Question 1

A patient is going for digital subtraction angiography.The patient education plan to prepare the patient for the procedure should include which instruction?

Accepted Answer

A)  Inform the patient that the procedure is very noisy and earplugs will be provided 
B)  Tell the patient that repositioning will be required at appropriate intervals 
C)  Instruct the patient to remaining motionless during the entire procedure 
D)  Let the patient know he will be expected to swallow frequently during the procedure

Question 2

The nurse is caring for a patient with a closed head injury with a Glasgow Coma Scale (GCS)score of 6.What does this score indicate about the patient's neurologic status?

Accepted Answer

A)  Patient is in a vegetative state. 
B)  Patient is a paraplegic. 
C)  Patient is in a coma. 
D)  Patient is able to obey commands.

Question 3

The nurse is caring for a critically injured patient who can only be aroused by vigorous external stimuli.Which category should the nurse use to document the patient's level of consciousness?

Accepted Answer

A)  Lethargic 
B)  Obtunded 
C)  Stuporous 
D)  Comatose

Question 4

The nurse is caring for a patient immediately after a craniotomy.When assessing the size and shape of the patient's pupils the nurse notes the patient's left pupil is oval.What does this finding indicate?

Accepted Answer

A)  Cortical dysfunction 
B)  Intracranial hypertension 
C)  Hydrocephalus 
D)  Metabolic coma

Question 5

The nurse is caring for a patient with a head injury and observes a rhythmic increase and decrease in the rate and depth of respiration followed by brief periods of apnea.What should the nurse document under breathing pattern?

Accepted Answer

A)  Central neurogenic hyperventilation 
B)  Apneustic breathing 
C)  Ataxic respirations 
D)  Cheyne-Stokes respirations

Question 6

A patient with a serious head injury has been admitted.The nurse knows that certain neurologic findings can indicate the prognosis for the patient.Which finding denotes the most serious prognosis?

Accepted Answer

A)  Decorticate posturing 
B)  Decerebrate posturing 
C)  Absence of Babinski reflex 
D)  Glasgow Coma Scale (GCS) score of 14

Question 7

The nurse and a new graduate nurse are caring for a comatose patient on continuous electroencephalography (cEEG)monitor.The new graduate says "This monitor is great.How come we don't use it on all the neuro patients?" What are the drawbacks to using this type of monitor?

Accepted Answer

A)  Size of machine 
B)  Expensive 
C)  Labor-intensive program 
D)  Requires expertise for interpretation 
E)  Artifacts from ICU environment

Question 8

While the Glasgow Coma Scale (GCS)is part of the routine neurologic assessment,the nurse knows that it is not a valid measure for certain types of patients.In which patient is the GCS not valid?

Accepted Answer

A)  Patient with hemiplegia 
B)  Patient with Parkinson disease 
C)  Patient with dyslexia 
D)  Patient who is intoxicated

Question 9

Why is assessment of level of conscious (LOC)the most important aspect of the neurologic examination?

Accepted Answer

A)  The LOC is the most prognostic indicator of the patient's outcome. 
B)  The LOC is generally limited to the Glasgow Coma Scale making it the quickest part of the assessment. 
C)  In most situations the LOC deteriorates before any other neurologic changes are noted. 
D)  The LOC is the easiest part of the neurologic exam and thus is generally performed first.

Question 10

The patient was admitted with a head injury and an intracranial pressure (ICP)monitoring device was placed.The nurse knows to notify the practitioner if what type of wave start to appear on the monitor?

Accepted Answer

A)  A waves 
B)  B wave 
C)  C waves 
D)  D waves

Question 11

A patient has been admitted with acute confusion and other focal neurologic signs.The practitioner is going to perform a lumbar puncture.What is an abnormal finding in the cerebrospinal fluid?

Accepted Answer

A)  Clear and colorless 
B)  Glucose of 60 mg/dL 
C)  Protein of 20 mg/dL 
D)  30 red blood cells

Question 12

The nurse is starting a peripheral intravenous catheter in the right hand of an unconscious patient.During the procedure the patient reaches over with his left hand and tries to remove the noxious stimuli.How would the nurse document this response?

Accepted Answer

A)  Decorticate posturing 
B)  Decerebrate posturing 
C)  Withdrawal 
D)  Localization

Question 13

The nurse is caring for a patient who is going to have digital subtraction angiography.The patient asks what is the difference between conventional and digital subtraction angiography.What should the nurse tell the patient?

Accepted Answer

A)  Digital subtraction angiography has fewer complications. 
B)  Digital subtraction angiography is noninvasive. 
C)  Digital subtraction angiography uses significantly less dye. 
D)  Digital subtraction angiography is done through the femoral vein.

Question 14

According to the 2007 Brain Trauma Foundation guidelines,the recommended CPP range is:

Accepted Answer

A)  10 to 30 mm Hg. 
B)  30 to 50 mm Hg. 
C)  50 to 70 mm Hg. 
D)  70 to 85 mm Hg.

Question 15

The practitioner wishes to evaluate the functional integrity of cerebral motor pathways in a brain-injured patient.Which test should the nurse anticipate the practitioner will order?

Accepted Answer

A)  Electroencephalography 
B)  Xenon computed tomography (CT) 
C)  Motor-evoked potentials 
D)  Emission tomography

Question 16

A patient has been admitted with acute confusion and other focal neurologic signs.The practitioner is going to perform a lumbar puncture.What is the most serious complication of lumbar puncture?

Accepted Answer

A)  Meningitis 
B)  Dural tear 
C)  Brainstem herniation 
D)  Spinal cord trauma

Question 17

A patient is undergoing a preoperative evaluation for carotid arteries.What two test should the nurse expect to see ordered for the patient?

Accepted Answer

A)  Ultrasound and magnetic resonance angiography 
B)  Conventional angiography and evoked potential 
C)  Computed tomography (CT) and magnetic resonance angiography 
D)  Transcranial Doppler and extracranial Doppler

Question 18

The nurse is caring for a patient who has sustained a traumatic head injury.The practitioner has asked the nurse to test the patient's oculocephalic reflex.Which findings indicate that the patient has an intact oculocephalic reflex?

Accepted Answer

A)  The patient's eyes move in the same direction the head is turned. 
B)  The patient's eyes move in the opposite direction to the movement of the patient's head. 
C)  The patient's eyes rove and move in opposite directions from each other. 
D)  The patient's eyes move up and down and then back and forth.

Question 19

The nurse is caring for a patient who has just had a cerebral angiogram.Which intervention should be part of the nursing management plan?

Accepted Answer

A)  Ensuring that the patient is adequately hydrated 
B)  Maintaining the patient on an NPO status 
C)  Administering antibiotics to the patient 
D)  Keeping the patient flat in bed for 24 hours

Question 20

Considering anatomic location,which cranial nerve will be affected first by downward pressure onto the infratentorial structures?

Accepted Answer

A)  III 
B)  VI 
C)  IX 
D)  X

Exam 22: Neurologic Clinical Assessment and Diagnostic Procedures