Question 1

A patient is stuporous but reacts by withdrawing from painful stimuli.What term is most appropriate for this patient?&#10;A) Comatose&#10;B) Lethargic&#10;C) Semicomatose&#10;D) Somnolent

Accepted Answer

The patient is not fully unconscious (comatose), but is in a state of reduced consciousness (semicomatose) as evidenced by being stuporous (not fully aware or awake) and only reacting to painful stimuli by withdrawal. Lethargic refers to a state of extreme fatigue or drowsiness, while somnolent refers to a state of drowsiness or sleepiness. Neither of these terms accurately describe the patient's condition in this case.

Question 2

The nurse assessing the level of consciousness in a patient will perform the following: ______ (Arrange in order from the simplest to the most complex.Do not separate answers with a space or punctuation.Example: ABCD.)

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.

EDCBA

Accepted Answer

The level of consciousness is assessed by starting with the simplest stimuli and progressing to more complex stimuli as needed.

Question 3

What should be immediately reported by the nurse caring for a 90-year-old patient with a closed head injury?&#10;A) Blood pressure change from 147/72 to 176/70-mm Hg&#10;B) Respiration rate increase from 14 to 18 breaths/min&#10;C) Slow pupillary reaction bilaterally&#10;D) Temperature decrease from 100.2$\degree$ F to 97.6$\degree$ F

Accepted Answer

A significant increase in blood pressure, especially with a widening pulse pressure, can indicate increased intracranial pressure, which is critical to report immediately in a patient with a head injury.

Question 4

The nurse conducting a Romberg test will ask the patient to do what? ______ (Arrange in the correct sequence.Do not separate answers with a space or punctuation.Example: ABCD.)&#10;A)Touch his or her nose with the index finger with the eyes open.&#10;B)Stand with eyes closed.&#10;C)Touch his or her nose with the index finger with the eyes closed.&#10;D)Touch his or her fingertip to nurse's fingertip.&#10;E)Pat the knees with the palms and then the back of the hands rapidly.

Accepted Answer

The answer of The nurse conducting a Romberg test will...

Question 5

A patient with a severe head injury begins to assume a posture of flexed upper extremities, with plantarflexed lower extremities.What do these assessments indicate?&#10;A) Increasing intracranial pressure (ICP)with decorticate posturing&#10;B) Decreasing ICP with decerebrate posturing&#10;C) Decreasing ICP with decorticate posturing&#10;D) Increasing ICP with decerebrate posturing

Accepted Answer

The flexed upper extremities and plantarflexed lower extremities indicate decorticate posturing, which is a sign of increasing intracranial pressure. This posture results from damage to the corticospinal tract, leading to abnormal flexor muscle tone in the upper extremities and abnormal extensor muscle tone in the lower extremities.

Question 6

Which neurologic finding would be considered abnormal in an 88-year-old patient?&#10;A) Slow papillary response to light&#10;B) Jerky eye movements&#10;C) Dizziness and problems with balance&#10;D) Absence of the Achilles tendon jerk

Accepted Answer

Dizziness and problems with balance are not typically considered normal age-related changes and may indicate an underlying neurologic issue in an elderly patient.

Question 7

Which assessment on a patient on mannitol therapy for cerebral edema indicates the medication is effective in decreasing ICP?&#10;A) Increased BP&#10;B) Increased urinary output&#10;C) Decreased pulse&#10;D) Widening pulse pressure

Accepted Answer

Mannitol therapy is a type of osmotic diuretic that works by increasing the osmolarity of blood, which decreases the amount of fluid in the brain and helps reduce the intracranial pressure (ICP). Therefore, an increase in urinary output indicates that the medication is effectively reducing ICP. The other options are not indications of effective mannitol therapy. Increased BP can indicate worsening of cerebral edema, decreased pulse can indicate hypotension or bradycardia, and widening pulse pressure can indicate impending herniation.

Question 8

What is the most reliable indicator of neurologic status?&#10;A) Blood pressure&#10;B) Pulse rate&#10;C) Temperature&#10;D) Level of consciousness

Accepted Answer

Level of consciousness is the most reliable indicator of neurologic status as it reflects the brain's ability to maintain alertness and respond appropriately to stimuli. Blood pressure, pulse rate, and temperature can all be affected by a variety of factors and may not necessarily indicate neurologic function.

Question 9

Which three symptoms are characteristic of Cushing triad associated with increased ICP?&#10;A) Hypotension, tachycardia, and narrowing pulse pressure&#10;B) Hypertension, tachycardia, and headache&#10;C) Widening pulse pressure, headache, and seizure&#10;D) Bradycardia, hypertension, and widening pulse pressure

Accepted Answer

The Cushing triad consists of three classic signs of increased intracranial pressure: bradycardia (slow heart rate), hypertension (high blood pressure), and widening pulse pressure (the difference between the systolic and diastolic blood pressure readings). Hypotension, tachycardia, and narrowing pulse pressure are not characteristic of the Cushing triad. Headache and seizure can be associated with increased intracranial pressure, but are not part of the Cushing triad.

Question 10

What should a nurse instruct a patient after a lumbar puncture to prevent a headache?&#10;A) Lie flat.&#10;B) Lie on left side.&#10;C) Stay in semi-Fowler position.&#10;D) Ambulate in the room with assistance.

Accepted Answer

The patient should lie flat after a lumbar puncture for several hours to prevent a headache. This will allow the spinal fluid to replenish and prevent leakage of fluid that can cause a headache.

Question 11

What diagnostic test might be contraindicated for a patient who has a pacemaker?&#10;A) Computed tomography (CT)&#10;B) Electromyography (EMG)&#10;C) Magnetic resonance imaging (MRI)&#10;D) Electroencephalography (EEG)

Accepted Answer

The answer of What diagnostic test might be contraindicated for...

Question 12

How can the nurse help reduce ICP in caring for the patient after a craniotomy?&#10;A) Keeping the patient flat in bed&#10;B) Elevating the head of the bed 30 degrees&#10;C) Closely monitoring the IV rate&#10;D) Turning the patient to the right side

Accepted Answer

The answer of How can the nurse help reduce ICP...

Question 13

Which describes the Babinski reflex?&#10;A) Downward curl of the toes&#10;B) Big toe bending upward&#10;C) Spreading out of the toes&#10;D) Pain in the big toe

Accepted Answer

The answer of Which describes the Babinski reflex?&#10;A) Downward curl...

Question 14

To what does the neural synapse refer?&#10;A) Length of time it takes for afferent neurons to carry impulses to the central nervous system (CNS)&#10;B) Length of time it takes for efferent neurons to carry impulses to the motor neurons&#10;C) Space between the axons and the dendrites of a neuron&#10;D) Space between the axons of one neuron and the dendrites of the next

Accepted Answer

The answer of To what does the neural synapse refer?&#10;A)...

Question 15

Which neurotransmitters support smooth neural transmission? (Select all that apply.)&#10;A) Acetylcholine&#10;B) CSF&#10;C) Dopamine&#10;D) Dendrite&#10;E) Epinephrine

Accepted Answer

The answer of Which neurotransmitters support smooth neural transmission? (Select...

Question 16

What should the nurse assess when a patient is scheduled for an angiogram?&#10;A) Dizziness&#10;B) Allergy to shrimp&#10;C) Increased BP&#10;D) Irregular heartbeat

Accepted Answer

The answer of What should the nurse assess when a...

Question 17

An older adult patient is experiencing extreme stress related to an admission to the hospital.What should the nurse expect the patient to demonstrate?&#10;A) Decreased heart rate&#10;B) Decreased blood pressure (BP)&#10;C) Irregular respiration&#10;D) Dilation of the pupils

Accepted Answer

The answer of An older adult patient is experiencing extreme...

Question 18

Which are normal brain alterations associated with age? (Select all that apply.)&#10;A) Decrease in brain weight&#10;B) Pigmentation of brain with lipofuscin&#10;C) Present of amyloid&#10;D) Tiny clot formation&#10;E) Tangled nerve fibers

Accepted Answer

The answer of Which are normal brain alterations associated with...

Deck 21: Neurologic System Introduction