Chapter 14 Care of the Patient with a Neurologic Disorder

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Chapter 14  Care of the Patient with a Neurologic Disorder

 

 

Complete chapter Questions And Answers
 

Sample Questions

 

 

MULTIPLE CHOICE

1. What are the two divisions of the nervous system?

  1. Somatic and the autonomic
  2. Cerebellum and the brainstem
  3. Medulla oblongata and the diencephalon
  4. Central and the peripheral

ANS: D
The central and the peripheral are the two divisions of the nervous system. The autonomic and the somatic are the division of the peripheral nervous system.

DIF: Cognitive Level: Knowledge REF: Page 671 OBJ: 1
TOP: Anatomy and physiology KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity

2. What is the cranial nerve that supplies most of the organs in the thoracic and abdominal cavities and also carries motor fibers to glands that produce digestive juices and other secretions?

  1. Somatic motor nerve
  2. Visceral sensory nerve
  3. Abducens nerve
  4. Vagus nerve

ANS: D
The vagus nerve extends from the throat, larynx, and organs in the thoracic and abdominal cavities. It is responsible for sensations and will accelerate peristalsis when stimulated.

DIF: Cognitive Level: Knowledge REF: Page 676, Table 14-1
OBJ: 5 TOP: Anatomy and physiology
KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity

3. The newly admitted patient to the emergency room 30 minutes ago after a fall off a ladder has gradually decreased in consciousness and has slowly reacting pupils, a widening pulse pressure, and verbal responses that are slow and unintelligible. What is the most appropriate position for the patient?

  1. Neck placed in a neutral position
  2. Head raised slightly with hips flexed
  3. Supine in gravity neutral position
  4. Turn on right side with head elevated

ANS: A
Place the neck in a neutral position (not flexed or extended) to promote venous drainage.

DIF: Cognitive Level: Application REF: Page 690 OBJ: 12
TOP: Intracranial pressure (ICP) KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity

4. Which question is likely to elicit the most valid response from the patient who is being interviewed about a neurologic problem?

  1. “Do you have any sensations of pins and needles in your feet?”
  2. “Does the pain radiate from your back into your legs?”
  3. “Can you describe the sensations you are having?”
  4. “Do you ever have any nausea or dizziness?”

ANS: C
For patients with suspected neurologic conditions, the presence of many symptoms or subjective data may be significant. Offering leading questions is not beneficial and may allow the patient to give misinformation. Questions should be specific about symptoms.

DIF: Cognitive Level: Application REF: Page 677 OBJ: 8 TOP: Assessment KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity

5. What is the cardinal sign of increased intracranial pressure in a brain injured patient?

  1. Pupil changes
  2. Ipsilateral paralysis
  3. Vomiting
  4. Decrease in the level of consciousness

ANS: D
Collection of objective data includes a change in level of consciousness. A change in the level of consciousness is the earliest sign of increased intracranial pressure.

DIF: Cognitive Level: Analysis REF: Page 688 OBJ: 12
TOP: Intracranial pressure (ICP) KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity

6. The nurse is aware that when assessing a patient by the FOUR score coma scale, the patient is assessed in four categories: eye response, brainstem reflexes, motor response, and respiration. How are these results reported?

  1. As a sum of the scores of the four categories
  2. As part of the Glasgow coma scale
  3. As individual scores in each category
  4. As progressive scores during a 24-hour period

ANS: C
The FOUR score coma scale assesses the patient in four categories: eye response, brainstem reflexes, motor response, and respiration. The scores are reported as individual scores in each category. It is frequently done in conjunction with the Glasgow coma scale, not part of it.

DIF: Cognitive Level: Comprehension REF: Page 769 OBJ: 11
TOP: FOUR Score Coma Scale KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity

7. As the result of a stroke, a patient has difficulty discerning the position of his body without looking at it. In the nurse’s documentation, which would best describe the patient’s inability to assess spatial position of his body?
a. Agnosia

b. Proprioception

c. Apraxia d. Sensation

ANS: B
Patients may experience a loss of proprioception with a stroke. This may include apraxia and agnosia (a total or partial loss of the ability to recognize familiar objects or people).

DIF: Cognitive Level: Application REF: Page 694 OBJ: 19 TOP: Stroke KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity

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