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NUR 237 unit 1
| Question | Answer |
|---|---|
| Cranial Nerve I | Olfactory - smell (sensory) |
| Cranial Nerve II | Optic - vision (sensory) |
| Cranial Nerve III | Oculomotor - eye movement, pupil constriction, and eyelid elevation (motor) |
| Cranial Nerve IV | 4 Trochlear - Eye movement (controls superior oblique muscle) (motor) |
| Cranial Nerve V | 5 Trigeminal- Facial sensation (touch, pain, temperature) and chewing (both sensory & motor) |
| Cranial Nerve VI | 6 Abducens- Lateral eye movement (controls lateral rectus muscle) (motor) |
| Cranial Nerve VII | 7 Facial- Facial expression, taste on anterior 2/3 of tongue, salivary and tear gland secretion (both sensory & motor) |
| Cranial Nerve VIII | 8 Acoustic / Vestibulocochlear Hearing and balance (sensory) |
| Cranial Nerve IX | 9 Glossopharyngeal Taste on posterior 1/3 of tongue, swallowing, and gag reflex (both sensory & motor) |
| Cranial Nerve X | 10 Vagus Controls heart rate, digestion, speech, and swallowing; sensation from throat and organs (both sensory & motor) |
| Cranial Nerve XI | 11 Spinal Accessory Controls movement of neck and shoulders (motor) |
| Cranial Nerve XII | 12 Hypoglossal Tongue movement (motor) |
| Norepinephrine (NE) | Controls alertness, arousal, mood, and stress response (“fight or flight”). |
| Epinephrine (Adrenaline) | Increases heart rate, blood pressure, and energy; part of stress response. |
| Dopamine (DA) | Controls movement, motivation, pleasure, and emotional responses. |
| What structures make up the CNS? | The brain and spinal cord. |
| What structures make up the PNS? | Cranial and spinal nerves. |
| What does the afferent division do? | Carries sensory impulses from the body to the CNS. Carry messages to brain |
| What does the efferent division do? | Carries motor impulses from the CNS to muscles and glands. Carry messages from the brain |
| What is a reflex arc? | A pathway that controls an involuntary response to a stimulus. |
| What are the divisions of the autonomic nervous system? | Sympathetic and Parasympathetic. |
| What does the sympathetic system control? | Fight or flight” responses — increases heart rate, BP, dilates pupils. |
| What does the parasympathetic system control? | “Rest and digest” — lowers heart rate and supports digestion. |
| What is the function of the cerebrum? | Controls thought, memory, learning, and voluntary muscle movement. |
| What is the function of the cerebellum? | Coordinates voluntary movement, posture, and balance. |
| What structures make up the diencephalon? | Thalamus and hypothalamus. |
| What is the main role of the thalamus? | Relay center for sensory impulses to the cerebral cortex. |
| What is the main role of the hypothalamus? | Maintains homeostasis by regulating temperature, thirst, hunger, and hormones. |
| What are the three parts of the brainstem? | Midbrain, pons, and medulla oblongata. |
| What vital functions are controlled by the medulla oblongata? | Heart rate, respiration, and blood pressure. |
| What does the pons regulate? | Respiration and sleep. |
| What does the midbrain control? | Reflexes for vision and hearing. |
| Function of acetylcholine? | Stimulates skeletal muscles and transmits nerve impulses. |
| Function of norepinephrine and epinephrine? | Increases alertness and prepares body for stress. |
| Function of dopamine? | Affects movement, motivation, and pleasure. |
| Function of serotonin? | Regulates mood, sleep, and appetite. |
| Function of GABA? | Inhibitory neurotransmitter that calms the nervous system. |
| What are endorphins? | Natural pain relievers produced by the brain |
| What happens to neurons with aging? | Loss of neurons and decreased function. |
| How does pupil size change with age? | Pupils become smaller. |
| What can help maintain brain function in older adults? | Mental activity and social engagement. |
| What is included in a neuro assessment? | Mental status, cranial nerves, motor function, reflexes, and coordination. |
| What is the Glasgow Coma Scale used for? | Measuring level of consciousness. |
| What is the FOUR score used for? | Assessing brainstem reflexes and respiratory patterns. |
| What does a “neuro check” include? | LOC, pupils, motor response, and vital signs. |
| What is the patellar reflex? | Knee-jerk response when knee is tapped |
| What is a positive Babinski reflex ? | Abnormal; indicates CNS damage. big toe bends upward and the other toes fan out when the sole of the foot is stimulated |
| What is the oculocephalic reflex? | Eye movement in response to head turning; tests brainstem integrity. |
| How can neurologic injuries be prevented? | Use helmets, seat belts, and avoid drug use. |
| Why should insecticide safety gear be used? | Chemicals can cause neurotoxicity. |
| You demonstrate understanding of the physiologic changes in the nervous system associated with aging by: | Providing extra time for the patient to process and answer questions. |
| A nurse scrapes an object along the sole of a patient’s foot and notes that the great toe bends upward and smaller toes fan outward. | Motor abnormality of the cortex. |
| You assess consensual reflex of the eyes. To do this, you: | Shine a light in one eye and observe for any change in the other eye’s pupil. |
| Appropriate interventions for a patient with right hemiplegia from a stroke? | Remind patient to pay attention to left side, protect extremities during transfers, initiate ROM exercises. |
| Patient with expressive aphasia — expected response when shown a key and asked, “What is this?” | The patient responds, “Argh ooh.” |
| “Neuro” check includes which assessments? | Direct light reflex, plantar reflex, vital signs, muscle strength, alertness/orientation. |
| Discharge teaching for an indifferent older adult stroke patient — best statement: | “Talk to me about how you are feeling about being discharged.” |
| Dysphagia patient statement indicating need for further teaching: | “I can watch my crime show on TV while I eat.” |
| 22-year-old with head trauma—unequal pupils (R 7mm, L 4mm). | Call for the rapid response team. |
| Glasgow Coma Scale findings: opens eyes to pain (2), incomprehensible sounds (2), extends extremities to pain (2). | Coma |
| If there’s an injury to your spine, where is the level of disability compared to the level of injury? | Lower than the level of injury |
| Name the four main regions of the spine. | Cranial, Thoracic, Lumbar, Sacral |
| What system activates with stress and low blood sugar? | Sympathetic nervous system |
| What part of the midbrain controls respirations? | The pons |
| What does Cranial Nerve #5 (Trigeminal) control? | face sensation and chewing |
| Do nerve cells regenerate? | No; they die after 4–6 minutes without oxygen |
| What coats the axon of a neuron? | Schwann cells (lipids) |
| What condition is caused by decreased dopamine? | Parkinson’s disease |
| What is the Babinski reflex? | Normal: toes contract; Abnormal: toes fan backward |
| Normal intracranial pressure (ICP)? | 5–15 mmHg |
| What is cerebrospinal fluid (CSF)? | Thin, clear fluid from brain/spinal cord; leakage from ears/nose/eyes = emergency |
| How to remove CSF from brain? | Lumbar puncture (spinal tap) |
| Most common imaging study? | CT scan |
| What does an EEG measure? | Brain electrical activity |
| EEG prep? | No caffeine, wash hair, remove metal |
| Post-op position for head/ENT surgeries? | Head elevated |
| What does PEARLA stand for? | Pupils Equal And Reactive to Light and Accommodation (distance focus) |
| What does the Glasgow Coma Scale measure? | Eye, speech, and motor responses |
| Three meninges layers? | Dura mater, Arachnoid, Pia mater |
| Infection of meninges is called? | Meningitis |
| Raccoon eyes and Battle’s sign indicate? | Skull fracture |
| Subdural hematoma location? | Under the dura mater |
| Epidural hematoma location? | Above the dura mater |
| Hemiplegia vs Paraplegia? | Hemiplegia = half body; Paraplegia = below waist |
| Post-surgical head injury care? | Raise head 30°, control temperature |
| Signs of increasing ICP? | Widened pulse pressure, slow/bounding pulse, changes in BP, pulse, or respirations |
| First patient to report? | One with chest pain |
| Priority with spinal cord compression? | Save life and prevent further injury |
| Cranial | Brain and brainstem functions |
| Thoracic | Controls upper back and chest |
| Lumbar | Controls lower back and legs |
| Sacral | Controls bladder, bowel, and sexual function |
| Sympathetic | “Fight or flight”—increases HR, BP, dilates pupils, decreases digestion |
| Parasympathetic | “Rest and digest”—slows HR, stimulates digestion, conserves energy |
| What does the Trigeminal (Cranial Nerve V) control? | Sensory perception in the face; hyperalgesia indicates nerve sensitivity or damage. |
| How long can nerve cells survive without oxygen? | 4–6 minutes before permanent damage. |
| What are Schwann cells and their role? | Lipid-based cells that coat the axon (myelin sheath); they can regenerate to aid peripheral nerve repair. |
| What disorder is linked to decreased dopamine levels? | Parkinson’s disease — causes tremors, rigidity, and bradykinesia. |
| Define circadian rhythm and IDL (International Date Line). | Circadian rhythm regulates sleep-wake cycles; IDL helps manage time zones and travel-related jet lag. |
| Normal ICP value and meaning of elevated pressure? | 5–15 mmHg; elevated ICP indicates excess fluid or swelling in the cranial cavity. |
| What are signs of skull fracture? | Raccoon eyes (periorbital bruising) or Battle’s sign (behind-ear bruising). |
| Concussion | temporary brain dysfunction |
| Contusion | bruising of brain tissue. |
| Post-surgical and ICP care tips? | Head elevated 30°, avoid overhydration, monitor for diabetes insipidus, maintain normal temperature. |
| What are warning signs of increased ICP? | Altered LOC, changes in vitals (Cushing’s triad), unequal pupils, headache, vomiting. |
| What’s the top priority in spinal cord injury management? | Maintain airway, stabilize spine, and prevent further damage. |
| Describe the pathophysiology of a head injury. | Brain function is disturbed, sometimes without structural damage, leading to temporary or prolonged cognitive and neurological effects. |
| List common signs and symptoms of head (brain) injury. | Headache, dizziness, nausea/vomiting, confusion, memory issues, and fatigue. |
| What is the nursing treatment plan for concussion or mild brain injury? | Encourage rest, sleep, and gradual return to normal activities. |
| What defines a skull fracture | A break in skull bone |
| what symptoms are expected with a skull fracture? | bruising, swelling, bleeding, amnesia, unequal pupils, and reduced consciousness. |
| Nursing priorities for skull fracture management? | Keep head elevated, maintain airway, monitor neuro status, and prepare for surgery if ICP increases or fragments are present. |
| Define increased intracranial pressure (ICP). | A buildup of pressure inside the skull due to swelling, bleeding, or obstruction of CSF flow. |
| Identify symptoms of increased ICP. | Lethargy, slow speech, headache, vomiting, unequal pupils, and decreased LOC. |
| pharmacological and supportive treatments for ICP. | Mannitol or Lasix (osmotic diuretics) Decadron (steroids) Ventilator support Antiseizure meds |
| What complications can arise from ICP? | Hydrocephalus and diabetes insipidus due to pituitary disruption. |
| What are the key nursing goals for patients with ICP? | Maintain adequate cerebral perfusion and reduce intracranial pressure. |
| Define a spinal cord injury and list common causes. | Damage to spinal cord causing loss of movement/sensation; caused by falls, accidents, compression, twisting, or tearing injuries. |
| What are the three main treatment goals for spinal cord injuries? | Save life, prevent further damage, and promote healing and rehabilitation. |
| What are priority nursing interventions for spinal cord injury? | Maintain airway and immobilization Manage urinary function Provide emotional and sexual health support |
| key complications of spinal cord injury? | Spinal/neurogenic shock (loss of reflexes) Autonomic dysreflexia (hypertensive crisis, sweating, headache) DVT, infection, skin breakdown |
| Describe autonomic dysreflexia. | A life-threatening response to stimuli below injury level causing high BP, sweating, flushing, and goosebumps. |
| What causes low back pain and herniated disks? | A ruptured or slipped intervertebral disk presses on spinal nerves. |
| Subdural hematoma explanation | It is the collection of blood between the brain and the inner surface of the dura mater.” |
| A nurse is admitting a patient with a possible basilar skull fracture. Which clinical finding(s) would likely confirm the diagnosis? | Battle sign Ecchymosis around eyes Rhinorrhea |
| Which statement by a high school athlete being discharged after experiencing a concussion indicates a need for more teaching? | “I can go to football practice tomorrow.” |
| You keep a postcraniotomy patient’s neck in midline position and ensure that there is no excessive hip flexion. The rationale for your action would be that this position: | prevents a further increase in intracranial pressure. |
| A nursing assistant is attending to the needs of a patient with a head injury who is lethargic and has increased ICP. Which action by the nursing assistant indicates a need for further instruction? | Monitoring blood pressure every shift |
| The classic signs of increased ICP include which of the following? | Rising systolic blood pressure Widening pulse pressure Bradycardia |
| The surgeon inserts an intraventricular catheter into the lateral ventricle of a patient with increased ICP. When asked by a relative about the procedure, an accurate response would be: | “The catheter is used to remove excess fluid inside the brain.” |
| A 30-year-old male is admitted to the emergency department after a motor vehicle accident. After examination, the patient is diagnosed with a T6 spinal cord injury. He has flaccid paralysis, slowed heart rate, low blood pressure, and no bowel sounds. | spinal shock |
| A 40-year-old male with a T4 spinal cord injury suddenly complains of severe headache, increased pulse rate, sweating, flushing above the level of the spinal cord lesion, and “goosebumps” below the level of injury. | Identify the cause of stimulation. Administer ordered antihypertensives. Loosen tight clothing. |
| Postoperative pain management for the patient with lumbar surgery may include: | 1. use of ice packs on the area of back pain for up to 20 minutes each hour while awake for the first 48 hours. NSAID medications given orally or IV. of opioids delivered by PCA. |
| Which hematoma is a medical emergency? | Epidural hematoma — rapid arterial bleed increases ICP quickly. |
| What is a subdural hematoma? | Venous bleed that develops slowly, causing confusion or drowsiness days later. |
| complete spinal injury | no function below |
| incomplete | partial function remains |
| What is the first nursing action for autonomic dysreflexia? | Sit the patient upright and identify/remove the cause (e.g., kinked catheter). |
| What are signs of herniated lumbar disk? | Pain radiating down the leg, weakness, tingling. |
| What should patients avoid after spinal surgery? | Bending at the waist, twisting, lifting heavy items, and prolonged sitting. |
| Whats often the cause for dysreflexia | full bladder |
Created by:
kaimcd