NUR 101 exam 8
A neuro assessment includes
Understanding of the tests used to diagnose neurologic disorders Knowledge of nursing interventions related to assessment and diagnostic testing Knowledge of the anatomy of the nervous system
cranial nerve is responsible for facial sensation, corneal reflex, and mastication
trigeminal (V)
grief in a child, what is some normal responses
"it is my fault mommy died for not listening" sleeping pattern changes nightmares
Glascow Coma Scale
A normal response is 15. A score of 7 or less is considered comatose.
"For a long time now, food just doesn't taste as well as it used to." The nurse should be aware that the etiology of this problem is most likely to involve:
Age-related changes to the neurological system
most common cause(s) of blindness and visual impairment among adults over the age of 40? Select all that apply.
Diabetic retinopathy Macular degeneration Glaucoma
The nurse is caring for a client after lumbar puncture. The client reports a severe headache. Which actions should the nurse complete? Select all that apply.
Maintain the client on bed rest. Administer fluids to the client. Position the client in the supine position. Administer analgesic medication.
Which terms refers to the progressive hearing loss associated with aging?
Presbycusis
client diagnosed with a stroke and cannot elicit a gag reflex. This deficit is related to which of the following cranial nerves
Vagus nerve X gag reflex, laryngeal hoarseness, swallowing ability, and the symmetrical rise of the uvula and soft palate
A nurse needs to change a dressing on an abdominal wound for a patient who is hearing-impaired and whose speech is difficult to understand. Which of the following is the best approach for the nurse?
Write down the steps of the procedure for the patient to read before beginning the treatment.
Nerve impulses (in the neuron)
allow for messages to move from one neuron to another
can cause tinnitus (ear ringing)
aspirin in high doses
The nurse is performing a neurologic assessment of a client whose injuries have rendered the client unable to follow verbal commands. How should the nurse proceed with assessing the client's level of consciousness (LOC)?
assess eye opening response to stimuli
Which term refers to the period of time during which mourning of a loss takes place?
bereavement
central nervous system includes
brain and spinal cord
strategies to use when teaching about anxiety
calm, nonthreatening manner atmosphere of low stimulation limit the time spent and amount of information
what to do first when an older adult is diagnosed with anxiety disorder
check any meds that they are on for interactions
client comes in to the ED with spinal precautions, what is the priority
checking that the cervical collar was correctly placed
to see if the patient can smell coffee, alcohol, and mint. The patient is unable to smell any of the odors. The nurse is aware that the patient has a dysfunction of which cranial nerve?
cn I olfactory
peripheral nervous system includes
cranial nerves spinal nerves autonomic nervous system
classic grief response for someone whose spouse just passed
difficulty sleeping
Which of the following cranial nerves is responsible for salivation, tearing, taste,facial expression and sensation in the ear?
facial
A patient sustained a head injury during a fall and has changes in personality and affect. What part of the brain does the nurse recognize has been affected in this injury?
frontal lobe
peripheral nervous system is important to
get messages to other body systems to work appropriately
Cranial nerve IX is also known as which of the following?
glossopharyngeal CN 9
a client has expressive aphasia, what can the nurse do to help communication
have the client point to needed objects although they can understand what you say, they cannot communicate their needs
which advance care directive should be done to make sure a clients wishes are carried out
healthcare power of attorney- appoint someone to carry them out for you
CN VIII is the vestibulochochlear acoustic nerve. It has to do with
hearing, air and bone conduction, and balance
a living will
holds no legal weight for future healthcare decisions to be made when the client cannot
sensory neurons
impulses from skin to muscle
motor neurons
impulses from the brain and spinal cord (CNS) that allow for muscles to actually contract
what is a risk factor for general anxiety disorder
low socioeconomic status
Which part of the brain contains regulatory centers for heartbeat, vasomotor activity, and breathing?
medulla oblongata
SEVERE anxiety sign is
nausea
the basic cell of the nervous system is the
neuron
nervous system
neurons nerve impulses sensory motor
is depression a normal part of aging
no! it is not normal can be caused by life events, losses leads to memory problems and social withdrawal
goal of improving quality of life, mood, and median survival.
palliative care
The client has difficulty copying a figure that the nurse has drawn and is diagnosed with visual-receptive aphasia. What brain region is primarily involved in this deficit?
parietal occipital lobe
a stroke effecting the right hemisphere of the brain,nurse should initally assess for
poor impulse control (safety issue!)
CN III is the oculomotor nerve and has to do with
pupillary response, conjugate movements, and nystagmas
unable to see out of their left eye. The client tells the nurse that symptoms began with seeing spots or moving particles in the field of vision but that there was no pain in the eye. we should be concerned with the
retinal detachment
parents whose child died by an accidental gunshot, now tell the nurse about being in gun legislation, what defense mechanism is this
sublimation they redirected feelings into an acceptable channel
VII (7) the facial nerve and has to do with
symmetry of facial movements and the ability to discriminate between the tastes of sugar and salt. The inability to close one eyelid indicates impairment of this nerve.
illustrates that a client suffers from major depression
symptoms last longer than 14 days
if a child loses someone, (grandparent) what should the nurse be asking about
the relationship that they had with that person
A patient recently noted difficulty maintaining his balance and controlling fine movements.
think cerebellum
severe pain in the face that was stimulated by brushing the teeth. What cranial nerve does the nurse understand can cause this type of pain?
trigeminal nerve V
a good question to ask someone being discharged after a mental illness
what skills can you now use if you experience these problems again
