Deck 69: Management of Clients with Cerebral Disorders

Question 1

A client with epilepsy has the nursing diagnosis Risk for Impaired Adjustment. Which statement by the client would indicate movement towards positive resolution of this diagnosis?

A) "Before activities, I should ask myself 'What would happen if I had a seizure?'"
B) "Do you know how to apply for food stamps since I can't work?"
C) "I feel so sad that so many activities are off-limits for me now."
D) "I have decided to sell my car since I will never be able to drive again."

Answer 1

"Before activities, I should ask myself 'What would happen if I had a seizure?'"

Question 2

The nurse gives diazepam to a client in status epilepticus to stop the seizure because prolonged seizure activity can cause

A) brain injury.
B) cardiac dysrhythmias.
C) muscle and tendon damage.
D) respiratory arrest.

Answer 2

brain injury.

Question 3

A nurse is teaching a newly diagnosed epileptic client about anticonvulsant medications. The nurse should include information to

A) help the client learn to control stress in his/her life.
B) limit heavy exercise and aerobic activities.
C) stop medications if seizures are controlled for several months.
D) take an extra dose of medication if a seizure is beginning.

Answer 3

help the client learn to control stress in his/her life.

Question 4

A client is being worked up for a possible brain tumor. An important intervention the nurse would include in the nursing care plan specific to this client is

A) documenting manifestations.
B) preparing the client for tests.
C) seizure precautions.
D) supporting the client and family.

Question 5

The client with epilepsy asks the nurse if he will have to take antispasmodic medication for the rest of his life. The nurse's most helpful response would be

A) "Maybe. You might be able to stop medication if you are seizure free for 2 years."
B) "No. After a stable pattern is recognized, you can take it sporadically."
C) "Yes. Epilepsy requires compliance to a regimen of lifelong medication."
D) "Yes. Stopping a med after you take it a while makes seizure activity worse."

Question 6

For a client who had a transsphenoidal resection of a pituitary tumor, the nurse plans to

A) assess the "mustache" dressing for drainage.
B) do minimal mouth care for the first 2 days.
C) encourage the use of straws when drinking.
D) provide heated mist and humidified oxygen.

Question 7

A week after a client experienced a ruptured cerebral aneurysm, he becomes extremely indecisive and has frequent episodes of incontinence. The nurse reports these events as probable

A) vasospasm.
B) automatisms.
C) focal seizures.
D) early-stage dementia.

Question 8

A nurse is reviewing leisure time activities with a client who has epilepsy. An important self-care measure the nurse teaches the client is to avoid

A) alcoholic beverages.
B) driving a motor vehicle.
C) hiking and camping.
D) light sports.

Question 9

The intraoperative nurse caring for a client having brain surgery to remove a tumor would be particularly careful about

A) inserting the IVs in the nondominant hand.
B) padding and assessing the skin under the head frame.
C) placing the client in straight alignment.
D) using a catheter bag with a urimeter.

Question 10

The cerebrospinal (CSF) fluid laboratory finding the nurse would expect in a client with bacterial meningitis is

A) clear color.
B) decreased glucose level.
C) decreased protein level.
D) negative nitrates.

Question 11

A client has been diagnosed with epilepsy and is going home. The client has received extensive teaching on the disease, medications, and lifestyle changes that are required. What else should the nurse include in the discharge plan?

A) A referral to a support group
B) Easy-to-prepare menu guide
C) Psychiatry clinic information
D) The city's bus schedule

Question 12

An important age-related consideration the nurse should include in the care plan for an elderly client with a seizure disorder is

A) a decreased serum albumin level can increase the free plasma level of medications.
B) fortunately, seizure medications have very few drug-drug interactions.
C) older adults have very few choices when it comes to seizure medications.
D) the elderly rarely have seizure disorders, so community support for them is poor.

Question 13

The nurse caring for a client receiving phenytoin (Dilantin) should assess for

A) anorexia, numbness, and tingling of extremities.
B) ataxia, nausea, and bleeding tendency.
C) headache, myalgias, and arthralgias.
D) unsteady gait, slurred speech, and blurred vision.

Question 14

Three days following intracranial surgery a client develops fever, nuchal rigidity, and headache. The nurse would suspect

A) cerebral emboli.
B) extradural hematoma.
C) increased ICP.
D) meningitis.

Question 15

The nurse institutes seizure precautions for a client with a history of epilepsy. Which action is inconsistent with seizure precautions?

A) Keeping oxygen and suction equipment nearby
B) Keeping the side rails up while the client is in bed
C) Padding the side rails of the bed
D) Taking an oral temperature when doing vital signs

Question 16

When doing an ophthalmologic examination the nurse practitioner assesses papilledema, which the practitioner recognizes as an indication of

A) compression of the second cranial nerve.
B) increased intraocular pressure.
C) migraine headache.
D) impending stroke.

Question 17

The nurse assesses for the most common manifestations of a post-traumatic brain abscess, which are

A) headache and lethargy.
B) photophobia and dizziness.
C) muscle spasms and tingling.
D) sluggish pupillary reactions.

Question 18

The nurse clarifies that a generalized seizure, unlike a partial seizure, involves

A) areas of special senses.
B) both hemispheres.
C) only one hemisphere.
D) the autonomic system.

Question 19

The nurse should observe a client with bacterial meningitis for

A) changes in sensorium.
B) high blood pressure.
C) hypothermia.
D) muscle spasms.

Question 20

When the client experiences convulsive movement beginning in the hand and progressing to the arm and face, the nurse recognizes this as being consistent with

A) clonic seizure.
B) complex partial seizure.
C) partial seizure with motor signs.
D) temporal lobe seizure.

Question 21

When a client is admitted to the hospital in an unconscious state following subarachnoid hemorrhage resulting from a ruptured intracranial aneurysm, the nurse anticipates that the manifestations that preceded the loss of consciousness were

A) generalized weakness and fatigue accompanied by anorexia.
B) gradual loss of speech or vision.
C) sudden severe headache accompanied by vomiting.
D) weakness, fever, nausea, and vomiting.

Question 22

The clinic nurse recommends to a client with cluster headaches that to abate the manifestations associated with an attack, he should inhale

A) 100% oxygen for 15 minutes.
B) deeply for 5 minutes.
C) oil of cloves for 5 minutes.
D) warm mist for 10 minutes.

Question 23

A client has cyclical headaches accompanied by constricted pupils, unilateral lacrimation, and rhinorrhea. The nurse is exploring ways to prevent these headaches with the client. The nurse could focus questions and interventions on modifying the client's

A) daily level of stress.
B) family history of brain tumors.
C) pattern of caffeine consumption.
D) usual alcohol intake.

Question 24

The nurse explains to a newly diagnosed epileptic client that the basic pathophysiology of epilepsy is related to

A) a period of hypoxia from sleep apnea.
B) brain waves losing amplitude.
C) excitation of neurons discharging in the brain stem.
D) specific metabolic disturbances.

Question 25

The nurse explains that an epidural blood patch may be used to treat a headache that has resulted from a

A) brain tumor.
B) concussion.
C) lumbar puncture.
D) migraine.

Question 26

The nurse observes for manifestations of typical migraine headaches, which include

A) aura, visual disturbances, and nausea.
B) bilateral pain, abrupt onset, and tinnitus.
C) diarrhea, nasal congestion, and eye redness.
D) scalp tenderness, sensation of pressure, and nighttime onset.

Question 27

When a client suffers a tonic-clonic seizure, the nurse should (Select all that apply)

A) insert an oral airway into the client's mouth.
B) move objects out of the client's way.
C) observe and document characteristics of the seizure.
D) place a pillow or some padding under the client's head.
E) turn the client gently on one side.

Question 28

Following surgery for a pituitary tumor, when the client develops diabetes insipidus, the nurse explains that the drug that will be helpful to remedy the manifestations is

A) atropine.
B) desmopressin.
C) diazepam (Valium).
D) NPH insulin.

Question 29

A nurse is teaching a client preventive strategies for migraine headaches. The nurse would evaluate that teaching goals have been met when the client says (Select all that apply)

A) "Do you know where I can learn relaxation techniques like yoga?"
B) "Eating on a regular schedule may help prevent some migraines."
C) "I should keep a headache diary to see if I can identify headache triggers."
D) "Small amounts of alcohol should not cause any headaches."
E) "There may be some foods that trigger my headaches that I should avoid."

Question 30

A client who has had intracranial surgery develops urine output in excess of 200 ml per hour. The nurse reports the findings, suspecting

A) diabetes insipidus.
B) fluid volume excess.
C) hyponatremia.
D) hyperkalemia.