what are the three signs of brain death?

coma, apnea, absence of brain stem reflexes

in the setting of a head injury, what manifestations typically suggest a poorer prognosis? select All

Joint extension, lack of motor response

What are the effects of applying heat to a transdermal patch? Select All

Increase absorption, lethal complications

why is a patient unable to sweat?

blockage of sympathetic activity

what interventions would the nurse use as safety measures with a visually impaired client

using clock method while ambulating

In the event of a carotid endaterectomy, what could hypotension and hypertension cause?

cerebral ischemia/cerebral hemorrhage

studbud

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224 termsStudBud Administration15 plays

12-pain managenent 65-Assess. of Neuro Function 68-Mngmt of Pt. w/Neuro Trauma 70-Oncologic/ Neuro disorders 63- Eye and vision disordes 64-Hearing and balance disorders 67-cerebrovascular disorders 66-Mngmt of pt. w/neurological dysfunction 69-Neuro infec/Autoim dysf/neuropathie

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Questions 224

Answers

1
Most hemorrhagic strokes are due to?
ICP
decreased heart rate
HypoTN
HTN
2
How often would you turn a patient and reposition when in chair?
turn q3hrs; chair q2hrs
turn q2hrs; chair q2hrs
turn q2hrs; chair q1hrs.
turn q 4 hrs; chair q1hrs
3
A patient has belpasy. what cranial nerve would be affected?
IX
VII
V
VI
4
assess. findings uniqe to hemorrhagic strokes are vomiting, quicker changes in LOC, poss. focal seziures w/brain stem
False
True
5
what could trigger vasodilation and result in an increased intracranial pressure.
high perfusion pressure
high cerebral perfusion pressure
decrease platelets
decrease in cerebral perfusion
6
What is marked by conjunctival hyperemia, lid edema, ptosis, foreign body sensation & watery discharge
none are answers
bacterial conjuctivitis
viral conjunctivitis
fungal conjunctivitis
7
what are the three signs of brain death?
glascow score of 9, coma, tachycardia
mental eval score of 24, ALS, anoxia
no ECG activity, dyspnea, decreased respirations
coma, apnea, absence of brain stem reflexes
8
What cranial Nerves would you monitor following neck surgery
X ,V, II
X, XI, XII
II, III, I
X, IV, v
9
A nurse touched a patient's face with a sharp or dull object. what cranial nerve is being assessed?
CN IV
CN III
CN VII
CN V
10
in the setting of a head injury, what manifestations typically suggest a poorer prognosis? select All
Joint extension
lack of motor response
Decrease ICP
joint flexion
11
A nurse instructs the client to stick the tongue out and say Ah. What Cranial Nerve would the nurse assess?
CN XII
CN III
CN X
CN V
12
what position would you maintain to administer tube feedings and for at least an hour post feeding?
Semi-fowler
prone
High fowler
supine
13
A patient was provided analgesics 10 min ago and still complains of pain. which is best to describe the patient's pain?
Addiction
tolerance
drug seeking
psychological dependence
14
What are associated with loss of consciousness, stupor or confusion?
brain concussions
Intracranial hemorrhage
epidural hematoma
brain contusions
15
Cushing's reflex is a compensatory measure to decrease CPP
True
False
16
which test requires a tunning fork to be placed on the mastoid bone and then in front where normally AC>BC
whisper test
Weber
rhomberg
rinne
17
What is the major neurotransmitter of the PNS?
Dopamine
Gaba
ACH
Epinephrine
18
what decrease the production of aqueous humor and systemic effects could be observed (bradycardia/hypoTN)?
Valsartan
pilocarpine
diamox
timolol
19
What must be reperfused quickly or the area of infarction will enlarge
amygdyla region
Pneumbra region
Frontal region
parietal region
20
What is the route of administration to avoid for a patient who is thrombocytopenic?
Oral
IV
rectal
Subcutaneous
21
remove eye prosthesis by havng the client look upwards while the 4finger is pressng in down & to the side of low eye lid
True
False
22
Chest pain, cough, dyspnea, hypoxemia, tachycardia, tachypnea, petechiae and restlessness are all signs of what?
MI
PE
DVT
DIC
23
what increases the risk for retinal artery/vein occlusion, and loss of vision
diabtes, glaucoma, aging
HTN, arteriosclerosis
Red and blue are answers
none are answers
24
make sure the weights hang freely during traction
False
True
25
Avoid actions that contribute to straining (restraints) in the setting of a head injury?
False
True
26
changes in pituitary function is an indication of?
autonomic dysreflexia
brain tumor
MI
spinal shock
27
To prevent hepatoxicity, what is the recommend dosage not to exceed?
2000 mg/day
4000 mg/day
3400 mg/day
4500 mg/day
28
What are the effects of applying heat to a transdermal patch? Select All
Increase absorption
lethal complications
decrease absorption
nothing will happen
29
When would you administer medication for post-op pain?
When the patient wakes from a nap
when the patient is in pain
when instructed by the patient's caregiver
Around the clock
30
acute severe headache with loss of consciousness, nuchal rigidity and visual disturbances could suggest?
Cerebral aneurysm
DI
MI
CVA
31
what is contraindicated in the setting of asthma, COPD, Heart failure since bronchodilation is inhibited?
Diuretic
Ace inhibitor
Beta-Blockers
Calcium Chanel Blockers
32
which medical staff would help identify devices to maintain self-are independence?
RN
respiratory therapist
physician
Occupational therapist
33
How would you assess cognitive function and damage to the cortex?
MRI
CT scan
perform serial 7's
perform rule of 9's
34
Increased perfusion pressure/bleeding into subarachnoid space or brain tissue contribute to cerebral tissue anoxia
False
True
35
why is a patient unable to sweat?
malfunction of the hypotalumus
developmental delay
blockage of sympathetic activity
Sebaceous glands are blocked
36
why would you provide fluids in IV contrast?
risk for dehydration
maintain adequate hydration
to decrease risk for hypovolemia
renal clearance of agent
37
what is used to decrease agitation in head injury that has a rapid onset, short acting, allows accurate neuro assessment
Propofol(Diprivan)
Sumatriptin(Triptan)
Dexamethasone(Decadron)
Mannitol
38
Stimulation of the SNS results in?
shunting of blood to the kidneys
bradycardia
drowsiness
Pupil dilation
39
A nurse is performing a head to toe assessment. The nurse to shine the light for pupil reactions. which CN is assessed?
CN III
CN IV
CN II
CN I
40
which is one of the cardinal signs of parkinsons?
resting tremors
rigidity
postural instability
all are cardinal signs
41
what interventions would the nurse use as safety measures with a visually impaired client
using clock method while ambulating
keeping objects far
have client hold are about shoulder
hold arm and walk one step behind
42
avoid caffeine, monsodium glutamate, aspirin in the presence of Meniere's
False
True
43
A patient presents with spinal cord injury, flaccid paralysis and atrophy occur; which would be the cause?
damage to lower motor neurons
Upper motor neuron is stimulated
decrease in dopamine
damage to upper motor neuron
44
In the event of a carotid endaterectomy, what could hypotension and hypertension cause?
+4 DTR/lower motor neuron dysfunction
cerebral ischemia/cerebral hemorrhage
increased perfusion/decreased pulse
CSF leakage, ICP
45
to help client compensate for homonymous hemianopsia by encouraging them to look in direction of loss
True
False
46
What can occur following a head injury due to a decrease in gastric motility? Select All
severe abdominal pain
aspiration
diarrhea
regurgitation
47
What would the nurse do after assessing a patient with with a head injury with an absent gag reflex?
provide enteral feeding
Provide oral feeding
feeding through NG tube
provide parenteral feeding
48
conditions that can increase IOP could?
all answers are correct
lead to blindess
damage the optic nerve
impair blood flow to the retina
49
a nurse asked a patient to turn his head to the side. What CN is being assessed?
CN V
CN VII
CN XI
CN II
50
patient presents with progressive muscle weakness, atrophy, fatigue, hyperactive DTR, spasticity
Multiple Sclerosis
Parkinsons
Myasthenias Gravis
Amyotrophic Lateral Sclerosis
51
How would you prevent a DVT and pulmonary embolism? Select all
nsaids
warfarin
acetamenophin
anticoagulants
52
maintain the head of bed at 30-45 deg. for 3 hrs post myelogram and note any signs of meningitis
True
False
53
client will keep items in the field of vision & approach the client from same side to compensate 4 hemonymus hemianopsia
False
True
54
instill opthalmics: remove contact lens, hold lower lid down, instill eye drops before ointment
False
True
55
what sign of increased intracranial pressure is triggered by a significant decreased in cerebral perfusion?
constricting pulse pressure, tachycardia, hypotension
widening pulse pressure, bradycardia, hypertension
widening pulse pressure, bradycardia, hypotension
constricting pulse pressure, tachycardia, hypertension
56
how long does symptoms last from a resulting transient ischemic attack?
45 mins
30 min
60 min
90 min
57
What effect does NSAIDS have in relation to ? Select All
Can cause stroke
Renal failure
can cause Myocardial Infarction
Gastric Ulcers
58
which can impair pupil dilation?
tamulosin(Flomax)
timolol
brimonidine
acetazolamide(diamox)
59
what is a clinical manifestation of upper motor neuron injury?
flaccid
spinal injury
stiffness
atrophy
60
The nurse is assessing swallowing. What cranial nerve would you expect to assess?
CN III
CN X
CN XII
CN IX
61
with weber test, sound is heard better in the unaffected ear with sensorineural deafness.
True
False
62
In the setting of cerebral injury, abnormal posturing followed by what, is a sign of what neurologic impairment?
flaccidity
rigidity
stiffness
spasms
63
What increases the risk for deep vein thrombosis and pulmonary embolism? Select All
pregnancy
immobility
clotting disorders
cancer
64
what results from a noxious stimuli(full bladder, rectum, or pain) following the resolution of spinal shock?
Neuroleptic Malignant Syndrome
Neurogenic shock
Autonomic Dysreflexia
Spinal Edema
65
what position would the nurse place the client following a pneumatic retinopexy
semi-fowler
left lateral recumbent
supine
prone
66
If contrast is used, what must the nurse note prior to cerebral angiography?
HR and BP
Renal function and Pulses
BUN and Creatinine
The procedure doesn't require a prior note
67
marked by the unilateral otalgia, fever, hearing loss, bulging red tmypanic membrane or ottorhea
acute otitis media
narrowed angle glaucoma
chronic otitis media
external otitis media
68
How would you administer pain medication?
starting with the lowest dose and titrating up fast
starting with the highest dose and titrating down
start with high dose to relieve pain immediately
starting with the lowest dose and titrating up slowly
69
to prevent adduction, where is a pillow placed? elevate the distal extremity where to promote venous return
above shoulder/brachial
none are answers
under head/blow shoulder
axilla/above shoulder
70
What initiate inflammation and contribute to tissue swelling and pain?
Chronic Injury
Stress
Acute Injury
prostaglandins
71
TPA can cause hemorrhage if bp is too high/client is taking warfarin/received heparin in last 48hrs/<100,000 Platlt cnt
False
True
72
Acetazolamide(diamox) has diuretic effects and contains sulfa; monitor electrolytes and avoid with sulfa allergies
True
False
73
What would you provide for moderate pain?
Atorvastatin
Tylenol
Ibuprofen
carbidopa Levadopa
74
results in aphasia, slow cautious behavior and altered intellectual ability
right hemispheric stroke
left hemispheric stroke
frontal stroke
occipital stroke
75
What is the single most reliable indicator of pain?
Part of body that' s injured
Patient's Self-Report
Nurse
Family member
76
Spasticity is associated with the inability to perspire below the level of the injury?
False
True
77
what are signs of subarachnoid hemmorhage?
decreased LOC
old focal deficits
decreased Pain
none are answers
78
what is necessary for cerebral perfusion
blood pressure
Intact vessel
all are answers
adequate Cardiac output
79
Chest pain, cough, dyspnea, hypoxemia, tachycardia, tachypnea, petechiae and restlessness are signs of:
DVT
CVA
PE
MI
80
what medication is used to treat vertigo?
predinsolone
modafinil
meclizine (Antivert)
tamulosin
81
when would you apply heat to a transdermal patch?
never
bedtime
Mornings
afternoon
82
weakness to one side of the body ,dysarthria, and facial symmetry are signs of?
Heart Attack
ICP
iincreased cerebral perfusion
Brain attack
83
Nerve route injury could lead to allodynia?
True
False
84
How would you assess cranial nerve VIII?
Perform Audiogram
check for cerumen
Perform ROM test
Perform whisper test
85
damage that results in central vision loss
glaucoma
retina detachment
macular degenration
cataracts
86
what action does acetylcholine have on the heart?
produces asystole
produces tachycaria
produces arrythmias
produces bradycardia
87
defined as the loss of transparency to the eye lens and results in blurry vision, decr visual acuity, & senst. to glare
cataracts
glaucoma
CNIII
prosthesis
88
which increases the risk of hearing loss?
perforation of tympanic membrane
All are answers
aminoglycosides, loop diuretics
frequent ear infections, chronic exoposure to loud noise
89
Subdural hematomas in the setting of brain tissue atrophy allows for Symptoms to develop over weeks to months
True
False
90
What are the characteristics of Neuroleptic Malignant Syndrome?
High fever, stupor, rigidity
mild fever, rigidity, stupor
Low Fever, Rigidity, coma
Rigidity, coma, no fever
91
what scale is used to assess changes in LOC to rapidly identify early signs of ICP, motor, eye and verbal response?
DTR
Glascow
Mental
92
what are risk reduction strategies for cataracts?
All are answers
optimizing blood sugars
Using sunglasses outdoors
Reducing weight , smoking cessatation
93
AKA pupillar block glaucoma which is a quick rise in IOP and indicates a medical emergency
open angle glaucoma
Chronic angle closure
closed angle glaucoma
Acute Angle Closure
94
immobility increases the risk for? Select All
DIC, Thrombophlebitis
constipation and DVT
Pneumonia, decubiti
borborigmy, restlessness
95
pain, decreasing vision, eyelid redness or edema, and or yellowish/green discharge from eye following cataract symbolize
ICP
irritation of macula
papillaedma
infection
96
what disorders results in dysphagia, difficulty speaking and an increased risk for aspiration
Guillain Barr, encephalitis
MS, ALS
Parkinsons, Alzheimers
ALS, myasthenia gravis
97
crackling/ popping sound in the ear w/temp. hearing loss of hearing after midd. ear surg. how would the nurse respond?
call provider immediately
get crash cart
perform hearing assessment
inform client it's normal
98
What is the position and time frame a patient needs to lay if more than 20mL of CSF is removed?
4 hrs. Trendelenberg
2 hrs side-lying
1 hr Semi Fowlers
6hrs prone
99
What would be the time frame changes in LOC to occur when referring to subdural hematomas?
12-24hrs
36hrs
48-72hrs
24-48hrs
100
why are tetra/paraplegic patients provided ROM exercise at least 4 times a day?
to prevent arthritis and gout
to prevent osteoporosis
to prevent muscle wasting and manage pain
to prevent contractures and disuse syndrome
101
floaters, flashing lights, decrease in vision, curtain covering a portion of one eye are signs of retinal detachment
False
True
102
what would increase intracranial pressure that causes shivering?
water
sweaters
cooling blankets
comforters
103
A 4+ deep tendon reflex with sustained clonus always indicate?
PNS Impairment
SNS impairment
CNS impairment
Normal reaction
104
unilateral pupil dilation and a poor response to light suggest increased pressure to the 3rd cranial nerve.
True
False
105
During which would bowel and bladder activity stop below the level of injury and muscles become flaccid and paralyzed?
Ischemic Stroke
Hemorrhagic Stroke
Spinal Shock
Autonomic dysreflexia
106
increases risk for retinal detachment?
severe myopia
severe hyperopia
mild hyperopia
presbyopia
107
what puts a client at risk for meningitis?
subdural tear
pia tear
dural tear
arachnoid tear
108
what would you use to promote venous return and reduce the risk for deep vein thrombosis?
elevation of the legs
10 mL of oxygen with Venturi Mask
anti-embolism stockings
pneumatic compression device
109
How does NSAIDS primarily produce relief of pain?
chemical balance
Nerve endings
synapses
prostaglandins
110
what else can occur following an epidural hematoma; arterial hemmorhage and ?
Hypertension
Respiratory Arrest
CVA
Myocardial Infarct
111
Treatment of brain injury focuses on?
prevetion of primary injuries
prevention of secondary injuries
diagnosis
management of diabetes
112
Undersecretion of antidiuretic hormone results in?
hypokalemia and elevated serum osolality,
hypernatremia and elevated serum osmolality
elevated serum osmolality and hyponatremia
Hypernatremia, decreased serum osmolality
113
cognitive impairments following a head injury include what? Select All
memory improvement
auditory deficit
memory deficit
difficulty processing information
114
what test assess hearing loss where sound is heard better in affected ear with conductive deafness?
weber
whisper test
rhinne
rhomberg
115
Following a spinal cord injury, how would you position the patient?
semi-fowlers
on the left side
extended and flat
on stomach
116
what are the classic signs of meniere's
Vertigo, tinnitus, hearing loss
hearing loss, bleeding, foreign body
vertigo, pruritis, hyperemia
tinnitus, ear infection, drainage from ear
117
patient complains of lightheadedness, loss of balance, nausea and vomiting and states the world is moving. what is cause
hyponatremia
dizziness
dehydration
veritgo
118
A 3+ deep tendon reflex with sustained clonus always indicates CNS impairment.
True
False
119
what connects nasopharynx to the middle ear and opens with yawning, swallowing or the valsalva maneuver?
tympanic membrane
eustachian tune
ossicle bone
humorous
120
An excessive increase in antidiiuretic hormone (vasopressin) will result in?
hypokalemia
Hyperkalemia
hypernatremia
hyponatremia
121
what intervention would the nurse perform after a cervical diskectomy?
keep neck in neutral position
put pillow under patients head
place in prone position
place in high fowler
122
what inhibits the inflammatory response, suppress adrenal gland activity, hypernatremia, hypokalemia, mask infect,
corticosteroids
diphenydramine
opiods
NSAIDS
123
lowering BP too quickly could result in ischemia to the optic disc and brain
False
True
124
what medication produce undesirable effects such as constipation, nausea, pupil constriction and respiratory depression?
Opiods
antipyretics
antiemetics
adrenergics
125
a patient presents with blurred vision, difficulty focusing, and decrease peripheral vision?
retinal tear
macular degeneration
glaucoma
cataracts
126
What increases metabolic demands and could suggest damage to the brain stem in the setting of a head injury?
hypokalemia
hyperthermia
hypothermia
hypotension
127
apply gentle pressure 2 inner canthus to occlude the punctum 4 how long? how long to wait before instilling another med
1 min/ 10 min
5 min/ immediately after
2-4 min/ 5 min
1-2 min./ 5 min
128
broca is on the left side of the brain in which anoxia can contribute to?
aphasia
aphagia
dysphagia
dysarthria
129
What signs are causes of pain that stimulate the sympathetic nervous system?
Increase HR, Decrease BP, Decrease respirations
Increase BP, decrease HR, Increase respirations
Increase respirations, increase BP, increase HR
decrease HR, decrease respirations, decrease BP
130
what type of infection can occur following cataract surgery
conjuctiva
papillaedema
cyst
endophthalmitis
131
How would you treat a patient who presents with Autonomic Dysreflexia? Select All
place patient in upright position, Educ. about risk after injury abouve T6
insert foley, remove painful stimuli, manual disimpaction
explain to patient about the use of assistive devices
adminster hydralazine to lower BP
132
extreme hypertension, headache, diaphoresis above lesion, nasal congestion bradycardia
Spinal Shock
Cushings reflex
Neuroleptic Malignant Syndrome
Autonomic Dysreflexia
133
which medical staff would help to promote safe transfers and ambulation while reducing neck pain?
Occupational Therapist
Physical therapist
RN
UAP
134
what assessment is required to performe corneal and gag reflex, pupillary response to light and response to pain?
neurological assessment
mini mental
Glascow coma
complete head to toe
135
what neurotransmitters have excitatory effects that results in peripheral vasoconstriction?
serotonin
endorphins
Norepinephrine
Acetylcholine
136
what is the single most important diagnostic test done for testing loss
weber test
audiogram
rhinne test
audiometry
137
impaired gag reflex decrease the risk of aspiration
False
True
138
Which cranial nerve would be assessed in the use of a snellen chart to determine visual disturbances?
CN IV
CN II
CN VII
CN X
139
Signs of head injury that's worsening includes changes in loc, worsening headache, irritability, vomiting..? select all
hypercapnia
slurred speech
weakness
abnormal pupil response
140
how would you detect macular degeneration?
ottoscope
amsler grid
opthalmoscope
tonometry
141
What would you monitor closely following a carotid endartectomy?
o2 Sat
Blood pressure
Heart rate
Pulse
142
what medication could result in tarry stools(GI hemorrhage)?
anticuonvulsants
opiods
corticosteroids
anticholinergics
143
what can lead to conduction in hearing loss?
foreign bodies
otosclerosis
menieres
middle ear infection
144
remove wax using warm water (cold stimulates vomiting) and a gentle irrigation in order to avoid perforating tymp memb.
True
False
145
which cranial nerve has fibers that crossover from left to right before sending impulses to the occipital lobe?
CN IV
CN II
CN VI
CNIII
146
What would the nurse note after assessing cranial nerve III, IV, and VI?
myopia
Strabismus
cataracts
nystagmus
147
How would you a patient in the setting of spinal shock?
pain management and stabilization
Iv fluids and pain management
intestinal decompression and intermitten/indwelling catheter
straight catheter and stabilization
148
A client presents with a CSF leaks from the nose and ears indicate what kind of skull fracture?
occipital
temporal
frontal
basilar
149
In cerebral Vascular Accident, neurons control voluntary movement crossover where and Affect which side of the body?
medulla and opposite side
pons and opposite side
medulla and same side
Pons and same side
150
what decreases cerebral perfusion pressure and leads to cerebral anoxia and tissue death?
increased intracranial pressure
increasedC SF
problematic amygdala
decreased intracranial pressure
151
What intervention would the nurse perform after the use of IV contrast?
Check heart rate
provide oxygen
provide fluids to facilitate renal clearance
Check blood pressure
152
What are the causes of unrelieved pain? Select All
decrease glucagon ,increase insulin secretion, depress immune function
Increase glucagon, decrease insulin secretion, depress immune function
increase glucagon, increase insulin secretion, stimulate immune function
can lead to addictive behavior
153
How would you assess cranial nerve III, IV, and VI?
have patient raise eyebrows
have patient close eyes
have the patient follow an object through all the fields of vision
shine light to into patients eyes
154
what instructions you give to a new nurse who is getting ready to administer a placebo?
administer daily
Administer Subq. b.i.d. 2hrs
never administer a placebo
administer IV q. 4hrs
155
use hand roll if the client has spasticity to the upper extremity
True
False
156
face the individual who speech reads, communicate in a well lit room w/o obscuring your face &inform the client of topic
False
True
157
Which cranial nerve dysfunction increase the risk for aspiration?
III and IV
VIII and IX
IX and X
IV and V
158
which would you avoid using while irrigating foreign bodies in the ear canal that swell
water
mineral oil
159
what is the rationale for elevating HOB 30 deg. when reducing increased intracranial pressure?
to promote venous outflow from the brain
to prevent coughing on secretions
to keep patient from getting a headache
to maintain ventilation
160
flexor muscles are stronger than extensor muscles so the risk for flexion contractures?
none are answers
decrease when voluntary muscle control is lost
spasms when voluntary muscle control is lost
Increase when voluntary muscle control is lost
161
What word defines the inability to communicate verbally
Aphasia
Aphagia
Dysphagia
Dyslexia
162
What undesirable effects does opioids produce? Select All
pupil constriction
Nausea
constipation
respiratory depression
163
What would be contraindicated in the use of contrast medium?
allergies to iodine, shellfish, seafood
pregnant
Decreased creatinine
increase creatinine
164
Cervical dis herniation is typically accompanied by? Select All
Stiffness
parasthesias
pain
decreased visual acuity
165
What effect does serotonin has?
Excitatory
Inhibitory
166
what is the cardinal sign of spinal cord tumors?
headaches
pain
vertigo
chronic fatigue
167
bilateral pupil dilation suggests brain stem injury?
False
True
168
in which is central blood flow obstructed, the cells switch to anaerobic resp., ATP decreases, neurons lose function
Hemorrhagic Stroke
PE
MI
Ischemic Stroke
169
Pain is associated with what kind of tissue damage?
actual
none of the above
actual and potential
potential
170
which term defines pain to area that doesn't normally trigger pain response; associated with nonnoxious stimuli?
kinesia
ataxia
cachexia
allodynia
171
how would you help prevent ischemia?
keep patient in supine
keep head of the bed elevated 50 degrees
maintain gas exchange
maintain ICP 0-10
172
What effect does dopamine has?
Excitatory
Inhibitory
173
Catecholamines are found in the sympathetic Nervous System
False
True
174
Renal and pulses must be noted prior to which diagnostic test due to contrast medium being used?
CT
MRI
Cerebral angiography
Tensilon
175
Contrast medium is?
performed in patients with allergies
hepatotoxic
not harmful
nephrotoxic
176
How would you manage neuropathic pain? Select All
anticonvulsants
Haldol
benzodiazapine
antidepressants
177
a decrease in which neurotransmitter impairs voluntary movement?
ACH
dopamine
Serotonin
GABA
178
whistling is absent if the hearing aid isn't installed correctly?
False
True
179
what med increases the outflow of the aqueous humor by constricting the pupil and make it hard to see in the dark?
antibiotics(amoxicillan)
cycloplegic (cyclopentolate)
mydriatic(atropine)
Myotics(piocarpine)
180
what is the range of IOP that is determined by the amount of aqueous humor that is produced and drained?
10-15
10-21
5-10
50-100
181
What is the major neurotransmitter for the sympathetic nervous system?
ACH
Norepinephrine
Dopamine
GABA
182
Which drug does not have anti-inflammatory properties?
Aspirin
Acetaminophen
Ibuprofen
Diphahydramine
183
marked by deficits in depth perception, impulsive behavior, increased distractibility, lack/awareness of deficits
left hemispheric stroke
occipital stroke
right hemispheric stroke
frontal stroke
184
When is TPA given? which stroke is it giving for?
within 24 hrs; ischemic
within 60 min; ischemic
within 30 min; Ischemic
2 hours; hemorrhagic
185
What are harmful effects could be caused by use of corticosteroids
All could be a cause
hyperglycemia
Hypertention
sodium retention
186
blurry vision, stinging and burning are complications of
cataracts
lasik surgery
glaucoma
administration of ocular ointment
187
what measures IOP and screens for glaucoma?
retinoscope
tonometry
opthalmoscope
phoropter
188
Which neurotransmitter are excitatory and inhibit pain sensation?
Endorphins
Dopamine
ACH
Epinephrine
189
apply trochanter rolls to immobile patients to prevent internal rotation
False
True
190
what would the nurse inspect when administering enteral feedings to a client with dysphagia?
make sure the client is clear of secretions
make sure to hyperoxygenate
make sure cuff of trache tube inflated
make sure client has water
191
To avoid lumbar headache, what position must the patient be placed in?
semi fowler
high fowler
Prone 6 hrs more than 20ml CSF
Lateral recumbent
192
high cervial injuries above, which, that injure the phrenic nerve are a leading cause of death from Acute Resp. fail.?
C5
C7
C4
C3
193
How would you asses cranial nerve XI?
Have patient stand still with eyes closed
have patient shrug shoulders
have patient say ah
have patient raise both legs
194
What are non pharmacological pain management? select all
biologic and energy based therapies
massage
tylenol
physical modalities
195
What would you use to prevent footdrops and how long?
splint; q 4hrs
splint; q 2hrs
splint q 30 min
Boot q. 4hrs
196
what is the goal to prevent a secondary injury (hypoxia, ischemia) to the cord following a spinal injury?
maintain adequate tissue perfusion
maintain high partial pressure of aterial oxygen
maintain stabilized vital signs
maintain 100% oxygen Sat on room air
197
What would you as the nurse, teach the client to limit?
potasium
Sodium
calcium
fats
198
When is the National Institutes of Health Stroke Scale is used?
to determined severity before ct scan
to determine severity after administering t-PA
to determine severity after stoke has occured
to determine stroke before administering t-PA
199
what neurotransmitter affects behavior and fine movement?
serotonin
Dopamine
Epinephrine
ACH
200
How can you prevent irreversible nerologic damage?
maintain cerebral perfusion pressure below 30mm HG
maintain cerebral perfusion pressure at exactly 50mm Hg
maintain cerebral perfusion pressure above 50mm Hg
mantain cerebral perfusion pressure below 50mm Hg
201
What is the initial diagnostic test for a stroke?
CT w/ contrast
MRI w/o Contrast
MRI w/ contrast
CT w/o Contrast
202
Prostaglandin isn't needed for renal blood flow?
True
False
203
teach client to use a dryer on low heat(dry external canal) alcohol drops (infection) avoid use of foreign objects
Chronic otitis
Acute otitis
otitis externa
meinier's
204
Damage to which portion of the brain may result in an increased temperature?
pons
Parietal lobe
frontal lobe
Hypothalamus
205
a small gauge needle is used and a pt. is placed in prone after procedure to avoid what?
post cervical headache
Post Thoracic headache
pressure in the sacrum
Post lumbar headache
206
Air conduction is < Bone Conduction warrants a positive rinne test
False
True
207
what is the gold standard for brain tumor diagnostic?
MRI
CT w-w/o contrast
PET
SPECT
208
which actions would you avoid after eye surgery?
reading, watching tv, vacuuming
bending and stooping over short period of time
lifting, pushing or pulling objects > 2lbs
light activity
209
what medication helps to reduce fluid in the brain
Osmotic diuretic (mannitol)
Triptans(sumatriptan)
Histamine 2 receptor blockers
Corticosteroids (dexamethasone)
210
How would you manage nociceptive pain? Select All
opiods
nonopiods
Local anesthetics
steroids
211
what results in hypotension, bradycardia and a decrease in cardiac output which could lead to death?
Neurogenic Shock
SIADH
Neuroleptic Malignant Syndrome
Diabetes Insipidus
212
what may occur when blood pressure is sever in setting of Acute renal Failure, gestational HTN, pheochromocytoma
Myocardial infarction
Hemorrhagic Stroke
retinopathy
Macular degenration
213
when should you remove impaired object
completely after incident
2 hours after incident
never
4 hours after incident
214
the signs of meningitis includes headache, nuchal rigidity, photophobia, seizures, and fever)
False
True
215
accompanied by periocular pain, conjunctival hyperemia, and a fixed and semidilated pupil
Acute angle glaucoma
open angle glaucoma
narrow angle glaucoma
closed angle glaucoma
216
what could suggest hyperperfusion syndrom following a carotid endarterectomy?
bilateral pupil dilation
headache while resting
low blood pressure upon standing
unilateral headache that improves upon sitting or standing
217
bradycardia increased systolic pressure and a widening pulse pressure are signs of?
Neurogenic Shock
cushing's reflex
cushington's disease
Neuroleptic Malignant Syndrome
218
what are clinical manifestations of vertigo?
increased dizziness
headache
spinning sensation(you moving)
Spinning sensation(world moving)
219
What would you provide for mild to moderate pain?
aspirin or hydrocodone
tylenol or meloxicam
acetaminophen or aspirin
naproxen
220
alpha-adrenergic agonist(brimonidine) and carbonic anyhdrase inhibitors(acetazolamide)
decrease aqueous humor
increase aqueous humor
constricts the pupils
dilate pupils
221
what would be the reason a constant supply of oxygen and glucose is needed?
Cerebral cells aren't able to provide significant amounts
Type I diabetic
neurotransmitter ACH is being blocked
tissue in the brain hypertrophies
222
avoid massaging the calf or thing since this could lead to thrombus dislodgement
True
False
223
Hormonal dysfunction in the setting of a brain injury could lead to electrolyte and fluid volume disturbance?
True
False
224
how long would you place a recovering stroke client in prone position to prevent hip flexion?
30 min. several times a day
every 2 hours
15 mins several times a day
every 4 hours

MSII Flashcards | StudBud

MSII

224 termsStudBud Administration15 plays

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Questions 224

Answers

1
Most hemorrhagic strokes are due to?
ICP
decreased heart rate
HypoTN
HTN
2
How often would you turn a patient and reposition when in chair?
turn q3hrs; chair q2hrs
turn q2hrs; chair q2hrs
turn q2hrs; chair q1hrs.
turn q 4 hrs; chair q1hrs
3
A patient has belpasy. what cranial nerve would be affected?
IX
VII
V
VI
4
assess. findings uniqe to hemorrhagic strokes are vomiting, quicker changes in LOC, poss. focal seziures w/brain stem
False
True
5
what could trigger vasodilation and result in an increased intracranial pressure.
high perfusion pressure
high cerebral perfusion pressure
decrease platelets
decrease in cerebral perfusion
6
What is marked by conjunctival hyperemia, lid edema, ptosis, foreign body sensation & watery discharge
none are answers
bacterial conjuctivitis
viral conjunctivitis
fungal conjunctivitis
7
what are the three signs of brain death?
glascow score of 9, coma, tachycardia
mental eval score of 24, ALS, anoxia
no ECG activity, dyspnea, decreased respirations
coma, apnea, absence of brain stem reflexes
8
What cranial Nerves would you monitor following neck surgery
X ,V, II
X, XI, XII
II, III, I
X, IV, v
9
A nurse touched a patient's face with a sharp or dull object. what cranial nerve is being assessed?
CN IV
CN III
CN VII
CN V
10
in the setting of a head injury, what manifestations typically suggest a poorer prognosis? select All
Joint extension
lack of motor response
Decrease ICP
joint flexion
11
A nurse instructs the client to stick the tongue out and say Ah. What Cranial Nerve would the nurse assess?
CN XII
CN III
CN X
CN V
12
what position would you maintain to administer tube feedings and for at least an hour post feeding?
Semi-fowler
prone
High fowler
supine
13
A patient was provided analgesics 10 min ago and still complains of pain. which is best to describe the patient's pain?
Addiction
tolerance
drug seeking
psychological dependence
14
What are associated with loss of consciousness, stupor or confusion?
brain concussions
Intracranial hemorrhage
epidural hematoma
brain contusions
15
Cushing's reflex is a compensatory measure to decrease CPP
True
False
16
which test requires a tunning fork to be placed on the mastoid bone and then in front where normally AC>BC
whisper test
Weber
rhomberg
rinne
17
What is the major neurotransmitter of the PNS?
Dopamine
Gaba
ACH
Epinephrine
18
what decrease the production of aqueous humor and systemic effects could be observed (bradycardia/hypoTN)?
Valsartan
pilocarpine
diamox
timolol
19
What must be reperfused quickly or the area of infarction will enlarge
amygdyla region
Pneumbra region
Frontal region
parietal region
20
What is the route of administration to avoid for a patient who is thrombocytopenic?
Oral
IV
rectal
Subcutaneous
21
remove eye prosthesis by havng the client look upwards while the 4finger is pressng in down & to the side of low eye lid
True
False
22
Chest pain, cough, dyspnea, hypoxemia, tachycardia, tachypnea, petechiae and restlessness are all signs of what?
MI
PE
DVT
DIC
23
what increases the risk for retinal artery/vein occlusion, and loss of vision
diabtes, glaucoma, aging
HTN, arteriosclerosis
Red and blue are answers
none are answers
24
make sure the weights hang freely during traction
False
True
25
Avoid actions that contribute to straining (restraints) in the setting of a head injury?
False
True
26
changes in pituitary function is an indication of?
autonomic dysreflexia
brain tumor
MI
spinal shock
27
To prevent hepatoxicity, what is the recommend dosage not to exceed?
2000 mg/day
4000 mg/day
3400 mg/day
4500 mg/day
28
What are the effects of applying heat to a transdermal patch? Select All
Increase absorption
lethal complications
decrease absorption
nothing will happen
29
When would you administer medication for post-op pain?
When the patient wakes from a nap
when the patient is in pain
when instructed by the patient's caregiver
Around the clock
30
acute severe headache with loss of consciousness, nuchal rigidity and visual disturbances could suggest?
Cerebral aneurysm
DI
MI
CVA
31
what is contraindicated in the setting of asthma, COPD, Heart failure since bronchodilation is inhibited?
Diuretic
Ace inhibitor
Beta-Blockers
Calcium Chanel Blockers
32
which medical staff would help identify devices to maintain self-are independence?
RN
respiratory therapist
physician
Occupational therapist
33
How would you assess cognitive function and damage to the cortex?
MRI
CT scan
perform serial 7's
perform rule of 9's
34
Increased perfusion pressure/bleeding into subarachnoid space or brain tissue contribute to cerebral tissue anoxia
False
True
35
why is a patient unable to sweat?
malfunction of the hypotalumus
developmental delay
blockage of sympathetic activity
Sebaceous glands are blocked
36
why would you provide fluids in IV contrast?
risk for dehydration
maintain adequate hydration
to decrease risk for hypovolemia
renal clearance of agent
37
what is used to decrease agitation in head injury that has a rapid onset, short acting, allows accurate neuro assessment
Propofol(Diprivan)
Sumatriptin(Triptan)
Dexamethasone(Decadron)
Mannitol
38
Stimulation of the SNS results in?
shunting of blood to the kidneys
bradycardia
drowsiness
Pupil dilation
39
A nurse is performing a head to toe assessment. The nurse to shine the light for pupil reactions. which CN is assessed?
CN III
CN IV
CN II
CN I
40
which is one of the cardinal signs of parkinsons?
resting tremors
rigidity
postural instability
all are cardinal signs
41
what interventions would the nurse use as safety measures with a visually impaired client
using clock method while ambulating
keeping objects far
have client hold are about shoulder
hold arm and walk one step behind
42
avoid caffeine, monsodium glutamate, aspirin in the presence of Meniere's
False
True
43
A patient presents with spinal cord injury, flaccid paralysis and atrophy occur; which would be the cause?
damage to lower motor neurons
Upper motor neuron is stimulated
decrease in dopamine
damage to upper motor neuron
44
In the event of a carotid endaterectomy, what could hypotension and hypertension cause?
+4 DTR/lower motor neuron dysfunction
cerebral ischemia/cerebral hemorrhage
increased perfusion/decreased pulse
CSF leakage, ICP
45
to help client compensate for homonymous hemianopsia by encouraging them to look in direction of loss
True
False
46
What can occur following a head injury due to a decrease in gastric motility? Select All
severe abdominal pain
aspiration
diarrhea
regurgitation
47
What would the nurse do after assessing a patient with with a head injury with an absent gag reflex?
provide enteral feeding
Provide oral feeding
feeding through NG tube
provide parenteral feeding
48
conditions that can increase IOP could?
all answers are correct
lead to blindess
damage the optic nerve
impair blood flow to the retina
49
a nurse asked a patient to turn his head to the side. What CN is being assessed?
CN V
CN VII
CN XI
CN II
50
patient presents with progressive muscle weakness, atrophy, fatigue, hyperactive DTR, spasticity
Multiple Sclerosis
Parkinsons
Myasthenias Gravis
Amyotrophic Lateral Sclerosis
51
How would you prevent a DVT and pulmonary embolism? Select all
nsaids
warfarin
acetamenophin
anticoagulants
52
maintain the head of bed at 30-45 deg. for 3 hrs post myelogram and note any signs of meningitis
True
False
53
client will keep items in the field of vision & approach the client from same side to compensate 4 hemonymus hemianopsia
False
True
54
instill opthalmics: remove contact lens, hold lower lid down, instill eye drops before ointment
False
True
55
what sign of increased intracranial pressure is triggered by a significant decreased in cerebral perfusion?
constricting pulse pressure, tachycardia, hypotension
widening pulse pressure, bradycardia, hypertension
widening pulse pressure, bradycardia, hypotension
constricting pulse pressure, tachycardia, hypertension
56
how long does symptoms last from a resulting transient ischemic attack?
45 mins
30 min
60 min
90 min
57
What effect does NSAIDS have in relation to ? Select All
Can cause stroke
Renal failure
can cause Myocardial Infarction
Gastric Ulcers
58
which can impair pupil dilation?
tamulosin(Flomax)
timolol
brimonidine
acetazolamide(diamox)
59
what is a clinical manifestation of upper motor neuron injury?
flaccid
spinal injury
stiffness
atrophy
60
The nurse is assessing swallowing. What cranial nerve would you expect to assess?
CN III
CN X
CN XII
CN IX
61
with weber test, sound is heard better in the unaffected ear with sensorineural deafness.
True
False
62
In the setting of cerebral injury, abnormal posturing followed by what, is a sign of what neurologic impairment?
flaccidity
rigidity
stiffness
spasms
63
What increases the risk for deep vein thrombosis and pulmonary embolism? Select All
pregnancy
immobility
clotting disorders
cancer
64
what results from a noxious stimuli(full bladder, rectum, or pain) following the resolution of spinal shock?
Neuroleptic Malignant Syndrome
Neurogenic shock
Autonomic Dysreflexia
Spinal Edema
65
what position would the nurse place the client following a pneumatic retinopexy
semi-fowler
left lateral recumbent
supine
prone
66
If contrast is used, what must the nurse note prior to cerebral angiography?
HR and BP
Renal function and Pulses
BUN and Creatinine
The procedure doesn't require a prior note
67
marked by the unilateral otalgia, fever, hearing loss, bulging red tmypanic membrane or ottorhea
acute otitis media
narrowed angle glaucoma
chronic otitis media
external otitis media
68
How would you administer pain medication?
starting with the lowest dose and titrating up fast
starting with the highest dose and titrating down
start with high dose to relieve pain immediately
starting with the lowest dose and titrating up slowly
69
to prevent adduction, where is a pillow placed? elevate the distal extremity where to promote venous return
above shoulder/brachial
none are answers
under head/blow shoulder
axilla/above shoulder
70
What initiate inflammation and contribute to tissue swelling and pain?
Chronic Injury
Stress
Acute Injury
prostaglandins
71
TPA can cause hemorrhage if bp is too high/client is taking warfarin/received heparin in last 48hrs/<100,000 Platlt cnt
False
True
72
Acetazolamide(diamox) has diuretic effects and contains sulfa; monitor electrolytes and avoid with sulfa allergies
True
False
73
What would you provide for moderate pain?
Atorvastatin
Tylenol
Ibuprofen
carbidopa Levadopa
74
results in aphasia, slow cautious behavior and altered intellectual ability
right hemispheric stroke
left hemispheric stroke
frontal stroke
occipital stroke
75
What is the single most reliable indicator of pain?
Part of body that' s injured
Patient's Self-Report
Nurse
Family member
76
Spasticity is associated with the inability to perspire below the level of the injury?
False
True
77
what are signs of subarachnoid hemmorhage?
decreased LOC
old focal deficits
decreased Pain
none are answers
78
what is necessary for cerebral perfusion
blood pressure
Intact vessel
all are answers
adequate Cardiac output
79
Chest pain, cough, dyspnea, hypoxemia, tachycardia, tachypnea, petechiae and restlessness are signs of:
DVT
CVA
PE
MI
80
what medication is used to treat vertigo?
predinsolone
modafinil
meclizine (Antivert)
tamulosin
81
when would you apply heat to a transdermal patch?
never
bedtime
Mornings
afternoon
82
weakness to one side of the body ,dysarthria, and facial symmetry are signs of?
Heart Attack
ICP
iincreased cerebral perfusion
Brain attack
83
Nerve route injury could lead to allodynia?
True
False
84
How would you assess cranial nerve VIII?
Perform Audiogram
check for cerumen
Perform ROM test
Perform whisper test
85
damage that results in central vision loss
glaucoma
retina detachment
macular degenration
cataracts
86
what action does acetylcholine have on the heart?
produces asystole
produces tachycaria
produces arrythmias
produces bradycardia
87
defined as the loss of transparency to the eye lens and results in blurry vision, decr visual acuity, & senst. to glare
cataracts
glaucoma
CNIII
prosthesis
88
which increases the risk of hearing loss?
perforation of tympanic membrane
All are answers
aminoglycosides, loop diuretics
frequent ear infections, chronic exoposure to loud noise
89
Subdural hematomas in the setting of brain tissue atrophy allows for Symptoms to develop over weeks to months
True
False
90
What are the characteristics of Neuroleptic Malignant Syndrome?
High fever, stupor, rigidity
mild fever, rigidity, stupor
Low Fever, Rigidity, coma
Rigidity, coma, no fever
91
what scale is used to assess changes in LOC to rapidly identify early signs of ICP, motor, eye and verbal response?
DTR
Glascow
Mental
92
what are risk reduction strategies for cataracts?
All are answers
optimizing blood sugars
Using sunglasses outdoors
Reducing weight , smoking cessatation
93
AKA pupillar block glaucoma which is a quick rise in IOP and indicates a medical emergency
open angle glaucoma
Chronic angle closure
closed angle glaucoma
Acute Angle Closure
94
immobility increases the risk for? Select All
DIC, Thrombophlebitis
constipation and DVT
Pneumonia, decubiti
borborigmy, restlessness
95
pain, decreasing vision, eyelid redness or edema, and or yellowish/green discharge from eye following cataract symbolize
ICP
irritation of macula
papillaedma
infection
96
what disorders results in dysphagia, difficulty speaking and an increased risk for aspiration
Guillain Barr, encephalitis
MS, ALS
Parkinsons, Alzheimers
ALS, myasthenia gravis
97
crackling/ popping sound in the ear w/temp. hearing loss of hearing after midd. ear surg. how would the nurse respond?
call provider immediately
get crash cart
perform hearing assessment
inform client it's normal
98
What is the position and time frame a patient needs to lay if more than 20mL of CSF is removed?
4 hrs. Trendelenberg
2 hrs side-lying
1 hr Semi Fowlers
6hrs prone
99
What would be the time frame changes in LOC to occur when referring to subdural hematomas?
12-24hrs
36hrs
48-72hrs
24-48hrs
100
why are tetra/paraplegic patients provided ROM exercise at least 4 times a day?
to prevent arthritis and gout
to prevent osteoporosis
to prevent muscle wasting and manage pain
to prevent contractures and disuse syndrome
101
floaters, flashing lights, decrease in vision, curtain covering a portion of one eye are signs of retinal detachment
False
True
102
what would increase intracranial pressure that causes shivering?
water
sweaters
cooling blankets
comforters
103
A 4+ deep tendon reflex with sustained clonus always indicate?
PNS Impairment
SNS impairment
CNS impairment
Normal reaction
104
unilateral pupil dilation and a poor response to light suggest increased pressure to the 3rd cranial nerve.
True
False
105
During which would bowel and bladder activity stop below the level of injury and muscles become flaccid and paralyzed?
Ischemic Stroke
Hemorrhagic Stroke
Spinal Shock
Autonomic dysreflexia
106
increases risk for retinal detachment?
severe myopia
severe hyperopia
mild hyperopia
presbyopia
107
what puts a client at risk for meningitis?
subdural tear
pia tear
dural tear
arachnoid tear
108
what would you use to promote venous return and reduce the risk for deep vein thrombosis?
elevation of the legs
10 mL of oxygen with Venturi Mask
anti-embolism stockings
pneumatic compression device
109
How does NSAIDS primarily produce relief of pain?
chemical balance
Nerve endings
synapses
prostaglandins
110
what else can occur following an epidural hematoma; arterial hemmorhage and ?
Hypertension
Respiratory Arrest
CVA
Myocardial Infarct
111
Treatment of brain injury focuses on?
prevetion of primary injuries
prevention of secondary injuries
diagnosis
management of diabetes
112
Undersecretion of antidiuretic hormone results in?
hypokalemia and elevated serum osolality,
hypernatremia and elevated serum osmolality
elevated serum osmolality and hyponatremia
Hypernatremia, decreased serum osmolality
113
cognitive impairments following a head injury include what? Select All
memory improvement
auditory deficit
memory deficit
difficulty processing information
114
what test assess hearing loss where sound is heard better in affected ear with conductive deafness?
weber
whisper test
rhinne
rhomberg
115
Following a spinal cord injury, how would you position the patient?
semi-fowlers
on the left side
extended and flat
on stomach
116
what are the classic signs of meniere's
Vertigo, tinnitus, hearing loss
hearing loss, bleeding, foreign body
vertigo, pruritis, hyperemia
tinnitus, ear infection, drainage from ear
117
patient complains of lightheadedness, loss of balance, nausea and vomiting and states the world is moving. what is cause
hyponatremia
dizziness
dehydration
veritgo
118
A 3+ deep tendon reflex with sustained clonus always indicates CNS impairment.
True
False
119
what connects nasopharynx to the middle ear and opens with yawning, swallowing or the valsalva maneuver?
tympanic membrane
eustachian tune
ossicle bone
humorous
120
An excessive increase in antidiiuretic hormone (vasopressin) will result in?
hypokalemia
Hyperkalemia
hypernatremia
hyponatremia
121
what intervention would the nurse perform after a cervical diskectomy?
keep neck in neutral position
put pillow under patients head
place in prone position
place in high fowler
122
what inhibits the inflammatory response, suppress adrenal gland activity, hypernatremia, hypokalemia, mask infect,
corticosteroids
diphenydramine
opiods
NSAIDS
123
lowering BP too quickly could result in ischemia to the optic disc and brain
False
True
124
what medication produce undesirable effects such as constipation, nausea, pupil constriction and respiratory depression?
Opiods
antipyretics
antiemetics
adrenergics
125
a patient presents with blurred vision, difficulty focusing, and decrease peripheral vision?
retinal tear
macular degeneration
glaucoma
cataracts
126
What increases metabolic demands and could suggest damage to the brain stem in the setting of a head injury?
hypokalemia
hyperthermia
hypothermia
hypotension
127
apply gentle pressure 2 inner canthus to occlude the punctum 4 how long? how long to wait before instilling another med
1 min/ 10 min
5 min/ immediately after
2-4 min/ 5 min
1-2 min./ 5 min
128
broca is on the left side of the brain in which anoxia can contribute to?
aphasia
aphagia
dysphagia
dysarthria
129
What signs are causes of pain that stimulate the sympathetic nervous system?
Increase HR, Decrease BP, Decrease respirations
Increase BP, decrease HR, Increase respirations
Increase respirations, increase BP, increase HR
decrease HR, decrease respirations, decrease BP
130
what type of infection can occur following cataract surgery
conjuctiva
papillaedema
cyst
endophthalmitis
131
How would you treat a patient who presents with Autonomic Dysreflexia? Select All
place patient in upright position, Educ. about risk after injury abouve T6
insert foley, remove painful stimuli, manual disimpaction
explain to patient about the use of assistive devices
adminster hydralazine to lower BP
132
extreme hypertension, headache, diaphoresis above lesion, nasal congestion bradycardia
Spinal Shock
Cushings reflex
Neuroleptic Malignant Syndrome
Autonomic Dysreflexia
133
which medical staff would help to promote safe transfers and ambulation while reducing neck pain?
Occupational Therapist
Physical therapist
RN
UAP
134
what assessment is required to performe corneal and gag reflex, pupillary response to light and response to pain?
neurological assessment
mini mental
Glascow coma
complete head to toe
135
what neurotransmitters have excitatory effects that results in peripheral vasoconstriction?
serotonin
endorphins
Norepinephrine
Acetylcholine
136
what is the single most important diagnostic test done for testing loss
weber test
audiogram
rhinne test
audiometry
137
impaired gag reflex decrease the risk of aspiration
False
True
138
Which cranial nerve would be assessed in the use of a snellen chart to determine visual disturbances?
CN IV
CN II
CN VII
CN X
139
Signs of head injury that's worsening includes changes in loc, worsening headache, irritability, vomiting..? select all
hypercapnia
slurred speech
weakness
abnormal pupil response
140
how would you detect macular degeneration?
ottoscope
amsler grid
opthalmoscope
tonometry
141
What would you monitor closely following a carotid endartectomy?
o2 Sat
Blood pressure
Heart rate
Pulse
142
what medication could result in tarry stools(GI hemorrhage)?
anticuonvulsants
opiods
corticosteroids
anticholinergics
143
what can lead to conduction in hearing loss?
foreign bodies
otosclerosis
menieres
middle ear infection
144
remove wax using warm water (cold stimulates vomiting) and a gentle irrigation in order to avoid perforating tymp memb.
True
False
145
which cranial nerve has fibers that crossover from left to right before sending impulses to the occipital lobe?
CN IV
CN II
CN VI
CNIII
146
What would the nurse note after assessing cranial nerve III, IV, and VI?
myopia
Strabismus
cataracts
nystagmus
147
How would you a patient in the setting of spinal shock?
pain management and stabilization
Iv fluids and pain management
intestinal decompression and intermitten/indwelling catheter
straight catheter and stabilization
148
A client presents with a CSF leaks from the nose and ears indicate what kind of skull fracture?
occipital
temporal
frontal
basilar
149
In cerebral Vascular Accident, neurons control voluntary movement crossover where and Affect which side of the body?
medulla and opposite side
pons and opposite side
medulla and same side
Pons and same side
150
what decreases cerebral perfusion pressure and leads to cerebral anoxia and tissue death?
increased intracranial pressure
increasedC SF
problematic amygdala
decreased intracranial pressure
151
What intervention would the nurse perform after the use of IV contrast?
Check heart rate
provide oxygen
provide fluids to facilitate renal clearance
Check blood pressure
152
What are the causes of unrelieved pain? Select All
decrease glucagon ,increase insulin secretion, depress immune function
Increase glucagon, decrease insulin secretion, depress immune function
increase glucagon, increase insulin secretion, stimulate immune function
can lead to addictive behavior
153
How would you assess cranial nerve III, IV, and VI?
have patient raise eyebrows
have patient close eyes
have the patient follow an object through all the fields of vision
shine light to into patients eyes
154
what instructions you give to a new nurse who is getting ready to administer a placebo?
administer daily
Administer Subq. b.i.d. 2hrs
never administer a placebo
administer IV q. 4hrs
155
use hand roll if the client has spasticity to the upper extremity
True
False
156
face the individual who speech reads, communicate in a well lit room w/o obscuring your face &inform the client of topic
False
True
157
Which cranial nerve dysfunction increase the risk for aspiration?
III and IV
VIII and IX
IX and X
IV and V
158
which would you avoid using while irrigating foreign bodies in the ear canal that swell
water
mineral oil
159
what is the rationale for elevating HOB 30 deg. when reducing increased intracranial pressure?
to promote venous outflow from the brain
to prevent coughing on secretions
to keep patient from getting a headache
to maintain ventilation
160
flexor muscles are stronger than extensor muscles so the risk for flexion contractures?
none are answers
decrease when voluntary muscle control is lost
spasms when voluntary muscle control is lost
Increase when voluntary muscle control is lost
161
What word defines the inability to communicate verbally
Aphasia
Aphagia
Dysphagia
Dyslexia
162
What undesirable effects does opioids produce? Select All
pupil constriction
Nausea
constipation
respiratory depression
163
What would be contraindicated in the use of contrast medium?
allergies to iodine, shellfish, seafood
pregnant
Decreased creatinine
increase creatinine
164
Cervical dis herniation is typically accompanied by? Select All
Stiffness
parasthesias
pain
decreased visual acuity
165
What effect does serotonin has?
Excitatory
Inhibitory
166
what is the cardinal sign of spinal cord tumors?
headaches
pain
vertigo
chronic fatigue
167
bilateral pupil dilation suggests brain stem injury?
False
True
168
in which is central blood flow obstructed, the cells switch to anaerobic resp., ATP decreases, neurons lose function
Hemorrhagic Stroke
PE
MI
Ischemic Stroke
169
Pain is associated with what kind of tissue damage?
actual
none of the above
actual and potential
potential
170
which term defines pain to area that doesn't normally trigger pain response; associated with nonnoxious stimuli?
kinesia
ataxia
cachexia
allodynia
171
how would you help prevent ischemia?
keep patient in supine
keep head of the bed elevated 50 degrees
maintain gas exchange
maintain ICP 0-10
172
What effect does dopamine has?
Excitatory
Inhibitory
173
Catecholamines are found in the sympathetic Nervous System
False
True
174
Renal and pulses must be noted prior to which diagnostic test due to contrast medium being used?
CT
MRI
Cerebral angiography
Tensilon
175
Contrast medium is?
performed in patients with allergies
hepatotoxic
not harmful
nephrotoxic
176
How would you manage neuropathic pain? Select All
anticonvulsants
Haldol
benzodiazapine
antidepressants
177
a decrease in which neurotransmitter impairs voluntary movement?
ACH
dopamine
Serotonin
GABA
178
whistling is absent if the hearing aid isn't installed correctly?
False
True
179
what med increases the outflow of the aqueous humor by constricting the pupil and make it hard to see in the dark?
antibiotics(amoxicillan)
cycloplegic (cyclopentolate)
mydriatic(atropine)
Myotics(piocarpine)
180
what is the range of IOP that is determined by the amount of aqueous humor that is produced and drained?
10-15
10-21
5-10
50-100
181
What is the major neurotransmitter for the sympathetic nervous system?
ACH
Norepinephrine
Dopamine
GABA
182
Which drug does not have anti-inflammatory properties?
Aspirin
Acetaminophen
Ibuprofen
Diphahydramine
183
marked by deficits in depth perception, impulsive behavior, increased distractibility, lack/awareness of deficits
left hemispheric stroke
occipital stroke
right hemispheric stroke
frontal stroke
184
When is TPA given? which stroke is it giving for?
within 24 hrs; ischemic
within 60 min; ischemic
within 30 min; Ischemic
2 hours; hemorrhagic
185
What are harmful effects could be caused by use of corticosteroids
All could be a cause
hyperglycemia
Hypertention
sodium retention
186
blurry vision, stinging and burning are complications of
cataracts
lasik surgery
glaucoma
administration of ocular ointment
187
what measures IOP and screens for glaucoma?
retinoscope
tonometry
opthalmoscope
phoropter
188
Which neurotransmitter are excitatory and inhibit pain sensation?
Endorphins
Dopamine
ACH
Epinephrine
189
apply trochanter rolls to immobile patients to prevent internal rotation
False
True
190
what would the nurse inspect when administering enteral feedings to a client with dysphagia?
make sure the client is clear of secretions
make sure to hyperoxygenate
make sure cuff of trache tube inflated
make sure client has water
191
To avoid lumbar headache, what position must the patient be placed in?
semi fowler
high fowler
Prone 6 hrs more than 20ml CSF
Lateral recumbent
192
high cervial injuries above, which, that injure the phrenic nerve are a leading cause of death from Acute Resp. fail.?
C5
C7
C4
C3
193
How would you asses cranial nerve XI?
Have patient stand still with eyes closed
have patient shrug shoulders
have patient say ah
have patient raise both legs
194
What are non pharmacological pain management? select all
biologic and energy based therapies
massage
tylenol
physical modalities
195
What would you use to prevent footdrops and how long?
splint; q 4hrs
splint; q 2hrs
splint q 30 min
Boot q. 4hrs
196
what is the goal to prevent a secondary injury (hypoxia, ischemia) to the cord following a spinal injury?
maintain adequate tissue perfusion
maintain high partial pressure of aterial oxygen
maintain stabilized vital signs
maintain 100% oxygen Sat on room air
197
What would you as the nurse, teach the client to limit?
potasium
Sodium
calcium
fats
198
When is the National Institutes of Health Stroke Scale is used?
to determined severity before ct scan
to determine severity after administering t-PA
to determine severity after stoke has occured
to determine stroke before administering t-PA
199
what neurotransmitter affects behavior and fine movement?
serotonin
Dopamine
Epinephrine
ACH
200
How can you prevent irreversible nerologic damage?
maintain cerebral perfusion pressure below 30mm HG
maintain cerebral perfusion pressure at exactly 50mm Hg
maintain cerebral perfusion pressure above 50mm Hg
mantain cerebral perfusion pressure below 50mm Hg
201
What is the initial diagnostic test for a stroke?
CT w/ contrast
MRI w/o Contrast
MRI w/ contrast
CT w/o Contrast
202
Prostaglandin isn't needed for renal blood flow?
True
False
203
teach client to use a dryer on low heat(dry external canal) alcohol drops (infection) avoid use of foreign objects
Chronic otitis
Acute otitis
otitis externa
meinier's
204
Damage to which portion of the brain may result in an increased temperature?
pons
Parietal lobe
frontal lobe
Hypothalamus
205
a small gauge needle is used and a pt. is placed in prone after procedure to avoid what?
post cervical headache
Post Thoracic headache
pressure in the sacrum
Post lumbar headache
206
Air conduction is < Bone Conduction warrants a positive rinne test
False
True
207
what is the gold standard for brain tumor diagnostic?
MRI
CT w-w/o contrast
PET
SPECT
208
which actions would you avoid after eye surgery?
reading, watching tv, vacuuming
bending and stooping over short period of time
lifting, pushing or pulling objects > 2lbs
light activity
209
what medication helps to reduce fluid in the brain
Osmotic diuretic (mannitol)
Triptans(sumatriptan)
Histamine 2 receptor blockers
Corticosteroids (dexamethasone)
210
How would you manage nociceptive pain? Select All
opiods
nonopiods
Local anesthetics
steroids
211
what results in hypotension, bradycardia and a decrease in cardiac output which could lead to death?
Neurogenic Shock
SIADH
Neuroleptic Malignant Syndrome
Diabetes Insipidus
212
what may occur when blood pressure is sever in setting of Acute renal Failure, gestational HTN, pheochromocytoma
Myocardial infarction
Hemorrhagic Stroke
retinopathy
Macular degenration
213
when should you remove impaired object
completely after incident
2 hours after incident
never
4 hours after incident
214
the signs of meningitis includes headache, nuchal rigidity, photophobia, seizures, and fever)
False
True
215
accompanied by periocular pain, conjunctival hyperemia, and a fixed and semidilated pupil
Acute angle glaucoma
open angle glaucoma
narrow angle glaucoma
closed angle glaucoma
216
what could suggest hyperperfusion syndrom following a carotid endarterectomy?
bilateral pupil dilation
headache while resting
low blood pressure upon standing
unilateral headache that improves upon sitting or standing
217
bradycardia increased systolic pressure and a widening pulse pressure are signs of?
Neurogenic Shock
cushing's reflex
cushington's disease
Neuroleptic Malignant Syndrome
218
what are clinical manifestations of vertigo?
increased dizziness
headache
spinning sensation(you moving)
Spinning sensation(world moving)
219
What would you provide for mild to moderate pain?
aspirin or hydrocodone
tylenol or meloxicam
acetaminophen or aspirin
naproxen
220
alpha-adrenergic agonist(brimonidine) and carbonic anyhdrase inhibitors(acetazolamide)
decrease aqueous humor
increase aqueous humor
constricts the pupils
dilate pupils
221
what would be the reason a constant supply of oxygen and glucose is needed?
Cerebral cells aren't able to provide significant amounts
Type I diabetic
neurotransmitter ACH is being blocked
tissue in the brain hypertrophies
222
avoid massaging the calf or thing since this could lead to thrombus dislodgement
True
False
223
Hormonal dysfunction in the setting of a brain injury could lead to electrolyte and fluid volume disturbance?
True
False
224
how long would you place a recovering stroke client in prone position to prevent hip flexion?
30 min. several times a day
every 2 hours
15 mins several times a day
every 4 hours