Question 1

Which condition(s)may cause seizures?

Accepted Answer

Stroke,cerebral tumors,hyperpyrexia,epilepsy,and metabolic toxicity are conditions that may all potentially cause seizures.

Question 2

Which symptom is a key sign of a brain tumor?

Accepted Answer

A headache that awakens the patient is an early sign of a brain tumor.Morning nausea,difficulty reading,and increasing blood pressure are nonspecific findings that can be attributed to multifactorial causes.

Question 3

The nurse is caring for a stroke patient who is experiencing homonymous hemianopsia.The patient asks if he is going to have any limitations when discharged from the hospital.The nurse anticipates the patient will be restricted from what activity?

Accepted Answer

Homonymous hemianopsia is blindness in part of the visual field of both eyes.Driving a vehicle may be very dangerous for this patient.With proper occupational therapy,the patient should be able to ambulate independently,cook,and read.

Question 4

Which nursing intervention best encourages self-feeding in a patient with right-sided paralysis after a CVA?

Accepted Answer

Finger foods on the nonparalyzed side encourage self-feeding.Privacy is more supportive to early efforts than being in a common dining room.Smaller helpings on the same side of the nonparalyzed limb are conducive to self-feeding.

Question 5

The dysarthric patient seated in the dining room of the long-term care facility yells,"Poon! Poon! Poon!" with increasing frustration.What is the nurse's best response?

Accepted Answer

Attempting to interpret the dysarthric communication through questions that can be answered simply will reduce frustration.

Question 6

The nurse is providing medication teaching to a patient with epilepsy who is taking phenytoin (Dilantin).Which statement best indicates that the nurse's teaching has been successful?

Accepted Answer

Dilantin can cause gingival hyperplasia.The patient should brush teeth and floss regularly,and schedule dentist visits every 3 to 6 months.Alcohol interferes with the metabolism of anticonvulsants,increases lethargy,and may trigger seizures.The patient should not consume alcohol at all while taking Dilantin.The patient should not take antacids within 2 hours of taking Dilantin.Dilantin may turn the urine pink.

Question 7

A patient diagnosed with a primary brain tumor asks the nurse if this is a common disease.Which response is most appropriate for the nurse to make?

Accepted Answer

About 200,000 new brain tumors are discovered each year in the United States with approximately 40,000 of those being primary tumors and the rest are metastatic tumors from a different site of origin.Many primary brain tumors are benign.Telling the patient his question doesn't really matter is dismissive and nontherapeutic.

Question 8

The nurse is writing the care plan for a cerebrovascular accident (CVA)patient who has partial left-sided paralysis and is experiencing ataxia.Which intervention is most beneficial for this patient?

Accepted Answer

The patient with ataxia has experienced a loss of balance or poor coordination; therefore,placing the call light on this patient's right side and reminding her to call for help will best address her high risk for falling.Pureed foods and thickened liquids are necessary for the patient with dysphagia,and a communication board would assist a patient with dysarthria or aphasia.

Question 9

The nurse instructs a person taking phenytoin (Dilantin)that periodic blood tests will be necessary.The nurse explains that the laboratory checks will monitor for which potential medication-induced change?

Accepted Answer

Periodic blood tests are recommended for people taking phenytoin to monitor for liver damage.

Question 10

The patient reports intense intermittent headaches over the last 6 months that are preceded by specific symptoms.What symptom is the patient most likely experiencing?

Accepted Answer

The headaches are most likely migraines.Scotoma (spots before the eyes)is the typical prodromal symptom of a migraine headache.

Question 11

The nurse is assisting a patient with agnosia after a CVA.Which intervention is most appropriate?

Accepted Answer

Identifying objects and their intended use is helpful to people with agnosia who can no longer recognize items.The other options are helpful to people with apraxia,hemianopsia,and altered coordination,respectively.

Question 12

The nurse is caring for a patient who recently suffered a cerebrovascular accident (CVA).Family members ask the nurse why their father had a seizure.Which response is best for the nurse to make?

Accepted Answer

Thrombi from a CVA can occlude vessels,cutting off oxygen supply to cells of the brain and causing a seizure.

Question 13

Following a craniotomy for the removal of a brain tumor,the patient exhibits nuchal rigidity,rash on the chest,headache,and a positive Brudzinski sign.What do these assessment findings indicate to the nurse?

Accepted Answer

Nuchal rigidity,skin rash,headache,and a positive Brudzinski sign are indicative of meningitis.

Question 14

The nurse is providing teaching to a patient newly diagnosed with simple partial seizure disorder.Which statement by the nurse is most accurate?

Accepted Answer

Simple partial seizures only involve one side of the brain and one side of the body.Complex partial seizures may or may not result in an alteration in level of consciousness.Generalized seizures affect both sides of the body.Simple partial seizures may respond to treatment.

Question 15

The nurse is caring for a patient with bacterial meningitis.What interventions should the nurse include in the plan of care?

Accepted Answer

The environment is kept quiet with minimal stimulation to reduce the possibility of seizure.The care is done with general precautions.Fluid intake is encouraged,as are daytime naps to preserve energy.

Question 16

The nurse is assessing a patient on intravenous (IV)phenytoin (Dilantin).Which assessment finding is most concerning to the nurse?

Accepted Answer

IV phenytoin can cause cardiac arrhythmias and hypotension,especially if given faster than 50 mg/min.

Question 17

The nurse is caring for an anxious 20-year-old college student who just suffered his first seizure in his dorm room.The patient asks the nurse if he is now an epileptic.What is the nurse's best response?

Accepted Answer

Epilepsy diagnosis is made after all other causes of seizure activity have proven negative.All seizures are not considered to be epilepsy.

Question 18

A patient was recently diagnosed as having Bell palsy.Which nursing intervention is most important for the nurse to include in the patient's care plan?

Accepted Answer

Treatment consists of closing and patching the eye if it loses the blink reflex.Artificial tear eyedrops also are used to prevent dryness of the cornea.Corticosteroids are given if they can be started right after the beginning of symptoms.They are ineffective if delayed more than 7 days.Acyclovir may be prescribed as well,since herpes virus may be a causative organism.Bell palsy is usually a painless condition.Bell palsy does not pose a particular risk for aspirations.Cool air may trigger or exacerbate Bell palsy.

Question 19

The nurse reinforces the information given by the physician that endarterectomy as an intervention for stroke prevention is reserved for people who have carotid obstruction of greater than what percentage?

Accepted Answer

Endarterectomy is reserved for people with carotid obstruction of more than 60%.

Question 20

The nurse is caring for a patient with brain tumor-related hydrocephalus who is scheduled to undergo placement of a ventriculoperitoneal (V-P)shunt.Which information is most important for the nurse to include when explaining the purpose of the procedure?

Accepted Answer

Obstruction of CSF flow may require placing a shunt to reduce CSF pressure and prevent increased intracranial pressure (ICP).A shunt is a tube placed in a ventricle and attached to a small manual pump that moves excess CSF fluid from the ventricles to the peritoneal cavity or into the atrium of the heart,so that it may be absorbed.

Quiz 23: Care of Patients with Disorders of the Brain

Which condition(s) may cause seizures?

Which symptom is a key sign of a brain tumor?

The nurse is caring for a stroke patient who is experiencing homonymous hemianopsia.The patient asks if he is going to have any limitations when discharged from the hospital.The nurse anticipates the patient will be restricted from what activity?

Which nursing intervention best encourages self-feeding in a patient with right-sided paralysis after a CVA?

The dysarthric patient seated in the dining room of the long-term care facility yells,"Poon! Poon! Poon!" with increasing frustration.What is the nurse's best response?

The nurse is providing medication teaching to a patient with epilepsy who is taking phenytoin (Dilantin) .Which statement best indicates that the nurse's teaching has been successful?

A patient diagnosed with a primary brain tumor asks the nurse if this is a common disease.Which response is most appropriate for the nurse to make?

The nurse is writing the care plan for a cerebrovascular accident (CVA) patient who has partial left-sided paralysis and is experiencing ataxia.Which intervention is most beneficial for this patient?

The nurse instructs a person taking phenytoin (Dilantin) that periodic blood tests will be necessary.The nurse explains that the laboratory checks will monitor for which potential medication-induced change?