Deck 14: Care of the Patient With a Neurologic Disorder

Question 1

A patient has been complaining of headaches. If the headaches are migraine, the nurse would expect to assess that the headaches:

A) They are observed during times of stress.
B) They become worse toward evening.
C) They have their onset when the person is in his or her twenties or thirties.
D) They may cause unusual smells or sounds for the patient before the pain begins.

Answer 1

They may cause unusual smells or sounds for the patient before the pain begins.

Question 2

A patient, age 23, has a comminuted fracture of T6-T7. She has a spinal cord injury resulting in paraplegia. She manifests signs and symptoms of autonomic dysreflexia, which is frequently triggered by

A) bladder distention.
B) nausea.
C) food allergies.
D) electrolyte imbalance.

Answer 2

bladder distention.

Question 3

The name of this area of the brain means "bridge." It is the origin of cranial nerves V through VIII and is responsible for sending impulses to the structures inferior and superior to it. It also contains a respiratory center that complements the part of the brain stem located inferior to it. It is called the

A) medulla oblongata.
B) diencephalon.
C) cerebellum.
D) pons.

Answer 3

pons.

Question 4

A patient has a head injury and is presenting with signs and symptoms of increased intracranial pressure. Which nursing intervention would be helpful in reducing this pressure?

A) Place the neck in a neutral position to promote venous drainage.
B) Suction hourly to stimulate the cough reflex.
C) Add extra blankets to keep the patient warm.
D) Turn the patient frequently to prevent skin impairment.

Question 5

The patient, injured in an automobile accident, is being evaluated in the emergency department for possible head injury. Which test should not be done if there is an indication of increased intracranial pressure?

A) CT scan
B) MRI scan
C) Lumbar puncture
D) Electroencephalogram

Question 6

A 39-year-old mother of four has a 6-year history of multiple sclerosis. During planning, the nurse remembers this is a degenerative neurological disease that

A) occurs most often in tropical climates.
B) occurs most often in the older adult.
C) has classic signs and symptoms that are readily recognized.
D) results from demyelination of the nerve sheath.

Question 7

A patient's neurological status deteriorates over hours, and a craniotomy is performed to evacuate the hematoma. Which nursing intervention is indicated to help decrease the threat of increased intracranial pressure?

A) Elevate the head of the bed 30 degrees.
B) Cluster nursing interventions to provide uninterrupted periods of rest.
C) Teach him to cough and deep breathe to prevent the necessity for suctioning.
D) Teach him to hold his breath and bear down while repositioning in bed.

Question 8

A patient has recently suffered a stroke with left-sided weakness. She has problems with choking, especially when she drinks thin liquids. What nursing interventions would be most helpful in assisting this patient to swallow safely?

A) Having her avoid all liquids
B) Instructing her to tuck her chin when swallowing
C) Giving her sips of water with each bite
D) Having her turn her head to the left

Question 9

A patient, age 69, is being evaluated by a neurologist for signs of muscle rigidity, masklike face (area from forehead to chin), and propulsive gait. These signs are often characteristic of

A) multiple sclerosis.
B) Parkinsonism.
C) Alzheimer's disease.
D) epilepsy.

Question 10

The Glasgow coma scale is a screening tool used to assess level of consciousness in three major areas. They are

A) verbal, sensation, motor.
B) eye, motor, verbal.
C) verbal, pain, reflexes.
D) eye, pain, verbal.

Question 11

Before the patient undergoes computed tomographic (CT) scanning with a contrast medium, the nurse should

A) verify that the patient is not allergic to seafood or iodine.
B) explain that the patient will have to change position frequently during the procedure.
C) maintain a safe distance from the patient to reduce the exposure to radiation.
D) verify that the patient has no metal objects such as an implant or a pacemaker.

Question 12

When the seriousness of craniocerebral trauma is assessed, it is important to remember that

A) heavy scalp bleeding indicates serious trauma.
B) open injuries are always more serious than closed injuries.
C) signs and symptoms may not occur until several days after the trauma.
D) trauma to the frontal lobe is more significant than to any other area.

Question 13

A patient, age 52, is brought to the emergency department by ambulance after she hit her head on her bathroom sink and fell unconscious to the floor. Which assessment should the nurse perform first?

A) History of health problems
B) Patency of airway
C) Neurological status
D) Status of bodily functions

Question 14

As the result of a stroke, a patient has difficulty discerning the position of his body without looking at it. In the nurse's documentation, which would best describe the patient's inability to assess spatial position of his body?

A) Agnosia
B) Proprioception
C) Apraxia
D) Sensation

Question 15

The cranial nerve that supplies most of the organs in the thoracic and abdominal cavities and also carries motor fibers to glands that produce digestive juices and other secretions is the

A) somatic motor nerve.
B) visceral sensory nerve.
C) abducens nerve.
D) vagus nerve.

Question 16

A patient has been diagnosed with organic brain pathology. He is presenting with signs and symptoms of total or partial loss of the ability to recognize familiar objects or people through sensory stimulation. This condition is called

A) apraxia.
B) agnosia.
C) aphasia.
D) dysphagia.

Question 17

A patient, age 45, is to have a myelogram to confirm the presence of a herniated intervertebral disk. Which nursing action should be planned for her with respect to this diagnostic test?

A) Obtain an allergy history before the test.
B) Ambulate the patient when she is returned to her room after the test.
C) Warn her that paralysis could result from injection of the contrast medium.
D) Keep her NPO for 6 to 8 hours after the test.

Question 18

When obtaining a health history from a patient with a neurological problem, the nurse is likely to elicit the most valid response from the patient with which question?

A) "Do you have any sensations of pins and needles in your feet?"
B) "Does the pain radiate from your back into your legs?"
C) "Can you describe the sensations you are having in your head?"
D) "Do you ever have any nausea or dizziness?"

Question 19

A patient has a history of tonic-clonic seizures. She was admitted to the neurological unit after having had three tonic-clonic seizures in the past 2 days. Her husband reported that she had been sleeping for long periods after each seizure. The nurse explains to him that this rest period after a tonic-clonic seizure is called a

A) convalescent period.
B) post-status epilepticus period.
C) post-tonic-clonic period.
D) postictal period.

Question 20

A patient has been injured in a motorcycle accident and is presenting with signs and symptoms of increased intracranial pressure. What is the most significant sign or symptom of increased intracranial pressure?

A) Pupil changes
B) Ipsilateral paralysis
C) Vomiting
D) Decrease in the level of consciousness

Question 21

Involuntary rhythmic movement of the eyes, with oscillations that may be horizontal, vertical, or mixed movements, is called ___________________.

Question 22

An 83-year-old patient has had a stroke. He is right-handed and has a history of hypertension and "little" strokes. He presents with right hemiplegia. To afford him the best visual field, the nurse should approach him

A) from the right side.
B) from the left side.
C) from the center.
D) from either side.

Question 23

A ___________ is a diagnostic procedure used to identify lesions by observing the flow of radiopaque dye through the subarachnoid space and is similar to a lumbar puncture.

Question 24

The avoidance of ___________ __________ decreases the risk for lung cancer.

Question 25

A therapeutic measure to reduce increased intracranial pressure is

A) suction the patient every 2 hours.
B) place in a semiprone position.
C) reduce fluid intake.
D) keep the patient flat in bed.

Question 26

A method of reducing a person's risk of becoming infected with the West Nile virus would be to

A) wear shorts and short-sleeve shirts.
B) apply baby lotion to all extremities.
C) apply insect repellent that contains DEET.
D) apply flea and tick repellent.

Question 27

In the aging process, older adults are able to

A) react to events immediately.
B) master new material quickly.
C) remember information from the immediate present (short-term memory).
D) learn new skills.

Question 28

The earliest sign of increased intracranial pressure is

A) headache.
B) dilated pupil.
C) decreasing level of consciousness.
D) diplopia (double vision).

Question 29

The best nursing intervention for restlessness in a patient with a head injury is

A) sedation with an available narcotic.
B) restraints to prevent injury.
C) assessing for pain or distended bladder.
D) encouraging verbalization of the problem.

Question 30

If a patient with a head injury has drainage from the nose or ears, which nursing intervention would be appropriate?

A) Cleanse ear or nose with a soft cotton-tipped swab.
B) Gently suction the nasal cavity.
C) Allow the patient to wipe the nose or ears, but not blow the nose or place anything in the external ear.
D) Place a pressure dressing over the ear.

Question 31

A female patient is diagnosed with myasthenia gravis. Upon physical assessment, the nurse notices her left eyelid is drooping. The nurse's notes would document this as ___________ of the eyelid.

Question 32

When planning care for a patient with aphasia, the nurse should

A) talk loudly so he or she can hear.
B) refrain from giving explanations about procedures because the patient cannot understand them anyway.
C) provide as much environmental stimuli as possible to prevent feelings of isolation.
D) consider the type of aphasia that the patient has and adapt communication methods accordingly.

Question 33

Which body system would the nurse choose to closely monitor in a patient diagnosed with Guillain-Barré syndrome?

A) CNS
B) GI
C) Respiratory
D) Cardiovascular

Question 34

In assessing a patient with suspected Bell's palsy, what clinical manifestations might be present?

A) Inability to wrinkle forehead and pucker lips
B) Inability to touch nose with finger with eyes closed
C) Symmetric facial expressions
D) Excruciating lightninglike shock in lips

Question 35

Myasthenia gravis (MG) is an autoimmune disease of the neuromuscular junction characterized by the fluctuating weakness of certain skeletal muscle groups. The use of intravenous immune globulin

A) increases anxiety and depression.
B) reduces the production of acetylcholine antibodies.
C) removes the antibodies produced by the autoimmune response.
D) increases the production of acetylcholine antibodies.

Question 36

A lumbar puncture is performed to obtain which specimen?

A) Serum
B) Cerebral spinal fluid (CSF)
C) Urine
D) Arterial blood gases

Question 37

A patient, age 27, has been admitted to the neurological department because of seizures of unknown cause. The nurse should take precautions by

A) placing the patient in protective restraints.
B) being certain padded side rails are present.
C) suggesting that the family monitor the patient.
D) placing the patient with one-on-one nursing service.

Question 38

The three components of Cushing's response are: (Select all that apply.)

A) Increased pulse rate
B) Increased blood pressure
C) Widened pulse pressure
D) Bradycardia
E) Increased systolic blood pressure
F) Uncontrolled thermoregulation

Question 39

Important nursing measures needed when feeding a hemiplegic patient include: (Select all that apply.)

A) Mixing liquids and solid foods together
B) Taking the patient's dentures out to prevent choking
C) Checking the affected side of mouth for food accumulation
D) Offering small bites of food
E) Elevating the patient to no more than 30 degrees
F) Adding a thickening agent to liquids

Question 40

Which foods may worsen headaches? (Select all that apply.)

A) Yogurt
B) Caffeine
C) Beef
D) Pears
E) Marinated foods
F) Milk