Chapter 35- Common Neurosurgical and Neurological Disorders My Nursing Test Banks

 

1.

A patient has recently undergone successful surgery to remove a brain tumor and will be discharged soon. Which of the following would be the appropriate nursing intervention or interventions at this point? Select all that apply.

A)

Encourage the patient to return to her normal routine as soon as she is able.

B)

Instruct the patient to continue bed rest for 3 months.

C)

Refer the patient to hospice care.

D)

Discuss the side effects of new medications with the patient.

E)

Use teaching sheets to review the patients plan of care.

F)

Have family members leave the room while discussing the patients plan of care.

2.

A patient with a brain tumor is experiencing headaches, seizures, and nausea. The nurse understands that this patient has an increased possibility of having which types of tumor? Select all that apply.

A)

High-grade tumor

B)

Posterior fossa tumor

C)

Cerebral hemisphere tumor

D)

Low-grade tumor

3.

A nurse is caring for a patient with an arteriovenous malformation (AVM). What symptom is the nurse most likely to observe in this patient?

A)

Seizure

B)

Headache

C)

Intracranial pressure

D)

Hemorrhage

4.

A patient has a pituitary tumor that must be removed surgically. The nurse understands that this patient will most likely undergo what type of surgery in this case?

A)

Craniotomy

B)

Transsphenoidal surgery

C)

Transcranial surgery

D)

Stereotactic biopsy

5.

A patient has recently had a hemorrhagic stroke. The nurse should most strongly suspect which precipitating factor in this patient?

A)

Myocardial infarction

B)

Hypertension

C)

Atrial infarction

D)

Diabetes

6.

A patient has been found to have expressive, or nonfluent, dysphasia following a stroke and is having difficulty communicating with his family. What would be the appropriate nursing intervention for this patient?

A)

Explain to the family that the patient is intellectually impaired.

B)

Explain to the family that the patient is unable to understand the meaning of spoken language.

C)

Refer the patient to a rehabilitation specialist.

D)

Give the patient a note pad so that he can write responses to questions posed to him.

7.

A patient with epilepsy experiences a tonic-clonic seizure while in the ICU. What is the most appropriate nursing intervention?

A)

Leave the patient and find a physician immediately.

B)

Restrain the patient by tying his wrists to the sides of the bed.

C)

Turn the patient to his side.

D)

Administer warfarin.

8.

A patient has just been diagnosed with Guillain-Barr syndrome and is experiencing ascending, symmetrical muscle weakness and paralysis. Which nursing intervention could best help prevent complications of immobility?

A)

Assess strength of neck flexor muscles.

B)

Promote use of antiembolism stockings.

C)

Assist with plasmapheresis treatment.

D)

Administer intravenous immunoglobulin.

9.

A 45-year-old man in the ICU is diagnosed with generalized myasthenia gravis. The physician is discussing treatment options with the patient. The nurse understands that which treatment option would likely be the most effective for this patient in the long term in terms of remission, overall survival, and clinical improvement?

A)

Anticholinesterase

B)

Plasmapheresis

C)

Intravenous immunoglobulin

D)

Thymectomy

10.

A patient has been admitted to the CCU after surgery to remove a brain tumor. What nursing assessment indicates development of a significant complication?

A)

Gradually improving level of consciousness

B)

Serum sodium levels 138 to 142 mEq/L

C)

Minimal serous drainage on dressing

D)

Sudden onset of confusion

11.

A patient with a probable leak from a cerebral aneurysm is scheduled for surgical repair. What is the priority of nursing care in the preoperative period?

A)

Administration of prescribed stool softener medication

B)

Awaken every hour to assess neurologic status

C)

Encourage ambulation and exercise to tolerance

D)

Keep on high-fiber and low-calorie diet

12.

The patient has a cerebral aneurysm leak. While awaiting surgical repair, the patient has an episode of extreme light-headedness and is found to have a mean arterial pressure less than 55 mm Hg. The patients urinary output has been excessive and increasing over the past several hours. What is the best nursing intervention for this patient?

A)

Enforce complete bed rest

B)

Cautious volume replacement

C)

Intravenous diuretic therapy

D)

Continuous seizure precautions

13.

A patient is admitted to the CCU after aneurysm clipping. What is the best nursing strategy to prevent complications?

A)

Group care tasks to allow longer rest periods.

B)

Keep head elevated and in neutral position.

C)

Suction every 30 minutes to maintain airway.

D)

Keep monitor alarm volume on high.

14.

The patient has had a stroke or brain attack, believed to be ischemic in nature. The causes of an ischemic stroke are least likely to include which of the following?

A)

Thrombus of a cerebral artery

B)

Embolus of a cerebral artery

C)

Ruptured cerebral aneurysm

D)

Cerebrovascular obstruction

15.

A patient is being cared for in the CCU after a ruptured cerebral aneurysm. The nurse finds new onset of hemiparesis, slight lethargy, and complaints of diplopia. What complication does the nurse suspect?

A)

Aneurysm rebleed

B)

Increased intracranial pressure

C)

Cerebral artery vasospasm

D)

Carbon dioxide retention

16.

While shopping, a nurses friend experiences sudden unilateral weakness and slurred speech. What is the most important nursing intervention?

A)

Activate the emergency response system.

B)

Observe for return of neurologic stability.

C)

Notify close family members of the victim.

D)

Stabilize airway and cervical spine.

17.

A patient is in the emergency department being treated for an ischemic stroke. What is the nursing priority of care?

A)

Refer for rehabilitation care.

B)

Initiate fibrinolysis within 3 hours.

C)

Initiate intravenous glucose therapy.

D)

Administer 100% oxygen by mask.

18.

A patient has been diagnosed with partial seizures. What behavior during this patients seizures that would not occur during a generalized seizure does the nurse expect?

A)

Aura prior to seizure

B)

Twitching confined to one arm

C)

Absence of purposeful movement

D)

Postictal period or state

19.

A patient with seizure disorder is being treated with oral phenytoin (Dilantin). To prevent undesirable side effects of this medication, what is a nursing priority?

A)

Monitor all seizure activity.

B)

Use seizure precautions.

C)

Give medication with milk.

D)

Teach good oral care.

20.

Three weeks after a viral illness, a patient has an onset of weakness in the lower extremities that is progressing to the arms. The patient is admitted to the CCU with a diagnosis of rapidly progressing Guillain-Barr syndrome. What is the nursing care priority?

A)

Monitor respiratory system closely.

B)

Prevent hazards of immobility.

C)

Provide emotional support for patient and family.

D)

Control musculoskeletal pain.

21.

A patient with myasthenia gravis is being treated with corticosteroids. What symptom would indicate an undesirable side effect of the corticosteroid therapy?

A)

Increased weakness with activity

B)

Persistent ptosis

C)

Inability to swallow

D)

Stool positive for guaiac

Answer Key

1.

A, D, E

2.

C, D

3.

D

4.

B

5.

B

6.

D

7.

C

8.

B

9.

D

10.

D

11.

A

12.

B

13.

B

14.

C

15.

C

16.

A

17.

B

18.

B

19.

D

20.

A

21.

D

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