MEDSURG EXAM FINAL NEURO QUESITONS

2.

Treatment of bacterial meningitis will include

Aggressive administration of antipyretics.
Antibiotics within the hour, post blood culture.
Watching and waiting---no meds are started until cultures are conclusive.
Vaccination per CDC protocol.

Correct Answer

A. Antibiotics within the hour, post blood culture.

Explanation

The correct answer is "Antibiotics within the hour, post blood culture." This is because bacterial meningitis is a serious infection that requires prompt treatment with antibiotics. The administration of antibiotics should occur within the first hour after obtaining blood cultures to help target the specific bacteria causing the infection. This prompt treatment is crucial in preventing complications and improving outcomes for patients with bacterial meningitis.

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3.

A patient with suspected meningitis has the following results on LP: Opening pressure of 300 (elevated), WBCs 2500 with >80% neutrophils, Protein of 300 and glucose of 35mg/dL. These findings are…

Suggestive of viral infection.
Suggestive of fungal infection.
Expected in young adults.
Indicative of bacterial meningitis.

Correct Answer

A. Indicative of bacterial meningitis.

Explanation

The given results on LP, such as elevated opening pressure, high WBC count with predominantly neutrophils, high protein levels, and low glucose levels, are indicative of bacterial meningitis. This combination of findings is commonly seen in bacterial infections of the meninges.

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4.

You are accepting a patient to your neuro rehab unit from the intensive care unit. What will you prioritize FIRST when the patient is brought to your unit?

Get a set of vital signs and do a rapid, focused neuro assessment.
Get an oxygen saturation on this patient, get O2 on him if his saturation is below 96%.
Teach the family about hand hygiene practices on your unit.
Do a complete medication review with the nurse giving report.

Correct Answer

A. Get a set of vital signs and do a rapid, focused neuro assessment.

Explanation

When accepting a patient to the neuro rehab unit from the intensive care unit, the first priority should be to obtain a set of vital signs and perform a rapid, focused neuro assessment. This is crucial in order to assess the patient's current neurological status and identify any immediate concerns or changes that may require immediate intervention. By obtaining vital signs and conducting a neuro assessment, the healthcare team can gather important information about the patient's condition and make informed decisions regarding their care and treatment.

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5.

The drug used in the immediate (first line treatment) of seizures (may even be given during the seizure if prolonged) is which of the following?

Propofol (Diprivan).
Phenytoin (Dilantin).
Valproic acid (Depakote).
Lorazepam (Ativan).

Correct Answer

A. Lorazepam (Ativan).

Explanation

Lorazepam (Ativan) is the correct answer because it is commonly used as a first-line treatment for seizures. It is a benzodiazepine medication that works by enhancing the effects of a neurotransmitter called GABA, which helps to calm excessive electrical activity in the brain during a seizure. Lorazepam can be administered during a seizure if it is prolonged or as a preventive measure to stop further seizures. It is fast-acting and has a longer duration of action compared to other benzodiazepines, making it an effective choice for immediate seizure management.

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6.

Which of the following is true of diagnosis in Parkinson’s disease?

It is diagnosed on CT scan of the brain which can identify atrophy in the substantia nigra of the basal ganglia.
It is diagnosed when a patient has 2 or more cardinal symptoms with asymmetrical presentation. MUST INCLUDE BRADYKINESIA
It is diagnosed as a “rule in” when patients respond appropriately to Dopamine-receptor agonists:(pramipexole (Mirapax) or ropinerole (Requip).
It is diagnosed by blood work and possibly LP where increased levels of oligoclonal bands are diagnostic.

Correct Answer

A. It is diagnosed when a patient has 2 or more cardinal symptoms with asymmetrical presentation. MUST INCLUDE BRADYKINESIA

Explanation

The correct answer is that Parkinson's disease is diagnosed when a patient has 2 or more cardinal symptoms with asymmetrical presentation, and it must include bradykinesia. This means that for a diagnosis of Parkinson's disease to be made, the patient must exhibit at least two of the main symptoms of the disease, such as tremors, rigidity, or bradykinesia (slowness of movement), and these symptoms should be more pronounced on one side of the body compared to the other. This criteria helps to differentiate Parkinson's disease from other movement disorders.

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7.

Which sign is this?

Brudkinski’s
Kernig’s sign
Cleopatra’s reflex
Homan’s sign

Correct Answer

A. Brudkinski’s

Explanation

Brudzinski's sign is a physical examination technique used to assess for meningitis. It involves flexing the patient's neck, which causes involuntary flexion of the hips and knees. This sign is indicative of meningeal irritation and can help diagnose meningitis.

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8.

Your patient is s/p stroke. His BP in the ER was 190/110. He was diagnosed (by CT scan) as having an ischemic stroke. His current BP (4 hours post admission) is 160/90. Treatment for his BP would include:

Administration of IV calcium channel blockers.
Administration of intravenous vasodilators.
Resumption of home medications including an ACE inhibitor.
Close monitoring of BP at this time.

Correct Answer

A. Close monitoring of BP at this time.

Explanation

The correct answer is close monitoring of BP at this time. This is because the patient's BP has already decreased from 190/110 to 160/90 within 4 hours of admission. It is important to monitor the BP closely to ensure that it continues to decrease gradually and does not drop too quickly, which could lead to hypoperfusion of the brain. Administering IV calcium channel blockers or intravenous vasodilators may cause a rapid drop in BP, which is not recommended in this situation. Resuming home medications, including an ACE inhibitor, may be considered later on, but close monitoring is the immediate priority.

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9.

Which of the following patients is most at risk for post stroke depression (PSD)?

The patient who has a history of depression, has aphasia and is being transferred to a rehab facility.
The patient with a history of anxiety, has apraxia, and is being transferred into home care services.
The patient with a minor stroke, inability to swallow who is transferring to home.
A patient with no history of depression, minimal language or motor deficits, who is being transferred to a short-stay rehab unit.

Correct Answer

A. The patient who has a history of depression, has aphasia and is being transferred to a rehab facility.

Explanation

The patient who has a history of depression, has aphasia and is being transferred to a rehab facility is most at risk for post-stroke depression (PSD). Having a history of depression increases the likelihood of developing PSD. Aphasia, which is a language deficit, can lead to frustration and difficulty in communicating, further increasing the risk of developing depression. Additionally, being transferred to a rehab facility may disrupt the patient's social support system, which can also contribute to the development of PSD.

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10.

Which of the following is NOT a question on the Geriatric Depression Scale?

Do you often get bored?
Are you basically satisfied with your life?
Do you feel pretty worthless the way you are now?
Do you have a lack of energy?

Correct Answer

A. Do you have a lack of energy?

Explanation

he question, like the question “do you feel happy most of the time, do you feel it is wonderful to be alive, do you feel full of energy (are the hopeful components of the scale) and serve to make sure the patient is not just saying yes to every question.

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11.

Which is an appropriate order upon transfer of the post stroke patient from the ICU?

Q 4 hour completion of the NIHSS scale.
HOB flat except for eating.
Maintain BP <120/80.
Restart (or start) moderate to high intensity statin therapy.

Correct Answer

A. Restart (or start) moderate to high intensity statin therapy.

Explanation

*you will allow the BP to be 140-160 to optimize cerebral perfusion, HOB always at 30 degrees, q 4 hour NEURO checks but the NIHSS is done daily.

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12.

Which medications would you see in the hospitalized patient post stroke?

Subcutaneous enoxaparin daily to prevent DVT and PE.
ASA for patients not receiving fibrinolytic therapy.
Fluid administration of Normal Saline at 125mL/hour
Ativan

Correct Answer(s)

A. Subcutaneous enoxaparin daily to prevent DVT and PE.
A. ASA for patients not receiving fibrinolytic therapy.
A. Fluid administration of Normal Saline at 125mL/hour

Explanation

The hospitalized patient post stroke would typically receive subcutaneous enoxaparin daily to prevent deep vein thrombosis (DVT) and pulmonary embolism (PE). ASA (aspirin) would be prescribed for patients who are not receiving fibrinolytic therapy. Fluid administration of Normal Saline at 125mL/hour is also necessary to maintain hydration and prevent complications. Ativan (lorazepam) is not mentioned as a standard medication for post-stroke patients, so it is not included in the answer.

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Medsurg Exam Final Neuro Quesitons

Which of the following therapies should be involved in the post stroke patient?

Quiz Preview

Treatment of bacterial meningitis will include

A patient with suspected meningitis has the following results on LP: Opening pressure of 300 (elevated), WBCs 2500 with >80% neutrophils, Protein of 300 and glucose of 35mg/dL. These findings are…

You are accepting a patient to your neuro rehab unit from the intensive care unit. What will you prioritize FIRST when the patient is brought to your unit?

The drug used in the immediate (first line treatment) of seizures (may even be given during the seizure if prolonged) is which of the following?

Which of the following is true of diagnosis in Parkinson’s disease?

Which sign is this?

Your patient is s/p stroke. His BP in the ER was 190/110. He was diagnosed (by CT scan) as having an ischemic stroke. His current BP (4 hours post admission) is 160/90. Treatment for his BP would include:

Which of the following patients is most at risk for post stroke depression (PSD)?

Which of the following is NOT a question on the Geriatric Depression Scale?

Which is an appropriate order upon transfer of the post stroke patient from the ICU?

Which medications would you see in the hospitalized patient post stroke?