MDCIV E1

Position-change technique recommended after a microdiscectomy

Log-rolling technique

Key intervention to prevent arboviral encephalopathy

Wear DEET insect repellent on exposed skin and clothing as directed.

Primary parameter the nurse must monitor in a client with diabetes insipidus following head trauma

Fluid balance

Cerebral hemisphere likely affected in a stroke client who is impulsive, easily distracted, and lacks spatial awareness

Right hemisphere

Medication commonly prescribed prophylactically to prevent seizures prior to brain tumor surgery

Phenytoin

Priority nursing assessment during a myasthenic crisis

Monitor respiratory function

Major neurologic complication to monitor for in herpes simplex encephalitis

Seizures

Complications that can result from a brain tumor compressing adjacent normal tissue

Focal neurologic deficits and increased intracranial pressure (ICP)

Postoperative assessment priority following microvascular decompression surgery for trigeminal neuralgia

Facial motor and sensory deficits

Method used to assess level of consciousness (LOC) when a client cannot follow verbal commands

Assess eye opening and motor/verbal responses to stimuli.

Bed positioning recommended to reduce increased ICP after a traumatic brain injury

Elevate the head of the bed approximately $30^\circ$.

Common nursing diagnosis for a client diagnosed with amyotrophic lateral sclerosis (ALS)

Impaired verbal communication

Interventions that help prevent venous thromboembolism (VTE) after traumatic brain injury

Apply sequential compression devices (SCDs), reposition every $2\,\text{hours}$, and administer prescribed anticoagulants when safe.

Interventions to protect the affected eye in Bell's palsy

Tape the eye closed during sleep, apply lubricating eye drops or ointment, and wear protective sunglasses or goggles.

Immediate nursing action if a stroke client's neurologic condition acutely deteriorates

Notify the healthcare provider immediately using SBAR communication and activate the appropriate emergency response.

Physical finding that characterizes a positive Brudzinski's sign

Passive neck flexion causes involuntary flexion of the hips and knees.

Priority nursing action for a client with rapidly progressing Guillain-Barré syndrome

Monitor respiratory function

Diagnostic neurodiagnostic test typically ordered when Creutzfeldt-Jakob disease is suspected

Electroencephalogram (EEG)

Nursing action required when a client drinks coffee and cola prior to an EEG

Notify the healthcare provider and discuss whether the test should be postponed.

Most important medication administration instruction for a client diagnosed with epilepsy

Take anticonvulsants consistently as prescribed and never stop them abruptly.

Priority intervention to prevent autonomic dysreflexia in a client with a spinal cord injury at $\text{T6--T7}$

Prevent bladder distension

Pump rate ($\text{mL/hr}$) for dobutamine $250\,\text{mg}$ in $250\,\text{mL}$ $\text{D}_5\text{W}$ prescribed at $4\,\mu\text{g/kg/min}$ for an $80\,\text{kg}$ client

$$19\,\text{mL/hr}$$

Interventions that reduce fall risk in a client with Parkinson's disease

Use a walker or prescribed assistive device and remove environmental hazards in the home.

Immediate priority for a client with a central nervous system disorder who displays irregular respirations

Ensure a clear airway and assess breathing.

Client teaching for an individual with Parkinson's disease experiencing progressive mobility difficulties

Use assistive devices for mobility and adaptive tools for activities of daily living.

Initial nursing action for a client experiencing severe localized pain from a spinal cord tumor

Assess pain characteristics and neurologic status, then administer prescribed analgesics as appropriate.

Key educational focus for family members of a client recovering from a hemorrhagic stroke

Modifying the home environment for safety

Vascular mechanism through which alcohol contributes to migraine headaches

Alcohol triggers migraines and induces changes in blood vessel tone, including vasodilation.

Assessment finding in a client with a subdural hematoma that demands immediate clinical intervention

Sudden deterioration in level of consciousness (LOC) and new focal neurologic deficits

Clinical finding in a client with a supratentorial lesion requiring immediate intervention

Pupillary changes and impaired extraocular movements

Classic motor sign characteristic of Parkinson's disease

Resting tremors

Primary etiology difference between aseptic and septic meningitis

Aseptic meningitis is commonly viral; septic meningitis is bacterial.

Medication typically prescribed to treat an acute multiple sclerosis relapse

Intravenous (IV) methylprednisolone

Intervention to prevent complications in a client with right-sided weakness secondary to a left hemispheric stroke

Assist with passive range-of-motion exercises on the affected side.

Pump rate ($\text{mL/hr}$) for nitroprusside $50\,\text{mg}$ in $250\,\text{mL}$ $\text{D}_5\text{W}$ at $0.3\,\mu\text{g/kg/min}$ for an $80\,\text{kg}$ client

$$7\,\text{mL/hr}$$

Clinical triad of manifestations associated with an acoustic neuroma

Vertigo, staggering gait, and tinnitus

Appropriate recovery goal for a client with spatial-perceptual deficits following a right hemispheric stroke

Demonstrate improved spatial-perceptual orientation within one week.

Priority medical/surgical intervention required for an acute epidural hematoma

Emergency surgical evacuation (such as craniotomy or burr holes)

The three components of Cushing's triad (late sign of increased ICP)

Widened pulse pressure, bradycardia, and irregular respirations

Seizure type presenting as initial muscle rigidity followed by alternating contractions and relaxation

Generalized tonic-clonic seizure

Flow rate ($\text{gtt/min}$) to infuse $1000\,\text{mL}$ normal saline over $8\,\text{hours}$ using a drop factor of $15\,\text{gtt/mL}$

$$31\,\text{gtt/min}$$

Lifestyle and self-care measures that help prevent recurring seizures

Avoid alcohol and known seizure triggers, and never discontinue anticonvulsant medications abruptly.

Nursing interventions to help maintain normal ICP following traumatic brain injury

Monitor Glasgow Coma Scale (GCS), monitor arterial blood gases (ABGs) to guide ventilation, provide prescribed sedation when indicated, and elevate the head of the bed at least $30^\circ$.

Anticipated actions for a client on amphetamine therapy who develops staring spells, lip-smacking, and episodic amnesia

Obtain an EEG and temporarily hold the amphetamine pending prescriber evaluation.