should thrombolytic medications be provided to reverse stroke symptoms?

1250 hours

23. Following ischemic stroke, thrombolytic therapy must be given within how many hours?

4.5

60. A client with myasthenia gravis is admitted to the hospital. The nurse reviews the health record and notes that the client is taking pyridostigmine (Mestinon). The nurse checks the client for which side effect of this medication?

Abdominal cramps

49. What nursing intervention is most important for the patient with myasthenia gravis?

Allow frequent rest periods

71. What lab tests should be closely monitored in a client who has Guillain-Barre syndrome?

Arterial blood gases

70. Some clients are placed on platelet aggregation inhibitors to prevent brain attacks. Which of the following is an example of platelet aggregation inhibitors?

Aspirin or ticlid

48. The patient with which disorder would benefit from avoiding cold windy weather?

Bell palsy

35. The nurse is providing care for a patient after surgery for treatment of trigeminal neuropathy. Which nursing intervention will the nurse initiate for this patient?

Check the eye on the surgery side for corneal sensation.

12. The nurse is preparing to assist a patient with eating who is recovering from a stroke. Which intervention is appropriate?

Check the patient's mouth periodically presence pocketed food.

25. The nurse is caring for a patient experiencing an acute exacerbation of multiple sclerosis (MS). Which pathophysiological change does the nurse recognize as causing the manifestations of MS?

Demyelination and destruction of nerve fibers

21. What are modifiable risk factors of stroke? (select all that apply)

Diabetes mellitus Hyperkalemia Gender

44. The nurse is teaching a patient with MG how to recognize a cholinergic crisis. Which manifestations does the nurse include in this teaching? (Select all that apply.)

Diarrhea, Salivation, Vomiting, Increased bronchial secretions

55. A nurse is collecting data from a client with Bell's palsy. Which finding should the nurse expect to note in the client?

Inability to close the eye on the effected side

26. The nurse is assisting with care of patients diagnosed with neuromuscular disorders. Which complication does the nurse recognize as a medical emergency?

Indications of the development of pneumonia

69. Which area of the brain is affected in the client who has right-sided weakness and aphasia due to a TIA?

Left hemisphere

28. The nurse is collecting data from a patient who is diagnosed with MG. Which data is most important for the nurse to obtain?

Monitor the patient's respiratory function and the ability to swallow effectively.

72. A client who has had a brain attack has left-sided flaccidity. This may be described as which of the following?

O Contralateral hemiplegia

47. Which assessment takes priority in the patient with Guillain-Barre Syndrome?

RR and depth

1. The nurse is providing care for patient diagnosed with stroke resulting in language disorder. Which type of disorder does the nurse recognize if the patient raises an arm in response to the nurse's direction to stick out his tọngue?

Receptive aphasia

5. A patient comes into the emergency department with unilateral paralysis, aphasia, and inability to follow directions. Which emergency management by the health care provider (HCP) is unexpected by the nurse?

Scheduling laboratory tests, electrocardiogram (ECG), and computerized tomography (CT) scan to be performed within 45 minutes

10. The nurse is providing care for a patient recovering from a right hemisphere infarct who now exhibits unilateral neglect. Which nursing intervention is most important at promoting safety for this patient?

Teach the patient to purposefully check the location of the left limbs.

16. The HCP is preparing to discharge a patient from the hospital after a stroke. The patient is insistent on being sent to a rehabilitation center. The nurse is aware that the patient must meet which qualification to go to rehabilitation?

The ability to participate in intensive therapy

20. The nurse is involved in a blood pressure clinic in the community, and an individual with possible stroke symptoms is brought for evaluation. Which findings in the FAST (Face, Arms, Speech, and Time) assessment indicate the need to call emergency personnel? (Select all that apply.)

The patient is unable to repeat a stated phrase exactly as it was stated. The patient's face shows signs of uneven symmetry when asked to smile. When asked to close the eyes and hold arms straight in front, one arm drifts downward.

33. The nurse is assisting with the care of a patient diagnosed with postpolio syndrome. The nurse asks the registered nurse (RN) to explain the source of the disease. Which answer by the RN is correct?

The patient must first have had a poliovirus infection.

61. A nurse is obtaining a history from client admitted to the hospital with a cerebral thrombotic stroke. The nurse collects data from the client, knowing that, before this type of stroke, the client likely experienced:

Transient hemiplegia and loss of speech

13. The nurse is providing care for a patient diagnosed with a cerebral aneurysm and subarachnoid hemorrhage. Which statement by the patient indicates a need for additional information?

"No strenuous activity until this condition is cured by surgery."

52. A nurse reinforces home-care instructions to a client with Bell's palsy about treatment measures for the disorder. Which statement by the client indicates a need for further instruction?

"I should place ice packs to the affected side of my face."

66. A client is placed on neostigmine (Prostigmin) for newly diagnosed Myasthenia gravis. The client asks, "How does that work?" Which of the following responses by the nurse is best?

"It makes more neurotransmitter available so your muscles can contract."

27. A patient who is prescribed neostigmine for newly diagnosed MG asks how the medication works. Which response does the nurse provide to the patient?

"It makes more neurotransmitters available so that your muscles can contract."

29. A mother of three young children has a 3-year history of MG and recently stopped helping in the children's classrooms because of fatigue. Which advice does the nurse give to help the patient best cope with the problem?

"Time your medication so its action peaks during the time you need the most energy."

63. A client with Parkinson's disease dislikes having muscle tremors and asks the nurse what can be done to make them less noticeable. The nurse should offer which suggestion to the client?

"Try holding onto the arm of a chair or grasping coins that in your pocket."

31. The nurse reviews information with a patient and family members about the patient's recent diagnosis of amyotrophic lateral sclerosis (ALS). Which comment by a family member indicates a need for clarification?

"When the heart muscle is affected, death will occur shortly."

67. A 76-year-old gentleman is admitted to the ER with right-sided weakness and difficulty speaking. Within an hour his symptoms have subsided and he is feeling fine. The physician diagnoses a TIA, and the client is admitted for observation and testing. The client asks, "What is a TIA?" What is the best response by the nurse?

"Your brain was temporarily deprived of oxygen."

17. The nurse is reviewing the medical records of patients in an HCP's practice. Which patient does the nurse recognize as the greatest risk for a stroke?

An older female patient who has osteoporosis, a femur fracture, and hyperlipidemia

2. A patient arrives at the emergency department and states, "Something is wrong. I just don't feel right." Which objective data causes the nurse to suspect the patient is experiencing some type of stroke?

Ataxia is present when the patient attempts to ambulate.

36. The nurse is preparing a patient with MG to undergo plasmapheresis. Which laboratory tests does the nurse verify and place on the medical record before the procedure?

Complete blood count, platelets, and clotting studies

15. The nurse is aware that children can be at risk for embolic stroke. Which condition is least likely to cause a child to have a stroke?

Contact sport trauma

76. What are reversible risk factors for brain attack?

Diet, smoking

68. A client is diagnosed with Bell's Palsy by his physician. What symptoms should the nurse assess for in this client?

Drooping of one side of his face

78. Which of the following is not included among the causes of a stroke?

Encephalitis

54. A client with myasthenia gravis is ready to return home and confides that she is concerned that her husband will no longer find her physically attractive. The nurse should plan to:

Encourage the client to share her feelings with her husband.

75. The nurse follows orders for q4hr neuro checks. Which of the following priorities should be included in the assessment?

Glasgow scale, pupil response, vital signs

14. A patient is admitted from the emergency department to the hospital unit following the diagnosis of an ischemic stroke. The patient did not qualify for tPA therapy. The nurse is aware that which post-stroke condition places the patient at greatest risk for deep vein thrombosis (DVT)?

Hypercoagulability related to the admitting diagnosis

58. A nurse is caring for a client with Parkinson's disease who is taking benztropine mesylate (Cogentin) daily. The nurse understands that the priority nursing action when caring for clients who are taking his medication is to monitor which of the following?

Intake and output

56. A nurse is collecting data about a client with Brown-Sequard syndrome. Which finding does the nurse expect to note?

Loss of touch and vibration sensation

37. A patient is scheduled for a thymectomy. For which peripheral nervous system disorder does the nurse plan care for this patient?

MG

59. A client with Guillain-Barre' syndrome is being admitted to the hospital. The client's chief complaint is an ascending paralysis that has reached the level of the waist. The nurse plans to have which of the following items available for emergency?

O Cardiac monitor and intubation tray

24. To protect from aspiration, what intervention should be carried out first following a stroke?

O Have a swallowing evaluation

45. Symptom of multiple sclerosis are caused by damage to which structure (s)?

O Myelin sheath

6. A patient arrives in the emergency department at 0200 exhibiting the manifestations of a stroke. The patient reports going to bed at 2100 and being negative for symptoms. If the CT reveals an ischemic stroke related to a blood clot, for which reason is tPA therapy withheld?

O The therapy is based on the timethe patient went to bed.

65. On which understanding should the nurse base teaching of the client who has experienced a TIA?

OA TIA may be a forewarning that the client may have a CVA.

18. The nurse is assisting with the care of a patient following an ischemic stroke who does not qualify for tPA therapy. The patient's current blood pressure is 190/110 mm Hg. For which reason will the patient's hypertension remain untreated?

OPermissive hypertension is being therapeutically used to salvage brain tissue.

57. A nurse is preparing to feed a client who has dysphagia. The nurse plans to do which of the following to assist the client with swallowing?

OProvide foods that have a soft consistency.

4. A patient comes into the emergency department with symptoms of a stroke. Which medication does the nurse expect to be given to the patient if diagnostic testing confirms an ischemic stroke?

OTissue-type plasminogen activator (tPA)

11. The nurse is assisting the registered nurse (RN) in providing care for a patient who is recovering from a stroke. Which assigned intervention by the RN will the nurse question?

Observe the patient performing astive range of motion (ROM) on the affected side.

3. The nurse is providing care for a patient diagnosed with an ischemic stroke on the left side of the brain. The nurse notices that the patient does not easily locate items placed at the bedside. In which area does the nurse place items for easy location?

One the right side

34. A patient reports to the nurse an inability to rest or sleep due to a long-term condition causing a constant urge to move the legs called restless legs syndrome (RLS). The patient expresses a need for some type of relief. Which suggestion by the nurse is most likely to help the patient?

Pramipexole or ropinrole medication therapy

32. A patient with trigeminal neuralgia is admitted to the hospital for diagnostic testing and possible surgery. Which intervention is appropriate for this patient?

Provide soft foods at body temperature at mealtimes.

8. A patient is recovering from a stroke. The family reports to the nurse that the patient alternates between periods of crying for no given reason to periods of laughing inappropriately. Which condition does the nurse suspect the patient is exhibiting?

Pseudobulbar effect

73. A 50-year-old elementary school teacher is admitted with respiratory distress related to post polio syndrome. Which of the following nursing interventions will be most important to her continued functioning?

Regular periods of rest between mild activities

62. A client with myasthenia gravis is having difficulty with the motor aspects of speech. He has difficulty forming words, and his voice has a nasal tone. The nurse should use which communication strategy when working with this client?

Repeat what the client said to verify the message.

43. A patient with MS has been prescribed baclofen to relax muscles. Which information is included in the nurse's teaching about this drug? (Select all that apply.)

Report any shortness of breath or other respiratory problems." " Avoid driving or operating machinery until the effects of the drug are known." "Prevent constipation by increasing fluids and fiber-rich food; use suppositories when necessary."

50. A licensed practical nurse who is employed in a long-term care facility is observing a nursing assistant ambulating a client with right-sided weakness. The LPN determines that the nursing assistant was performing the procedure safely if the LPN observed the nursing assistant:

Standing on the right side of the client

7. The patient is diagnosed with a cerebral vascular accident that has the slowest rate of recovery and the highest probability of causing extensive neurologic deficits. For which type of stroke does the nurse plan care for this patient?

Subarachnoid hemorrhage (SAH)

22. What are warning signs of stroke? (select all that apply)

Sudden dizziness Sudden numbness on one side

74. A 36-year-old store clerk has been extremely fatigued for the past 2 months and is having difficulty lifting even light objects. Her physician suspects myasthenia gravis and asks the nurse to assist with a Tensilon test. What client response to the Tensilon test leads the nurse to suspect myasthenia gravis?

The client's ptosis is temporarily improved

concerned about the patient's 41. The nurse is providing care for a patient being treated for trigeminal neuropathy. The nurse is nutritional status because of an inability to eat without experiencing severe pain. Which patient behavior indicates the nurse's interventions are successful?

The patient can eat multiple small, soft, lukewarm meals daily.

64. Upper Gl series identify structural abnormalities of the esophagus, swallowing dysfunction and oral aspiration.

True

46. What are symptoms of cholinergic crisis? (select all that apply)

Urination Vomiting Lacrimation

19. The nurse is providing care for a patient with expressive aphasia. Which intervention does the nurse expect to find in the patient's plan of care? (Select all that apply.)

Use a picture board. Provide pencil and paper.

77. Which of the following options for assisting the client with trigeminal neuralgia to wash her face is best?

Use lukewarm water and cotton balls

53. A client recovering from a brain attack (stroke) has become irritable and angry about the associated limitations. The nurse should take which approach to help the client regain motivation to succeed?

Use supportive statements to correct behavior.

51. A licensed practical nurse is assisting a registered nurse at a health screening clinic. Which client behavior is significant and indicates the need for the reinforcement of brain attack (stroke) prevention education?

Uses oral contraceptives and condoms for pregnancy and disease prevention

38. The nurse is collecting information from a patient in the HCP's office. The patient is exhibiting symptoms associated with Bell palsy. Which population group does the nurse recognize as being at greatest risk for the condition?

Women in the third trimester of pregnancy