neurology QUIZ

1. A nurse is teaching a wellness class and is covering the warning signs of stroke. A patient asks, "What is the most important thing for me to remember?" Which is an appropriate response by the nurse?

1. "Know your family history."
2. "Keep a list of your medications."
3. "Be alert for sudden weakness or numbness."
4. "Call 911 if you notice a gradual onset of paralysis or confusion."

2. A patient is placed in ventilator support with the diagnosis of botulism and failure to thrive. Which nursing actions would be most appropriate for this patient?

Select all that apply.
1. maintaining intravenous fluids at KVO (keep vein open)
2. assessing bowel sounds once a shift
3. referring the patient for a physical therapy consult
4. recording the patient's ongoing calorie count
5. assessing the patient's urinary output every hour

3. Which of the following is the priority nursing diagnosis for a patient diagnosed with a spinal cord injury?

1. Fluid Volume Deficit
2. Impaired Physical Mobility
3. Ineffective Airway Clearance
4. Altered Tissue Perfusion

4. A patient was diagnosed with a left cerebral hemorrhage. Which topics are most appropriate for the nurse to include in patient and family teaching?

Select all that apply.
1. how to use a sign board
2. transfer techniques
3. information about impulse control
4. time adjustment to complete activities
5. safety precautions for transferring

5. A patient has the nursing diagnosis of Impaired Swallowing and complains of frequent heartburn. What is the most appropriate action by the nurse?

1. Assist the patient in maintaining a sitting position for 30 minutes after the meal.
2. Teach the patient the "chin tuck" technique when swallowing.
3. Check the patient's mouth for pocketing of food.
4. Assist the patient to a 90-degree sitting position, or as high as tolerated, during meals.

6. A patient with a spinal cord injury at the T1 level complains of a severe headache and an "anxious feeling." Which is the most appropriate initial reaction by the nurse?

1. Try to calm the patient and make the environment soothing.
2. Assess for a full bladder.
3. Notify the healthcare provider.
4. Prepare the patient for diagnostic radiography.

7. A patient hospitalized with a known AV malformation begins to complain of a headache and becomes disorientated. Which is the most appropriate action by the nurse?

1. Recommend to the family members that they start to look for a long-term care facility.
2. Prepare to give aspirin or a "clot buster."
3. Prepare the patient for surgery.
4. Document the changes and monitor closely.

8. A school nurse is called after a student falls down a flight of stairs. The student is breathing, but unconsciousness. After calling the ambulance, which is the most appropriate action by the nurse?

1. Protect the patient's neck and head from any movement.
2. Place the patient on his side to prevent aspiration.
3. Immobilize the neck,,securing the head.
4. Try to rouse the patient by gently shaking his shoulders.

9. A hospitalized patient with a C7 cord injury begins to yell "I can't feel my legs anymore." Which is the most appropriate action by the nurse?

1. Remind the patient of her injury and try to comfort her.
2. Call the healthcare provider and get an order for radiologic evaluation.
3. Prepare the patient for surgery, as her condition is worsening.
4. Explain to the patient that this could be a common, temporary problem.

10. A patient with a spinal cord injury (SCI) is admitted to the unit and placed in traction. Which of the following actions is the nurse responsible for when caring for this patient?

Select all that apply.
1. modifying the traction weights as needed
2. assessing the patient's skin integrity
3. applying the traction upon admission
4. administering pain medication
5. providing passive range of motion

11. The nurse is educating a patient and the family about different types of stabilization devices. Which statement by the patient indicates that the patient understands the benefit of using a halo fixation device instead of Gardner-Wells tongs?

1. "I will have less pain if I use the halo device."
2. "The halo device will allow me to get out of bed."
3. "I am less likely to get an infection with the halo device."
4. "The halo device does not have to stay in place as long."

12. A post-stroke patient is going home on oral Coumadin (warfarin). During discharge teaching, which statement by the patient reflects an understanding of the effects of this medication?

1. "I will stop taking this medicine if I notice any bruising."
2. "I will not eat spinach while I'm taking this medicine."
3. "It will be OK for me to eat anything, as long as it is low fat."
4. "I'll check my blood pressure frequently while taking this medication."

13. A patient with a spinal cord injury was given IV Decadron (dexamethasone) after arriving in the emergency department. The patient also has a history of hypoglycemia. During the hospital stay, the nurse would expect to see which of the following?

1. increased episodes of hypoglycemia
2. possible episodes of hyperglycemia
3. no change in the patient's glycemic parameters
4. both hyper- and hypoglycemic episodes

14. Which of the following nursing actions is appropriate for preventing skin breakdown in a patient who has recently undergone a laminectomy?

1. Provide the patient with an air mattress.
2. Place pillows under patient to help patient turn.
3. Teach the patient to grasp the side rail to turn.
4. Use the log roll to turn the patient to the side.

15. Which of the following is the priority nursing diagnosis for the patient who has undergone surgery for a spinal fusion?

1. Acute Pain
2. Impaired Mobility
3. Risk for Infection
4. Risk for Injury

16. A patient is admitted with signs of a stroke (CVA). On admission, vital signs were blood pressure 128/70, pulse 68, and respirations 20. Two hours later the patient is not awake, has a blood pressure of 170/70, pulse 52, and the left pupil is now slower than the right pupil in reacting to light. These findings suggest which of the following?

1. impending brain death
2. decreasing intracranial pressure
3. stabilization of the patient's condition
4. increased intracranial pressure

17. A hospitalized patient has become unresponsive. The left side of the body is flaccid. The attending physician believes the patient may have had a stroke (CVA). What is the nurse's priority intervention?

1. Move the patient to the critical care unit.
2. Assess blood pressure.
3. Assess the airway and breathing.
4. Observe urinary output.

18. A patient whose status is post-stroke (CVA) has severe right-sided weakness. Physical therapy recommends a quad cane. Which of the following is proper use of the cane by the patient?

1. The patient holds the cane in the left hand. The patient moves the cane forward first, then the right leg, and then the left leg.
2. The cane is held in either hand and moved forward at the same time as the left leg. Then the patient drags the right leg forward.
3. The patient holds the cane in the right hand for support. The patient moves the cane forward first, then the left leg, and then the right leg.
4. The patient holds the cane in the left hand. The patient moves the left leg forward first, then moves the cane and the right leg forward together.

19. The family of a patient who has had a brain attack (CVA) asks if the patient will ever talk again. The nurse should do which of the following?

1. Explain that the patient's speech will return to normal with time.
2. Explain that it is difficult to know how far the patient will progress.
3. Tell the family that nurses cannot discuss such issues. Tell them to ask the physician.
4. Tell the family what they see today is all they can expect.

20. The nurse is teaching regarding risk factors for stroke (CVA). The greatest risk factor is which of the following?

1. diabetes
2. heart disease
3. renal insufficiency
4. Hypertension

21. The nurse recognizes that the most common type of brain attack (CVA) is related to which of the following?

1. ischemia
2. hemorrhage
3. headache
4. Vomiting

22. When caring for a patient admitted post-stroke (CVA) who has altered consciousness, the nurse should place the patient in which position?

1. side-lying
2. supine
3. prone
4. semi-Fowler's

23. The nurse must be alert to complications in the patient who has suffered a ruptured intracranial aneurysm. The nurse should assess the patient for signs of which of the following?
Select all that apply.

1. headache
2. hydrocephalus
3. rebleeding
4. vasospasm
5. stiff neck

24. The nurse is caring for a patient with increased intracranial pressure (IICP). The nurse realizes that some nursing actions are contraindicated with IICP. Which nursing action should be avoided?

1. Reposition the patient every two hours.
2. Position the patient with the head elevated 30 degrees.
3. Suction the airway every two hours per standing orders.
4. Provide continuous oxygen as ordered.

25. Prodromal manifestations prior to an intracranial aneurysm rupture could be recognized by the nurse as which of the following?

Select all that apply.
1. visual deficits
2. headache
3. mild nausea
4. dilated pupil
5. stiff neck

26. Which patient is at highest risk for a spinal cord injury?

1. 18-year-old male with a prior arrest for driving while intoxicated (DWI)
2. 20-year-old female with a history of substance abuse
3. 50-year-old female with osteoporosis
4. 35-year-old male who coaches a soccer team

27. The nurse understands that when the spinal cord is injured, ischemia results and edema occurs. How should the nurse explain to the patient the reason that the extent of injury cannot be determined for several days to a week?