Chapter 16: Disorders of Neuro system

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A nurse is preparing to teach staff about the most common type of traumatic brain injury. Which type of traumatic brain injury should the nurse discuss?

a. Penetrating trauma

b.     Diffuse axonal injury

c.      Focal brain injury

d.     Concussion

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Concussion

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A coup injury resulting from a blow to the frontal portion of the skull would occur in which region of the brain?

a. Frontal

b.     Temporal

c.      Parietal

d.     Occipital

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frontal

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43 Terms

1
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A nurse is preparing to teach staff about the most common type of traumatic brain injury. Which type of traumatic brain injury should the nurse discuss?

a. Penetrating trauma

b.     Diffuse axonal injury

c.      Focal brain injury

d.     Concussion

Concussion

2
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A coup injury resulting from a blow to the frontal portion of the skull would occur in which region of the brain?

a. Frontal

b.     Temporal

c.      Parietal

d.     Occipital

frontal

3
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What is the main source of bleeding in extradural (epidural) hematomas?

a. Arterial

b.     Venous

c.      Capillary

d.     Sinus

Arterial

4
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A 69-year-old patient with a history of alcohol abuse presents to the emergency room (ER) after a month-long episode of headaches and confusion. The patient’s history and symptomology support which medical diagnosis?

a. Concussion

b.     Chronic subdural hematoma

c.      Epidural hematoma

d.     Subacute subdural hematoma

Chronic subdural hematoma

5
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Immediately after being struck by a motor vehicle, a patient is unconscious, but the patient regains consciousness before arriving at the hospital and appears alert and oriented. The next morning the patient is confused and demonstrates impaired responsiveness. The patient’s history and symptoms support which medical diagnosis?

a. Mild concussion

b.     Subdural hematoma

c.      Extradural (epidural) hematoma

d.     Mild diffuse axonal injury

Extradural (epidural) Hematoma

6
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Which assessment finding by the nurse characterizes a mild concussion?

a.      A brief loss of consciousness

b.     Significant behavioral changes

c.      Retrograde amnesia

d.     Permanent confusion

retrograde amnesia

7
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A CT scan reveals that a patient has an open basilar skull fracture. Which major complication should the nurse observe for in this patient?

a. Hematoma formation

b.     Meningeal infection

c.      Increased intracranial pressure (ICP)

d.     Cognitive deficits

Meningeal Infection

8
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A patient diagnosed with a diffuse brain injury (DBI) is at increased risk for which complication?

a.      Complete loss of vision

b.     Arrhythmia

c.      Acute brain swelling

d.     Meningitis infection

Acute brain swelling

9
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After falling, a patient’s Glasgow Coma Scale (GCS) was 5 initially and 7 after 1 day. The patient remained unconscious for 2 weeks but is now awake, confused, and experiencing anterograde amnesia. This history supports which medical diagnosis?

a. Mild diffuse brain injury

b.     Moderate diffuse brain injury

c.      Severe diffuse brain injury

d.     Postconcussive syndrome

Moderate diffuse brain injury

10
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Who is most at risk of spinal cord injury because of preexisting degenerative disorders?

a.    Infants

b.     Men

c.      Women

d.     The elderly

The elderly

11
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A patient is brought to the ER for treatment of injuries received in a motor vehicle accident. An MRI reveals spinal cord injury, and his body temperature fluctuates markedly. The most accurate explanation of this phenomenon is that:

a. he developed pneumonia.

b.     his sympathetic nervous system has been damaged.

c.      he has a brain injury.

d.     he has septicemia from an unknown source.

his sympathetic nervous system has been changed

12
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Six weeks ago a patient suffered a T6 spinal cord injury. What complication does the nurse suspect when the patient develops a blood pressure of 200/120, a severe headache, blurred vision, and bradycardia?

a.      Extreme spinal shock

b.     Acute anxiety

c.      Autonomic hyperreflexia

d.     Parasympathetic areflexia

Autonomic Hyperreflexia

13
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A patient diagnosed with a spinal cord injury experienced spinal shock lasting 15 days. The patient is now experiencing an uncompensated cardiovascular response to sympathetic stimulation. What does the nurse suspect caused this condition?

a.      Toxic accumulation of free radicals below the level of the injury

b.     Pain stimulation above the level of the spinal cord lesion

c.      A distended bladder or rectum

d.     An abnormal vagal response

A distended bladder or rectum

14
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A patient presents with acute low back pain. There is no history of trauma. An MRI reveals that the vertebra at L5 has slipped forward relative to those below it. Which of the following conditions will be documented on the chart?

a. Degenerative disk disease

b.     Spondylolysis

c.      Spondylolisthesis

d.     Spinal stenosis

Spondylolisthesis

15
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The majority of intervertebral disk herniations occur between which vertebral levels (cervical, C; thoracic, T; lumbar, L; sacral, S)?

a. C1-C3

b.     T1-T4

c.      T12-L3

d.     L4-S1

L4 - S1

16
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A 30-year-old white male recently suffered a cerebrovascular accident. Which of the following is the most likely factor that contributed to his stroke?

a. Age

b.     Gender

c.      Diabetes

d.     Race

Diabetes

17
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Which of the following would increase a patient’s risk for thrombotic stroke?

a.      Hyperthyroidism

b.     Hypertension

c.      Anemia

d.     Dehydration

Dehydration

18
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Of the following groups, who are at highest risk for a cerebrovascular accident (CVA)?

a.      Blacks over 65 years of age

b.     Whites over 65 years of age

c.      Blacks under 65 years of age

d.     Whites under 65 years of age

Blacks over 65 years of age

19
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A 72-year-old patient demonstrates left-sided weakness of upper and lower extremities. The symptoms lasted less than an hour and resolved with no evidence of infarction. The patient most likely experienced a(n):

a. stroke in evolution.

b.     arteriovenous malformation.

c.      transient ischemic attack.

d.     cerebral hemorrhage.

Transient ischemic attack

20
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A major contributing process in CVAs is the development of atheromatous plaques in cerebral circulation. Where do these plaques most commonly form?

a. In the larger veins

b.     Near capillary sphincters

c.      In cerebral arteries

d.     In the venous sinuses

In cerebral arteries

21
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A 60-year-old patient with a recent history of head trauma and a long-term history of hypertension presents to the ER for changes in mental status. MRI reveals that the patient has experienced a subarachnoid hemorrhage. What does the nurse suspect caused this type of stroke?

a.      Rheumatic heart disease

b.     Thrombi

c.      Aneurysm

d.     Hypotension

Aneurysm

22
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A 75-year-old patient experienced a lacunar stroke. When looking through the history of the patient’s chart, which of the following would the nurse expect to find?

a. An embolus

b.     An ischemic lesion

c.      A hemorrhage

d.     An aneurysm

An ischemic lesion

23
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Upon autopsy of a 25-year-old, abnormalities in the media of the arterial wall and degenerative changes were detected. Which of the following would most likely accompany this finding?

a.      Fusiform aneurysm

b.     Saccular aneurysm

c.      Arteriovenous malformation

d.     Thrombotic stroke

Saccular aneurysm

24
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A 48-year-old patient presents at the ER reporting an acute severe headache, nausea, photophobia, and nuchal rigidity. Which medical diagnosis is supported by these signs and symptoms?

a.      Diffuse brain injury

b.     Subarachnoid hemorrhage

c.      Epidural hematoma

d.     Classic concussion

Subarachnoid hemorrhage

25
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A 65-year-old patient diagnosed with a subarachnoid hemorrhage secondary to uncontrolled hypertension appears drowsy and confused with pronounced focal neurologic deficits. This symptomology would place this hemorrhage at which grade?

a. I

b.     II

c.      III

d.     IV

III

26
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A patient presents to a primary care provider reporting fever, headache, nuchal rigidity, and decreased consciousness. History includes a previously treated sinusitis. Which medical diagnosis is best supported by this assessment data?

a. Aseptic meningitis

b.     Bacterial meningitis

c.      Fungal meningitis

d.     Nonpurulent meningitis

Bacterial meningitis

27
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Most causes of encephalitis are which of the following?

a.      Bacterial

b.     Viral

c.      Fungal

d.     Toxoid

viral

28
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A 15-month-old child from Pennsylvania was brought to the ER with symptomology that includes fever, seizure activity, cranial palsies, and paralysis. Which form of encephalitis is best supported by the available assessment data?

a. Eastern equine encephalitis

b.     Venezuelan encephalitis

c.      St. Louis encephalitis

d.     West Nile encephalitis

eastern equine encephalitis

29
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A patient is newly diagnosed with multiple sclerosis (MS). What physiological change is causing the patient’s symptoms?

a.      Depletion of dopamine in the central nervous system (CNS)

b.     Demyelination of nerve fibers in the CNS

c.      The development of neurofibril webs in the CNS

d.     Reduced amounts of acetylcholine at the neuromuscular junction

Demyelination of nerve fibers in the CNS

30
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When a patient asks, “What is the cause of multiple sclerosis?” the nurse bases the answer on the interaction between:

a.      vascular and metabolic factors.

b.     bacterial infection and the inflammatory response.

c.      autoimmunity and genetic susceptibility.

d.     neurotransmitters and inherited genes.

autoimmunity and genetic susceptibility

31
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Patient teaching is considered successful regarding myasthenia gravis when the patient identifies its cause as being:

a.      viral infection of skeletal muscle.

b.     atrophy of motor neurons in the spinal cord.

c.      demyelination of skeletal motor neurons.

d. autoimmune injury at the neuromuscular junction

autoimmune injury at the neuromuscular junction

32
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Patients diagnosed with myasthenia gravis often have tumors or pathologic changes in the:

a. brain.

b.     pancreas.

c.      thymus.

d.     lungs.

thymus

33
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What are the most common primary central nervous system (CNS) tumors in adults?

a. Meningiomas

b.     Oligodendrogliomas

c.      Astrocytomas

d.     Ependymomas

Astrocytomas

34
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A patient presents with seizures. An MRI reveals a meningioma most likely originating from the:

a.      dura mater and arachnoid membrane.

b.     astrocytes.

c.      pia mater.

d.     CNS neurons.

Dura mater and arachnoid membrane

35
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The patient reports generalized muscle weakness. The health care provider orders administration of the medication edrophonium chloride (Tensilon). This medication is used in the diagnosis of:           

a.      amyotrophic lateral sclerosis (ALS).

b.     myasthenia gravis.

c.      multiple sclerosis (MS).

d.     autonomic hyperreflexia.

myasthenia gravis

36
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Which information is basic to the assessment findings associated with a patient diagnosed with an aneurysm?

a.      A headache is the most common symptom.

b.     The majority are asymptomatic.

c.      Nosebleeds are an early symptom.

d.     Epidural hemorrhage occurs in over 80% of patients.

the majority are asymptomatic

37
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What is the most common early symptom of a brain abscess?

a.      Neck rigidity

b.     Vomiting

c.      Drowsiness

d.     Headache

headache

38
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Neurotransmitter released into ganglia by preganglionic parasympathetic neurons

acetylcholine

39
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neurotransmitter released at target tissues by postganglionic parasympathetic neurons

acetylcholine

40
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neurotransmitter released in basal ganglia by neurons with cell bodies in the substantia nigra

dopamine

41
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neurotransmitter released at neuromuscular junctions by somatic motor neurons

acetylcholine

42
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neurotransmitter released into ganglia by preganglionic sympathetic neurons

acetylcholine

43
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neurotransmitter released at target tissues by most postganglionic sympathetic neurons

norepinephrine