Neurological Problems (Exam Mode) By Rnpedia.Com
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- 1.What is the priority nursing diagnosis for a patient experiencing a migraine headache?
- A.
Acute pain related to biologic and chemical factors
- B.
Anxiety related to change in or threat to health status
- C.
Hopelessness related to deteriorating physiological condition
- D.
Risk for Side effects related to medical therapy
- 2.You are creating a teaching plan for a patient with newly diagnosed migraine headaches. Which key items should be included in the teaching plan? (Choose all that apply).
- A.
Avoid foods that contain tyramine, such as alcohol and aged cheese.
- B.
Avoid drugs such as Tagamet, nitroglycerin and Nifedipine.
- C.
Abortive therapy is aimed at eliminating the pain during the aura.
- D.
A potential side effect of medications is rebound headache.
- E.
Complementary therapies such as relaxation may be helpful.
- F.
Continue taking estrogen as prescribed by your physician.
- 3.The patient with migraine headaches has a seizure. After the seizure, which action can you delegate to the nursing assistant?
- A.
Document the seizure.
- B.
Perform neurologic checks.
- C.
Take the patient’s vital signs.
- D.
Restrain the patient for protection.
- 4.You are preparing to admit a patient with a seizure disorder. Which of the following actions can you delegate to LPN/LVN?
- A.
Complete admission assessment.
- B.
Set up oxygen and suction equipment.
- C.
Place a padded tongue blade at bedside.
- D.
Pad the side rails before patient arrives.
- 5.A nursing student is teaching a patient and family about epilepsy prior to the patient’s discharge. For which statement should you intervene?
- A.
“You should avoid consumption of all forms of alcohol.”
- B.
“Wear you medical alert bracelet at all times.”
- C.
“Protect your loved one’s airway during a seizure.”
- D.
“It’s OK to take over-the-counter medications.”
- 6.A patient with Parkinson disease has a nursing diagnosis of Impaired Physical Mobility related to neuromuscular impairment. You observe a nursing assistant performing all of these actions. For which action must you intervene?
- A.
The NA assists the patient to ambulate to the bathroom and back to bed.
- B.
The NA reminds the patient not to look at his feet when he is walking.
- C.
The NA performs the patient’s complete bath and oral care.
- D.
The NA sets up the patient’s tray and encourages patient to feed himself.
- 7.The nurse is preparing to discharge a patient with chronic low back pain. Which statement by the patient indicates that additional teaching is necessary?
- A.
“I will avoid exercise because the pain gets worse.”
- B.
“I will use heat or ice to help control the pain.”
- C.
“I will not wear high-heeled shoes at home or work.”
- D.
“I will purchase a firm mattress to replace my old one.”
- 8.A patient with a spinal cord injury (SCI) complains about a severe throbbing headache that suddenly started a short time ago. Assessment of the patient reveals increased blood pressure (168/94) and decreased heart rate (48/minute), diaphoresis, and flushing of the face and neck. What action should you take first?
- A.
Administer the ordered acetaminophen (Tylenol).
- B.
Check the Foley tubing for kinks or obstruction.
- C.
Adjust the temperature in the patient’s room.
- D.
Notify the physician about the change in status.
- 9.Which patient should you, as charge nurse, assign to a new graduate RN who is orienting to the neurologic unit?
- A.
A 28-year-old newly admitted patient with spinal cord injury
- B.
A 67-year-old patient with stroke 3 days ago and left-sided weakness
- C.
An 85-year-old dementia patient to be transferred to long-term care today
- D.
A 54-year-old patient with Parkinson’s who needs assistance with bathing
- 10.A patient with a spinal cord injury at level C3-4 is being cared for in the ED. What is the priority assessment?
- A.
Determine the level at which the patient has intact sensation.
- B.
Assess the level at which the patient has retained mobility.
- C.
Check blood pressure and pulse for signs of spinal shock.
- D.
Monitor respiratory effort and oxygen saturation level.
- 11.You are pulled from the ED to the neurologic floor. Which action should you delegate to the nursing assistant when providing nursing acre for a patient with SCI?
- A.
Assess patient’s respiratory status every 4 hours.
- B.
Take patient’s vital signs and record every 4 hours.
- C.
Monitor nutritional status including calorie counts.
- D.
Have patient turn, cough, and deep breathe every 3 hours.
- 12.You are helping the patient with an SCI to establish a bladder-retraining program. What strategies may stimulate the patient to void? (Choose all that apply).
- A.
Stroke the patient’s inner thigh.
- B.
Pull on the patient’s pubic hair.
- C.
Initiate intermittent straight catheterization.
- D.
Pour warm water over the perineum.
- E.
Tap the bladder to stimulate detrusor muscle.
- 13.The patient with a cervical SCI has been placed in fixed skeletal traction with a halo fixation device. When caring for this patient the nurse may delegate which action (s) to the LPN/LVN? (Choose all that apply).
- A.
Check the patient’s skin for pressure form device.
- B.
Assess the patient’s neurologic status for changes.
- C.
Observe the halo insertion sites for signs of infection.
- D.
Clean the halo insertion sites with hydrogen peroxide.
- 14.You are preparing a nursing care plan for the patient with SCI including the nursing diagnoses Impaired Physical Mobility and Self-Care Deficit. The patient tells you, “I don’t know why we’re doing all this. My life’s over.” What additional nursing diagnosis takes priority based on this statement?
- A.
Risk for Injury related to altered mobility
- B.
Imbalanced Nutrition, Less Than Body Requirements
- C.
Impaired Adjustment to Spinal Cord Injury
- D.
Poor Body Image related to immobilization
- 15.Which patient should be assigned to the traveling nurse, new to neurologic nursing care, who has been on the neurologic unit for 1 week?
- A.
A 34-year-old patient newly diagnosed with multiple sclerosis (MS)
- B.
A 68-year-old patient with chronic amyotrophic lateral sclerosis (ALS)
- C.
A 56-year-old patient with Guillain-Barre syndrome (GBS) in respiratory distress
- D.
A 25-year-old patient admitted with CA level spinal cord injury (SCI)
- 16.The patient with multiple sclerosis tells the nursing assistant that after physical therapy she is too tired to take a bath. What is your priority nursing diagnosis at this time?
- A.
Fatigue related to disease state
- B.
Activity Intolerance due to generalized weakness
- C.
Impaired Physical Mobility related to neuromuscular impairment
- D.
Self-care Deficit related to fatigue and neuromuscular weakness
- 17.The LPN/LVN, under your supervision, is providing nursing care for a patient with GBS. What observation would you instruct the LPN/LVN to report immediately?
- A.
Complaints of numbness and tingling
- B.
Facial weakness and difficulty speaking
- C.
Rapid heart rate of 102 beats per minute
- D.
Shallow respirations and decreased breath sounds
- 18.The nursing assistant reports to you, the RN, that the patient with myasthenia gravis (MG) has an elevated temperature (102.20 F), heart rate of 120/minute, rise in blood pressure (158/94), and was incontinent off urine and stool. What is your best first action at this time?
- A.
Administer an acetaminophen suppository.
- B.
Notify the physician immediately.
- C.
Recheck vital signs in 1 hour.
- D.
Reschedule patient’s physical therapy.
- 19.You are providing care for a patient with an acute hemorrhage stroke. The patient’s husband has been reading a lot about strokes and asks why his wife did not receive alteplase. What is your best response?
- A.
“Your wife was not admitted within the time frame that alteplase is usually given.”
- B.
“This drug is used primarily for patients who experience an acute heart attack.”
- C.
“Alteplase dissolves clots and may cause more bleeding into your wife’s brain.”
- D.
“Your wife had gallbladder surgery just 6 months ago and this prevents the use of alteplase.”
- 20.You are supervising a senior nursing student who is caring for a patient with a right hemisphere stroke. Which action by the student nurse requires that you intervene?
- A.
The student instructs the patient to sit up straight, resulting in the patient’s puzzled expression.
- B.
The student moves the patient’s tray to the right side of her over-bed tray.
- C.
The student assists the patient with passive range-of-motion (ROM) exercises.
- D.
The student combs the left side of the patient’s hair when the patient combs only the right side.
- 21.Which action (s) should you delegate to the experienced nursing assistant when caring for a patient with a thrombotic stroke with residual left-sided weakness? (Choose all that apply).
- A.
Assist patient to reposition every 2 hours.
- B.
Reapply pneumatic compression boots.
- C.
Remind patient to perform active ROM.
- D.
Check extremities for redness and edema.
- 22.The patient who had a stroke needs to be fed. What instruction should you give to the nursing assistant who will feed the patient?
- A.
Position the patient sitting up in bed before you feed her.
- B.
Check the patient’s gag and swallowing reflexes.
- C.
Feed the patient quickly because there are three more waiting.
- D.
Suction the patient’s secretions between bites of food.
- 23.You have just admitted a patient with bacterial meningitis to the medical-surgical unit. The patient complains of a severe headache with photophobia and has a temperature of 102.60 F orally. Which collaborative intervention must be accomplished first?
- A.
Administer codeine 15 mg orally for the patient’s headache.
- B.
Infuse ceftriaxone (Rocephin) 2000 mg IV to treat the infection.
- C.
Give acetaminophen (Tylenol) 650 mg orally to reduce the fever.
- D.
Give furosemide (Lasix) 40 mg IV to decrease intracranial pressure
- 24.You are mentoring a student nurse in the intensive care unit (ICU) while caring for a patient with meningococcal meningitis. Which action by the student requires that you intervene immediately?
- A.
The student enters the room without putting on a mask and gown.
- B.
The student instructs the family that visits are restricted to 10 minutes.
- C.
The student gives the patient a warm blanket when he says he feels cold.
- D.
The student checks the patient’s pupil response to light every 30 minutes.
- 25.A 23-year-old patient with a recent history of encephalitis is admitted to the medical unit with new onset generalized tonic-clonic seizures. Which nursing activities included in the patient’s care will be best to delegate to an LPN/LVN whom you are supervising? (Choose all that apply).
- A.
Document the onset time, nature of seizure activity, and postictal behaviors for all seizures.
- B.
Administer phenytoin (Dilantin) 200 mg PO daily.
- C.
Teach patient about the need for good oral hygiene.
- D.
Develop a discharge plan, including physician visits and referral to the Epilepsy Foundation.
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