A neurologists explains that arousal is mediated by the:
Reticular activating system
A 20-year-old male suffers a severe closed head injury in a motor vehicle accident. He remains in a vegetative state (VS) 1 month after the accident. Which of the following structures is most likely keeping him in a vegetative state?
Brainstem
A 16-year-old male took a recreational drug that altered his level of arousal. Physical exam revealed a negative Babinski sign, equal and reactive pupils, and roving eye movements. Which of the following diagnosis will the nurse most likely see on the cha
Metabolically induced coma
The breathing pattern that reflects respirations based primarily on carbon dioxide (CO2) levels in the blood is:
Cheyne-Stokes
A 45-year-old female presents to the emergency room (ER) reporting excessive vomiting. A CT scan of the brain reveals a mass in the:
Medulla oblongata
A teenage boy sustains a severe closed head injury following an all-terrain vehicle (ATV) accident. He is in a state of deep sleep that requires vigorous stimulation to elicit eye opening. How should the nurse document this in the chart?
Stupor
A 50-year-old male suffers a severe head injury when his motorcycle hits a tree. His breathing becomes deep and rapid but with normal pattern. What term should the nurse use for this condition?
Central neurogenic hyperventilation
When a student asks what can cause dilated, fixed pupils, what is the nurse's best response? Dilated fixed pupils can be caused by:
Brainstem hypoxia
An attorney spoke to the nurses regarding brain death. Which statement indicates the nurses understood brain death? For legal purposes, brain death is defined as:
Cessation of brain function
When thought content and arousal level are intact but a patient cannot communicate, the patient has:
Locked-in syndrome
A 10-year-old female was brought to the ER following a sudden onset of convulsions. The primary care provider thinks that she experienced an explosive, disorderly discharge of cerebral neurons referred to as:
Seizure
A 30-year-old female had a seizure that started with her fingers and progressive1y spread up her arm and then extended to her leg, with no loss of consciousness. How should the nurse chart this?
Focal motor seizure
A 20-year-old male was at the supermarket when he fell to the ground. Bystanders reported that he lost consciousness and his body tensed up then relaxed, then tensed and relaxed several times. He most likely was experiencing a(n):
Tonic-clonic seizure
When a patient has a peculiar sensation that immediately precedes a seizure, what term should the nurse use to describe this sensation?
Aura
A patient has memory loss of events that occurred before a head injury. What cognitive disorder does the nurse suspect the patient is experiencing?
Retrograde amnesia
A 65-year-old male recently suffered a cerebral vascular accident. He is now unable to recognize and identify objects by touch because of injury to the sensory cortex. How should the nurse document this finding?
Agnosia
A 75-year-old female suffers a stroke and now has difficulty writing and production of language. This condition is most likely caused by occlusion of the:
Middle cerebral artery
A patient with an addiction to alcohol checked into a rehabilitation center. He experiences delirium, inability to concentrate, and is easily distracted. From which of the following is he most likely suffering?
Acute confusional state
A nurse thinks a patient may be experiencing dementia. Which assessment finding will most help support this diagnosis?
Loss of recent and remote memory
The progress notes read: the cerebellar tonsil has shifted through the foramen magnum due to increased pressure within the posterior fossa. The nurse would identify this note as a description of _____ herniation.
Infratentorial
The patient is experiencing an increase in intracranial pressure. This increase results in:
Brain tissue hypoxia
A compensatory alteration in the diameter of cerebral blood vessels in response to increased intracranial pressure is called:
Autoregulation
The primary care provider states that the patient has vasogenic edema. The nurse realizes vasogenic edema is clinically important because:
The blood-brain barrier is disrupted
A 51-year-old male is admitted to the neurological critical care unit with a severe closed head injury. All four extremities are in rigid extension, his forearm is hyperpronated, and his legs are in plantar extension. How should the nurse chart this condi
Decerebrate posturing
A 20-year-old male is admitted to the neurological critical care unit with a severe closed head injury. When an intraventricular catheter is inserted, the ICP is recorded at 24 mm Hg. How should the nurse interpret this reading? This reading is:
Higher than normal
A 70-year-old female is being closely monitored in the neurological critical care unit for a severe closed head injury. After 48 hours, her condition begins to deteriorate. Her pupils are small and sluggish, pulse pressure is widening, and she is bradycar
Stage 3
An infant is diagnosed with noncommunicating hydrocephalus. What is an immediate priority concern for this patient?
Interstitial edema
An adult has hydrocephalus. When the patient asks the nurse what caused this, how should the nurse respond? Hydrocephalus in adults is most often caused by:
Defective CSF reabsorption
A 16-year-old male fell off the bed of a pickup truck and hit his forehead on the road. He now has resistance to passive movement that varies proportionally with the force applied. He is most likely suffering from:
Gegenhalten
A patient has paralysis of both legs. What type of paralysis does the patient have?
Paraplegia
A patient has excessive movement. What disorder will the nurse see documented on the chart?
Hyperkinesia
Which principle should the nurse remember while planning care for a patient with spinal shock? Spinal shock is characterized by:
Cessation of spinal cord function below the lesion
A 40-year-old male complains of uncontrolled excessive movement and progressive dysfunction of intellectual and thought processes. He is experiencing movement problems that begin in the face and arms that eventually affect the entire body. The most likely
Huntington disease
A nurse notes that a patient walks with the leg extended and held stiff, causing a scraping over the floor surface. What type of gait is the patient experiencing?
Spastic gait
A male patient complains of tiring easily, has difficulty rising from a sitting position, and cannot stand on his toes. The nurse would expect a diagnosis of:
Hypotonia
A nurse recalls neural systems basic to cognitive functions include _____ systems. (more than one answer)
-Attentional
-Memory and language
-Affective
The nurse is explaining clinical manifestations of alterations in the extrapyramidal system. The nurse would correctly include (more than one answer):
-Little or no paralysis of voluntary movement
-Normal or slightly increased tendon reflexes
-Presence of tremor
-Rigidity in muscle tone
A neurologist is teaching about brain injuries. Which information should the neurologist include? The most severe diffuse brain injury caused by rotational acceleration is most likely to be located _____ the brainstem.
More peripheral to
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?
Concussion
A 15-year-old male suffered diffuse brain injury after wrecking an all-terrain vehicle. He had momentary confusion and retrograde amnesia after 5 to 10 minutes. His injury could be categorized as:
Grade II
A 25-year-old male was in an automobile accident. At impact, his forehead struck the windshield. In this situation, a nurse recalls the coup injury would occur in the _____ region.
Frontal
While planning care for a patient with an extradural hematoma, which principle should the nurse remember? The main source of bleeding in extradural (epidural) hematomas is:
Arterial
A 69-year-old male with a history of alcohol abuse presents to the emergency room (ER) after a month-long episode of headaches and confusion. Based on his alcoholism, a likely cause of his neurologic symptoms is:
Chronic subdural hematoma
A 15-year-old male was struck by a motor vehicle and suffered a traumatic brain injury. Paramedics found him unconscious at the scene of the accident. During the ambulance ride, he regained consciousness and was able to maintain a conversation with the me
Extradural (epidural) hematoma
Which assessment finding by the nurse characterizes a mild concussion?
Retrograde amnesia
A 39-year-old male suffers a severe brain injury when he falls off a building while working. CT scan reveals that he has a basilar skull fracture. Based upon his injuries, what major complication should the nurse observe for in this patient?
Meningeal infection
A 65-year-old female loses her balance while walking in the woods, causing her to fall and hit her head. She loses consciousness and is in a coma for 5 days. She is diagnosed as having diffuse brain injury. Which of the following would most likely occur i
Blunted affect
A 10-year-old male was climbing on a house and fell. He suffered a severe brain injury. His Glasgow Coma Scale (GCS) was 5 initially and 7 after 1 day. He remained unconscious for 2 weeks, then was confused and suffered from anterograde amnesia. Which of
Moderate diffuse brain injury
_____ are most at risk of spinal cord injury from minor trauma.
The elderly
An initial assessment finding associated with acute spinal cord injury is _____ the injury.
Loss of voluntary control below
When a patient asks how bad the injuries will be from a spinal injury, what is the nurse's best response? It is difficult to know the full extent of the injury because of:
Swelling with the spinal cord
A 20-year-old male is brought to the emergency room (ER) for treatment of injuries received in a motor vehicle accident. A spinal cord injury is suspected. What two regions should the nurse assess as they are most likely to be damaged?
Cervical and lumbar regions
A 33-year-old male is brought to the ER for treatment of injuries received in a motor vehicle accident. An MRI reveals an injury of the cervical cord. Cord swelling in this region may be life threatening because:
Diaphragm function may be impaired
A 15-year-old male 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:
His sympathetic nervous system has been damaged and thermal control disturbed.
Six weeks ago a female patient suffered a T6 spinal cord injury. She then developed a blood pressure of 200/120, a severe headache, blurred vision, and bradycardia. What does the nurse suspect the patient is experiencing?
Autonomic hyperreflexia
A 20-year-old female suffered from spinal cord injury that resulted from a motor vehicle accident. She had spinal shock lasting 15 days and is now experiencing an uncompensated cardiovascular response to sympathetic stimulation. What does the nurse suspec
A dissented bladder or rectum
A 50-year-old male presents with low back pain. He denies trauma and says he just woke up and it was hurting. An MRI reveals that the vertebra at L5 slid forward relative to those above and below it. Which of the following conditions will be documented on
Spondylolisthesis
The majority of intervertebral disk herniations occur between which vertebral levels (cervical, C; thoracic, T; lumbar, L; sacral, S)?
L4 to S1
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?
Diabetes
Which of the following would increase a patient's risk for thrombotic stroke?
Dehydration
Of the following groups, who are at highest risk for a cerebrovascular accident (CVA)?
Blacks over 65 years of age
A 72-year-old male demonstrates left-sided weakness of upper and lower extremities. The symptoms lasted 4 hours and resolved with no evidence of infarction. The patient most likely experienced a(n):
Transient ischemic attack
A major contributing process in CVAs is the development of atheromatous plaques in cerebral circulation. These most commonly form:
In cerebral arteries
A 60-year-old female 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 she had a hemorrhagic stroke. What does the nurse suspect caused this type of stroke?
Aneurysm
A 75-year-old male experienced a lacunar stroke. When looking through the history of the patient's chart, which of the following would the nurse expect to find?
Hypertension
A 25-year-old male died from a gunshot wound to the heart. Upon autopsy, abnormalities in the media of the arterial wall and degenerative changes were detected. Which of the following most likely accompanied this finding?
Saccular aneurysm
A 48-year-old female presents at the ER reporting an acute severe headache, nausea, photophobia, and nuchal rigidity. What does the nurse suspect caused these signs and symptoms?
Subarachnoid hemorrhage
A cause of hydrocephalus in subarachnoid hemorrhage is:
Scarring of meninges and impairment of CSF resorption
A 65-year-old male suffers a subarachnoid hemorrhage secondary to uncontrolled hypertension. He appears drowsy and confused with pronounced focal neurologic deficits. This condition is grade:
III
A 25-year-old female presents to her primary care provider reporting fever, headache, nuchal rigidity, and decreased consciousness. She was previously treated for sinusitis. Which of the following is the most likely diagnosis?
Bacterial Meningitis
A neurologist is teaching about encephalitis. Which information should the neurologist include? Most causes of encephalitis are:
Viral
A 15-month-old child from Pennsylvania was brought to the ER for fever, seizure activity, cranial palsies, and paralysis. Which of the following diagnosis will be documented in the chart?
Eastern equine encephalitis
A 23-year-old female begins having problems with tiredness, weakness, and visual changes. Her diagnosis is multiple sclerosis (MS). What is occurring in the patient's body?
Demyelination of nerve fibers in the CNS
When a patient asks, "What is the cause of multiple sclerosis?" how should the nurse reply? The cause of MS seems to be an interaction between:
Autoimmunity and genetic susceptibility
A patient is admitted with amyotrophic lateral sclerosis (ALS). Which classic assessment findings will support the diagnosis of ALS?
Muscle weakness and atrophy
Which statement by a patient indicates teaching was successful regarding myasthenia gravis? Myasthenia gravis results from:
Autoimmune injury at the neuromuscular junction
Patients with myasthenia gravis often have tumors or pathologic changes in the:
Thymus
Which statement by the nurse indicates teaching was successful regarding CNS tumors in adults? The most common primary CNS tumors in adults are:
Astrocytomas
A 45-year-old male presents with seizures. An MRI reveals a meningioma most likely originating from the:
Dura mater and arachnoid membrane
As a portion of the assessment of the patient with meningitis, the health care provider flexes the patient's neck to the chest. The patient responds with flexion of the legs and thighs. The name for this response is:
Brudzinski's sign
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:
Myasthenia gravis
Which information indicates the nurse understands assessment findings of an aneurysm?
The majority are asymptomatic
An older adult is admitted to the ER following a fall. The patient complains of pain in the back. The patient has a history of osteoporosis. The nurse would expect the patient's injury and subsequent pain is most likely due to:
A spinal compression fracture
The nursing student would correctly identify the most common symptom of brain abscess as:
Headache
When the spouse of a patient experiencing a thrombotic stroke asks when "clot busting" treatment should begin, how should the nurse respond? Recommendations suggest that treatment for a thrombotic stroke begin within ________ hours of onset of symptoms.
Three