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Neurologic 2
Patho D236 WGU
| Question | Answer |
|---|---|
| The caregiver of a client tells a nurse the client has paralysis of the upper and lower left limbs on the right side. On assessment, the nurse finds motor and sensory loss in the client’s limbs. Which diagnostic procedure does the nurse expect the health-care provider to prescribe? 1. Blood studies 2. Electrocardiogram 3. Magnetic resonance angiography (MRA) 4. Computed tomography (CT) scan with contrast | MRA is the test used to further confirm whether a stroke has occurred because it determines the presence of a clot or aneurysm. The MRA test is also used to distinguish cerebral hemorrhage and ischemia. |
| The nurse is providing care for a client admitted with a stroke. Which information and manifestation support the presence of an ischemic stroke? 1. Symptoms followed a contact injury 2. Medical history indicates chronic hypertension 3. Manifestations occurred over a period of hours 4. Diagnostic tests reveal increased cranial pressure | Manifestations occurred over a period of hours |
| The nurse is reviewing the medical record of a client admitted with the diagnosis of an ischemic stroke involving the middle cerebral artery. For which reason does the nurse consider the client’s condition to be serious? 1. Onset of deficits is sudden. 2. Treatment involves anticoagulants. 3. High risk of the condition recurring. 4. A large area of brain tissue is involved. | A large area of brain tissue is involved.---- The middle cerebral artery supplies a large area of brain tissue; when occluded, it causes a deficit of a major region of the brain. Most strokes involve a branch of the middle cerebral artery. |
| Which statement by an attending nurse requires correction? 1A small blood vessel infarction that is associated with hypertension is known as a lacunar infarct 2The right atrium undergoes atrial fibrillation with stasis of blood and clot formation in an ischemic stroke 3The ischemia of the brain is caused by a thromboembolism from carotid stenosis in a transient ischemic attack 4The cerebral artery ruptures and causes a large amount of blood to compress the brain tissue in hemorrhagic shock | 2-The LEFT atrium undergoes atrial fibrillation with stasis of blood and clot formation in an ischemic stroke; therefore, this statement of the student nurse requires correction. |
| A nurse is caring for four clients diagnosed with different cerebrovascular disorders. Which client is most likely to require an endarterectomy surgical procedure to prevent the recurrence of the condition? 1. The client with lacunar infarct 2. The client with ischemic stroke 3. The client with hemorrhagic stroke 4. The client with transient ischemic attack (TIA) | 2-This client has an ischemic stroke. Arteriosclerosis of the carotid artery, called carotid stenosis, is also a common cause of ischemic stroke. If it is determined to be the cause of the ischemic stroke, the client would require an endarterectomy surgery to remove the blockage. |
| A nurse is caring for four clients who have different cerebrovascular disorders. Which client would require a magnetic resonance angiography (MRA) to accurately confirm the client’s condition? 1. The client with a brain tumor 2. The client with a cerebral abscess 3. The client with a carotid artery aneurysm 4. The client with a brain stroke | 3- MRA is an imaging study used to diagnose severe carotid artery occlusions. This diagnostic test helps determine the presence of a clot or aneurysm; therefore, this client requires an MRA for accurate diagnosis of a carotid artery aneurysm. |
| A health-care provider instructs the nurse to administer thrombolytic therapy to a client diagnosed with an ischemic stroke. Which detail does the nurse check in the client’s health history before administering the medication? Select all that apply. 1. A history of diabetes 2. A history of bleeding ulcers 3. A history of a recent head injury 4. A history of aspirin use 5. A history of warfarin (Coumadin) use | 2,3,5 |
| Which neurotransmitter is depleted in clients with Parkinson’s disease? | Dopamine levels are decreased in clients with Parkinson’s disease due to the progressive loss of dopamine-producing cells in the substantia nigra of the brain. |
| While reviewing the medication prescribed for a client, the nurse finds the client is on a therapy to decrease the release of the excitatory neurotransmitter glutamate. Which disorder does the nurse recognize in the client? 1. Myasthenia gravis 2. Huntington’s disease 3. Guillain-Barré syndrome 4. Amyotrophic lateral sclerosis | Therapy to decrease the release of the excitatory neurotransmitter glutamate through medication such as riluzole helps in blocking the channels associated with the damaged neurons. Amyotrophic lateral sclerosis is a disorder characterized by a loss of upper and lower motor neurons. Therefore, the nurse identifies the client with amyotrophic lateral sclerosis |
| After a theoretical session about edrophonium (Tensilon) testing, the nurse educator asks a staff nurse to select a client from a group with different neurological disorders on which to perform the test. Which client is the nurse expected to select? 1. A client with multiple sclerosis 2. A client with myasthenia gravis 3. A client with Huntington’s disease 4. A client with Guillain-Barré syndrome | Edrophonium (Tensilon) testing determines the response of the muscle to the drug Tensilon. In myasthenia gravis, the muscles become weakened due to the impaired ability to respond to nerve signals. Therefore, this is the client the staff nurse needs to select. |
| A client comes to the clinic and asks for a test to determine the possibility of developing Huntington’s disease (HD). Which preparation does the nurse make to fulfill the request? 1. Acquires saliva to test for a genetic biomarker 2. Assesses the client for emotional symptoms 3. Obtains a small sample of blood from the client 4. Prepares testing to determine cognitive symptoms | The discovery of the HD gene, at locus 14p16.3, has resulted in the development of a test that is able to detect the majority of individuals who are at risk for developing this condition. In order to perform the genetic test, a small sample of blood is tested for the presence or absence of the HD genetic mutation |
| The nurse is performing a Babinski reflex test on a client to assess the neurologic system. Which is the correct interpretation by the nurse? 1. A negative Babinski reflex indicates an upper motor neuron disorder. 2. Flaring of the toes in response to stimulation indicates an upper motor neuron disorder. 3. When the toes flex inward upon stimulation of the sole of the foot, the test is positive. | A positive Babinski reflex, where the client has flaring of the toes in response to stimulation of the sole of the foot, indicates an upper motor neuron disorder. Therefore, this is the correct interpretation by the nurse. |
| The health-care provider is monitoring a client who is unconscious. Which assessments does the nurse expect the health-care provider to prescribe? Select all that apply. 1. Hearing 2. Vital signs 3. Orientation 4. Pupil response 5. Glasgow Coma Scale | 2,4,5 |
| Which supportive care is provided to a client diagnosed with Guillain-Barré syndrome? Select all that apply. 1. Provide mechanical ventilation. 2. Monitor hemodynamics continuously. 3. Provide physical and occupational therapy. 4. Administer antipsychotic medications as prescribed. 5. Provide speech therapy and swallowing interventions. | 1,2,3 |
| A client experienced traumatic brain injury (TBI) participating in a contact sport. The health-care provider is focused on preventing increased intracranial pressure (ICP). Which intervention does the nurse expect the health-care provider to prescribe initially? 1. Placing a catheter in the ventricles 2. Lowering blood pressure 3. Infusing hypertonic IV solution 4. Decompressing with a craniotomy | . Blood volume can be reduced by lowering blood pressure, which is a noninvasive procedure involving the administration of vasodilation medications. The nurse expects this intervention initially. |
| Which manifestation does the nurse expect to find on assessment of a client with a skull fracture in the frontal fossa? 1. Whiplash 2. Battle’s sign 3. Thunderclap headache 4. Periorbital ecchymosis | ? |
| Laboratory reports for a client after an accident show a fracture in the temporal bone of the middle ear. Which type of fracture does the nurse suspect in this client? 1. Basilar skull fracture 2. Linear fracture 3. Depressed fracture 4. Temporal bone fracture | A basilar skull fracture is located at the base of the skull. It involves the temporal bone, which encloses the inner ear organs, carotid artery, meningeal membrane, and jugular vein. Therefore, the nurse suspects a basilar skull fracture in the client. |
| Which statement made by an attending staff nurse indicates understanding? 1 Subdural hematomas cause bleeding in the space below the skull bone and above the dura mater 2 Subdural hematomas cause bleeding in the space below the dura mater and above the arachnoid membrane 3 Subdural hematomas cause cerebral aneurysms in the terminal portion of the internal carotid artery 4 Subdural hematomas cause tearing of the cerebral and meningeal vessels within the subarachnoid space of the brain | A subdural hematoma causes bleeding in the space below the dura mater and above the arachnoid membrane. Therefore, this statement made by the student nurse indicates effective teaching. |
| The nurse suspects cerebral edema in a client with a cerebral contusion. Which diagnostic test will confirm this? 1. Skull x-ray 2. Cerebral angiography 3. Magnetic resonance imaging (MRI) 4. Computerized tomography (CT) scan | An MRI scan has greater sensitivity for cerebral edema. Therefore, this test will be beneficial for detecting cerebral edema. |
| The computerized tomography (CT) scan of a client shows traumatic subarachnoid hemorrhage. Which are the causes for this condition? Select all that apply 1. Trauma to the carotid artery 2. Stretching of the vertebral artery 3. Rupture of the middle meningeal artery 4. Rotational-acceleration injury of the brain 5. Defects in the muscle layers of the artery wall | 1,2,4 |
| The health-care provider is examining a client who reports headache and intermittent diplopia since experiencing a head injury. Funduscopic examination reveals unclear and undefined borders of the optic disc. Which immediate response is expected from the health-care provider? 1. Inquiring about nausea and vomiting 2. Asking about the presence of tinnitus 3. Providing drops to lower eye pressure 4. Prescribing magnetic resonance imaging (MRI) on the brain | 4...Papilledema is a critical sign of intracranial hypertension, a potentially life-threatening situation. Treatment focuses on the underlying pathological process that caused the elevated intracranial pressure, such as a brain tumor. Untreated papilledema eventually may lead to permanent blindness. |
| A client reports to a health-care provider a decrease in the ability to see faces and to read over a period of several months. Medical history reveals treatment for high cholesterol and a smoking habit of one pack of cigarettes daily. Which diagnosis is the health-care provider most likely to associate with the client’s condition? 1. Cataracts 2. Nonexudative age-related macular degeneration (AMD) 3. Exudative AMD 4. Diabetic retinopathy | .3--The client does exhibit the manifestations of AMD; however, the rapid onset is most likely indicative of exudative “wet” AMD. |
| During assessment of a client, the nurse finds the client has blurred vision and swelling of the optic disc. Which condition does the nurse interpret from the findings? | 3-- Papilledema is a condition that occurs with an increase in intracranial pressure; it results in swelling of the optic nerve. Therefore, the client will have blurred vision. |
| Which eye disorder is associated with irregular clumping of proteinaceous substances within the lens? 1. Cataract 2. Glaucoma 3. Papilledema 4. Diabetic retinopathy | 1--- Cataract is an eye disorder associated with clumping of excessive proteinaceous layers within the cornea or lens. |
| The nurse is using an Amsler grid to assess the vision of a client. The client tells the nurse, “I am noticing black spots while looking through the grid.” Which interpretation does the nurse associate with the assessment finding? 1. The client has cataracts. 2. The client has retinoblastoma. 3. The client has diabetic retinopathy. 4. The client has age-related macular degeneration. | 4--. The Amsler grid helps determine age-related macular degeneration. Black spots in the client’s central vision when looking through the Amsler grid indicate he or she has age-related macular degeneration. |
| A client reports symptoms of severe headache, vomiting, and double vision. After assessing the client, the nurse determines the client has swelling of the optic nerve. Which interpretation does the nurse associate with these findings? 1. The client has cataracts. 2. The client has papilledema. 3. The client has diabetic retinopathy. 4. The client has acute angle closure glaucoma. | 2--. Papilledema is swelling of the optic disc due to damage of the optic nerve. The client has headache, nausea, and double vision, with swelling of the optic disc, indicating he or she has papilledema. |
| The nurse is teaching a client with age-related macular degeneration about the necessary measures to improve the condition. Which statements made by the client indicate effective learning? Select all that apply. 1. “I should maintain a low-fat diet.” 2. “I should limit smoking to twice a day.” 3. “I should take folic acid supplements.” 4. “I should wear wraparound sunglasses.” 5. “I should apply a cold compress to my eyes.” | 1,3,4 |
| Which part of the ear conducts sound waves to the tympanic membrane? 1. Inner ear 2. Middle ear 3. External ear 4. Cochlea | 3.. The external ear is the funnel-shaped part; it conducts sound waves to the tympanic membrane through the ear canal. |
| A client reports difficulty hearing. The nurse finds that the client’s external ear exhibits a cause for the altered function. Which finding in the client supports the nurse’s finding? 1. There are balance problems. 2. The eardrum is inflamed. 3. There is pain with swallowing. 4. The auditory ossicles do not move | The external ear includes the tympanic membrane or eardrum; therefore, inflammation of the eardrum is indicative of possible infection and altered function. |
| . While reviewing the laboratory reports of a client, the nurse finds an increased volume of endolymph fluid in the inner ear. On further examination, the nurse finds that the client is positive for the Romberg test. Which pathological condition does the nurse anticipate in the client? 1. Otitis media 2. Labyrinthitis 3. Ménière’s disease 4. Vestibular schwannoma | 3--- An increased volume of endolymph fluid in the inner ear and a positive Romberg test would indicate Ménière’s disease in the client. |
| . After multiple follow-up visits, the nurse finds that a client with persistent otitis media for 12 weeks is not improved using the initial treatment regimen. Which intervention is the nurse most likely expecting to be prescribed? 1. The Romberg test 2. A low-salt diet 3. A tympanostomy 4. Destructive surgery | 3---. A tympanostomy is performed in clients who have chronic otitis media. Persistence of otitis media for longer than 6 to 12 weeks indicates chronic otitis media; therefore, the nurse should anticipate that a primary health-care provider would order a tympanostomy for the client. 4 This is incorrect. Destructive surgery is performed in clients who h |
| The nurse reviews a culture report on a client’s ear secretions, which identifies the presence of Staphylococcus aureus and Pseudomonas bacterial strains. The client initially presented with pain, tenderness, and itching on the auricle. Which conclusion does the nurse conclude from these findings? 1. The client has otitis externa. 2. The client has labyrinthitis. 3. The client has Ménière’s disease. 4. The client has vestibular schwannoma. | Otitis externa is an infection of the external ear. S. aureus and Pseudomonas bacterial strains are the common etiologic organisms of otitis externa. A client who has otitis externa is characterized by pain, tenderness, and itching on the auricle. |
| A parent of a child reports the child is irritable, tugs the ear, and has poor feeding behaviors. On assessment, the nurse finds the child has a red and bulged tympanic membrane. Which other findings in the child is the nurse most likely observe? Select all that apply. 1. Vomiting 2. Yellow skin 3. Runny nose 4. Hypothermia 5. Ear drainage | 1,3 |
| . A client reports hearing loss to the nurse. With assessment, the nurse suspects the client has Ménière’s disease. Which statements does the nurse anticipate from the client? Select all that apply. 1. “I feel like falling while walking.” 2. “My appetite has increased lately.” 3. “The room is spinning around me.” 4. “I hear buzzing and ringing sounds in my ear.” 5. “I feel like someone is calling me frequently.” | 3,4 |
Created by:
kristimisty27