A neurologist explains that arousal is mediated by the:
Reticular activating system
Regulates aspects of attention and information processing and maintains consciousness
Reticular activing system
Affects movment
cerebral cortex
Controls things such as hiccups and vomiting
medulla oblongata
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 structure 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. What is the diagnosis the nurse will most likely see on the chart?
Metabolically induced coma
This type of comma a person generally retains ocular reflexes even when other signs of brainstem damage are present
metabolically induced
This type of comma is manifested by asymmetric responses
structurally induced
The breathing pattern that reflects respirations based primarily on carbon dioxide (CO2) levels in the blood:
Cheyne-stokes
This type of breathing occurs as a result of dysfuction of the medullary neurons
Ataxic
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 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
The loss of the ability to think rapidly and clearly and is characterized by impaired judgment and decision making.
confusion
Condition in which there is no verbal response to the external environment or to any stimuli; noxious stimuli such as deep pain or suctioning do not yield motor movement
Coma
mild to moderate reduction in arousal (awakeness) with limited response to the environment
Obtundation
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 erm should the nurse use for this condition?
Central neurogenic hyperventilation
breathing pattern of deep all-or-none breaths accompanied by a slow respiratory rate.
Gasping
Breathing pattern that is completely irregular that occurs with random shallow and deep breaths and irregular pauses.
Ataxic
Breathing pattern manifested by a prolonged inspiratory pause alternating with an end-expiratory pause
Apneusis
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
complete unawareness of the self or surrounding environment and complete loss of cognitive function
VS
When thought content and arousal level are intact but a patient cannot communicate, the patient has:
Locked-in syndrome
Occurs when the individual cannot communicate through speech or body movement but is fully conscious, with intact cognitive function.
Locked-in syndrome
Difficulty speaking
dysphagia
characterized by problems with coordinated movement
cerebellar motor syndrome
A 10-year-old female was brought to the ER following a sudden onset of convulstions. 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 progressively spread up her arm and then extended to her leg, with no loss of consciousness. how should the nurse chart this?
Focal motor seizure
This type of seizure involves symmetrical movements of selected extremities
myoclonic
This type of seizer involves all body parts and loss of consciousness
tonic-clonic
This type of seizure is without muscle tone
atonic
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 liely was experiencing a(n):
Tonic-clonic seizure
A seizure without movement
absence
A simple seizure with minimal jerking present
myoclonic
A seizure that involves only on body part
partial
When a patient has a peculiar sensation that immediately precedes a seizure, what term should the nurse use to describe this sensation:
Aura
A manifestation that occurs hours preceding a seizure
prodroma
An inability to recognize objects
agnosia
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
Loss of ability to form new memories
anterograde amnesia
Type of memory deficit involves the failure to stay alert and oriented to stimuli
executive memory deficit
type of memory deficit where the person reports inability to focus attention and has failure to perceive objects and other stimuli
selective memory deficit
A 65-year-old male recently suffered a cerebral vascular accident. He is now unable to recognize and identify object by touch because of injury to the senory cortex. How should the nurse document this finding?
Agnosia
A disorder of communication
hypomimesis
An impairment of comprehension of language
dysphasia
The ability to repeat
echolalia
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 arter
A patient with an addiction to alcohol checked into a rehabilitation center. He experiences delirium, inability to concentrate, and is easily distracted. What is he most likely suffering from?
Acute confusional state
Characterized by loss of recent and remote memory
dementia
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
This herniation involves tempral lobe and hippocampal gyrus shifting from the middle fossa to posterior fossa
supratentorial
This herniation is a type of suprtentorial herniation and is the straight downward shift of the diencephalon through the tentorial notch.
central
This herniation occurs when the cingulate gyrus shifts under the falx cerebri. Little is known about its clinical manifestations.
Gyrus
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 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 conditi
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 mmHg. How should the nurse interpret this reading?
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 deterioriate. Her pupils are small and sluggish, pulse pressure is widening, and she is bradyca
Stage 3
stage of intracranial hypertension that is characterized by an ICP that may not change because of the effective compensatory mechanisms, and there may be few symptoms.
Stage 1
stage of intracranial hypertension that is characterized by subtle and transient symptoms, including episodes of confusion, restlessness, drowsiness, and slight pupillary and breathing changes.
Stage 2
stage of intracranial hypertension that is characterized by cessation of cerebral blood flow
stage 4inst
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
This is manifested by a gradual increase in tone causing increased resistance until tone suddenly reduces
spasticity
This is manifested by muscle resistance to passive movement of a reigid limb that is uniform in both flexion and extension througout the motion.
rigidity
This is manifested by sustained involuntary twisting movement
dystonia
A patient has paralysis of both legs. What type of paralysis does this patient have?
paraplegia
paralysis of all four extremities
quadriplegia
Loss of sensation, but no paralysis
paresthesia
A patient has excessive movement. What disorder will the nurse see documented on the chart?
hyperkinesia
Patient with decreased movement
hypokinesia
patient with loss of movemnt
akinesia
patient with abnormal movment
dyskinesia
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 progessive dysfunction of intellectual and thought processes. He is experiencing movement problems that being in the face and arms that eventually affect the entire body. The most likely
Huntington disease
This is manifested by rapid, repetitive, sterotypic movements. Most characteristic is continual chewing with intermittent protrusions of the tonue, lip smacking, and facial grimacing.
Tardive dyskinesia
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
Type of gait that is wide-based with the feet apart and often turned outward or inward for greater stability
cerebellar
Type of gait that occurs when the person walks with small steps and a dcreased arm swing
basal ganglion
Type of gait associated with bilateral injury and spasticity. The legs are abducted so they touch each other.
scissors
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:
hyptonia
A nurse recalls neural systems basic to cognitive functions include _____ systems. (Select all that apply.)
a. Attentional
b. Memory and language
c. Affective
d. Sensory and motor
e. Tactile
A, B, C
The nurse is explaining clinical manifestations of alterations in the extrapyramidal system. The nurse would correctly include (select all that apply):
A. little or no parlaysis of voluntary movement
B. normal or slightly increased tendon reflexes
C. posi
A, B, D, E