neuro quiz

B) Occipital

A patient is brought to the ER following a motor vehicle accident in which he sustained head trauma.

Preliminary assessment reveals a vision deficit in the patients left eye. The nurse should associate this

abnormal finding with trauma to which of the following cerebral lobes?

A) Temporal

B) Occipital

C) Parietal

D) Frontal

B) Removing all metal-containing objects

A patient scheduled for magnetic resonance imaging (MRI) has arrived at the radiology department. The

nurse who prepares the patient for the MRI should prioritize which of the following actions?

A) Withholding stimulants 24 to 48 hours prior to exam

B) Removing all metal-containing objects

C) Instructing the patient to void prior to the MRI

D) Initiating an IV line for administration of contrast

B) Reduction in cerebral blood flow

A gerontologic nurse planning the neurologic assessment of an older adult is considering normal, age-

related changes. Of what phenomenon should the nurse be aware?

A) Hyperactive deep tendon reflexes

B) Reduction in cerebral blood flow

C) Increased cerebral metabolism

D) Hypersensitivity to painful stimuli

B) Increased heart rate

The nurse has admitted a new patient to the unit. One of the patients admitting orders is for an

adrenergic medication. The nurse knows that this medication will have what effect on the circulatory

system?

A) Thin, watery saliva

B) Increased heart rate

C) Decreased BP

D) Constricted bronchioles

C) Clonus

A nurse is assessing reflexes in a patient with hyperactive reflexes. When the patients foot is abruptly

dorsiflexed, it continues to beat two to three times before settling into a resting position. How would the

nurse document this finding?

A) Rigidity

B) Flaccidity

C) Clonus

D) Ataxia

B) Parietal-occipital area

The nurse is doing an initial assessment on a patient newly admitted to the unit with a diagnosis of

cerebrovascular accident (CVA). The patient has difficulty copying a figure that the nurse has drawn and

is diagnosed with visual-receptive aphasia. What brain region is primarily involved in this deficit?

A) Temporal lobe

B) Parietal-occipital area

C) Inferior posterior frontal areas

D) Posterior frontal area

D) Pia mater

What term is used to describe the fibrous connective tissue that hugs the brain closely and extends into every fold of the brains surface?

A) Dura mater

B) Arachnoid

C) Fascia

D) Pia mater

C) Loss of voluntary control of movement

The nurse is caring for a patient with an upper motor neuron lesion. What clinical manifestations should

the nurse anticipate when planning the patients neurologic assessment?

A) Decreased muscle tone

B) Flaccid paralysis

C) Loss of voluntary control of movement

D) Slow reflexes

D) Patient demonstrates an absence of deep tendon reflexes.

The nurse is admitting a patient to the unit who is diagnosed with a lower motor neuron lesion. What entry in the patients electronic record is most consistent with this diagnosis?

A) Patient exhibits increased muscle tone.

B) Patient demonstrates normal muscle structure with no evidence of atrophy.

C) Patient demonstrates hyperactive deep tendon reflexes.

D) Patient demonstrates an absence of deep tendon reflexes.

D) A smoke detector

An elderly patient is being discharged home. The patient lives alone and has atrophy of his olfactory organs. The nurse tells the patients family that it is essential that the patient have what installed in the

home?

A) Grab bars

B) Nonslip mats

C) Baseboard heaters

D) A smoke detector

A) Position the patient prone.

The patient in the ED has just had a diagnostic lumbar puncture. To reduce the incidence of a post-lumbar puncture headache, what is the nurses most appropriate action?

A) Position the patient prone.

B) Position the patient supine with the head of bed flat.

C) Position the patient left side-lying.

D) Administer acetaminophen as ordered.

D) Assessment of gag reflex

The nurse is conducting a focused neurologic assessment. When assessing the patients cranial nerve function, the nurse would include which of the following assessments?

A) Assessment of hand grip

B) Assessment of orientation to person, time, and place

C) Assessment of arm drift

D) Assessment of gag reflex

D) Hearing and equilibrium

A nurse is caring for a patient diagnosed with Mnires disease. While completing a neurologic

examination on the patient, the nurse assesses cranial nerve VIII. The nurse would be correct in

identifying the function of this nerve as what?

A) Movement of the tongue

B) Visual acuity

C) Sense of smell

D) Hearing and equilibrium

A) Cerebellar dysfunction

A patient exhibiting an uncoordinated gait has presented at the clinic. Which of the following is the most plausible cause of this patients health problem?

A) Cerebellar dysfunction

B) A lesion in the pons

C) Dysfunction of the medulla

D) A hemorrhage in the midbrain

D) Test for air and bone conduction (Rinne test).

The nursing students are learning how to assess function of cranial nerve VIII. To assess the function of cranial nerve VIII the students would be correct in completing which of the following assessment

techniques?

A) Have the patient identify familiar odors with the eyes closed.

B) Assess papillary reflex.

C) Utilize the Snellen chart.

D) Test for air and bone conduction (Rinne test).

A) Constricted pupils

16. A patient is being given a medication that stimulates her parasympathetic system. Following

administration of this medication, the nurse should anticipate what effect?

A) Constricted pupils

B) Dilated bronchioles

C) Decreased peristaltic movement

D) Relaxed muscular walls of the urinary bladder

A) Positioning the patient with the head of the bed elevated 45 degrees

A patient with lower back pain is scheduled for myelography using metrizamide (a water-soluble

contrast dye). After the test, the nurse should prioritize what action?

A) Positioning the patient with the head of the bed elevated 45 degrees

B) Administering IV morphine sulfate to prevent headache

C) Limiting fluids for the next 12 hours

D) Helping the patient perform deep breathing and coughing exercises

C) Increase in the secretion of sweat

A patient is having a fight or flight response after receiving bad news about his prognosis. What affect

will this have on the patients sympathetic nervous system?

A) Constriction of blood vessels in the heart muscle

B) Constriction of bronchioles

C) Increase in the secretion of sweat

D) Constriction of pupils

B) When level of consciousness is decreased

C) With brain stem pathology

D) In the presence of peripheral nervous system disease

19. The nurse educator is reviewing the assessment of cranial nerves. What should the educator identify as

the specific instances when cranial nerves should be assessed? Select all that apply.

A) When a neurogenic bladder develops

B) When level of consciousness is decreased

C) With brain stem pathology

D) In the presence of peripheral nervous system disease

E) When a spinal reflex is interrupted

C) Hypothalamus

A patient in the OR goes into malignant hyperthermia due to an abnormal reaction to the anesthetic. The

nurse knows that the area of the brain that regulates body temperature is which of the following?

A) Cerebellum

B) Thalamus

C) Hypothalamus

D) Midbrain

B) Decreased availability of dopamine

The nurse is planning the care of a patient with Parkinsons disease. The nurse should be aware that treatment will focus on what pathophysiological phenomenon?

A) Premature degradation of acetylcholine

B) Decreased availability of dopamine

C) Insufficient synthesis of epinephrine

D) Delayed reuptake of serotonin

A) Function of the hypoglossal nerve

A patient is admitted to the medical unit with an exacerbation of multiple sclerosis. When assessing this patient, the nurse has the patient stick out her tongue and move it back and forth. What is the nurse

assessing?

A) Function of the hypoglossal nerve

B) Function of the vagus nerve

C) Function of the spinal nerve

D) Function of the trochlear nerve

C) Sympathetic storm

A trauma patient was admitted to the ICU with a brain injury. The patient had a change in level of

consciousness, increased vital signs, and became diaphoretic and agitated. The nurse should recognize which of the following syndromes as the most plausible cause of these symptoms?

A) Adrenal crisis

B) Hypothalamic collapse

C) Sympathetic storm

D) Cranial nerve deficit

B) Understanding of the tests used to diagnose neurologic disorders

C) Knowledge of nursing interventions related to assessment and diagnostic testing

D) Knowledge of the anatomy of the nervous system

Assessment is crucial to the care of patients with neurologic dysfunction. What does accurate and appropriate assessment require? Select all that apply.

A) The ability to select mediations for the neurologic dysfunction

B) Understanding of the tests used to diagnose neurologic disorders

C) Knowledge of nursing interventions related to assessment and diagnostic testing

D) Knowledge of the anatomy of the nervous system

E) The ability to interpret the results of diagnostic tests

C) Observe for facial movement symmetry, such as a smile.

When caring for a patient with an altered level of consciousness, the nurse is preparing to test cranial nerve VII. What assessment technique would the nurse use to elicit a response from cranial nerve VII?

A) Palpate trapezius muscle while patient shrugs should against resistance.

B) Administer the whisper or watch-tick test.

C) Observe for facial movement symmetry, such as a smile.

D) Note any hoarseness in the patients voice.

B) Acoustic

26. The nurse is caring for a patient who exhibits abnormal results of the Weber test and Rinne test. The nurse should suspect dysfunction involving what cranial nerve?

A) Trigeminal

B) Acoustic

C) Hypoglossal

D) Trochlear

C) Age-related neurologic changes

The nurse caring for an 80 year-old patient knows that she has a pre-existing history of dulled tactile sensation. The nurse should first consider what possible cause for this patients diminished tactile

sensation?

A) Damage to cranial nerve VIII

B) Adverse medication effects

C) Age-related neurologic changes

D) An undiagnosed cerebrovascular accident in early adulthood

D) Thorough assessment is necessary because changes in cognition are always considered to be pathologic.

A 72-year-old man has been brought to his primary care provider by his daughter, who claims that he has been experiencing uncharacteristic lapses in memory. What principle should underlie the nurses assessment and management of this patient?

A) Loss of short-term memory is normal in older adults, but loss of long-term memory is pathologic.

B) Lapses in memory in older adults are considered benign unless they have negative consequences.

C) Gradual increases in confusion accompany the aging process.

D) Thorough assessment is necessary because changes in cognition are always considered to be

pathologic.

A) Hot or cold packs

A gerontologic nurse educator is providing practice guidelines to unlicensed care providers. Because reaction to painful stimuli is sometimes blunted in older adults, what must be used with caution?

A) Hot or cold packs

B) Analgesics

C) Anti-inflammatory medications

D) Whirlpool

B) Electroencephalography (EEG)

A trauma patient in the ICU has been declared brain dead. What diagnostic test is used in making the

determination of brain death?

A) Magnetic resonance imaging (MRI)

B) Electroencephalography (EEG)

C) Electromyelography (EMG)

D) Computed tomography (CT)

C) You will need to lie still throughout the procedure.

A patient is scheduled for CT scanning of the head because of a recent onset of neurologic deficits. What

should the nurse tell the patient in preparation for this test?

A) No metal objects can enter the procedure room.

B) You need to fast for 8 hours prior to the test.

C) You will need to lie still throughout the procedure.

D) There will be a lot of noise during the test.

The test may result in dizziness or lightheadedness.

A patient for whom the nurse is caring has positron emission tomography (PET) scheduled. In

preparation, what should the nurse explain to the patient?

A) The test will temporarily limit blood flow through the brain.

B) An allergy to iodine precludes getting the radio-opaque dye.

C) The patient will need to endure loud noises during the test.

D) The test may result in dizziness or lightheadedness.

A) Lumbar puncture

A patient is scheduled for a myelogram and the nurse explains to the patient that this is an invasive procedure, which assesses for any lesions in the spinal cord. The nurse should explain that the preparation is similar to which of the following neurologic tests?

A) Lumbar puncture

B) MRI

C) Cerebral angiography

D) EEG

B) Demyelinating disease

34. The physician has ordered a somatosensory evoked responses (SERs) test for a patient for whom the nurse is caring. The nurse is justified in suspecting that this patient may have a history of what type of neurologic disorder?

A) Hypothalamic disorder

B) Demyelinating disease

C) Brainstem deficit

D) Diabetic neuropathy

C) Whether the patient has had any complications of the test

A patient had a lumbar puncture performed at the outpatient clinic and the nurse has phoned the patient and family that evening. What does this phone call enable the nurse to determine?

A) What are the patients and familys expectations of the test

B) Whether the patients family had any questions about why the test was necessary

C) Whether the patient has had any complications of the test

D) Whether the patient understood accurately why the test was done

D) The parasympathetic nervous system makes the bladder contract.

A patient is currently being stimulated by the parasympathetic nervous system. What effect will this nervous stimulation have on the patients bladder?

A) The parasympathetic nervous system causes urinary retention.

B) The parasympathetic nervous system causes bladder spasms.

C) The parasympathetic nervous system causes urge incontinence.

D) The parasympathetic nervous system makes the bladder contract.

B) Assess the patients eye opening and response to stimuli.

The nurse is performing a neurologic assessment of a patient whose injuries have rendered her unable to

follow verbal commands. How should the nurse proceed with assessing the patients level of

consciousness (LOC)?

A) Assess the patients vital signs and correlate these with the patients baselines.

B) Assess the patients eye opening and response to stimuli.

C) Document that the patient currently lacks a level of consciousness.

D) Facilitate diagnostic testing in an effort to obtain objective data.

B) Muscle tone

In the course of a focused neurologic assessment, the nurse is palpating the patients major muscle groups at rest and during passive movement. Data gleaned from this assessment will allow the nurse to describe which of the following aspects of neurologic function?

A) Muscle dexterity

B) Muscle tone

C) Motor symmetry

D) Deep tendon reflexes

D) Guide the patient through the performance of rapid, alternating movements.

The neurologic nurse is testing the function of a patients cerebellum and basal ganglia. What action will most accurately test these structures?

A) Have the patient identify the location of a cotton swab on his or her skin with the eyes closed.

B) Elicit the patients response to a hypothetical problem.

C) Ask the patient to close his or her eyes and discern between hot and cold stimuli.

D) Guide the patient through the performance of rapid, alternating movements.

C) Document successful completion of the assessment.

40. During the performance of the Romberg test, the nurse observes that the patient sways slightly. What is

the nurses most appropriate action?

A) Facilitate a referral to a neurologist.

B) Reposition the patient supine to ensure safety.

C) Document successful completion of the assessment.

D) Follow up by having the patient perform the Rinne test.

C) Mannitol (Osmitrol)

A patient is being admitted to the neurologic ICU following an acute head injury that has resulted in cerebral edema. When planning this patients care, the nurse would expect to administer what priority

medication?

A) Hydrochlorothiazide (HydroDIURIL)

B) Furosemide (Lasix)

C) Mannitol (Osmitrol)

D) Spirolactone (Aldactone)

B) Maintaining a patent airway

The nurse is providing care for a patient who is unconscious. What nursing intervention takes highest priority?

A) Maintaining accurate records of intake and output

B) Maintaining a patent airway

C) Inserting a nasogastric (NG) tube as ordered

D) Providing appropriate pain control

C) Participate in interventions to increase cerebral perfusion pressure.

The nurse is caring for a patient in the ICU who has a brain stem herniation and who is exhibiting an altered level of consciousness. Monitoring reveals that the patients mean arterial pressure (MAP) is 60 mm Hg with an intracranial pressure (ICP) reading of 5 mm Hg. What is the nurses most appropriate action?

A) Position the patient in the high Fowlers position as tolerated.

B) Administer osmotic diuretics as ordered.

C) Participate in interventions to increase cerebral perfusion pressure.

Prepare the patient for craniotomy.

B) Monitor serum electrolytes.

The nurse is caring for a patient who is postoperative following a craniotomy. When writing the plan of

care, the nurse identifies a diagnosis of deficient fluid volume related to fluid restriction and osmotic

diuretic use. What would be an appropriate intervention for this diagnosis?

A) Change the patients position as indicated.

B) Monitor serum electrolytes.

C) Maintain NPO status.

D) Monitor arterial blood gas (ABG) values.

Loosen the patients restrictive clothing.

A patient with a documented history of seizure disorder experiences a generalized seizure. What nursing action is most appropriate?

A) Restrain the patient to prevent injury.

B) Open the patients jaws to insert an oral airway.

C) Place patient in high Fowlers position.

D) Loosen the patients restrictive clothing.

C) Administration of thorough oral hygiene

A patient who has been on long-term phenytoin (Dilantin) therapy is admitted to the unit. In light of the adverse of effects of this medication, the nurse should prioritize which of the following in the patients

plan of care?

A) Monitoring of pulse oximetry

B) Administration of a low-protein diet

C) Administration of thorough oral hygiene

D) Fluid restriction as ordered

C) Sumatriptan succinate (Imitrex)

A nurse is admitting a patient with a severe migraine headache and a history of acute coronary

syndrome. What migraine medication would the nurse question for this patient?

A) Rizatriptan (Maxalt)

B) Naratriptan (Amerge)

C) Sumatriptan succinate (Imitrex)

D) Zolmitriptan (Zomig)

D) Obeys commands with appropriate motor responses.

The nurse is caring for a patient with increased intracranial pressure (ICP). The patient has a nursing diagnosis of ineffective cerebral tissue perfusion. What would be an expected outcome that the nurse would document for this diagnosis?

A) Copes with sensory deprivation.

B) Registers normal body temperature.

C) Pays attention to grooming.

D) Obeys commands with appropriate motor responses.

B) Glasgow Coma Scale

A patient exhibiting an altered level of consciousness (LOC) due to blunt-force trauma to the head is admitted to the ED. The physician determines the patients injury is causing increased intracranial

pressure (ICP). The nurse should gauge the patients LOC on the results of what diagnostic tool?

A) Monro-Kellie hypothesis

B) Glasgow Coma Scale

C) Cranial nerve function

D) Mental status examination

B) Confusion

While completing a health history on a patient who has recently experienced a seizure, the nurse would

assess for what characteristic associated with the postictal state?

A) Epileptic cry

B) Confusion

C) Urinary incontinence

D) Body rigidity

C) Meningitis

A patient with increased ICP has a ventriculostomy for monitoring ICP. The nurses most recent

assessment reveals that the patient is now exhibiting nuchal rigidity and photophobia. The nurse would

be correct in suspecting the presence of what complication?

A) Encephalitis

B) CSF leak

C) Meningitis

D) Catheter occlusion

B) Lumbar puncture

The nurse is participating in the care of a patient with increased ICP. What diagnostic test is

contraindicated in this patients treatment?

A) Computed tomography (CT) scan

B) Lumbar puncture

C) Magnetic resonance imaging (MRI)

D) Venous Doppler studies

B) Intravenous diazepam (Valium)

The nurse is caring for a patient who is in status epilepticus. What medication does the nurse know may

be given to halt the seizure immediately?

A) Intravenous phenobarbital (Luminal)

B) Intravenous diazepam (Valium)

C) Oral lorazepam (Ativan)

D) Oral phenytoin (Dilantin)

A) Disorientation and restlessness

The nurse has created a plan of care for a patient who is at risk for increased ICP. The patients care plan

should specify monitoring for what early sign of increased ICP?

A) Disorientation and restlessness

B) Decreased pulse and respirations

C) Projectile vomiting

D) Loss of corneal reflex

B) Maintain head of bed (HOB) elevated at 30 to 45 degrees.

The neurologic ICU nurse is admitting a patient following a craniotomy using the supratentorial

approach. How should the nurse best position the patient?

A) Position the patient supine.

B) Maintain head of bed (HOB) elevated at 30 to 45 degrees.

C) Position patient in prone position.

D) Maintain bed in Trendelenberg position.

.

B) Alcohol causes vasodilation of the blood vessels.

A clinic nurse is caring for a patient diagnosed with migraine headaches. During the patient teaching session, the patient questions the nurse regarding alcohol consumption. What would the nurse be correct in telling the patient about the effects of alcohol?

A) Alcohol causes hormone fluctuations.

B) Alcohol causes vasodilation of the blood vessels.

Test Bank - Brunner & Suddarth's Textbook of Medical-Surgical Nursing 14e (Hinkle 2017) 1247

C) Alcohol has an excitatory effect on the CNS.

D) Alcohol diminishes endorphins in the brain.

A) Vigilant monitoring of fluid balance

A patient has developed diabetes insipidus after having increased ICP following head trauma. What nursing assessment best addresses this complication?

A) Vigilant monitoring of fluid balance

B) Continuous BP monitoring

C) Serial arterial blood gases (ABGs)

D) Monitoring of the patients airway for patency

D) Diabetes insipidus

What should the nurse suspect when hourly assessment of urine output on a patient postcraniotomy exhibits a urine output from a catheter of 1,500 mL for two consecutive hours?

A) Cushing syndrome

B) Syndrome of inappropriate antidiuretic hormone (SIADH)

C) Adrenal crisis

D) Diabetes insipidus

D) It indicates an injury at the midbrain level.

During the examination of an unconscious patient, the nurse observes that the patients pupils are fixed

and dilated. What is the most plausible clinical significance of the nurses finding?

A) It suggests onset of metabolic problems.

B) It indicates paralysis on the right side of the body.

C) It indicates paralysis of cranial nerve X.

D) It indicates an injury at the midbrain level.

C) The patient may occasionally make nonpurposeful movements.

Following a traumatic brain injury, a patient has been in a coma for several days. Which of the following

statements is true of this patients current LOC?

A) The patient occasionally makes incomprehensible sounds.

B) The patients current LOC will likely become a permanent state.

C) The patient may occasionally make nonpurposeful movements.

D) The patient is incapable of spontaneous respirations.

A) Achieve as high a level of function as possible.

The nurse is caring for a patient with permanent neurologic impairments resulting from a traumatic head

injury. When working with this patient and family, what mutual goal should be prioritized?

A) Achieve as high a level of function as possible.

B) Enhance the quantity of the patients life.

C) Teach the family proper care of the patient.

D) Provide community assistance.

D) The patients activities immediately prior to the seizure.

The nurse is providing care for a patient who is withdrawing from heavy alcohol use. The nurse and other members of the care team are present at the bedside when the patient has a seizure. In preparation

for documenting this clinical event, the nurse should note which of the following?

A) The ability of the patient to follow instructions during the seizure.

B) The success or failure of the care team to physically restrain the patient.

C) The patients ability to explain his seizure during the postictal period.

D) The patients activities immediately prior to the seizure.

A) Assessing the patients verbal response

23. The nurse is caring for a patient whose recent health history includes an altered LOC. What should be the nurses first action when assessing this patient?

A) Assessing the patients verbal response

B) Assessing the patients ability to follow complex commands

C) Assessing the patients judgment

D) Assessing the patients response to pain

A) Contractures

C) Pressure ulcers

D) Venous thromboembolism

E) Pneumonia

The nurse caring for a patient in a persistent vegetative state is regularly assessing for potential

complications. Complications of neurologic dysfunction for which the nurse should assess include which of the following? Select all that apply.

A) Contractures

B) Hemorrhage

C) Pressure ulcers

D) Venous thromboembolism

E) Pneumonia

C) Dexamethasone

The nurse is caring for a patient with a brain tumor. What drug would the nurse expect to be ordered to

reduce the edema surrounding the tumor?

A) Solumedrol

B) Dextromethorphan

C) Dexamethasone

D) Furosemide

A) Inform the care team and assess for further signs of possible increased ICP.

The nurse is caring for a patient who sustained a moderate head injury following a bicycle accident. The nurses most recent assessment reveals that the patients respiratory effort has increased. What is the nurses most appropriate response?

A) Inform the care team and assess for further signs of possible increased ICP.

B) Administer bronchodilators as ordered and monitor the patients LOC.

C) Increase the patients bed height and reassess in 30 minutes.

D) Administer a bolus of normal saline as ordered.

D) Loss of brain stem reflexes

A patient has a poor prognosis after being involved in a motor vehicle accident resulting in a head injury. As the patients ICP increases and condition worsens, the nurse knows to assess for indications of approaching death. These indications include which of the following?

A) Hemiplegia

B) Dry mucous membranes

C) Signs of internal bleeding

D) Loss of brain stem reflexes

C) Generalized seizure

A patient has experienced a seizure in which she became rigid and then experienced alternating muscle relaxation and contraction. What type of seizure does the nurse recognize?

A) Unclassified seizure

B) Absence seizure

C) Generalized seizure

D) Focal seizure

A) Fluid restriction

When caring for a patient with increased ICP the nurse knows the importance of monitoring for possible secondary complications, including syndrome of inappropriate antidiuretic hormone (SIADH). What nursing interventions would the nurse most likely initiate if the patient developed SIADH?

A) Fluid restriction

B) Transfusion of platelets

C) Transfusion of fresh frozen plasma (FFP)

D) Electrolyte restriction

.

A) Transcranial Doppler flow study

B) Cerebral angiography

C) MRI

The nurse is admitting a patient to the unit who is scheduled for removal of an intracranial mass. What diagnostic procedures might be included in this patients admission orders? Select all that apply.

A) Transcranial Doppler flow study

B) Cerebral angiography

C) MRI

D) Cranial radiography

E) Electromyelography (EMG)

A) Administer morphine sulfate as ordered.

A patient is recovering from intracranial surgery performed approximately 24 hours ago and is

complaining of a headache that the patient rates at 8 on a 10-point pain scale. What nursing action is most appropriate?

A) Administer morphine sulfate as ordered.

B) Reposition the patient in a prone position.

C) Apply a hot pack to the patients scalp.

D) Implement distraction techniques.

C) Pituitary gland

A patient is recovering from intracranial surgery that was performed using the transsphenoidal approach. The nurse should be aware that the patient may have required surgery on what neurologic structure?

A) Cerebellum

B) Hypothalamus

C) Pituitary gland

D) Pineal gland

A) Recognize that this may represent the peak of post-surgical cerebral edema.

A patient is postoperative day 1 following intracranial surgery. The nurses assessment reveals that the patients LOC is slightly decreased compared with the day of surgery. What is the nurses best response to this assessment finding?

A) Recognize that this may represent the peak of post-surgical cerebral edema.

B) Alert the surgeon to the possibility of an intracranial hemorrhage.

C) Understand that the surgery may have been unsuccessful.

D) Recognize the need to refer the patient to the palliative care team.

B) Absence seizure

A school nurse is called to the playground where a 6-year-old girl has been found unresponsive and staring into space, according to the playground supervisor. How would the nurse document the girls activity in her chart at school?

A) Generalized seizure

B) Absence seizure

C) Focal seizure

D) Unclassified seizure

C) A dysrhythmia in the nerve cells in one section of the brain

A neurologic nurse is reviewing seizures with a group of staff nurses. How should this nurse best

describe the cause of a seizure?

A) Sudden electrolyte changes throughout the brain

B) A dysrhythmia in the peripheral nervous system

C) A dysrhythmia in the nerve cells in one section of the brain

D) Sudden disruptions in the blood flow throughout the brain

D) Phenytoin

The nurse is caring for a patient who has undergone supratentorial removal of a pituitary mass. What medication would the nurse expect to administer prophylactically to prevent seizures in this patient?

A) Prednisone

B) Dexamethasone

C) Cafergot

D) Phenytoin

A) Place the patient in a side-lying position.

A hospital patient has experienced a seizure. In the immediate recovery period, what action best protects the patients safety?

A) Place the patient in a side-lying position.

B) Pad the patients bed rails.

C) Administer antianxiety medications as ordered.

D) Reassure the patient and family members.

B) As soon as the patient senses the onset of symptoms

A nurse is caring for a patient who experiences debilitating cluster headaches. The patient should be taught to take appropriate medications at what point in the course of the onset of a new headache?

A) As soon as the patients pain becomes unbearable

B) As soon as the patient senses the onset of symptoms

C) Twenty to 30 minutes after the onset of symptoms

D) When the patient senses his or her symptoms peaking

C) The patient takes vasodilators for the treatment of angina.

A nurse is collaborating with the interdisciplinary team to help manage a patients recurrent headaches. What aspect of the patients health history should the nurse identify as a potential contributor to the patients headaches?

A) The patient leads a sedentary lifestyle.

B) The patient takes vitamin D and calcium supplements.

C) The patient takes vasodilators for the treatment of angina.

D) The patient has a pattern of weight loss followed by weight gain

A) Are you exposed to any toxins or chemicals at work?

B) How would you describe your ability to cope with stress?

C) What medications are you currently taking?

E) Does anyone else in your family struggle with headaches?

An adult patient has sought care for the treatment of headaches that have become increasingly severe and frequent over the past several months. Which of the following questions addresses potential etiological factors? Select all that apply?

A) Are you exposed to any toxins or chemicals at work?

B) How would you describe your ability to cope with stress?

C) What medications are you currently taking?

D) When was the last time you were hospitalized?

E) Does anyone else in your family struggle with headaches?

.

C) Place a pillow in the axilla when there is limited external rotation.

A patient has had an ischemic stroke and has been admitted to the medical unit. What action should the

nurse perform to best prevent joint deformities?

A) Place the patient in the prone position for 30 minutes/day.

B) Assist the patient in acutely flexing the thigh to promote movement.

C) Place a pillow in the axilla when there is limited external rotation.

D) Place patients hand in pronation.

C) To remove atherosclerotic plaques blocking cerebral flow

A patient diagnosed with transient ischemic attacks (TIAs) is scheduled for a carotid endarterectomy. The nurse explains that this procedure will be done for what purpose?

A) To decrease cerebral edema

B) To prevent seizure activity that is common following a TIA

C) To remove atherosclerotic plaques blocking cerebral flow

D) To determine the cause of the TIA

C) Depression

The nurse is discharging home a patient who suffered a stroke. He has a flaccid right arm and leg and is experiencing problems with urinary incontinence. The nurse makes a referral to a home health nurse because of an awareness of what common patient response to a change in body image?

A) Denial

B) Fear

C) Depression

D) Disassociation

B) Alteration in level of consciousness (LOC)

When caring for a patient who had a hemorrhagic stroke, close monitoring of vital signs and neurologic changes is imperative. What is the earliest sign of deterioration in a patient with a hemorrhagic stroke of which the nurse should be aware?

A) Generalized pain

B) Alteration in level of consciousness (LOC)

C) Tonicclonic seizures

D) Shortness of breath

B) White male, age 60, with history of uncontrolled hypertension

The nurse is performing stroke risk screenings at a hospital open house. The nurse has identified four patients who might be at risk for a stroke. Which patient is likely at the highest risk for a hemorrhagic stroke?

A) White female, age 60, with history of excessive alcohol intake

B) White male, age 60, with history of uncontrolled hypertension

C) Black male, age 60, with history of diabetes

D) Black male, age 50, with history of smoking

A) Cardiac and respiratory status

A patient who just suffered a suspected ischemic stroke is brought to the ED by ambulance. On what should the nurses primary assessment focus?

A) Cardiac and respiratory status

B) Seizure activity

C) Pain

D) Fluid and electrolyte balance

D) Absolute bed rest in a quiet, nonstimulating environment

A patient with a cerebral aneurysm exhibits signs and symptoms of an increase in intracranial pressure (ICP). What nursing intervention would be most appropriate for this patient?

A) Range-of-motion exercises to prevent contractures

B) Encouraging independence with ADLs to promote recovery

Test Bank - Brunner & Suddarth's Textbook of Medical-Surgical Nursing 14e (Hinkle 2017) 1261

C) Early initiation of physical therapy

D) Absolute bed rest in a quiet, nonstimulating environment

D) The patient should be taught to interlace fingers, place palms together, and slowly bring scapulae forward to avoid excessive force to shoulder.

A patient recovering from a stroke has severe shoulder pain from subluxation of the shoulder and is being cared for on the unit. To prevent further injury and pain, the nurse caring for this patient is aware of what principle of care?

A) The patient should be fitted with a cast because use of a sling should be avoided due to adduction

of the affected shoulder.

B) Elevation of the arm and hand can lead to further complications associated with edema.

C) Passively exercising the affected extremity is avoided in order to minimize pain.

D) The patient should be taught to interlace fingers, place palms together, and slowly bring scapulae

forward to avoid excessive force to shoulder.

A) Provide a board of commonly used needs and phrases.

The patient has been diagnosed with aphasia after suffering a stroke. What can the nurse do to best make the patients atmosphere more conducive to communication?

A) Provide a board of commonly used needs and phrases.

B) Have the patient speak to loved ones on the phone daily.

C) Help the patient complete his or her sentences.

D) Speak in a loud and deliberate voice to the patient.

A) Facial droop

The nurse is assessing a patient with a suspected stroke. What assessment finding is most suggestive of a stroke?

A) Facial droop

B) Dysrhythmias

C) Periorbital edema

D) Projectile vomiting

C) The patient should be placed in a prone position for 15 to 30 minutes several times a day.

The nurse is caring for a patient diagnosed with an ischemic stroke and knows that effective positioning of the patient is important. Which of the following should be integrated into the patients plan of care?

A) The patients hip joint should be maintained in a flexed position.

B) The patient should be in a supine position unless ambulating.

C) The patient should be placed in a prone position for 15 to 30 minutes several times a day.

D) The patient should be placed in a Trendelenberg position two to three times daily to promote

cerebral perfusion.

B) Maintain the patient on complete bed rest.

12. A patient has been admitted to the ICU after being recently diagnosed with an aneurysm and the patients admission orders include specific aneurysm precautions. What nursing action will the nurse incorporate into the patients plan of care?

A) Elevate the head of the bed to 45 degrees.

B) Maintain the patient on complete bed rest.

C) Administer enemas when the patient is constipated.

D) Avoid use of thigh-high elastic compression stockings.

B) Maintain and improve cerebral tissue perfusion.

A nurse is caring for a patient diagnosed with a hemorrhagic stroke. When creating this patients plan of care, what goal should be prioritized?

A) Prevent complications of immobility.

B) Maintain and improve cerebral tissue perfusion.

C) Relieve anxiety and pain.

D) Relieve sensory deprivation.

C) Take antihypertensive medication as ordered.

The nurse is preparing health education for a patient who is being discharged after hospitalization for a hemorrhagic stroke. What content should the nurse include in this education?

A) Mild, intermittent seizures can be expected.

B) Take ibuprofen for complaints of a serious headache.

C) Take antihypertensive medication as ordered.

D) Drowsiness is normal for the first week after discharge

.

D) Call the physician immediately.

A patient diagnosed with a cerebral aneurysm reports a severe headache to the nurse. What action is a priority for the nurse?

A) Sit with the patient for a few minutes.

B) Administer an analgesic.

C) Inform the nurse-manager.

D) Call the physician immediately.

A) Evidence of hemorrhagic stroke

A patient is brought by ambulance to the ED after suffering what the family thinks is a stroke. The nurse caring for this patient is aware that an absolute contraindication for thrombolytic therapy is what?

A) Evidence of hemorrhagic stroke

B) Blood pressure of 180/110 mm Hg

C) Evidence of stroke evolution

D) Previous thrombolytic therapy within the past 12 months

B) Elevation of the head of the bed

17. When caring for a patient who has had a stroke, a priority is reduction of ICP. What patient position is most consistent with this goal?

A) Head turned slightly to the right side

B) Elevation of the head of the bed

C) Position changes every 15 minutes while awake

D) Extension of the neck

A) The patient should be approached on the side where visual perception is intact.

A patient who suffered an ischemic stroke now has disturbed sensory perception. What principle should guide the nurses care of this patient?

A) The patient should be approached on the side where visual perception is intact.

B) Attention to the affected side should be minimized in order to decrease anxiety.

C) The patient should avoid turning in the direction of the defective visual field to minimize shoulder

subluxation.

D) The patient should be approached on the opposite side of where the visual perception is intact to

promote recovery.

D) Exercise the affected extremities passively four or five times a day.

What should be included in the patients care plan when establishing an exercise program for a patient affected by a stroke?

A) Schedule passive range of motion every other day.

B) Keep activity limited, as the patient may be over stimulated.

C) Have the patient perform active range-of-motion (ROM) exercises once a day.

D) Exercise the affected extremities passively four or five times a day

D) Place the patients extremities where she can see them.

A female patient is diagnosed with a right-sided stroke. The patient is now experiencing hemianopsia. How might the nurse help the patient manage her potential sensory and perceptional difficulties?

A) Keep the lighting in the patients room low.

B) Place the patients clock on the affected side.

C) Approach the patient on the side where vision is impaired.

D) Place the patients extremities where she can see them.