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NUR 270: Neuro
NUR 270: Neuro
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1
What is the seventh cranial nerve?
Facial
Abducens
Trigeminal
Acoustic
2
What is not included in the 3 things the cerebellum coordinates?
Memory & cognition
Muscle movement
Balance & equilibrium
Coordination
3
Which of the following is a contraindication for administering t-PA in an ischemic stroke patient?
History of gastrointestinal bleeding two months ago
Recent head trauma within the last 3 weeks
Blood pressure of 140/90
Stroke symptoms started 2 hours ago
4
What are axons responsible for?
receivers of information
senders of information
insulating and speeding conduction
storing information
5
What part of the meninges is filmy and web like?
Arachnoid
Subarachnoid
Pia
Dura
6
Inital dose of t-PA should be given over ____ minutes with _____% of it as a bolus over ____ minutes
1hr, 20%, 2 min
2hrs, 20%, 2 min
60 min, 10%, 1min
30 min, 10%, 1 min
7
What does hypocarbia cause?
Vasoconstriction
Vasodilation
8
What controls involuntary movement?
somatic
Sensory
Autonomic
Motor
9
What is the tenth cranial nerve?
Glossopharyngeal
Vagus
Spinal accessory
Hypoglossal
10
What type of nerve is the trochlear nerve?
Sensory
Motor
Both
11
What diagnostic study gives us information on brain function, cerebral blood flow, glucose, and O2?
MRA
EMG
EEG
PET
12
What isolation precaution is bacterial meningitis?
Airborne
Droplet
Standard
Contact
13
What part of the brain includes the thalamus and hypothalamus?
Diencephalon
Cerebellum
Cerebral cortex
Cerebrum
14
Low PaO2 means...
Increased CO2 leading to increased ICP
Decreased CO2 leading to decreased ICP
Increased CO2 leading to decreased ICP
Decreased CO2 leading to increased ICP
15
What part of the nerve impulse is usually affected by medication?
Synapse
Axons
Neurotransmitters
Action potential
16
What transmits impulses from sensory organs to the CNS?
Autonomic
Motor
Somatic
Sensory
17
What forms the protective covering of the brain and spinal cord?
Nerves
Meninges
Muscles
Skull
18
What BP would you want to keep your patient at after a stroke?
120/80
150/100
130/90
190/120
19
We need 2 IV lines if giving t-PA
False
True
20
What would be a normal CCP range?
30-100
10-15
70-100
60-70
21
When do compensatory mechanisms not kick in for increased ICP?
If increased ICP happens to fast
If vessels dilate in the brain
If vessels constrict in the brain
Increases ICP in small increments over time
22
What diagnostic test measures electrical signals in the brain that are generated by hearing, touch, and sight?
EEG
PET
EMG
Evoked potentials
23
What transmits impulses from the CNS to muscles and glands?
Somatic
Autonomic
Sensory
Motor
24
What do we want to avoid for a patient with increased ICP?
Coughing and deep breathing
Body position maintained in head up position
Head in midline and neutral position
No flextion in hips or knees
25
What are dendrites responsible for?
receiving information
Storing information
Insulating and speeding conduction
Sending information
26
Patient is having trouble urinating after the start of t-PA, it is okay to put a foley in while this med is running
True
False
27
What public education should you provide for meningitis?
Keep all vaccines up to date
Meningitis is not contagious
Stay in crowded dorms
Stay hydrated and rest
28
What part of the brain is needed for singing, playing musical instruments, and processing nonverbal visual experiences?
Frontal
Occipital
Parietal
Temporal
29
What would be considered excessive drainage to report after a craniotomy?
>50mL in 4 hours
>20mL in 8hrs
>50mL in 8hrs
>20mL in 12 hours
30
What part of the meninges is hard and thick?
Arachnoid
Subdural
Dura
Pia
31
What are NOT things neuroglial cells do?
Protect neurons
Support neurons
Produce neurons
Nourish neurons
32
The goal for rehab after a traumic brain injury is getting them back to pre injury status
True
False
33
What type of bleed is an epidural hematoma?
Venous
Arterial
34
Moderate traumatic brain injuries require a short acute/critical care stay for close monitoring
False
True
35
Which result from the glascow coma scale should you intubate?
9
7
12
15
36
When do symptoms usually resolve for a TIA?
30-60 min
24 hours
48 hours
6 hours
37
What level of CPP does the brain not perfuse at?
<100
<30
<50
<60
38
What is the fifth cranial nerve?
Trigeminal
Abducens
Acoustic
Trochlear
39
What is not included in Cushings Triad?
Bradycardia
Widened pulse pressure
Severe HTN
Change in LOC
40
What diagnostic test is contraindicated in patients with increased ICP?
EEG
PET
Lumbar puncture
Evoked potentials
41
What is a coupe?
Initial strike
Additional strike after initial strike
42
What is the second cranial nerve?
Oflactory
Optic
Oculomotor
Trochlear
43
What type of nerve is the trigeminal nerve?
Both
Motor
Sensory
44
What part of the brain is considered the respiratory center?
Pons
Cerebral cortex
Cerebellum
Medulla
45
What ocular sign should you treat as herniation until proven otherwise?
Asymmetric & dilated
Fixed & dilated
Pinpoint & nonresponsive
46
Which intervention is the priority for a patient with increased ICP?
Administering mannitol as prescribed
Keeping the head o the bed flat
Encouraging coughing and deep breathing
Performing a lumbar puncture
47
What is not included in the 3 areas of the forebrain?
Cerebrum
Diencephalon
Cerebral cortex
Cerebellum
48
What ocular sign is considered a "blown pupil"?
Fixed & dilated
Pinpoint & nonresponsive
Asymmetric & dilated
49
What position should a patient be in after a craniotomy?
HOB increased to 30 degrees
Extreme hip or neck flextion
HOB increased to 10 degrees
Have pressure on operative side
50
What type of nerve is the olfactory nerve?
Both
Motor
Sensory
51
What is the 8th cranial nerve?
Abducens
Trigeminal
Acoustic
Facial
52
What type of nerve is the hypoglossal nerve?
Motor
Both
Sensory
53
Early recognition & aggressive treatment is the goal for strokes
True
False
54
What is not included in characteristics for a moderate traumatic brain injury?
Glasgow coma sclae of 9-12
CT/MRI can capture images of tissue damage quite clearly early
A period of LOC for 30 min to 6 hours
Memory loss up to 24 hours
55
What type of bleed is an subdural hematoma?
Venous
Arterial
56
What is the outermost layer of the meninges?
Arachnoid
Dura
Pia
Subdural
57
What type of meningitis is a medical emergency with a high mortality rate often within 24 hours?
Bacterial
Viral
58
What is the earliest sign of increased ICP?
Bradycardia
Change of LOC
Cushings triad
Severe HTN
59
What is the cerebellum responsible for?
Coordinates movement
Sensory
Motor and judgement
Creativity and memory
60
What posturing has extremities going away from the core?
Decerebrate
Decorticate
61
What is the third cranial nerve?
Olfactory
Optic
Oculomotor
Trochlear
62
When caring for a patient with meningitis, what nursing care would you want to provide?
Lay HOB flat
Record I/O and weight
VS and neurologic checks once a shift
Place a TV on for background noise and turn on all lights
63
What do neurons do?
store messages
regulate BS
transmit messages
produce hormones
64
A patient is being assessed using the FAST mnemonic. What does the "A" in FAST stand for?
Alertness
Arm weakness
Ataxia
Airway obstruction
65
What part of the brain translates impulses into understandable feelings and thoughts?
Cerebral cortex
Cerebrum
Basal ganglia
Cerebellum
66
A patient with a glasgow coma scale score of 6 would be classified as having which severity of TBI?
Severe
Concussion
Mild
Moderate
67
What part of the meningies is very delicate and provides support for blood vessels?
Subarachnoid
Pia
Subdural
Arachnoid
68
What is the ninth cranial nerve?
Spinal accessory
Hypoglossal
Vagus
Glossopharyngeal
69
What is the second compensatory mechanism the body uses for increased ICP?
Autoregulation
Herniation
Tachypnea
Increase absorption or decrease rate of CSF being produced
70
When would you discontinue t-PA and notfy the provider?
Bradycardia, BP 150/100
Severe headache, nausea, vomiting
Fever, tachycardia
Tachycardia, O2 95%
71
What helps regulate motor function and is located at the base of the cerebrum?
Basal ganglia
Cerebral cortex
Brainstem
Cerebellum
72
What part of the brain is responsible for understanding sensory input?
Occipital
Frontal
Parietal
Temporal
73
What subjective data would you want to ask in a traumatic brain injury?
Drainage from ears or nose
Health history, ask when, where, and how injury occured
Vital signs indicating increased ICP
Any lacerations or bleeding
74
What what level of ICP does intracranial hypertension occur?
>5
>10
>20
>15
75
Which term represents the loss of balance amoung patients with a brainstem or cerebellar injury?
Papilledema
Ovoid pupil
Ataxia
Diplopia
76
The nurse is caring for a patient who is receiving tPA. Which assessment finding requires immediate intervention?
Blood pressure of 170/100
Sudden decrease in level of consciousness
Mild headache
Pink-tinged urine
77
What is a cause of a thrombotic stroke?
Atherosclerosis
Aneurysm
Endocarditis
AFib
78
When can t-PA be given?
No time frame as long as its not a hemorrhagic stroke
Within first 12 hours
Within first 3hrs
Within first 6 hours
79
What posturing has extremities going towards from the core?
Decorticate
Decerebrate
80
What type of nerve is the accessory nerve?
Both
Motor
Sensory
81
What is the fourth cranial nerve?
Optic
Oculomotor
Trochlear
Olfactory
82
What is the innermost layer of the meninges?
Pia
Subarachnoid
Subdural
Arachnoid
83
What occurs when a stimulus of significant magnitude alters membrane potential?
Movement
Cells die
Action potential
Neurotransmitters activate
84
What layer of the meninges does spinal fluid flow?
Subdural
Arachnoid
Pia
Subarachnoid
85
What type of hematoma is a neurologic emergency?
Epidural
Subdural
86
What disorders are usually secondary causes from imbalances of neurotransmitters?
Endocrine
Development
Musculoskeletal
Neurological
87
Which side of the brain benefits from a structured repetitious and consistent routine with damage?
Right
Left
88
At what level of CPP do neurons die?
<50
<60
<30
<100
89
What type of nerve is the abducens nerve?
Both
Motor
Sensory
90
A patient is diagnosed with an embolic ischemic stroke. Which of the following is the most likely cause?
Subarachnoid hemorrhage
Trauma
Atrial fibrillation
Chronic hypertension
91
What is a contrecoup?
Additional strike after initial strike
Initial strike
92
At what level of ICP do neurons die?
>20
>5
>10
>15
93
What type of hematoma has the highest mortality rate?
Subacute
Acute
Chronic
94
What is the myelin sheath responsible for?
Sending information
receiving information
Storing information
insulating and speeding conduction
95
A patient with a brain tumor presents with symptoms of increased ICP. Which finding suggests brainstem compression?
Decerebrate posturing
Mild confusion
Hemiparesis
Nausea and vomiting
96
What is the eleventh cranial nerve?
Glossopharyngeal
Vagus
Hypoglossal
Spinal accessory
97
What medication puts you at an increased risk for strokes?
Lipid lowering agents
Antihypertensives
Oral contraceptives
NSAIDs
98
The forebrain is above the brain stem and cerebellum
True
False
99
What type of nerve is the oculomotor nerve?
Both
Motor
Sensory
100
What condition is not included for a mild traumatic brain injury?
No evidence of brain damage on CT/MRI
Glasgow coma scale of 9 to 12
Loss of memory for events immediately before and after the accident
Possible LOC for up to 30 min
101
When a pt with a TBI experiences ataxia, which assessment finding would the nurse expect?
Hypotension
Loss of balance
An inability to distinguish colors
A thrombus
102
When should you assess neurologic status and vital signs post op from a craniotomy?
Every hour for the first 2 hours
Every 15-30 min for the first 1-2 hours
Every 15-30 min for the first 4-6 hours
Every hour for the first 4-6 hours
103
Why do we monitor temperature after a stroke?
Decreased temp can increase ICP
Fever can increase ICP
Looking for adverse effects of meds
Looking for infection
104
What is a cause of a hemorrhagic stroke?
A fib
Atherosclerosis
MI/CAD
Aneurysm
105
What timeframe describes an subacute hematoma?
2 weeks to several months after impact
Within 48hrs after impact
48hrs-2 weeks after impact
Within 24hrs after impact
106
When a patient has a basilar skull fracture what do you assess for?
Cardiac arrythmias
hemorrhage
Hypertension
CSF leakage from nose and ears
107
What system releases norepinephrine?
Sympathetic
Parasympathetic
108
What is a cause for an embolic stroke?
Hypertension
AV malformation
Atherosclerosis
A fib
109
Where do outbreaks usually occur for meningitis?
At home in a spacious environment
Doctors office
College dormitories
On a farm
110
What is not included in things you should immediately report after a craniotomy?
Motor weakness or paralysis, aphasia, sluggish pupil reaction
Personality changes
Periorbital edema
Decreased LOC
111
What does not cause viral meningitis?
Cancer
Herpes simplex, HIV
Enterovirus
Mumps, varicella zoster
112
A 30 yo client experienced a frontal lobe infarction. What is the appropriate nursing intervention?
Place all items directly in front of the client
Enable the bed alarm safety system
Use a picture board to communicate
Teach to use a call light before getting out of bed
113
What part of the brain is subdivided into 4 lobes and is the location of higher brain functions?
Cerebellum
Basal ganglia
Cerebral cortex
Cerebrum
114
What is the first drug of choice for increased ICP?
Hypertonic saline
Mannitol
Furosemide
Fentanyl
115
The autonomic nervous system is part of the _______ nervous system
Central
Peripheral
116
What part of the brain includes wenickes area for language comprehension?
Temporal
Occipital
Parietal
Frontal
117
What do raccoons eyes and battles sign indicate?
Severe traumatic brain injury
Mild traumatic brain injury
Moderate traumatic brain injury
Basilar skull fracture
118
What are the 2 types of neurons?
Motor and sensory
Movement and psychological
CNS and PNS
psychological and sensory
119
Which patient assessment finding is consistent with a stroke in the right hemisphere?
Anger and frustration
Deficit in the right visual field
Unawareness of any deficit
Slowness
120
What is not a cause of increased ICP?
Hemorrhage
Moderate exercise
Tumors
Infection
121
What is the sixth cranial nerve?
Acoustic
Abducens
Facial
Trigeminal
122
We only worry about hyperglycemia with a stroke to prevent secondary brain damage
True
False
123
What severity of brain injury causes transient confusion, feeling dazed, and feeling disoriented?
None
Severe
Mild
Moderate
124
What part of the brain causes probelms with emotional outbursts if damaged?
Right
Left
125
Intellect declines in response to aging
True
False
126
What controls conscious movement of skeletal muscles?
Motor
Somatic
Autonomic
Sensory
127
What part of the brain causes probelms with unilateral neglect if damaged?
Right
Left
128
What part of the brain causes probelms with eating/grooming if damaged?
Left
Right
129
What determines the severity of a stroke?
Change in LOC
Type of stroke
Location & extent of brain involved
Patients medical history
130
What is not included in things we need when giving t-PA?
Weight
MRI
2 IV lines
Foley
131
What is NOT included in the classic S/S of a stroke?
Slowely starting to have trouble walking
SUDDEN touble seeing in one or both eyes
SUDDEN severe headache with no known cause
SUDDEN numbness or weakness of face, arm, or leg
132
What lobe in the brain is responsible for motor and judgement?
Frontal
Temporal
Occipital
Parietal
133
What is not included in follow up care after an angiogram?
Assess for any change in LOC
Maintain pressure dressing for 2hrs
Keep extremitiy straight and immobilized
Walk pt to bathroom 30 minutes after procedure
134
What part of the brain plays a major role in the autonomic nervous system and controls temperature and cognition?
Cerebellum
Thalamus
Cerebrum
Hypothalamus
135
What part of the brain causes probelms with visual perceptual if damaged?
Left
Right
136
What part of the brain is responsible for communication?
Occipital
Parietal
Temporal
Frontal
137
What part of the brain is brocas speech center in?
Parietal
Frontal
Occipital
Temporal
138
What is the final compensatory mechanism the body uses for increased ICP?
Tachypnea
Herniation
Increase absorption or decrease rate of CSF being produced
Autoregulation
139
Which part of the brain has the main function of life support and basic functions?
Cerebral cortex
Cerebellum
Cerebrum
Brainstem
140
The PNS includes ___ pairs of spinal nerves and ___ cranial nerves
30, 12
12, 31
31, 15
31, 12
141
What is not included in preoperative care of the craniotomy patient?
Baseline assessments
Bowel prep
Ambulation
Provide psychosocial support
142
Symptoms for a TIA could last as long as 24 hours
False
True
143
What type of nerve is the glossopharyngeal nerve?
Sensory
Both
Motor
144
What is hemianopsia?
Increased pressure in the eye
Loss of vision on one side in one or both eyes
Complete loss of vision
Blurred vision
145
What type of nerve is the acoustic nerve?
Motor
Sensory
Both
146
What is an indication that a CSF test would be abnormal?
Contains only a few cells
Colorless
Pink tinged
Clear
147
What type of nerve is the facial nerve?
Motor
Both
Sensory
148
When to notify the physician with a change in glasgow coma scale?
Any change
Change in 3
Change in 4
Change in 2
149
What is not included in the characteristics of a severe traumatic brain injury?
CT and MRI can capture images of tissue damage quite clearly early
LOC longer than 6 hours
Glascow coma scale of 3-8
Glascow coma scale of 8-10
150
What is stereotactic surgery?
Spinal surgery to fix herniated discs
Excision of part of the skull
Focuses on treatment for aneurysms and narrowed vessels in the brain
Beam of radiation and precision equipment to target an area of the brain
151
What does the CPP do?
Causes herniation
Pressure that is needed for CSF changes
the pressure that is needed to maintain bloodflow to the brain
152
A nurse is assessing a patient with a basilar skull fracture. Which finding requires immediate intervention?
Bruising behind the ear
Clear fluid leaking from the nose
Periorbital bruising
Complaint of a headache
153
What is a vehicle that contains neurotransmitters that helps impulses go from one neuron to the next?
neuron
synapse
axon
action potential
154
What would cause CSF to increase?
Cerebral edema
Tumor
Hydrocephalus
Hemorrhage
155
What is post concussion syndrome?
When there is no evidence of brain damage on CT/MRI
When symptoms from mild traumatic brain injury last days, weeks, or months
When you have LOC for more than 72hrs
When symptoms from mild traumatic brain injury resolve within 72hrs
156
What part of the brain helps control respiratory pattern and rate?
Medulla
Cerebellum
Cerebrum
Pons
157
What posturing indicates damage to the brainstem/midbrain?
Decorticate
Decerebrate
158
What type of stroke is often missed because its only symptom is uncoordinated movement?
Cerebellar
Cryptogenic
Hemorrhagic
Ischemic
159
What ocular sign shows brainstem dysunction at the level of pons?
Asymmetric & dilated
Pinpoint & nonresponsive
Fixed & dilated
160
Why is a BE FAST screening important?
To assess onet and last seen normal
To assess if patient is a possible t-PA candidate
To assess what type of stoke
To assess LOC
161
For every minute delay in treatment of a stroke the brain looses neurons, synapses, and myelination
True
False
162
What is the priority nursing intervention when someone suddenly becomes confused?
Lab electrolyte results
Drug reconciliation
Temperature
SpO2
163
What part of the brain is damaged if you have memory loss and speech difficulties?
Occipital
Frontal
Parietal
Temporal
164
Which of the following is a classic sign of an acute stroke?
Low-grade fever and chills
Intermittent muscle cramps
Gradual onset of memory loss
Sudden confusion and trouble speaking
165
What part of the brain can have personality changes with damage to it?
Occipital
Temporal
Parietal
Frontal
166
What is the normal range of ICP?
10-15
11
15-20
5-10
167
What part of the brain causes probelms with performing routine ADLs if damaged?
Left
Right
168
Vaccinate ____ yo against N. meningitidis and booster at age ___
11/12, 16
11/12, 25
7, 16
7, 21
169
What does hypercarbia cause?
Vasoconstriction
Vasodilation
170
What part of the brain helps regulate respiration, circulation, and conducts impulses between the spinal cord & brain?
Cerebral cortex
Cerebellum
Cerebrum
Brainstem
171
At what oxygen saturation should you maintain a patient having a stroke?
Greater than 93%
100%
Greater than 95%
Greater than 90%
172
How often do you do vital signs and neurologic checks for meningitis?
Once per shift
every 2-4 hrs
Every 4-6 hrs
Every hour
173
What is the first cranial nerve?
Oculomotor
Optic
Olfactory
Trochlear
174
What part of the brain will have problems with spacial reationships if damaged?
Occipital
Frontal
Temporal
Parietal
175
What is not included in the 3 essential components of the brain?
Brain tissue
CSF
Neurotransmitters
Blood
176
What is the 12th cranial nerve?
Hypoglossal
Glossopharyngeal
Vagus
Spinal accessory
177
What type of hematoma involves lucid intervals?
Epidural
Subdural
178
What 2 things does the brain need a constant supply of?
O2 and CO2
Neurotransmitters and glucose
O2 and glucose
O2 and neurotransmitters
179
t-PA has to be double checked with another nurse before giving and followed up with a CT/MRI after treatment
False
True
180
What part of the brain causes probelms with memory if damaged?
Right
Left
181
What type of stroke is characterized by a sudden onset with dramatic BP increases?
Thrombotic
Intracerebral
Embolic
Subarachnoid
182
What is not a drug that can cause meningitis?
Antibiotics
Steriods
NSAIDs
IV immuniglobulins
183
What does the cerebrum not control?
Creativity
Memory
Intelligence
Movement
184
What s/s are not included for meningitis?
Decreased LOC, disoriented
Cranial nerve dysfunction
Bradycardia, hypotension
Severe headache, fever
185
What part of the brain is considered a major "relay station" for the CNS?
Cerebrum
Cerebellum
Hypothalamus
Thalamus
186
What type of stroke is usually caused by a ruptured aneurysm or AV malformation?
Subarachnoid
Intracerebral
Thrombotic
Embolic
187
What type of nerve is the vagus nerve?
Both
Motor
Sensory
188
What timeframe describes an acute hematoma?
2 weeks to several months after impact
Within 24hrs after impact
48hrs-2 weeks after impact
Within 48hrs after impact
189
What is the first compensatory mechanism the body uses for increased ICP?
Increase absorption or decrease rate of CSF being produced
Autoregulation
Herniation
Tachypnea
190
What part of the body regulates reflexes?
Cerebral cortex
Cerebrum
Brainstem
Spinal cord
191
Which type of stroke is characterized by "the worst headache of my life"?
Thrombotic
Intracerebral
Subarachnoid
Embolic
192
What diagnostic test identifies muscle and nerve disorders?
MRA
EEG
EMG
PET
193
What type of nerve is the optic nerve?
Both
Motor
Sensory
194
What timeframe describes an chronic hematoma?
2 weeks to several months after impact
48hrs-2 weeks after impact
Within 48hrs after impact
Within 24hrs after impact
195
What part of the brain is the primary visual center?
Temporal
Parietal
Occipital
Frontal
196
What system releases acetylcholine?
Parasympathetic
Sympathetic
197
What is not included in patient/family education for a mild traumatic brain injury?
No driving or alcohol
Strenuous activity can continue right away
Someone to stay with patient
S/S to observe for
198
Which type of stroke is commonly associated with a ruptured aneurysm?
Subarachnoid hemorrhage
Intracerebral hemorrhage
Ischemic thrombotic stroke
Ischemic embolic stroke
199
Among those pt who reach the hospital alive, which complication is the leading cause of death from head trauma?
Internal bleeding
Increased ICP
Hypotension
Hypoxia
200
A patient arrives at the emergency department with signs of a stroke. What is the priority diagnostic test?
CT without contrast
EEG
MRI
Carotid ultrasound
