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Nervous System Disorder Test

Terms in this set (59)

The nurse is caring for a client following an angiogram. Which nursing intervention is recommended for this client?
Encourage fluids, if not contraindicated
A nurse is assisting with a cerebral arteriography for a client with a head injury. What is the nruse's role when assisting with this procedure?
Obtain a baseline neurologic assessment before the procedure
The nurse monitors an 80-year-old client's blood urea nitrogen (BUN) and creatinine before and after positron emission tomography. The dye used in the test increases the client's risk for which side effect?
Kidney damage
The nurse is preparing a 25-year-old male client for a resting electroencephalogram (EEG). What information will the nurse provide the client regarding preparation for this test?
Tell the client that he will be asked to watch a pattern a TV monitor
The nurse is caring for clients diagnosed with neurologic disorders. Which would the nurse describe as the most commonly reported by these clients?
Cephalgia (head pain)
Which measures should the nurse implement when caring for a client in an active seizure?
Place a soft pad beneath the client's head
A nurse is caring for a client with trigeminal neuralgia. What knowledge about the nature of the client's condition will guide the nurse's care prior to surgery?
The pain may be triggered by the slightest touch of the trigger zone
Which intervention should the nurse implement when providing care for a client diagnosed with paraplegia?
Encourage the use of high-top sneakers to prevent footdrop
The nurse is counseling a 30-year-old paraplegic client. Which information would the nurse include in a teaching plan concerning female health related issues?
Tampons are not recommended for use and can be dangerous
The nurse is carinf for a client diagnosed with a subdural hematoma. Which usually causes this condition?
An accumulation of blood between the dura and skull
T/F - The radioisotope used in brain scans will accumulate in greater quantity in normal brain tissue than at the site of pathology.
False
T/F - Clients with migraine headaches may have sensory warnings that a headache will occur
True
T/F - An oral airway must be inserted after seizure activity has begun to maintain a patent airway
False
T/F - Bell palsy is temporary, partial, one-sided facial paralysis and weakness caused by inflammation of the 5th cranial nerve
False
T/F - Inflammation of the meninges, referred to as meningitis, is a contagious infection
True
The spinal tap is performed by inserting a hollow needle with a stylet into the _______ space of the spinal canal under strict aseptic technique
subarachnoid
Status ______ refers to a seizure or a series of seizures, lasting 30 minutes or longer, in which the person does not regain consciousness
epilepticus
Paralysis of all four extremities resulting from an injury above the first thoracic vertebra is referred to as ________.
quadriplegia
An ________ hematoma is the accumulation of blood, mostly from the temporal artery, between the dura and the skull.
Epidural
__________ is a chronic, progressive disease affecting the dopamine-producing cells of the brain, resulting in individuals being unable to control muscle movements.
Parkinsonism
A nurse is collecting data from a client who reports severe headache and a stiff neck. Data collection reveals positive kernig's and brudzinski's signs. Which of the following actions should the nurse perform first?
Implement droplet precautions
A nurse is checking for the presence of Brudzinski's sign in a client who has suspected meningitis. Which of the following actions should the nurse take when performing this technique? (Select all that apply.)
1. place the client in supine position
2. place hands behind the client's neck
3. Bend the clients head toward chest.
A nurse is contributing to the plan of care for a client who has meningitis and is at risk for increased intracranial pressure (ICP). Which of the following interventions should the nurse recommend? (Select all that apply) (3)
1. Implement seizure precautions
2. Turn off room lights and television
3. Monitor for impaired extraocular movements
A health department nurse is reviewing the use of the meningococcal vaccine (MCV4) for the prevention of meningitis with a newly licensed nurse. Which of the following information should the nurse include?
Recommend this vaccine for adolescents before starting college
A nurse is contributing to the plan of care for a client who has bacterial meningitis. Which of the following interventions should the nurse include? Select all that apply (3)
1. Provide an emesis basin at the bedside
2. Administer antipyretic medication
3. Perform a skin assessment
A nurse is collecting data from a client who has a seizure disorder. The client reports sensing an aura and is about to have a seizure. Which of the following actions should the nurse implement? Select all that apply (5)
A. provide privacy
B. Ease the client to the floor if standing
C. Move furniture away from the client
D. Loosen the client's clothing
E. Protecting the client's head with padding
A nurse is caring for a client who just experienced a generalized seizure. Which of the following actions should the nurse perform first?
A. Keep the client in a side-lying position.
A nurse is reinforcing discharge instructions with a female client who has a prescription for phenytoin. Which of the following information should the nurse include?
C. Take the medication at the same time every day
A nurse is reinforcing education about trigger factors that can cause seizures with a client who has a new diagnosis of generalized seizures. Which of the following information should the nurse include in this review? Select all that apply (3)
A. Avoid overwhelming fatigue
B. Remove caffeinated products from the diet
C. Limit looking at flashing lights
A nurse is reinforcing discharge teaching to a client who has seizures and received a vagal nerve stimulator to decrease seizure activity. Which of the following statements should the nurse include?
"I can expect to have a temporary voice change"
A nurse is reviewing the plan of care for a client who has PD. Which of the following interventions should the nurse identify as the priority?
Schedule a swallowing evaluation
A nurse is contributing to a plan of care for the nutritional needs of a client who has stage IV PD. Which of the following actions should the nurse include in the plan of care? Select all that apply (2)
1. Record diet and fluid intake daily
2. Offer nutritional supplements between meals
A nurse is reinforcing teaching with the family of a client who has Parkinson's Disease and a new prescription for bromocriptine. Which of the following statements by a family member should the nurse identify as understanding of the teaching?
"This medication can cause dizziness"
- Orthostatic hypotension is a common adverse effect of bromocriptine, a dopamine receptor agonist. The family members should have the client rise slowly when standing up to decrease the risk for dizziness and lightheadedness
A nurse is collecting data from a client who has Parkinson's disease. Which of the following findings should the nurse expect? Select all that apply (4)
1. Pill-rolling tremor of the fingers
2. Shuffling gait
3. Drooling
4. Lack of facial expression
A nurse is caring for a client who has PD and is starting to display bradykinesia. Which of the actions should the nurse take?
Give the client extra time to perform activities
- Bradykinesia is abnormally slowed movement and is seen in clients who have PD. The nurse should give the client extra time to perform activities and encourage the client to remain active
- Bradykinesia means slowness of movement, and it is one of the cardinal symptoms of Parkinson's.
A nurse is reinforcing teaching with the partner of an older adult client who has AD and has a new prescription for donepezil. Which of the following statements by the partner indicates the teaching is effective?
This medication should help my partner's daily function
A nurse working in a long term care facility is caring for a client who has AD. Which of the following actions should the nurse take?
Provide finger foods for the client's snacks and meals
A nurse is making a home visit to a client who had AD. The client's partner states that the client is often disoriented to time and place, is unsteady on his feet, and has a history of wandering. Which of the following safety measures should the nurse review with the partner ? Select all that apply (4)
1. Remove floor rugs
2. Provide increased lighting in stairwells
3. Install handrails in the bathroom
4. Place the mattress on the floor
A nurse is caring for a client who has AD and falls frequently. Which of the following actions is the priority for the nurse to take to keep the client safe?
Place the client in a room close to the nurses' station
A nurse is caring for a client who has AD. A family member of the client ask the nurse about risk factors for the disease. Which of the following information should the nurse include? Select all that apply
1. Exposure to metal waste products
2. Previous head injury
3. History of herpes infection
A nurse is caring for a client who has experienced a right-hemisphere stroke. Which of the following findings should the nurse expect? (Select all that apply) (4)
1. Impulse control difficulty
2. Left hemiplegia
3. Loss of depth perception
4. Lack of situational awareness
A nurse is caring for a client who has left homonymous hemianopsia. Which of the following interventions should the nurse implement?
Place the bedside table on the right side of the bed
A nurse is contributing to the plan care for a client who has dysphagia and a new dietary prescription. Which of the following interventions should the nurse include in the plan (Select all that apply) (4)
1. Have suction equipment available for use
2. Feed the client thickened liquids
3. Place food on the unaffected side of the client's mouth
4. Instruct the client to swallow with her neck flexed
A nurse is contributing to the plan of care for a client who has a global aphasia (both receptive and expressive). Which of the following interventions should the nurse include in the client's plan? (Select all that apply)
1. Speak to the client at a slower rate
2. Assist the client to use flash cards with pictures
3. Give instructions one step at a time
A nurse is collecting data on a client who has experienced left-hemispheric stroke. Which of the following manifestations should the nurse expect?
Frustrated about deficits
A nurse is carind for a client who has multiple sclerosis. Which of the following findings should the nurse expect?
Loss of cognitive function
A nurse is collecting data from a client who has a new diagnosis of multiple sclerosis. Which of the following findings should the nurse expect? (Select all that apply)
1. Areas of paresthesia
2. Involuntary eye movements
3. Ataxia
A nurse is reinforcing teaching with a client who has multiple sclerosis and a new prescription for bacoflen. Which of the following statemetns should the nurse include in the teaching?
"This medication may cause your skin to appear yellow in color"
A nurse in a clinic is caring for a client who has frequent migraine headaches. The client asks about foods that can cause headaches. The nurse should reccommend that the client avoid which of the following foods?
Salted cashews
A nurse in a clinic is reinforcing teaching with a client who has a history of migraine headaches about a new prescription for zolmitriptan. Which of the following statements by the client indicates understanding of the teaching?
I should expect facial flushing when I take this medication
A nurse in a provider's office is collecting data from a client who has a cluster headaches. Which of the following findings should the nurse expect? (Select all that apply) (3)
1. Client experiences altered sleep-wake cycle
2. Headache occurs at approximately the same time of day
3. Nasal congestion and drainage occur
A nurse is reinforcing discharge instructions with a client who has a new diagnosis of migraine headaches. Which of the following instructions should the nurse include?
Apply a cool cloth to the face during a headache
A nurse is obtaining a health history from a client who is being evaluated for the cause of frequent headaches. Which of the following question should the nurse ask to identify the findings of migraine headaches?
Is there a pattern of headaches among family members
a nurse is collecting data from a client who has increased intracranial pressure. Which of the following findings should the nurse expect? Select all that apply.
1. disoriented to time and place
2. restlessness and irritability
3. unequal pupils
4. headache
a nurse is reviewing a prescription for dexamethasone with a client who has an expanding brain tumor. Which of the following are appropriate statements by the nurse? Select all that apply
1. it is given to reduce swelling of the brain
2. you may notice weight gain
3. it can cause you to retain fluids
a nurse is caring for a client who has a benign brain tumor. The client asks the nurse if he can expect this same type of tumor to occur in other areas of his body. Which of the following is an appropriate response by the nurse?
it is limited to brain tissue
a nurse is reviewing the health record of a client who has a malignant brain tumor and notes the client has a positive Romberg sign. Which of the following actions should the nurse take to check for this manifestation?
have the client stand erect with eyes closed
a nurse is assisting with the care of a client following surgical evacuation of a subdural hematoma. Which of the following data is the priority to monitor?
oxygen saturation
a nurse is caring for a client who is at risk for increased intracranial pressure. Which of the following actions should the nurse take to decrease the potential for raising the client's intracranial pressure? Select all that apply (2)
1. decrease the noise level in the client's room
2. administer is stool softener
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