Deck 27: Neurologic Disorders

Question 1

The nurse caring for a 90-year-old patient with a closed head injury would immediately report:

A) Blood pressure change from 147/72 to 176/70 mm Hg
B) Respiration rate increase from 14 to 18 breaths/min
C) Slow pupillary reaction bilaterally
D) Temperature decrease from 100.2° to 97.6° F

Answer 1

Blood pressure change from 147/72 to 176/70 mm Hg

Question 2

The nurse explains that the neural synapse refers to the:

A) Length of time it takes for afferent neurons to carry impulses to the central nervous system (CNS)
B) Length of time it takes for efferent neurons to carry impulses to the motor neurons
C) Space between the axons and the dendrites of a neuron
D) Space between the axons of one neuron and the dendrites of the next

Answer 2

Space between the axons of one neuron and the dendrites of the next

Question 3

A patient with generalized convulsive disorder has a nursing diagnosis of "Deficient knowledge,related to lack of information about the side effects of phenytoin (Dilantin)." Which goal and outcome criteria would be most appropriate?

A) Absence of gastrointestinal (GI) complaint; takes medication with food
B) Stimulation of gingiva; brushes teeth vigorously to encourage gingival growth
C) Maintenance of normal pattern of elimination; limits fluids and eats foods that reduce diarrhea
D) Maintenance of normal sleep pattern; reduces stimuli and takes warm baths to induce drowsiness

Answer 3

Absence of gastrointestinal (GI) complaint; takes medication with food

Question 4

A patient with Parkinson disease is depressed because his drug protocol of L-dopa and Sinemet are no longer controlling his symptoms.The nurse's response that would be the most helpful information is that:

A) Other drugs can be combined with L-dopa to increase its effectiveness.
B) The effect of these drugs has an uneven course; symptoms will begin to subside again soon.
C) The two drugs can be given in higher doses to control the symptoms.
D) Surgical interventions have been very effective in the control of parkinsonian symptoms.

Question 5

The nurse explains that the three symptoms characteristic of Cushing triad associated with increased ICP are:

A) Hypotension, tachycardia, and narrowing pulse pressure
B) Hypertension, tachycardia, and headache
C) Widening pulse pressure, headache, and seizure
D) Bradycardia, hypertension, and widening pulse pressure

Question 6

The neurologic finding that would be considered abnormal in an 88-year-old patient would be:

A) Slow papillary response to light
B) Jerky eye movements
C) Dizziness and problems with balance
D) Absence of the Achilles tendon jerk

Question 7

The nurse should assess the patient scheduled for an angiogram for:

A) Dizziness
B) Allergy to shrimp
C) Increased BP
D) Irregular heartbeat

Question 8

The intervention that should be added to the nursing care plan for supporting nutritional intake for a patient with Parkinson disease would be to:

A) Offer large meals with a variety of finger foods.
B) Thicken liquids to make them easier to swallow.
C) Puree all foods and drink through a straw.
D) Offer a diet high in carbohydrates and fat and low in protein.

Question 9

A patient with Parkinson disease is considering taking St.John's wort,an herbal remedy for depression,in addition to Sinemet and L-dopa.The best response is to make the patient aware that:

A) Depression is reduced by the use of herbal remedies such as St. John's wort.
B) Doses of St. John's wort and parkinsonian drugs should be taken on alternate days.
C) St. John's wort must be taken in large doses to reduce depression.
D) Herbal remedies can interfere with the effectiveness of the parkinsonian drugs.

Question 10

The patient with meningitis who has a positive Brudzinski sign will:

A) Flex the hips when the neck is flexed by the nurse.
B) Will not be able to extend the flexed leg fully because of hamstring pain.
C) Resist efforts of the nurse to flex his or her neck.
D) Flex the big toe upward and fan out the other toes.

Question 11

The patient who is stuporous but reacts by withdrawing from painful stimuli is said to be:

A) Comatose
B) Lethargic
C) Semicomatose
D) Somnolent

Question 12

The patient in the emergency department states that she fell and hit her head and blacked out for a while but became alert again.Suspecting an epidural hematoma,the nurse will be diligent in the assessment of:

A) Headache
B) Drowsiness
C) Increasing respiration rate
D) Vomiting

Question 13

The assessment indicating that mannitol therapy for cerebral edema is effective in a patient with increased ICP is:

A) Increased BP
B) Increased urinary output
C) Decreased pulse
D) Widening pulse pressure

Question 14

The nurse evaluates a positive outcome to the goal of teaching for the nursing diagnosis of "Knowledge deficit,related to conservation of energy in a patient with multiple sclerosis" (MS)when the patient says:

A) "Now that I am taking steroids, I will be able to work like I used to."
B) "I'm making a list of things that are important and things I will simply have to let go."
C) "I will make a plan to allow for long rest periods at least four times a day."
D) "I am working on balancing time between rest, work, and family time."

Question 15

A patient who has a pacemaker might be ineligible for:

A) Computed tomography (CT)
B) Electromyography (EMG)
C) Magnetic resonance imaging (MRI)
D) Electroencephalography (EEG)

Question 16

A patient with a severe head injury begins to assume a posture of flexed upper extremities,with plantar-flexed lower extremities.These assessments indicate:

A) Increasing intracranial pressure (ICP) with decorticate posturing
B) Decreasing ICP with decerebrate posturing
C) Decreasing ICP with decorticate posturing
D) Increasing intracranial pressure with decerebrate posturing.

Question 17

An older adult patient who is experiencing extreme stress related to an admission to the hospital would be expected to demonstrate:

A) Decreased heart rate
B) Decreased blood pressure (BP)
C) Irregular respiration
D) Dilation of the pupils

Question 18

The most reliable indicator of neurologic status is:

A) BP
B) Pulse rate
C) Temperature
D) Level of consciousness

Question 19

To prevent a headache after lumbar puncture,the nurse instructs the patient to:

A) Lie flat
B) Lie on left side
C) Stay in semi-Fowler position
D) Ambulate in the room with assistance

Question 20

The nurse documents a normal finding from the Babinski reflex as the:

A) Downward curl of the toes
B) Big toe bending upward
C) Spreading out of the toes
D) Pain in the big toe

Question 21

A family member asks the nurse what would be an appropriate gift for a patient with Parkinson disease.The most useful reply would be:

A) Soft-soled house shoes
B) Jigsaw puzzle
C) Set of card games
D) Satin sheets

Question 22

The nurse organizes the plan of care with regard to normal brain alterations associated with age,which are:

A) Decrease in brain weight
B) Pigmentation of brain with lipofuscin
C) Present of amyloid
D) Tiny clot formation
E) Tangled nerve fibers

Question 23

Before giving an enteral feeding to a patient,the nurse should:

A) Palpate the abdomen to check for residual feeding.
B) Warm the feeding.
C) Elevate the head of the bed 30 degrees.
D) Ask the patient to tip his head forward.

Question 24

In caring for the patient after a craniotomy,the nurse can help reduce ICP by:

A) Keeping the patient flat in bed.
B) Elevating the head of the bed 30 degrees.
C) Closely monitoring the IV rate.
D) Turning the patient to the right side.

Question 25

The nurse caring for an immobilized patient with a brain tumor stimulates the patient several times a day with range-of-motion exercises and changes his position every 2 hours to try to prevent a disuse syndrome,which includes:

A) Pooling of pulmonary secretions
B) Paralysis
C) Muscle tremor
D) Pressure ulcers
E) Altered visual perceptions

Question 26

The nurse conducting a Romberg test will ask the patient to: (Arrange in the correct sequence.)

A) Touch his or her nose with the index finger with the eyes open.
B) Stand with eyes closed.
C) Touch his or her nose with the index finger with the eyes closed.
D) Touch his or her fingertip to nurse's fingertip.
E) Pat the knees with the palms and then the back of the hands rapidly.

Question 27

When a patient falls to the floor in a generalized seizure,the nurse should:

A) Cradle the head to prevent injury.
B) Insert an object between the teeth to prevent the patient from biting the tongue.
C) Manually restrain the limbs.
D) Keep the patient on his or her back to prevent aspiration.

Question 28

The nurse updates the nursing care plan for a patient with amyotrophic lateral sclerosis (ALS)who is uniquely prone to depression because:

A) Nutritional intake is poor.
B) Intellectual capacity is not affected.
C) Mobility is limited.
D) Communication is altered.

Question 29

The nurse assessing the level of consciousness in a patient will perform the following: (Arrange in order from the simplest to the most complex.)

A) Apply pressure to the nail bed.
B) Shake the patient.
C) Touch the patient.
D) Call the patient's name.
E) Approach the patient.

Question 30

The nursing assessment that would indicate a need for suctioning a patient with Guillain-Barré who is experiencing impaired breathing patterns because of neuromuscular failure is:

A) Decreased pulse rate, respiration of 20 breaths per minute
B) Increased pulse rate, adventitious breath sounds
C) Increased pulse rate, respiration of 16 breaths per minute
D) Decreased pulse, abdominal breathing

Question 31

In caring for an unconscious patient who suffered a head injury 10 days ago,the nurse positions the patient to prevent the limbs from:

A) Flexion deformities
B) Atrophy
C) Paralysis
D) Pathologic fracture

Question 32

The nurse explains that neurotransmitters,which support smooth neural transmission,are:

A) Acetylcholine
B) CSF
C) Dopamine
D) Dendrite
E) Epinephrine