Deck 35: Brain and Spinal Cord Injury

Question 1

The medical reports of a client who suffered an accident show injuries at the sixth thoracic vertebra.Which condition does the nurse suspect in the client?
1)Concussion
2)Neurogenic shock
3)Diffuse axonal injury
4)Conus medullaris syndrome

Answer 1

2

Question 2

While assessing the motor strength in a client with a spinal cord injury,the nurse finds that the movements of the client are active against gravity.Which score should the nurse record?
1)Two
2)Three
3)Four
4)Five

Answer 2

2

Question 3

What does interruption of the dorsal spinal cord columns cause in a client with spinal cord injury?
1)Ipsilateral paralysis
2)Loss of proprioception
3)Positive Babinski sign
4)Loss of pain and temperature sensation

Answer 3

2

Question 4

The primary health-care provider prescribes myelography for a client who sustained a spinal cord injury.What is the rationale for this diagnostic test?
1)To provide a detailed picture of the intervertebral discs
2)To provide information on the integrity of the carotid arteries
3)To look for obstructed cerebrospinal fluid (CSF)flow around the spinal cord
4)To show malalignment of the bones that may aggravate injury to the spinal cord

Question 5

A client who sustained a rear-end motor vehicle collision is admitted to the emergency department.Which injury should the nurse expect to be present in the client?
1)Penetrating injury
2)Rotational injury
3)Hyperextension injury
4)None of the above

Question 6

The nurse is assessing a client who presents to the emergency room with a spinal cord injury.Which finding in the client's reports made the nurse suspect central cord syndrome?
1)Hemisection of the spinal cord
2)Acute intervertebral disc herniation
3)Hyperextension of the cervical spine
4)Fractures at L1 and L2

Question 7

Which disorder is associated with the compression of the bilateral nerve roots of the lumbosacral region?
1)Horner's syndrome
2)Cauda equina syndrome
3)Brown-Séquard syndrome
4)Anterior spinal artery syndrome

Question 8

The registered nurse is teaching about subdural hematomas to a group of student nurses.Which statement made by the student nurse indicates effective teaching?
1)"Subdural hematomas cause bleeding in the space below the skull bone and above the dura mater."
2)"Subdural hematomas cause bleeding in the space below the dura mater and above the arachnoid membrane."
3)"Subdural hematomas cause cerebral aneurysms occurring in the terminal portion of the internal carotid artery."
4)"Subdural hematomas cause tearing of the cerebral and meningeal vessels within the subarachnoid space of the brain."

Question 9

The laboratory reports of a client who had an accident show a fracture in the temporal bone of the middle ear.Which type of fracture should the nurse suspect in this client?
1)Basilar skull fracture
2)Linear fracture
3)Depressed fracture
4)Both A and C

Question 10

While assessing the extent of spinal cord injury in a client using the American Spinal Injury Association (ASIA)impairment scale,the nurse concludes that the client belongs to category C.Which findings enabled the nurse to reach this conclusion?
1)The sensory and motor functions are normal.
2)There is no sensory or motor function preserved in the sacral segments S4-S5.
3)The sensory function is preserved with no motor function below the neurological level.
4)There is motor function is preserved,and most key muscles below the neurologic level have a muscle grade less than 3.

Question 11

After assessing the sensory function in a client with a skull fracture,the nurse records the sensory index score as one.What does this score in the client indicate?
1)Intact sensitivity to stimuli
2)Impaired sensitivity to stimuli
3)Absence of sensitivity to stimuli
4)Both A and B

Question 12

Which factor can cause herniation of the brain stem?
1)Cerebral vasospasm
2)Rupture of a cerebral artery
3)Compression of optic nerve
4)Oculomotor nerve dysfunction

Question 13

The registered nurse is teaching about Brown-Séquard syndrome to a group of student nurses.Which statement made by the student nurse indicates effective learning?
1)"Brown-Séquard syndrome causes incontinence."
2)"Brown-Séquard syndrome results in disrupted aortic blood flow."
3)"Brown-Séquard syndrome is characterized by swelling of the neuronal axons."
4)"Brown-Séquard syndrome is associated with penetrating injuries that lead to the hemisection of the spinal cord."

Question 14

The registered nurse is teaching about the diagnostic tests for spinal cord injury to a group of student nurses.Which statement made by the student nurse indicates the need for further teaching?
1)"Myelography demonstrates intrinsic spinal cord pathology."
2)"X-rays show injury or malalignment of bones."
3)"Subtle fractures and soft tissue injury are more evident with computerized topography (CT)scans."
4)"Magnetic resonance imaging (MRI)provides detailed pictures of the spinal cord,intervertebral discs,and CSF spaces."

Question 15

Which nerve is responsible for sexual function?
1)Cervical nerve
2)Lumbar nerve
3)Thoracic nerve
4)Both A and B

Question 16

While caring for a client with a neck injury,the nurse finds that the client has no sensation in the arms and hands.Which disorder should the nurse suspect in the client?
1)Horner's syndrome
2)Central cord syndrome
3)Cauda equina syndrome
4)Conus medullaris syndrome

Question 17

What is the cause of Horner's syndrome?
1)Fractures of L1 and L2
2)Injury at T1 and above
3)Damage to the ascending and descending neural tracts
4)Disruption of blood flow to the anterior two thirds of the spinal cord

Question 18

Which statement made by the mother of the client with spinal cord injury made the nurse suspect an axial loading injury?
1)"My child was injured in a fireworks accident yesterday."
2)"My child was injured while diving in the swimming pool."
3)"My child was injured when he fell from the first floor of our house."
4)"My child was injured during an accident while driving at a fast speed."

Question 19

Which symptom should the nurse expect in a client with a skull fracture in the frontal fossa?
1)Whiplash
2)Battle's sign
3)Thunderclap headache
4)Periorbital ecchymosis

Question 20

While reviewing the clinical history of a client with brain injury,the nurse finds that there is a bruising of the mastoid process behind the ear of the affected side.Which fracture should the nurse suspect in the client?
1)Linear fracture
2)Basilar skull fracture
3)Depressed fracture
4)Frontal fossa fracture

Question 21

A client with diffuse axonal injury is experiencing difficulty with speech.Which region of the brain does the nurse suspect to be affected?
1)Brain stem
2)Broca's area
3)Occipital lobe
4)Cerebral motor cortex

Question 22

The registered nurse is teaching about neurogenic shock to a group of student nurses.Which statement made by the student nurse indicates the need for further teaching? Select all that apply.
1)"Neurogenic shock reduces the systemic blood pressure."
2)"Neurogenic shock results in peripheral vasodilation."
3)"Neurogenic shock causes flaccid muscles and paralysis."
4)"Loss of the anal reflex is the hallmark sign of neurogenic shock."
5)"Neurogenic shock causes a lack of normal sympathetic outflow from the T1-L2 region of the spinal cord."

Question 23

The nurse suspects cerebral edema in a client with a cerebral contusion.Which diagnostic test will help in confirming the diagnosis?
1)Skull x-ray
2)Cerebral angiography
3)Magnetic resonance imaging (MRI)
4)Computed tomography (CT)scan