Chapter 32- Anatomy and Physiology of the Nervous System.rtf (42 kb) My Nursing Test Banks

 

1.

A patient in the ICU has a malignant brain tumor. Based on knowledge of the cellular units that make up the nervous system, the nurse understands that which cell type is the least likely to be the origin of this patients tumor?

A)

Neuron

B)

Astrocyte

C)

Ependymal cell

D)

Oligodendroglia

2.

A patient was involved in a car accident and is in hypovolemic shock, with severe hypotension. Due to damage to the glossopharyngeal nerve, the baroreceptor reflex is inhibited in the patient. What effect of this impaired reflex should the nurse expect to see in this patient?

A)

Rapid increase in blood pressure

B)

Lack of immediate withdrawal from painful stimuli

C)

Lack of compensatory increase in heart rate

D)

Continuance of motor activity in the intestines

3.

A patient in the ICU, in addition to his critical illness, suffers from clinical depression and is receiving medication for it. The nurse understands that this patients anti-depression medications are most likely to inhibit the reuptake of which of the following neurotransmitters? Select all that apply.

A)

Acetylcholine

B)

Endorphin

C)

Enkephalin

D)

Serotonin

E)

Norepinephrine

F)

Substance P

4.

A patient in the ICU is receiving an experimental drug to treat a brain tumor. The nurse understands that which of the following characteristics would be important in such a drug? Select all that apply.

A)

Protein-based

B)

Lipid-soluble

C)

Small-molecule

D)

Water-soluble

5.

A patient in the ICU has suffered severe head trauma as the result of a diving accident. Damage was sustained only in the frontal lobes of the brain. Which function is most likely to be impaired with this injury?

A)

Breathing

B)

Maintain steady posture when standing

C)

Sneezing

D)

Writing with a pen

6.

After having a stroke, an elderly patient is unsteady on his feet and cannot walk across the room without assistance. The nurse recognizes that which sensation is most likely impaired in this patient?

A)

Visceral

B)

Proprioceptive

C)

Exteroceptive

D)

Visual

7.

A neurologist is testing a patients responsiveness to various stimuli. He pricks the patients foot with the point of a safety pin, and the patient jerks her foot back immediately. The nurse recognizes that the integrative central nervous system component involved in this reflex is which of the following?

A)

Spinal cord interneuron

B)

Medulla oblongata

C)

Midbrain

D)

Cerebrum

8.

A patient who experienced severe trauma in a multiple car accident on the freeway explained that he didnt even notice the pain of his injuries as he was helping his daughters escape from their burning car. He asked the nurse what kept him from feeling the pain immediately. What would be the nurses best reponse?

A)

The accident occurred when it was cold outside.

B)

The patient has fewer nociceptors than normal.

C)

The patient has an impaired thalamus.

D)

Endogenous opioid peptides blocked transmission of the pain message to the brain.

9.

A nurse witnesses a patient having a panic attack in the ICU after learning that he has terminal lung cancer. Recognizing that he is in the alarm phase of the general adaptation syndrome, what physiological adaptations should the nurse expect?

A)

Drop in blood pressure

B)

Release of cortisol

C)

A shock state

D)

Heart rate drops from its peak but remains elevated

10.

A patient was recently admitted to the ICU with a knife wound to his chest that punctured his lung following a fight with his brother. He has undergone surgery and is stable, but is afraid of the possibility of infection. He will have to miss work for at least 6 weeks while he recovers. Which stressor will likely have the most long-term negative impact on this patient?

A)

His relationship with his brother

B)

The pain from his wound

C)

The financial hardship of missing 6 weeks of work

D)

Fear of infection

11.

A patient is receiving a medication that has difficulty crossing the bloodbrain barrier. What type of healthy neuroglia does an intact bloodbrain barrier indicate?

A)

Microglia

B)

Astrocytes

C)

Neurons

D)

Oligodendroglia

12.

A patient has a disease resulting in a deficit of acetylcholinesterase. What effects will the patient experience?

A)

Increased rapidity of neural transmission

B)

Reversed direction of neural transmission

C)

Rapid resetting of postsynaptic membrane receptors

D)

Delayed resetting of postsynaptic membrane receptors

13.

A patient has experienced a traumatic and significant loss of cerebrospinal fluid. To prevent further injury, what is the highest nursing priority?

A)

Institute seizure precautions.

B)

Prevent blows to the head.

C)

Keep on strict bed rest.

D)

Pharmacologic paralysis.

14.

A patient has a ruptured aneurysm on a vessel that joins the circle of Willis. If this results in significant neurologic deficit, what additional factor would the nurse expect?

A)

Fully patent circle of Willis

B)

Additional atrophic vessel on the circle

C)

Affected vessel is the internal carotid artery

D)

Affected vessel is the basilar artery

15.

A patient has experienced head trauma involving damage to the thalamus. What behavior does the nurse anticipate?

A)

Persistent wakefulness

B)

Complete lack of pain perception

C)

Disturbance of diurnal rhythms

D)

Disturbances in speech formation

16.

After a head injury, a patient has entered a state of persistent coma. What brainstem network has been injured?

A)

Bulboreticular formation

B)

Limbic system

C)

Sleep centers

D)

Reticular activating system (RAS)

17.

A patient has damage to a spinal nerve involving the dorsal root of the nerve. What effects does the nurse expect?

A)

Loss of sensation and motor control

B)

Loss of sensation

C)

Loss of motor function

D)

Varies with specific nerve

18.

The patient is experiencing an episode of supraventricular tachycardia at a rate of 280 beats per minute. The physician uses carotid sinus massage in an attempt to slow the heart rate. What normally occurring reflex is the underlying basis of this therapy?

A)

Baroreceptor

B)

Deep tendon

C)

Superficial spinal

D)

Withdrawal

19.

The patient has a painful extremity injury and is receiving an opioid analgesic and a nonsteroidal anti-inflammatory drug (NSAID) as needed along with rest, elevation, and cold therapy to the injured area. What therapy is most directly related to the cause of the pain?

A)

Opioid analgesic

B)

Immobilization of extremity

C)

Nonsteroidal anti-inflammatory drug

D)

Elevation of extremity

20.

A patient has suffered a serious injury complicated by critical illness and is being cared for in the CCU. One of the goals of therapy is to support the patients native state of homeostasis. What nursing action is designed to support or maintain homeostasis?

A)

Administer antacids to prevent gastric alkalinity.

B)

Give large amounts of IV fluids.

C)

Administer pharmacologic paralyzing agents.

D)

Identify and remove stressors.

21.

A patient who has recently been through a job change and a divorce has been admitted to the CCU after an accidental trauma. He has had massive blood loss and exposure to extreme cold. Considering the stress response, what does the nurse understand?

A)

Healing from the trauma will progress more rapidly.

B)

As stressors are additive, adverse effects are more likely.

C)

Only the physiologic stress is significant for this patient.

D)

Alleviation of psychological stress is the lowest priority.

22.

The patient has had a massive myocardial infarction resulting in severe compromise of contractility and hence cardiac output. The patients body responds to this insult by activating the stress response. What is the most significant adverse effect that activation of the stress response will have for this patient?

A)

Inhibition of parasympathetic outflow and gastrointestinal activity

B)

Stimulation of alpha receptors and increase in blood pressure

C)

Inhibition of venous constriction and reduction of volume return

D)

Stimulation of beta-1 receptors and increased cardiac contractility

Answer Key

1.

A

2.

C

3.

D, E

4.

B, C

5.

D

6.

B

7.

A

8.

D

9.

B

10.

A

11.

B

12.

D

13.

B

14.

B

15.

C

16.

D

17.

B

18.

A

19.

C

20.

D

21.

B

22.

B

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