Deck 54: Care of the Patient With a Neurologic Disorder

Question 1

What is the cranial nerve that supplies most of the organs in the thoracic and abdominal cavities and carries motor fibers to glands that produce digestive juices and other secretions?

A) Somatic motor nerve
B) Visceral sensory nerve
C) Abducens nerve
D) Vagus nerve

Answer 1

Vagus nerve

Question 2

What Glasgow Coma Scale rating would a patient receive who opens the eyes spontaneously,but has incomprehensible speech and obeys commands for movement?

A) 8
B) 10
C) 11
D) 12

Answer 2

12

Question 3

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?

A) Use a straw.
B) Tuck chin when swallowing.
C) Take a sip of liquid with each bite.
D) Turn head to the left.

Answer 3

Tuck chin when swallowing.

Question 4

What is the nurse assessing when asking the patient,"Who is the president of the United States?" during a level of consciousness assessment?

A) Orientation
B) Memory
C) Calculation
D) Fund of knowledge

Question 5

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?

A) Place patient in flat position and check temperature.
B) Administer oxygen and check oxygen saturation.
C) Place on side and check for leg swelling.
D) Sit upright and check blood pressure.

Question 6

What is the cardinal sign of increased intracranial pressure in a brain injured patient?

A) Pupil changes
B) Ipsilateral paralysis
C) Vomiting
D) Decrease in the level of consciousness

Question 7

As the result of a stroke,a patient has difficulty discerning the position of his body without looking at it.In the nurse's documentation,which would best describe the patient's inability to assess spatial position of his body?

A) Agnosia
B) Proprioception
C) Apraxia
D) Sensation

Question 8

A family member of a patient who has just suffered a tonic-clonic seizure is concerned about the patient's deep sleep.What is this behavior called?

A) Convalescent period
B) Neural recovery period
C) Sombulant period
D) Postictal period

Question 9

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?

A) Neck placed in a neutral position.
B) Head raised slightly with hips flexed.
C) Supine in gravity neutral position.
D) Turn on right side with head elevated.

Question 10

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?

A) It is an ominous indicator of permanent paralysis.
B) It is possibly a temporary condition and will clear.
C) It degenerates into a spastic paralysis.
D) It will progress up the cord to cause seizures.

Question 11

What are the two divisions of the nervous system?

A) Somatic and the autonomic
B) Cerebellum and the brainstem
C) Medulla oblongata and the diencephalon
D) Central and the peripheral

Question 12

What are surgical navigational systems?

A) Computerized devices that guide the surgeon
B) A set of detailed anatomic maps pinpointing specific areas of the brain
C) A written set of progressive processes for the resection of small brain tumors
D) The use of radioactive materials to pinpoint small tumors of the brain

Question 13

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?

A) Obtain an allergy history before the test.
B) Ambulate the patient when returned to the room after the test.
C) Use heated blanket to keep patient warm after procedure.
D) Keep NPO for 6 to 8 hours after the test.

Question 14

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?

A) As a sum of the scores of the four categories
B) As part of the Glasgow Coma Scale
C) As individual scores in each category
D) As progressive scores during a 24-hour period

Question 15

How would a nurse record the behavior when a patient with Alzheimer's disease attempts to eat using a napkin rather than a fork?

A) Apraxia
B) Agnosia
C) Aphasia
D) Dysphagia

Question 16

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?

A) Hypotension
B) Alzheimer's disease
C) Diabetes
D) Parkinson disease

Question 17

Which question is likely to elicit the most valid response from the patient who is being interviewed about a neurologic problem?

A) "Do you have any sensations of pins and needles in your feet?"
B) "Does the pain radiate from your back into your legs?"
C) "Can you describe the sensations you are having?"
D) "Do you ever have any nausea or dizziness?"

Question 18

The nurse is caring for a home health patient who had a spinal cord injury at C5 3 years ago.The nurse bases the plan of care on the knowledge that the patient will be able to:

A) feed self with setup and adaptive equipment.
B) transfer self to wheelchair.
C) stand erect with full leg braces.
D) sit with good balance.

Question 19

Which symptom is specific to migraine headaches?

A) Tachycardia
B) They become worse in the evening
C) They involve the entire head
D) They are preceded by an aura

Question 20

What is the nurse aware of when assessing a person with a craniocerebral injury?

A) Most injuries of this type are irreversible.
B) Open injuries are always more serious than closed injuries.
C) Signs and symptoms may not occur until several days after the trauma.
D) Trauma to the frontal lobe is more significant than to any other area.

Question 21

A ___________ is a diagnostic procedure used to identify lesions by observing the flow of radiopaque dye through the subarachnoid space.

Question 22

The nurse is aware that the characteristic gait of the person with Parkinson disease is a propulsive gait,which causes the patient to:

A) stagger and need support of a walker.
B) shuffle with arms flexed.
C) fall over to one wide when walking.
D) take small steps balanced on the toes.

Question 23

Involuntary rhythmic movement of the eyes,with oscillations that may be horizontal,vertical,or mixed movements,is called ___________________.

Question 24

How would the nurse instruct a patient with Parkinson disease to improve activity level?

A) To use a soft mattress to relax the spine.
B) To walk with a shuffling gait to avoid tripping.
C) To walk with hands clasped behind back to help balance.
D) To sit in hard chair with arms for posture control.

Question 25

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:

A) from the right side.
B) from the left side.
C) from the center.
D) from either side.

Question 26

Why are the drugs neostigmine (Prostigmin)and pyridostigmine (Mestinon)helpful to the person with myasthenia gravis?

A) Improves speech.
B) Improves visual disturbances.
C) Reduces pain.
D) Promotes nerve impulse transmission.

Question 27

What is the first sign of Bell's palsy?

A) Inability to wrinkle forehead and pucker lips on affected side
B) Sudden pain in nostril on affected side
C) Excessive salivation on the affected side
D) Excessive mucus running from nostril on affected side

Question 28

What does the nurse know about the stroke patient who has expressive aphasia?

A) Has difficulty comprehending spoken and written communication.
B) Cannot make any vocal sounds.
C) Has total loss and comprehension of language.
D) Can understand the spoken word,but cannot speak.

Question 29

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.

A) 3 hours
B) 4 hours
C) 6 hours
D) 8 hours

Question 30

What is the purpose of a "drug holiday" in the treatment of Parkinson disease?

A) Change all drugs.
B) Allow the natural dopamine levels to rise.
C) Restart drugs at a lower dosage with favorable results.
D) Reduce the extrapyramidal symptoms.

Question 31

Why is the patient with suspected Guillain-Barre Syndrome (GBS)hospitalized immediately?

A) The infection needs to be treated with IV antibiotics to prevent paralysis.
B) The brain may swell quickly causing seizures.
C) The disease can rapidly progress into respiratory failure.
D) IV hydration is needed to prevent possible fatal hypotension.

Question 32

Following a myelogram the nurse should include in the postprocedure care assessment for:

A) elevation of blood pressure.
B) urine retention.
C) sensation in lower extremities.
D) slurred speech.

Question 33

The nurse explains that the triad of signs of Parkinson disease is: _______,rigidity,and bradykinesia.

Question 34

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?

A) Cleanse nose with a soft cotton-tipped swab.
B) Gently suction the nasal cavity.
C) Gently wipe nose with absorbent gauze.
D) Ask patient to blow his nose.

Question 35

What is the basic problem that prompts most of the early signs of Alzheimer's disease?

A) Changes in mood
B) Misplacing things
C) Memory loss that disrupts daily life
D) Problems with words in speaking

Question 36

A patient is in which stage of Alzheimer's disease when she demonstrates "sundowning"?

A) Early stage
B) Second stage
C) Third stage
D) Final stage

Question 37

The nurse explains that the two divisions of the autonomic nervous system work to maintain homeostasis.Which is the first autonomic event?

A) Parasympathetic nervous system dominates
B) Extremely stressful or frightening event
C) Blood pressure,heart rate,and adrenaline output decrease
D) Sympathetic nervous system dominates
E) Heart rate and blood pressure rise,secretion of adrenaline

Question 38

What should the nurse do when the child arrives on the floor with the diagnosis of bacterial meningitis?

A) Arrange for humidified oxygen per mask.
B) Place the child in respiratory isolation.
C) Inquire about drug allergy.
D) Hold NPO until orders arrive.

Question 39

_________________ is/are responsible for the transmission of impulses between synapses.

Question 40

The waxy substance that covers the neuron fibers and increases the rate of transmission of impulses is the ________.