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Chapter 43: Nervous System
Terms in this set (21)
The nurse is about to administer a contrast medium to the client undergoing diagnostic testing. Which question will the nurse first ask the client?
A. "Are you allergic to iodine or shellfish?"
B. "Are you in pain?"
C. "Are you wearing any metal?"
D. "Do you know what this test is for?"
"Are you allergic to iodine or shellfish?"
The client has just returned from a cerebral angiography. Which symptom does the client display that causes the nurse to act immediately?
B. Increased temperature
C. Severe headache
D. Urge to void
The client has received contrast medium. Which teaching will the nurse provide to avoid any neurologic health problems after the procedure?
A. "Practice memory drills this afternoon."
B. "Drink at least 1000 to 1500 mL of water today."
C. "Avoid sunlight."
D. "Rest in bed for 24 hours."
"Drink at least 1000 to 1500 mL of water today."
Drinking an adequate amount of water helps flush the contrast out of the body
The client has undergone single-photon emission computed tomography (SPECT). Which instruction does the nurse give the client?
A. "Continue to use the ice pack."
B. "Call me if you have any itching."
C. "Keep the head of the bed flat."
D. "Return to your usual activity."
"Return to your usual activity."
The nurse understands that which client diagnosed with neurologic injury is typically at highest risk for depression?
A. Young man with a spinal cord injury
B. Young woman with a spinal cord injury
C. Older man with a mild stroke
D. Older woman with a mild stroke
Young man with a spinal cord injury
The nurse is aware that which cranial nerve allows a person to feel a light breeze on the face?
A. I (olfactory)
B. III (oculomotor)
C. V (trigeminal)
D. VII (facial)
The nurse is performing a neurologic assessment on an 81-year-old client. Which physiologic change does the nurse expect to find because of the client's age?
A. Decreased coordination
B. Increased sleeping during the night
C. Increased touch sensation
D. Stability in pain perception
The nurse prepares to assess a client with diabetes mellitus for sensory loss. Which equipment will the nurse need to perform this assessment?
C. Nothing; the client is asked to walk
D. Paper clip
The nurse is performing a rapid neurologic assessment on a trauma client. Which assessment finding is normal?
A. Decerebrate posturing
B. Increased lethargy
C. Minimal response to stimulation
D. Constriction of pupils
Constriction of pupils
Which client will the neurologic unit charge nurse assign to a registered nurse who has floated from the labor/delivery unit for the shift?
A. An older adult client who was just admitted with a stroke and needs an admission assessment.
B. A young adult client who has had a lumbar puncture and reports, "Light hurts my eyes."
C. An adult client who has just returned from having a cerebral arteriogram and needs vital sign checks every 15 minutes.
D. A middle-aged client who has a possible brain tumor and has questions about the scheduled magnetic resonance imaging.
An adult client who has just returned from having a cerebral arteriogram and needs vital sign checks every 15 minutes.
The nurse team leader is working with a nursing assistant in caring for a group of clients. Which task will the nurse plan to delegate to the nursing assistant?
A. Prepare a client who is going to radiology for a cerebral arteriogram.
B. Attend to the care needs of a client who has had a transcranial Doppler study.
C. Assist the physician in performing a lumbar puncture on a confused client.
D. Educate a client about what to expect during an electroencephalogram (EEG).
Attend to the care needs of a client who has had a transcranial Doppler study.
The nurse has just received change-of-shift report about a group of clients on the neurosurgical unit. Which client will the nurse attend to first?
A. Young adult post-motor vehicle accident client who is yelling obscenities at the nursing staff
B. Adult postoperative left craniotomy client whose hand grips are weaker on the right
C. Middle-aged adult post-cerebral aneurysm clipping client who is increasingly stuporous
D. Older adult-old post-carotid endarterectomy client who is unable to state the day of the week
Middle-aged adult post-cerebral aneurysm clipping client who is increasingly stuporous
The nurse has just received report on a group of clients on the neurosurgical unit. Which client will be the nurse's first priority?
A. Young adult client whose Glasgow Coma Scale (GCS) rating has changed from 15 to 10
B. Adult client whose deep tendon reflexes have become hyperactive
C. Middle-aged client who displays plantar flexion when the bottom of the foot is stroked
D. Older adult client who consistently demonstrates decortication when stimulated
Young adult client whose Glasgow Coma Scale (GCS) rating has changed from 15 to 10
The nurse has just t received report on a group of clients. Which client will the nurse assess first?
A. Young adult who was in a car accident and has a 13 Glasgow Coma Scale score
B. Adult who had a cerebral arteriogram and has a cool, pale right leg
C. Middle-aged adult who has a headache after undergoing a lumbar puncture
D. Older adult who has expressive aphasia after a left-sided stroke
Adult who had a cerebral arteriogram and has a cool, pale right leg
The nurse is reviewing the chart of a client who is scheduled for cerebral angiography. The nurse plans to report his condition to the health care provider. Which information will be most important for the nurse to communicate to the physician for a client who is scheduled for cerebral angiography?
A. Allergy to penicillin
B. History of bacterial meningitis
C. Poor skin turgor and dry mucous membranes
D. The client's dose of metformin (Glucophage) was held today
Poor skin turgor and dry mucous membranes
The client's assessment indicates dehydration. To prevent contrast-induced nephropathy, angiography should not be done until the client is hydrated.
The nurse is caring for a client who is scheduled to have a brain biopsy. The nurse anticipates that the health care provider will request which test before the brain biopsy is performed?
A. Lumbar puncture (LP)
B. Magnetic resonance imaging (MRI)
C. Skull x-ray
D. Transcranial Doppler ultrasonography (TCD)
Magnetic resonance imaging (MRI)
The nurse is instructing a client for whom a position emission tomography (PET) scan has been requested. Which statement indicates to the nurse that the client understands the instructions?
A. "It's okay to have a cup of coffee before the test."
B. "Because I am diabetic, I will take my insulin just before the test."
C. "I can continue to smoke cigarettes up to 2 hours before the test."
D. "I will drink plenty of fluids after the test."
"I will drink plenty of fluids after the test."
Fluid intake should be increased after the test because this helps to remove the radioisotope more quickly.
The results of a client's lumbar puncture indicate that the client's protein level is 150 mg/dL. The nurse suspects that the client may have which condition?
A. Guillain-Barré syndrome
C. Paraventricular tumor
D. Viral infection
The nurse is assessing a client with a neurologic condition who is reporting difficulty chewing when eating foods. The nurse suspects that which cranial nerve has been affected?
A. Abducens nerve
B. Facial nerve
C. Trigeminal nerve
D. Trochlear nerve
During a client's neurologic assessment, the nurse finds that he is arousable only if his trapezius muscle is pinched. How will the nurse document this client's level of consciousness?
This client's level of consciousness is considered stuporous—one who is arousable only with vigorous or painful stimulation.
Reference: p. 919, Physiological Integrity
A client with possible Alzheimer's disease is scheduled to have a positron emission tomography (PET) scan. The daughter asks the nurse how this test is different from a CT scan. What is the nurse's best response?
A. "The PET scan is a newer test that can see the brain more clearly."
B. "The PET scan provides information about brain function rather than structure."
C. "The CT scan makes a lot of noise and the PET scan is quieter."
D. "The CT scan requires a contrast medium to be injected and the PET scan does not."
"The PET scan provides information about brain function rather than structure."
A PET scan is a diagnostic tool that is not available in all medical centers. Its benefit over a CT scan or MRI is that it provides information about the function of the brain, specifically glucose and oxygen metabolism and cerebral blood flow.
Reference: p. 922, Physiological Integrity
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