Deck 47: Neurological Function, Assessment, and Therapeutic Measures

Question 1

A man narrowly misses another car while driving through a busy intersection. His sympathetic nervous system is activated; his heart pounds and his breathing is rapid. As he calms down, his heart rate and breathing return to normal. Which neurotransmitter is in charge now that the excitement is over and he is calmed down?

A)Norepinephrine
B)Acetylcholine
C)Prostaglandin
D)Serotonin

Answer 1

Acetylcholine

Question 2

What types of neurons transmit impulses from receptors in the internal organs to the central nervous system?

A)Somatic sensory neurons
B)Visceral sensory neurons
C)Interneurons
D)Efferent neurons

Answer 2

Visceral sensory neurons

Question 3

A neurologist has a patient stick out the tongue to test which cranial nerve (CN)?

A)I (olfactory)
B)IV (trochlear)
C)VII (facial)
D)XII (hypoglossal)

Answer 3

XII (hypoglossal)

Question 4

Which of the following structures and functions describes the ascending tracts of the spinal cord?

A)They are made of white matter and carry motor impulses.
B)They are made of gray matter and carry motor impulses.
C)They are made of white matter and carry sensory impulses.
D)They are made of gray matter and carry sensory impulses.

Question 5

What structure electrically insulates neurons?

A)Gray matter
B)Myelin sheath
C)Interneurons
D)Astrocytes

Question 6

The nurse is caring for a patient who is scheduled for a computed tomography (CT) scan of the brain because of new onset of headaches. Which statement by the nurse is most accurate when preparing the patient for the scan?

A)"You must shampoo your hair thoroughly tonight to remove oil and dirt."
B)"You may take fluids until about 8 a.m. Then we will give you a special radiopaque drink."
C)"We will partially shave your head tonight so that electrodes can be attached securely to your scalp."
D)"You will need to hold your head completely still during the examination."

Question 7

The nurse is assessing a patient's pupils for reactivity to light. Which cranial nerve (CN) is being tested?

A)CN III
B)CN IV
C)CN VI
D)CN XII

Question 8

Motor neurons compose which spinal nerve root?

A)Lateral
B)Dorsal
C)Ventral
D)Medial

Question 9

The nurse is caring for a 22-year-old female patient who is 2 days post craniotomy for a brain tumor. She was doing well until 2 a.m., when she begins crying and asks for her mother. She has a Glasgow Coma Scale (GCS) of 15, and pupils are equal and reactive. Her mother is sleeping in the visitors' lounge. What nursing action would be most appropriate at this time?

A)Administer an as-needed sedative to calm the patient.
B)Notify the neurosurgeon that the patient is upset and crying.
C)Ask the mother to come and stay with the patient.
D)Reassure the patient, and sit with her until she falls back asleep.

Question 10

The nurse is caring for a patient diagnosed with a cerebral tumor. The nurse anticipates abnormal findings when assessing which functions?

A)Heart rate and respiratory rate
B)Coordination and posture
C)Reflex movement
D)Movement and speech

Question 11

What part of the brain regulates coordination and muscle tone?

A)Cerebellum
B)Medulla
C)Frontal lobes
D)Hypothalamus

Question 12

What part of the brain regulates heart rate and blood pressure?

A)Medulla
B)Hypothalamus
C)Cerebrum
D)Cerebellum

Question 13

Which of the following carries nerve impulses at synapses?

A)Schwann's cells
B)Depolarizations
C)Cell membrane
D)Neurotransmitters

Question 14

The nurse is caring for a patient who has impaired functioning of the left glossopharyngeal (IX) nerve and the vagus (X) nerve. What intervention should the nurse plan to maintain the patient's safety while diagnostic testing is being completed?

A)Withhold oral fluid or foods.
B)Insert an oral airway.
C)Apply eye patches to keep the eyes closed.
D)Obtain a picture board and a Magic Slate.

Question 15

The nurse is caring for a patient admitted to the emergency room after a motor vehicle accident. Which of the following assessments is most important to carry out?

A)Visual analogue scale
B)Romberg test
C)Glasgow Coma Scale
D)Babinski test

Question 16

The nurse is caring for an individual with a head injury and notes unequal pupils. Which of the following terms would be used to document this finding?

A)Anisocoria
B)Aphasia
C)Nystagmus
D)Ophthalmoplegia

Question 17

What part of the brain initiates voluntary movement?

A)Parietal lobe
B)Hypothalamus
C)Cerebellum
D)Frontal lobe

Question 18

The nurse is assisting a neurologist with assessment of a patient with facial muscle weakness. When the neurologist asks the patient to identify different odors, which nerve is being tested?

A)I (olfactory)
B)II (optic)
C)VIII (acoustic)
D)X (vagus)

Question 19

What part of a neuron carries impulses toward the cell body?

A)Dendrite
B)Schwann cell
C)Axon
D)Myelin sheath

Question 20

The nurse is preparing a patient for an electroencephalogram (EEG). What information should be given to the patient?

A)The hair at the temporal area will have to be shaved.
B)Little needles will be stuck into the scalp.
C)The hair must be clean and dry before the test.
D)The patient must withhold fluids and food for 12 hours before the test.

Question 21

The human body has ________________pairs of spinal nerves.

Question 22

The nurse is providing post-procedure care for a patient who has had a lumbar puncture. Which of the following orders does the nurse anticipate?

A)Have the patient lie flat for 6 hours.
B)Keep the patient NPO for 4 hours.
C)Monitor the patient's pedal pulses every 4 hours.
D)Keep the head of the bed elevated 30 degrees for 8 hours.

Question 23

Which finding is abnormal in an aging patient and should be reported to the physician? (Select all that apply.?

A)Altered sleep patterns
B)Depression
C)Forgetfulness
D)Decreased postural stability
E)Decreased problem-solving ability
F)Fine motor tremors of the hands

Question 24

The nurse is caring for a patient who is scheduled for a lumbar puncture. Which of the following nursing interventions should the nurse anticipate providing? (Select all that apply.?

A)Ensure that the patient has given informed consent to the procedure.
B)Position the patient prone on the bed.
C)Keep the patient on bedrest with the head of the bed flat for 6 hours after the procedure.
D)Limit fluid intake.
E)Assess movement and sensation of lower extremities frequently for several hours after the procedure.
F)Check the puncture site for swelling or drainage.Completion
Complete each statement.

Question 25

Which of the following occur during a sympathetic nervous system response? (Select all that apply.?

A)Dilation of bronchioles
B)Decrease in peristalsis
C)Increase in salivary gland secretion
D)Decrease in heart rate to normal
E)Relaxation of bladder

Question 26

The nurse is assisting as a neurosurgeon examines a patient who has a positive Babinski reflex. What assessment finding would the nurse expect to observe?

A)The leg flexes when the patellar tendon is struck.
B)The leg extends when the patellar tendon is struck.
C)Toes curl downward when the sole of the foot is stroked.
D)The big toe extends when the sole of the foot is stroked.

Question 27

The nurse is providing care for a patient with a history of aspirating. Which of the following foods would the nurse remove from patient's tray? (Select all that apply.?

A)Bread with butter
B)Ground chicken
C)Coffee
D)Fruit juice
E)Ice cream
F)Applesauce

Question 28

The nurse is caring for a patient who is scheduled for a magnetic resonance imaging (MRI) scan. What explanation should be provided to the patient and family?

A)"An MRI measures muscle contraction after stimulation by tiny needle electrodes."
B)"An MRI uses electrodes placed on the scalp to measure activity of the brain."
C)"A scan of the brain will be done after injection of a radioisotope."
D)"An MRI is a noninvasive test that uses magnetic energy to visualize internal parts."

Question 29

The nurse is preparing a patient for a lumbar puncture. Which action is appropriate?

A)Administer enemas until clear.
B)Remove all metal jewelry.
C)Assist the patient into a side-lying position.
D)Remove the patient's dentures.

Question 30

The nurse is caring for a patient scheduled to undergo a computed tomography (CT) scan with contrast. Which of the following should be included in preprocedure preparation? (Select all that apply.?

A)Question the patient about allergies to dye, shellfish, or iodine.
B)Determine if the patient has aneurysm clips or metal pins in the body.
C)Check blood urea nitrogen (BUN) and creatinine levels.
D)Explain to the patient that a sensation of warmth may be felt when dye is injected.
E)Tell the patient to report any nausea, itchiness, or difficulty breathing during the scan.

Question 31

The nurse is providing care for a client admitted to the hospital after a motor vehicle accident. After being informed by family members that the patient is deaf-mute, which of the following actions should the nurse take?

A)Utilize a three-point scale to grade muscle strength.
B)Consider the Babinski response invalid.
C)Avoid use of the Glascow Coma Scale.
D)Perform the Romberg test with the patient in a seated position.Multiple Response
Identify one or more choices that best complete the statement or answer the question.

Question 32

Which of the following are functions of the hypothalamus? (Select all that apply.?

A)Regulation of body temperature
B)Production of growth hormone
C)Regulation of food and liquid intake
D)Production of epinephrine
E)Production of antidiuretic hormone and oxytocin
F)Regulation of serum calcium levels

Question 33

A patient who opens the eyes to painful stimuli, makes incomprehensible sounds, and withdraws from pain has a Glasgow Coma Scale score of ____________________.

Question 34

When the nurse shines a light in a patient's left pupil, both of the pupils constrict. What type of response should the nurse document?

A)Direct
B)Abnormal
C)Accommodation
D)Consensual

Question 35

A Glasgow Coma Scale score of less than ________________indicates a comatose state.

Question 36

The nurse is providing care for an 87-year-old woman who is recovering from a cerebral vascular accident. Which of the following precautions should the nurse take after noting the patient has a positive Romberg test?

A)Provide small, frequent meals.
B)Institute fall-risk precautions.
C)Darken the room and reduce stimuli.
D)Request a footboard and splints.

Question 37

A patient who experiences swaying or leaning to one side when standing with feet together and eyes closed for ________________seconds is said to have a positive Romberg test result.

Question 38

The nurse is providing care for patients on the neurological step-down unit and notices a patient startle when the alarm rings for a fire drill. After reassuring the patient that there is no danger, an assessment is completed. The nurse recognizes which of the following findings may be related to a sympathetic response?

A)Diminished bowel sounds
B)Wheezing
C)Confusion
D)Incontinence

Question 39

A patient who is severely brain damaged has decerebrate posturing with extended extremities. The nurse understands that damage most likely occurred in which area of the brain?

A)Cerebellum
B)Cerebrum
C)Brain stem
D)Hypothalamus

Question 40

The nurse is caring for a patient who has had a stroke (brain attack). The patient is unable to understand what the nurse is saying and appears frustrated. What term should the nurse document to describe this finding?

A)Dysphagia
B)Expressive aphasia
C)Receptive aphasia
D)Confusion