2220 - Nclex Neuro

Front 1

Paralysis of lateral gaze indicates a lesion of cranial nerve:

a. II
b. III
c. IV
d. VI

Back 1

b. III

Front 2

A patient's eyes jerk as they follow the nurse's moving finger. The nurse records this finding as:

a. nystagmus
b. normal
c. ophthalmoplegia
d. ophthalmic dyskinesia

Back 2

a. nystagmus

Front 3

Which drug would elevate osmolality of blood plasma, increasing flow of water from brain tissue to plasma.

a. Furosemide
b. Mannitol
c. Dexamethasone

Back 3

b. Mannitol

Osmotic diuretic
First drug of choice. Fluid elimination is more specific.

Front 4

Which diuretic will decrease water in brain tissue by reducing overall body water?

a. Furosemide
b. Mannitol

Back 4

a. Furosemide

Front 5

This drug decreases inflammation within brain tissue:

Back 5

Coricosteroids:
Dexamethasone (Decadron)

reduces edmea from rain tumors, trauma, abscsses, infarction, and hemorrrhage

take with Zantac as steroids predispose gastric ulcers

Front 6

This drug will precipitate if given in an IV line with ANYTHING other than NS. Needs to be stopped & flushed before given:

Back 6

phenytoin (Dilantin)

Antiseizure drug.
Doesn't decrease ICP directly but prevents seizures which would cause O2 to fall and CO2 to rise = cerebral vasodilation and edema.

Front 7

This drug does not precipitate with dextrose. Can be given IV push, is an antiseizure med:

Back 7

Fosphenytoin

Front 8

This drug is used t o induce a coma, decreasing metabolic needs of brain and decreasing cereberal blood flow:

Back 8

Barbiturates:
phenobarbital
thiopental (Pentothal)

Front 9

This drug decreases body's metabolic needs by paralyzing skeletal muscles:

Back 9

Neuromuscular blocking agent:
Pancuronium (pavulon)

Front 10

This drug inhibits mvmt of calcium ions accross cell membranes... Has greatest effect on cereberal arteries improves neuroloigal deficits due to spasm of cerebral artries:

Back 10

Ca Channel blocker:
Nimodipine (Nimotop)

Front 11

Vasogenic cerebral edema increases intracranial pressure by

A.shifting fluid in the gray matter.
B.altering the endothelial lining of cerebral capillaries.
C.leaking molecules from the intracellular fluid to the capillaries.
D.altering the osmotic gradient flow into the intravascular componen

Back 11

B.altering the endothelial lining of cerebral capillarie

Front 12

A patient with intracranial pressure monitoring has pressure of 12 mm Hg. The nurse understands that this pressure reflects

A. a severe decrease in cerebral perfusion pressure.
B. an alteration in the production of cerebrospinal fluid.
C. the loss of autoregulatory control of intracranial pressure.
D. a normal balance between brain tissue, blood, and cerebrospinal fluid.

Back 12

A patient with intracranial pressure monitoring has pressure of 12 mm Hg. The nurse understands that this pressure reflects

A. a severe decrease in cerebral perfusion pressure.
B. an alteration in the production of cerebrospinal fluid.
C. the loss of autoregulatory control of intracranial pressure.
D. a normal balance between brain tissue, blood, and cerebrospinal fluid.

Front 13

The nurse plans care for the patient with increased intracranial pressure with the knowledge that the best way to position the patient is to

A. keep the head of the bed flat.
B. elevate the head of the bed to 30 degrees.
C. maintain patient on left side with head supported on pillow.
D. use a continuous-rotation bed to continuously change patient position.

Back 13

B. elevate the head of the bed to 30 degrees.

Front 14

The nurse is alerted to a possible acute subdural hematoma in the patient who
A. has a linear skull fracture crossing a major artery.
B. has focal symptoms of brain damage with no recollection of a head injury.
C. develops decreased level of consciousness and a headache within 48 hours of a head injury.
D. has an immediate loss of consciousness with a brief lucid interval followed by decreasing level of consciousness.

Back 14

C. develops decreased level of consciousness and a headache within 48 hours of a head

Front 15

During admission of a patient with a severe head injury to the emergency department, the nurse places the highest priority on assessment for

A. patency of airway.
B. presence of a neck injury.
C. neurologic status with the Glasgow Coma Scale.
D. cerebrospinal fluid leakage from the ears or nose.

Back 15

A. patency of airway.

Front 16

Nursing management of a patient with a brain tumor includes
A. discussing with the patient methods to control inappropriate behavior.
B. using diversion techniques to keep the patient stimulated and motivated.
C. assisting and supporting the family in understanding any changes in behavior.
D. limiting self-care activities until the patient has regained maximum physical functioning.

Back 16

C. assisting and supporting the family in understanding any changes in behavior.

Front 17

The primary goal of nursing care after a craniotomy is
A. preventing infection.
B. ensuring patient comfort.
C. avoiding the need for secondary surgery.
D. preventing increased intracranial pressure.

Back 17

D. preventing increased intracranial pressure.

Front 18

A nursing measure that is indicated to reduce the potential for seizures and increased intracranial pressure in the patient with bacterial meningitis is

A. administering codeine for relief of head and neck pain.
B. controlling fever with prescribed drugs and cooling techniques.
C. keeping the room darkened and quiet to minimize environmental stimulation.
D. maintaining the patient on strict bed rest with the head of the bed slightly elevated.

Back 18

B. controlling fever with prescribed drugs and cooling techniques.

Front 19

A patient is suspected of having a cranial tumor. The signs and symptoms include memory deficits, visual disturbances, weakness of right upper and lower extremities, and personality changes. The nurse recognizes that the tumor is most likely located in the

A. frontal lobe.
B. parietal lobe.
C. occipital lobe.
D. temporal lobe.

Back 19

A. frontal lobe.

Front 20

Gliomas are the most common malignant tumors, they come from neuroglial cells of the brain and brainstem. They are difficult to remove and rarely curable. Two of the types are VERY aggresive and BAD. Which two:

a. astrocytoma
b. Oligodenrogliomas
c. Glioblastomas
d. Ependymoma
e. Medulloblastoma

Back 20

c. Glioblastomas
and
e. Medulloblastoma

Front 21

This is a "functioning tumor" and presenting symptoms are visual ditrubances, loss of body air, DM, sterility, and headaches. It is usually benign and curable, with surgery thru the nose:

Back 21

Pituitary Tumor

Front 22

This tumor arises from cranial nerves. Slow growing and benign, symptoms relate to compression of trigeminal and facial nerves (Bell's palsy). surgical removal done thru ear, results in hearing loss

Back 22

Acoustic Neuromas

Front 23

Surgery on this tumor is usually the only tx needed. Altho this type of tumor is benign, it tends to reoccur

Back 23

Miningiomas

Front 24

Assess cranial nerves;

Resistive shoulder shrugging

Back 24

Accessory XI

Front 25

Assess cranial nerves;

Smile, frown, close eyes

Back 25

Facial VII

Front 26

Assess cranial nerves;

Light touch to face

Back 26

Trigeminal V

Front 27

Assess cranial nerves;

Confrontation test

Back 27

Optic II

Front 28

Assess cranial nerves;

Tongue protrusion

Back 28

Hypoglossal XII

Front 29

Assess cranial nerves;

Corneal reflex test

Back 29

Trigeminal V

Front 30

Assess cranial nerves;

Identify odors

Back 30

Olfactory I

Front 31

Assess cranial nerves;

Pupillary response

Back 31

Oculomotor III

Front 32

Assess cranial nerves;

Eye movement

Back 32

Oculomotor III
Trochlear IV
Abducens VI

Front 33

Assess cranial nerves;

Salt and sugar discriminations

Back 33

Facial VII

Front 34

Assess cranial nerves;

Gag reflex

Back 34

Glossopharyngeal IX
and
Vagus X

Front 35

Assess cranial nerves;

Ticking watch, finger rub

Back 35

Acoustic VIII

Front 36

During a neuro assessment, nurse obtains most of the data r/t metal status

a. during history
b. asking specific problem-solving questions
c. noting behaviors
d. asking patient to complete written exam

Back 36

a. during history

Front 37

During an assessment of motor system, the nurse finds that the patient has a staggering gait and an abnormal arm swing. The nurse uses his info to:

a. protect pt from injury due to falls
b. assist pt to cope with disability
c. plan rehab program
d. help establish a dx of cerebellar dx

Back 37

a. protect pt from injury due to falls

Front 38

The earliest sigsn of increased ICP the nurse should assess for include

a. cushing triad
b. unexpected vomiting
c. decreasing LOC
d. dilated pupil with sluggish response

Back 38

c. decreasing LOC