Chapter 65 Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13Th Edition

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Chapter 65  Brunner & Suddarth’s Textbook of Medical-Surgical Nursing 13Th Edition

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

1. A patient is brought to the ER following a motor vehicle accident in which he sustained head trauma. Preliminary assessment reveals a vision deficit in the patient’s left eye. The nurse should associate this abnormal finding with trauma to which of the following cerebral lobes?

  1. A)  Temporal
  2. B)  Occipital
  3. C)  Parietal
  4. D)  Frontal

Ans: B

Feedback:

The posterior lobe of the cerebral hemisphere is responsible for visual interpretation. The temporal lobe contains the auditory receptive areas. The parietal lobe contains the primary sensory cortex, and is essential to an individual’s awareness of the body in space, as well as orientation in space and spatial relations. The frontal lobe functions in concentration, abstract thought, information storage or memory, and motor function.

2. A patient scheduled for magnetic resonance imaging (MRI) has arrived at the radiology department. The nurse who prepares the patient for the MRI should prioritize which of the following actions?

  1. A)  Withholding stimulants 24 to 48 hours prior to exam
  2. B)  Removing all metal-containing objects
  3. C)  Instructing the patient to void prior to the MRI
  4. D)  Initiating an IV line for administration of contrast

Ans: B

Feedback:

Patient preparation for an MRI consists of removing all metal-containing objects prior to the examination. Withholding stimulants would not affect an MRI; this relates to an electroencephalography (EEG). Instructing the patient to void is patient preparation for a lumbar puncture. Initiating an IV line for administration of contrast would be done if the patient was having a CT scan with contrast.

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3. A gerontologic nurse planning the neurologic assessment of an older adult is considering normal, age-related changes. Of what phenomenon should the nurse be aware?

  1. A)  Hyperactive deep tendon reflexes
  2. B)  Reduction in cerebral blood flow
  3. C)  Increased cerebral metabolism
  4. D)  Hypersensitivity to painful stimuli

Ans: B

Feedback:

Reduction in cerebral blood flow (CBF) is a change that occurs in the normal aging process. Deep tendon reflexes can be decreased or, in some cases, absent. Cerebral metabolism decreases as the patient advances in age. Reaction to painful stimuli may be decreased with age. Because pain is an important warning signal, caution must be used when hot or cold packs are used.

4. The nurse has admitted a new patient to the unit. One of the patient’s admitting orders is for an adrenergic medication. The nurse knows that this medication will have what effect on the circulatory system?

  1. A)  Thin, watery saliva
  2. B)  Increased heart rate
  3. C)  Decreased BP
  4. D)  Constricted bronchioles

Ans: B

Feedback:

The term “adrenergic” refers to the sympathetic nervous system. Sympathetic effects include an increased rate and force of the heartbeat. Cholinergic effects, which correspond to the parasympathetic division of the autonomic nervous system, include thin, watery saliva, decreased rate and force of heartbeat, and decreased BP.

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5. A nurse is assessing reflexes in a patient with hyperactive reflexes. When the patient’s foot is abruptly dorsiflexed, it continues to “beat” two to three times before settling into a resting position. How would the nurse document this finding?

  1. A)  Rigidity
  2. B)  Flaccidity
  3. C)  Clonus
  4. D)  Ataxia

Ans: C

Feedback:

When reflexes are very hyperactive, a phenomenon called clonus may be elicited. If the foot is abruptly dorsiflexed, it may continue to “beat” two to three times before it settles into a position of rest. Rigidity is an increase in muscle tone at rest characterized by increased resistance to passive stretch. Flaccidity is lack of muscle tone. Ataxia is the inability to coordinate muscle movements, resulting in difficulty walking, talking, and performing self-care activities.

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