Deck 14: Alterations in Cognitive Systems, Cerebral Hemodynamics and Motor Function

Question 1

A neurologists explains that arousal is mediated by the:

A) Cerebral cortex
B) Medulla oblongata
C) Reticular activating system
D) Cingulate gyrus

Answer 1

Reticular activating system

Question 2

A 30-year-old female had a seizure that started with her fingers and progressive1y spread up her arm and then extended to her leg,with no loss of consciousness.How should the nurse chart this?

A) Myoclonic seizure
B) Tonic-clonic seizure
C) Focal motor seizure
D) Atonic seizure

Answer 2

Focal motor seizure

Question 3

A 16-year-old male took a recreational drug that altered his level of arousal.Physical exam revealed a negative Babinski sign,equal and reactive pupils,and roving eye movements.Which of the following diagnosis will the nurse most likely see on the chart?

A) Psychogenic arousal alteration
B) Metabolically induced coma
C) Structurally induced coma
D) Structural arousal alteration

Answer 3

Metabolically induced coma

Question 4

The progress notes read: the cerebellar tonsil has shifted through the foramen magnum due to increased pressure within the posterior fossa.The nurse would identify this note as a description of _____ herniation.

A) Supratentorial
B) Central
C) Cingulated gyrus
D) Infratentorial

Question 5

A 10-year-old female was brought to the ER following a sudden onset of convulsions.The primary care provider thinks that she experienced an explosive,disorderly discharge of cerebral neurons referred to as:

A) Reflex
B) Seizure
C) Inattentiveness
D) Brain death

Question 6

The breathing pattern that reflects respirations based primarily on carbon dioxide (CO₂)levels in the blood is:

A) Cheyne-Stokes
B) Ataxic
C) Central neurogenic
D) Normal

Question 7

A 20-year-old male suffers a severe closed head injury in a motor vehicle accident.He remains in a vegetative state (VS)1 month after the accident.Which of the following structures is most likely keeping him in a vegetative state?

A) Cerebral cortex
B) Brainstem
C) Spinal cord
D) Cerebellum

Question 8

An attorney spoke to the nurses regarding brain death.Which statement indicates the nurses understood brain death? For legal purposes,brain death is defined as:

A) Cessation of brain function
B) Lack of cortical function
C) A VS
D) Death of the brainstem

Question 9

A teenage boy sustains a severe closed head injury following an all-terrain vehicle (ATV)accident.He is in a state of deep sleep that requires vigorous stimulation to elicit eye opening.How should the nurse document this in the chart?

A) Confusion
B) Coma
C) Obtundation
D) Stupor

Question 10

A 20-year-old male was at the supermarket when he fell to the ground.Bystanders reported that he lost consciousness and his body tensed up then relaxed,then tensed and relaxed several times.He most likely was experiencing a(n):

A) Partial seizure
B) Absence seizure
C) Myoclonic seizure
D) Tonic-clonic seizure

Question 11

A patient has memory loss of events that occurred before a head injury.What cognitive disorder does the nurse suspect the patient is experiencing?

A) Selective memory deficit
B) Anterograde amnesia
C) Retrograde amnesia
D) Executive memory deficit

Question 12

A 50-year-old male suffers a severe head injury when his motorcycle hits a tree.His breathing becomes deep and rapid but with normal pattern.What term should the nurse use for this condition?

A) Gasping
B) Ataxic breathing
C) Apneusis
D) Central neurogenic hyperventilation

Question 13

A 75-year-old female suffers a stroke and now has difficulty writing and production of language.This condition is most likely caused by occlusion of the:

A) Anterior communicating artery
B) Posterior communicating artery
C) Circle of Willis
D) Middle cerebral artery

Question 14

A nurse thinks a patient may be experiencing dementia.Which assessment finding will most help support this diagnosis?

A) Violent behavior
B) Hyperactivity
C) Depression
D) Loss of recent and remote memory

Question 15

When thought content and arousal level are intact but a patient cannot communicate,the patient has:

A) Cerebral death
B) Locked-in syndrome
C) Dysphagia
D) Cerebellar motor syndrome

Question 16

A patient with an addiction to alcohol checked into a rehabilitation center.He experiences delirium,inability to concentrate,and is easily distracted.From which of the following is he most likely suffering?

A) Acute confusional state
B) Echolalia
C) Dementia
D) Dysphagia

Question 17

When a student asks what can cause dilated,fixed pupils,what is the nurse's best response? Dilated fixed pupils can be caused by:

A) Brainstem hypoxia
B) Cerebral contusions
C) Compression of the hypothalamus
D) Spinal shock

Question 18

When a patient has a peculiar sensation that immediately precedes a seizure,what term should the nurse use to describe this sensation?

A) Prodroma
B) Agnosia
C) Spasm
D) Aura

Question 19

A 65-year-old male recently suffered a cerebral vascular accident.He is now unable to recognize and identify objects by touch because of injury to the sensory cortex.How should the nurse document this finding?

A) Hypomimesis
B) Agnosia
C) Dysphasia
D) Echolalia

Question 20

A 45-year-old female presents to the emergency room (ER)reporting excessive vomiting.A CT scan of the brain reveals a mass in the:

A) Skull fractures
B) Thalamus
C) Medulla oblongata
D) Frontal lobe

Question 21

A 16-year-old male fell off the bed of a pickup truck and hit his forehead on the road.He now has resistance to passive movement that varies proportionally with the force applied.He is most likely suffering from:

A) Spasticity
B) Gegenhalten
C) Rigidity
D) Dystonia

Question 22

A nurse notes that a patient walks with the leg extended and held stiff,causing a scraping over the floor surface.What type of gait is the patient experiencing?

A) Spastic gait
B) Cerebellar gait
C) Basal ganglion gait
D) Scissors gait

Question 23

A 20-year-old male is admitted to the neurological critical care unit with a severe closed head injury.When an intraventricular catheter is inserted,the ICP is recorded at 24 mm Hg.How should the nurse interpret this reading? This reading is:

A) Higher than normal
B) Lower than normal
C) Normal
D) Borderline

Question 24

The patient is experiencing an increase in intracranial pressure.This increase results in:

A) Brain tissue hypoxia
B) Intracranial hypotension
C) Ventricular swelling
D) Expansion of the cranial vault

Question 25

The nurse is explaining clinical manifestations of alterations in the extrapyramidal system.The nurse would correctly include (select all that apply):

A) Little or no paralysis of voluntary movement
B) Normal or slightly increased tendon reflexes
C) Positive (present) Babinski
D) Presence of tremor
E) Rigidity in muscle tone

Question 26

Which principle should the nurse remember while planning care for a patient with spinal shock? Spinal shock is characterized by:

A) Loss of voluntary motor function with preservation of reflexes
B) Cessation of spinal cord function below the lesion
C) Loss of spinal cord function at the level of the lesion only
D) Temporary loss of spinal cord function above the lesion

Question 27

A compensatory alteration in the diameter of cerebral blood vessels in response to increased intracranial pressure is called:

A) Herniation
B) Vasodilation
C) Autoregulation
D) Amyotrophy

Question 28

A 40-year-old male complains of uncontrolled excessive movement and progressive dysfunction of intellectual and thought processes.He is experiencing movement problems that begin in the face and arms that eventually affect the entire body.The most likely diagnosis is:

A) Tardive dyskinesia
B) Huntington disease
C) Hypokinesia
D) Alzheimer disease

Question 29

A 51-year-old male is admitted to the neurological critical care unit with a severe closed head injury.All four extremities are in rigid extension,his forearm is hyperpronated,and his legs are in plantar extension.How should the nurse chart this condition?

A) Decorticate posturing
B) Decerebrate posturing
C) Caloric posturing
D) Excitation posturing

Question 30

A patient has paralysis of both legs.What type of paralysis does the patient have?

A) Paraplegia
B) Quadriplegia
C) Infraparaplegia
D) Paresthesia

Question 31

An adult has hydrocephalus.When the patient asks the nurse what caused this,how should the nurse respond? Hydrocephalus in adults is most often caused by:

A) Overproduction of CSF
B) Intercellular edema
C) Elevated arterial blood pressure
D) Defective CSF reabsorption

Question 32

A male patient complains of tiring easily,has difficulty rising from a sitting position,and cannot stand on his toes.The nurse would expect a diagnosis of:

A) Parkinson disease
B) Hypotonia
C) Huntington disease
D) Paresis

Question 33

An infant is diagnosed with noncommunicating hydrocephalus.What is an immediate priority concern for this patient?

A) Metabolic edema
B) Interstitial edema
C) Vasogenic edema
D) Ischemic edema

Question 34

A nurse recalls neural systems basic to cognitive functions include _____ systems.(Select all that apply.)

A) Attentional
B) Memory and language
C) Affective
D) Sensory and motor
E) Tactile

Question 35

The primary care provider states that the patient has vasogenic edema.The nurse realizes vasogenic edema is clinically important because:

A) It usually has an infectious cause.
B) The blood-brain barrier is disrupted.
C) Increased intracranial pressure (ICP) is excessively high.
D) It always causes herniation.

Question 36

A patient has excessive movement.What disorder will the nurse see documented on the chart?

A) Hypokinesia
B) Akinesia
C) Hyperkinesia
D) Dyskinesia

Question 37

A 70-year-old female is being closely monitored in the neurological critical care unit for a severe closed head injury.After 48 hours,her condition begins to deteriorate.Her pupils are small and sluggish,pulse pressure is widening,and she is bradycardic.These clinical findings are evidence of what stage of intracranial hypertension?

A) Stage 1
B) Stage 2
C) Stage 3
D) Stage 4