Deck 58: Nursing Assessment: Nervous System

Question 1

A 71-year-old patient reports a change in sleep patterns occurring over the past 2 to 3 years.Based on knowledge of the effects of aging on the reticular activating system,what would the nurse expect the patient to exhibit?

A) Increased rapid-eye-movement sleep
B) Longer cycles of sleep
C) Increased sleep apnea
D) Increased spontaneous awakening

Answer 1

Increased spontaneous awakening

Question 2

To prepare a patient who is to have a lumbar puncture performed for analysis of cerebrospinal fluid,what should the nurse inform him about?

A) He will be given a mild sedative to help control muscle spasms.
B) He should cough as soon as he feels the needle enter the spinal canal.
C) He may be required to lie flat on his back for 24 hours following the test.
D) He will be positioned on his side with his knees drawn to the chest and his head flexed to the chest.

Answer 2

He will be positioned on his side with his knees drawn to the chest and his head flexed to the chest.

Question 3

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 by asking the patient which of the following questions?

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

Answer 3

"Can you describe the sensations you are having in your chest?"

Question 4

Which internal structure arises from the basilar and two internal carotid arteries?

A) Reticular formation
B) Blood-brain barrier
C) Circle of Willis
D) Anterior communicating centre

Question 5

Which of the following is an age-related change in the nervous system?

A) Increased efficiency of temperature-regulating mechanism
B) Decreased size of ventricles in the brain
C) Decrease in electrical activity
D) Increase in deep-tendon reflexes

Question 6

When reviewing the results of a patient's cerebrospinal fluid analysis obtained from a lumbar puncture,which of the following does the nurse identify as abnormal?

A) pH 7.35
B) White blood cell count 4 cells/microlitre (0.004 cells/L)
C) Protein 0.30 g/L (30 mg/dL)
D) Glucose 1.7 mmol/L (30 mg/dL)

Question 7

During the neurological assessment,the patient cooperates with the nurse's directions to grip with the hands and to move the feet,but does not respond to the nurse's questions.The nurse will suspect which of the following?

A) A temporal lobe lesion
B) Injury to the cerebellum
C) A brainstem lesion
D) Damage to the frontal lobe

Question 8

When interviewing an acutely confused patient who has a head injury,which question will provide the most useful information?

A) "Have you ever been hospitalized for a neurological problem?"
B) "Do you have any pain at the present time?"
C) "What have you had to eat in the last 24 hours?"
D) "Can you describe your usual pattern for coping with injury?"

Question 9

The charge nurse is observing a new staff nurse who is assessing a patient with a possible spinal cord lesion for sensation.Which action by the new nurse indicates a need for further teaching about neurological assessment?

A) Tests for light touch before testing for pain
B) Has the patient close the eyes during testing
C) Tells the patient,"You may feel a pinprick now."
D) Uses an irregular pattern to test for intact touch

Question 10

Which neurotransmitter is involved in emotions,moods,and regulating motor control?

A) Serotonin
B) Epinephrine
C) Dopamine
D) Substance P

Question 11

When admitting a patient with acute confusion to the hospital,the nurse will interview the patient about health problems and health history primarily for which of the following reasons?

A) To determine the patient's motivation for self-care
B) To include the patient in health care decisions
C) To use the information given by the patient to guide care
D) To assess the patient's baseline cognitive abilities

Question 12

What is the path of intervention with cranial nerve VI (abducens nerve)that is connected to the brain via the pons?

A) Motor path
B) Sensory path
C) Sympathetic path
D) Parasympathetic path

Question 13

To assess the functioning of the optic nerve (cranial nerve II),what should the nurse do?

A) Apply a cotton wisp strand to the cornea.
B) Perform a confrontational test for visual fields.
C) Evaluate pupil response to light and accommodation.
D) Ask the patient to follow a finger with the eyes as it is moved vertically,horizontally,and diagonally.

Question 14

A patient with a deep,large laceration of the left forearm,which has damaged nerve fibres as well as other tissue,asks the nurse to explain what the effect of the nerve damage will be.What is the best response to the patient?

A) Nerve cells cannot regenerate,and the sensory and motor loss will be permanent.
B) He will probably have return of normal motor and sensory function because peripheral nerve cells can regenerate.
C) Only nerve fibres within the central nervous system are capable of regeneration,and the nerve loss he has distal to his injury will be permanent.
D) There is a chance that some nervous function will return because peripheral nerve fibres can slowly regenerate if cell bodies have not been damaged.

Question 15

When the nurse administers a drug that increases the synaptic release of ?-aminobutyric acid (GABA),what is the effect the nurse would expect?

A) Widespread increases in nervous system activity
B) Suppression of nervous system activity
C) Increased patient alertness and arousal
D) Excitation of the affected postsynaptic neurons

Question 16

For a patient who has a corticospinal tract lesion,the nurse should assess for which of the following?

A) Extremity movement and strength
B) Cranial nerve function
C) Peripheral sensitivity to pain
D) Level of consciousness

Question 17

Neurological testing of the patient by the nurse indicates impaired functioning of the left glossopharyngeal nerve (cranial nerve IX)and the vagus nerve (cranial nerve X).Based on these findings,what should the nurse plan to do?

A) Insert an oral airway.
B) Withhold oral fluid or foods.
C) Provide highly seasoned foods.
D) Apply artificial tears to protect the cornea.

Question 18

The following orders are received for a patient who is unconscious after a head injury caused by an automobile accident.Which one should the nurse question?

A) Perform neurological checks every 15 minutes.
B) Prepare the patient for lumbar puncture.
C) Obtain X-ray films of the skull and spine.
D) Do computed tomography scanning with and without contrast.

Question 19

A patient has a lesion that affects lower motor neurons.During assessment of the patient's lower extremities,what does the nurse expect to find?

A) Spasticity
B) Flaccidity
C) Hyperreflexia
D) Loss of sensation

Question 20

Which of the following assessment findings would the nurse expect when examining a patient with a lesion of the left posterior temporal lobe?

A) Inability to reason or problem solve
B) Loss of sensation on the left side of the body
C) Inability to comprehend written or oral language
D) Inability to voluntarily move the right side of the body

Question 21

Which area of the cerebrum would the nurses suspect is injured when the patient is unable to understand spoken words?

A) Broca's area
B) Precentral gyrus
C) Wernicke's area
D) Postcentral gyrus