Deck 24: Care of Patients With Disorders of the Brain

Question 1

The nurse reinforces the information given by the physician that endarterectomy as an intervention for stroke prevention is reserved for people who have carotid obstruction of more than:

A)30%.
B)40%.
C)50%.
D)60%.

Answer 1

60%.

Question 2

The nurse is providing teaching to a patient newly diagnosed with simple partial seizure disorder.Which statement by the nurse is most accurate?

A)"Your seizures will typically only affect one side of your body."
B)"Simple partial seizures may result in an alteration of consciousness."
C)"The simple partial seizure may cause motor impairment to begin in all of your extremities."
D)"Simple partial seizures are not treatable."

Answer 2

"Your seizures will typically only affect one side of your body."

Question 3

The nurse instructs a person taking phenytoin (Dilantin)that periodic blood tests will be necessary.What is the physician monitoring for?

A)Potassium depletion
B)Liver damage
C)Increased creatinine levels
D)Increased sedimentation rates

Answer 3

Liver damage

Question 4

A patient diagnosed with a primary brain tumor asks the nurse if this is a common disease.Which response by the nurse is accurate?

A)"Brain tumors are very rare."
B)"About 40,000 people a year are diagnosed with a primary brain tumor."
C)"It doesn't really matter. We are just concerned with helping you."
D)"Almost all primary brain tumors are malignant."

Question 5

The nurse is aware that a key sign of a brain tumor is:

A)morning nausea.
B)difficulty reading.
C)headache that awakens patient.
D)increasing blood pressure.

Question 6

The nurse is writing the care plan for a cerebrovascular accident (CVA)patient who has partial left-sided paralysis and is experiencing ataxia.Which intervention will be beneficial for this patient?

A)Encourage the patient to ambulate as much as possible when she feels the energy to do so.
B)Ensure the patient receives pureed foods and thickened liquids.
C)Place the patient's call light on the right side of the patient and remind her to call for assistance before getting up.
D)Encourage the patient to use a communication board.

Question 7

The anxious 20-year-old college student who just suffered his first seizure in his dorm room asks the nurse if he is now an epileptic.What is the nurse's best response?

A)"No. All other causes of seizure activity must be ruled out before the diagnosis of epilepsy is made."
B)"Yes, but you may never have another seizure since it has just now manifested itself."
C)"No, but you should see a physician to get a prescription for a preventative antispasmodic."
D)"Yes. All seizures are considered to be epilepsy."

Question 8

The patient who suffered a CVA has developed agnosia.Which intervention by the nurse is most helpful?

A)Telling the patient "This is a spoon. You are to eat with it."
B)Moving the patient's hand with a toothbrush in repetitive motion to brush teeth
C)Telling the patient "The table edge is right in front of you."
D)Providing an adaptive fork to enhance self-feeding

Question 9

What intervention by the nurse would most encourage self-feeding in a patient who recently had a CVA with right-sided paralysis?

A)Place "finger foods" on the left side of the plate.
B)Support the right hand in holding an adaptive cup.
C)Seat the patient in the dining room with other residents.
D)Place large helpings of food in the center of the plate.

Question 10

The nurse on a rehabilitation unit is caring for a stroke patient who is experiencing homonymous hemianopsia.The patient asks if he is going to have any limitations when discharged from the hospital.The nurse anticipates the patient will be restricted from what activity?

A)Ambulating independently
B)Cooking on a stove
C)Reading a book
D)Driving a vehicle

Question 11

The nurse is caring for a patient who recently suffered a cerebrovascular accident (CVA).The family asks the nurse why their father had a seizure.What is the best response by the nurse?

A)"The seizure was most likely caused by brain cells being deprived of oxygen due to a blood clot in the brain."
B)"The stroke generated a toxin that excites the brain cells."
C)"The stroke causes an alteration in the cells adjacent to the blood clot."
D)"The stroke causes an increase in the depolarization of the brain cells due to the clot formation."

Question 12

A patient was recently diagnosed as having Bell's palsy.Which nursing intervention will the nurse include in the care plan for this patient?

A)Medication for pain relief
B)Protection of the eye on paralyzed side
C)Precautions against aspiration
D)Provision of a fan to cool the face

Question 13

The nurse is assessing a patient on IV phenytoin (Dilantin).Which assessment finding is the nurse concerned with?

A)BP 138/86
B)Frequent hiccups
C)Irregular apical pulse
D)Nausea and vomiting

Question 14

Following a craniotomy for the removal of a brain tumor,the patient exhibits nuchal rigidity,rash on the chest,headache,and a positive Brudzinski sign.What do these assessment findings indicate to the nurse?

A)Intracranial bleeding
B)Encephalitis
C)Increasing intracranial pressure
D)Meningitis

Question 15

The patient with brain tumor-related hydrocephalus is to have a ventriculoperitoneal (V-P)shunt.The nurse explains that this surgical intervention will:

A)redirect the cerebrospinal fluid from the ventricles to the peritoneum.
B)stimulate ventricles to reabsorb excess cerebrospinal fluid.
C)channel excess cerebrospinal fluid to the left atrium.
D)provide a port from which excess cerebrospinal fluid can be aspirated.

Question 16

The nurse is aware that seizures may be caused by: (Select all that apply.)

A)stroke.
B)cerebral tumor.
C)hyperpyrexia.
D)epilepsy.
E)metabolic toxicity.
F)None of the above.

Question 17

The nurse is caring for a patient with bacterial meningitis.What will the nurse include in the plan of care?

A)A quiet environment with minimal stimulation
B)Care using medical asepsis
C)Limitation of oral fluids
D)Distraction to reduce daytime naps

Question 18

The dysarthric patient seated in the dining room of the long-term care facility yells,"Poon! Poon! Poon!" with increasing frustration.What is the nurse's best response?

A)"Slow down, I can't understand what you are saying."
B)"Are you asking for a spoon?"
C)"Not being able to speak is frustrating."
D)"If you tell me what you want, I will get it."

Question 19

The nurse is providing medication teaching to a patient with epilepsy who is taking an anticonvulsant medication.What should the nurse tell the patient to be sure to avoid?

A)Taking alternative herbal remedies
B)Drinking alcohol
C)Using over-the-counter cold remedies
D)Taking diet pills with ephedra

Question 20

The patient reports intense intermittent headaches over the last 6 months that are preceded by specific symptoms.What symptom is the patient most likely experiencing?

A)Nausea and vomiting
B)Focal seizures
C)Scotoma
D)Fainting

Question 21

The nurse is aware that absence (petit mal)seizures are difficult to detect because: (Select all that apply.)

A)there is no aura.
B)the seizure appears to be a brief moment of absentmindedness.
C)there is a loss of consciousness.
D)the patient has no memory of the event.
E)there are no postictal signs.

Question 22

The patient had a carotid ultrasound that showed a 40% obstruction following a transient ischemic attack (TIA).The nurse anticipates that the treatment will consist of: (Select all that apply.)

A)diet modification.
B)lifestyle alteration.
C)aspirin for antiplatelet aggregation.
D)daily doses of nitrates.
E)endarterectomy.

Question 23

To help prevent aspiration while feeding a patient who has a right-sided paralysis,the nurse includes which interventions? (Select all that apply.)

A)Place the patient in high Fowler's position.
B)Instruct the patient to tilt the head and neck forward.
C)Instruct the patient to drink liquids through a straw.
D)Place food in the left side of the mouth.
E)Avoid mixing foods with different textures.

Question 24

The nurse caring for an adult patient on the medical unit who has a seizure will document: (Select all that apply.)

A)length of time of seizure.
B)location of initiation of seizure.
C)whether movements are unilateral or bilateral.
D)family's reaction during the seizure.
E)presence of incontinence.

Question 25

The patient with a right-sided paralysis from a stroke becomes frustrated with attempting to self-feed.He throws the spoon at the nurse and begins to cry.What nursing actions would be best? (Select all that apply.)

A)Retrieve the spoon and sit quietly for a few seconds.
B)Touch the patient and inquire if he would rather have a high-protein milkshake for his meal.
C)Remind the patient that such behavior is not acceptable.
D)Add an intervention to the NCP for increased support with self-feeding.
E)Complete an incident report.

Question 26

The nurse is completing a care plan for a stroke patient who is at risk for impaired physical mobility.Which interventions should the nurse include in the care plan? (Select all that apply.)

A)Assist the patient to stand.
B)Remind the patient to ambulate as much as possible.
C)Ensure that the call bell is easily available.
D)Coach the patient in active ROM.
E)Reinforce the use of a walker or cane.

Question 27

The nurse is educating a patient about his cluster headaches.The nurse is correct when stating that cluster headaches may be accompanied by which signs or symptoms? (Select all that apply.)

A)Reddened conjunctiva
B)Nasal congestion
C)Ptosis
D)Hypotension
E)Sensitivity along trigeminal nerve