Deck 23: Care of Patients with Disorders of the Brain

Question 1

Which condition(s)may cause seizures?

A) Stroke
B) Cerebral tumor
C) Hyperpyrexia
D) Epilepsy
E) Metabolic toxicity
F)Noune of above

Answer 1

Stroke
Cerebral tumor
Hyperpyrexia
Epilepsy
Metabolic toxicity

Question 2

Which symptom is a key sign of a brain tumor?

A) Morning nausea
B) Difficulty reading
C) A headache that awakens patient
D) Increasing blood pressure

Answer 2

A headache that awakens patient

Question 3

The nurse 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

Answer 3

Driving a vehicle

Question 4

Which nursing intervention best encourages self-feeding in a patient with right-sided paralysis after a CVA?

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 5

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 so that I can 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 6

The nurse is providing medication teaching to a patient with epilepsy who is taking phenytoin (Dilantin).Which statement best indicates that the nurse's teaching has been successful?

A) "I should decrease my alcohol intake to a single drink per day."
B) "I should visit the dentist every 3 to 6 months while taking this medication."
C) "I should take my antacid an hour after my Dilantin."
D) "This medication may turn my urine orange."

Question 7

A patient diagnosed with a primary brain tumor asks the nurse if this is a common disease.Which response is most appropriate for the nurse to make?

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 8

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 is most 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 9

The nurse instructs a person taking phenytoin (Dilantin)that periodic blood tests will be necessary.The nurse explains that the laboratory checks will monitor for which potential medication-induced change?

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

Question 10

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 11

The nurse is assisting a patient with agnosia after a CVA.Which intervention is most appropriate?

A) Showing the patient a spoon while calling it by name and describing its purpose.
B) Moving the patient's hand with a toothbrush in repetitive motion to brush teeth.
C) Describing the placement of food on the plate.
D) Providing an adaptive fork to enhance self-feeding.

Question 12

The nurse is caring for a patient who recently suffered a cerebrovascular accident (CVA).Family members ask the nurse why their father had a seizure.Which response is best for the nurse to make?

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 13

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 14

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."

Question 15

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

A) Maintain a quiet environment with minimal stimulation.
B) Provide all care using sterile technique.
C) Limit intake of oral fluids.
D) Provide magazines and other activities to reduce daytime naps.

Question 16

The nurse is assessing a patient on intravenous (IV)phenytoin (Dilantin).Which assessment finding is most concerning to the nurse?

A) Blood pressure (BP) 138/92
B) Frequent hiccups
C) Irregular apical pulse
D) Nausea and vomiting

Question 17

The nurse is caring for an anxious 20-year-old college student who just suffered his first seizure in his dorm room.The patient 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 18

A patient was recently diagnosed as having Bell palsy.Which nursing intervention is most important for the nurse to include in the patient's care plan?

A) Administer pain medication as needed.
B) Administer artificial tears and aclyclovir.
C) Implement aspiration precautions.
D) Offer the patient a small fan to cool the face.

Question 19

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 greater than what percentage?

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

Question 20

The nurse is caring for a patient with brain tumor-related hydrocephalus who is scheduled to undergo placement of a ventriculoperitoneal (V-P)shunt.Which information is most important for the nurse to include when explaining the purpose of the procedure?

A) A V-P shunt redirects the cerebrospinal fluid (CSF) from the ventricles to the peritoneum.
B) A V-P shunt stimulates ventricles to reabsorb excess CSF.
C) A V-P shunt channels excess CSF to the left atrium.
D) A V-P shunt provides a port from which excess CSF can be aspirated.

Question 21

The nurse is educating a patient about his cluster headaches.The nurse includes information that cluster headaches may be accompanied by which signs or symptoms?

A) Reddened conjunctiva
B) Nasal congestion
C) Ptosis
D) Lethargy
E) Sensitivity to touch

Question 22

The patient with a right-sided paralysis from a stroke becomes frustrated when attempting to self-feed.He throws the spoon at the nurse and begins to cry.What nursing action(s)is/are most appropriate at this time?

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 23

The nurse is caring for an adult patient with a history of seizures.In the event of a seizure,the nurse should document which information?

A) Duration of seizure
B) Location of initiation of seizure
C) Description of movements
D) Family's reaction during the seizure
E) Presence of incontinence

Question 24

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?

A) Assist the patient to stand.
B) Remind the patient to ambulate as much as possible.
C) Ensure that the call light is within reach.
D) Coach the patient in active range-of-motion (ROM).
E) Reinforce the use of a walker or cane.

Question 25

To help prevent aspiration while feeding a patient who has a right-sided paralysis,the nurse should implement which intervention(s)?

A) Place the patient in high Fowler 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 26

The nurse is aware that absence (petit mal)seizures are difficult to detect for which reason(s)?

A) Lack of an aura
B) Appearance as a brief moment of absentmindedness
C) Brief loss of consciousness (LOC)
D) Absence of patient memory of the event
E) Absence of postictal signs

Question 27

The nurse is caring for a patient admitted with a transient ischemic attack (TIA).A carotid ultrasound reveals a 40% obstruction.The nurse anticipates that the treatment will likely consist of which factor(s)?

A) Diet modification
B) Lifestyle alteration
C) Aspirin for antiplatelet aggregation
D) Daily doses of nitrates
E) Endarterectomy