Neurology

Question 1

The most Important initial step in the treatment of head
injury

Answer 1

Secure the airway

Question 2

What PRIORITY care to institute taking care of a patient
with acute cerebral vascular accident (CVA)?

Answer 2

By maintaining the patient’s respiratory function
(AIRWAY) r

Question 3

Increase in the difference between systolic and diastolic
pressure in head injury

Answer 3

Widening of pulse pressure

Question 4

Normal ICP adult

Answer 4

< 20mmg or (10-20 mmHg.)T

Question 5

Bowel care for a client post craniotomy

Answer 5

High fiber diet, increased fluid intake, and stool
softeners. To prevent constipation as patient may
have valsava causing increased intracranial pressure.

Question 6

Normal intracranial pressure (ICP) in children

Answer 6

< 5-20mmHg

Question 7

Black eye(s) discoloration under the eye(s) may indicate a
basilar skull fracture and this is commonly called as what
sign?

Answer 7

Raccoon’s eye

Question 8

Nursing care with Bell’s palsy

Answer 8

Steroid, analgesics as needed,
Provide eye care, dark glasses on days, eye pad at
night, eye ointment and artificial tears

Question 9

Ascending paralysis

Answer 9

Guillaine-Barre Syndrome
Priority: airway, as paralysis may ascend to the
diaphragm

Question 10

Bell’s Palsy

Answer 10

Eye care to protect cornea from injury.

Question 11

Priority in Guillaine-Barre

Answer 11

Respiratory due to the ascending paralysis

Question 12

Mildly dilated pupils with sluggish response may be an
early sign of?

Answer 12

Hemiation

Question 13

Bilateral fixed and pinpoint pupils may indicate pontine
lesion or adverse effects of drugs such as?

Answer 13

Opiates overdose (Morphine)

Question 14

A client will be receiving a Lovenox (enoxaparin), what is the
most important to diagnostic test that should be checked?
1. MRI of the calf 2. CT of the head
3. Abdominal ultrasound,

Answer 14

CT of the head to delermine if patient is having
cerebral hemorrhage. Answer: CT of the head

Question 15

Early symptom of Parkinson’s disease is
slowness of movement or continued motor tremors.

Answer 15

Slowness of movement with activity of daily living.

Question 16

Nursing priority to observe an hour post lumbar puncture
(1.) muscle weakness of upper extremities
(2.) headache
(3.) minimal oozing of clear fluid from the puncture site.

Answer 16

Answer (3) oozing of clear fluid from the puncture
site.
Headache is an expected symptom related to spinal
headache. Lower extremities should be a concern not
the upper extremities.

Question 17

A surgical procedure to remove the atheromas causing
carotid stenosis, resulting to TIAs or CVA

Answer 17

Carotid endarterectomy

Question 18

Carotid endarterectomy is diagnosed by?
[Carotid or femoral]

Answer 18

Ultrasound doppler or Magnetic Resonance
Arteriography (MRA)

Question 19

Risks after endarterectomy

Answer 19

Swelling of the neck due to hematoma and could
compress trachea.

Question 20

Purpose of displaying calendar to a client’s room with
Alzheimer’s disease.

Answer 20

To improve orientation to time.

Question 21

T1 vertebrae injury

Answer 21

Affects the legs and trunk below the injury

Question 22

Quadriplegia

Answer 22

Paralysis of the all 4 extremities with injury abovel
1 sI thoracic vertebra

Question 23

Paraplegic

Answer 23

Paralysis of the legs and lower body

Question 24

Common complication from Spinal anesthesia

Answer 24

Head ache

Question 25

priority of a client with Myasthenia Gravis

Answer 25

Airway due to failure of the respiratory muscle

Question 26

Parkinson's disease

Answer 26

Avoid caffeine and decaffeinated drinks

Question 27

Progressive weakness of the and atrophy of the muscles of the arms, trunk, or legs with respiratory insufficiency

Answer 27

ALS (Amyotrophic Lateral Sclerosis) (Lou Gehrig's disease) Priority: airways and safety against falling due to weakness

Question 28

Myelogram

Answer 28

Contraindicated with increased intracranial pressure

Question 29

Involuntary muscle spasms and essential tremors

Answer 29

Dystonia

Question 30

A temporary loss of function due to cerebral ischemia

Answer 30

Transient Ischemic Attack (TIA)

Question 31

Neuroleptic malignant syndrome

Answer 31

Hyperthermia

Question 32

Limps contract or stiffen, eyes roll, incontinence, loss of consciousness for 20-40 seconds.

Answer 32

Grand mal seizure (tonic phase)

Question 33

A condition requiring structured environment

Answer 33

Alzheimer’s disease

Question 34

Increased mucus production, repetitive movements and slowly tapers.

Answer 34

Grand mal (clonic phase)

Question 35

Indication of increased ICP

Answer 35

Halo around lights

Question 36

Indication of Lactulose in hepatic encephalopathy

Answer 36

To decrease the ammonia level and expect diarrhea

Question 37

Shuffling gait and early postural changes. Increased salivation and drooling

Answer 37

Parkinson's disease

Question 38

Approach client in unaffected side and place food, and belongings to unaffected side. Teach client to compensate by turning head to see things to the affected side.

Answer 38

Homonymous Hemianopsia

Question 39

Indication of Topomax (topiramate)

Answer 39

To treat seizures (epilepsy) Side effects: numbness and tingling in arms and legs, loss of appetite, exhaustion, fatigue, nausea, diarrhea, change in taste and weigh loss. Nurse alert: 1. increase the risk of suicidal thoughts. 2. Should be gradually withdrawn to minimize the potential for seizures or increased seizure frequency.

Question 40

Further instructions needed to position Ménière's disease.

Answer 40

Gradually change position and move body as a unit and head is turned with the body.

Question 41

Sundown Syndrome stage 1 Alzheimer

Answer 41

Reorient the client, stay calm and give sedatives.

Question 42

Increased disorientation and agitation only during evening and nighttime.

Answer 42

Sun downing Syndrome

Question 43

Expressive and Receptive Aphasia

Answer 43

Use simple 1-2 words, yes or no, simple and short questions, do not speak loudly (as hearing is not the problem). Face the patient and be calm for questions. May use communication board and be patient

Question 44

Expressive aphasia

Answer 44

Patient unable to send desired message. Listen and watch carefully when client attempts to talk. Allow sufficient time for client to answer. Anticipate the needs to decrease feelings of hopelessness and frustrations.

Question 45

Receptive aphasia

Answer 45

Unable to interpretlet or recognize message being received. Give simple and slow directions

Question 46

A common symptom of detached retina

Answer 46

Bright flashes of light

Question 47

Flexion of the upper extremities, extension of the lower extremities, and plantar flexion

Answer 47

Decorticate posturing

Question 48

Sudden, onset of pounding headache, pulse rate within normal limits, sudden hypertension of a patient with spinal cord injury, the nurse will be aware that client is having a.

Answer 48

Autonomic Dysreflexia (AD) Action: Let the client sit up to allow blood pool the legs to lower blood pressure and prevent hypertensive hemorrhage.

Question 49

Your instruction to patient with Multiple Sclerosis taking Dantrium.

Answer 49

When going outside the house, use sunscreen, hat, long sleeves, sunglasses, etc.

Question 50

Client has a Parkinson's disease, what to avoid when taking L-dopa

Answer 50

Vitamin B6 (organ meats, meat, whole grain cereals)

Question 51

An autoimmune disorder with rapid progressive muscle weakness to paralysis

Answer 51

Guillain-Barre Syndrome (GBS)

Question 52

weakness to paralysis Medications avoided in Guillain-Barre Syndrome

Answer 52

Narcotics and sedatives (may depress respiration)

Question 53

Extreme muscular weakness and easy fatigability

Answer 53

Myasthenia Gravis