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Questions and Answers

A patient cannot voluntarily move their right arm. Which area of the brain should the nurse suspect is affected?

  • Hypothalamus
  • Frontal lobe (correct)
  • Parietal lobe
  • Cerebellum

A patient's impulses are not conducting properly in their neurological system. Which part of the neuron should the nurse explain carries impulses toward the cell body?

  • Schwann cell
  • Myelin sheath
  • Axon
  • Dendrite (correct)

When reviewing the vital signs for a patient with a neurological problem, what part of the brain regulates heart rate and blood pressure?

  • Cerebrum
  • Hypothalamus
  • Cerebellum
  • Medulla (correct)

When discussing spinal nerves during a presentation on the neurological system, what other root makes up each spinal nerve, along with the dorsal root?

<p>Ventral (C)</p> Signup and view all the answers

When explaining the transmission of nerve impulses to a patient with a spinal cord injury, what structure should the nurse explain carries nerve impulses at synapses?

<p>Neurotransmitters (C)</p> Signup and view all the answers

A patient learns that abdominal pain is originating from the liver. What type of neurons transmit the impulses from receptors in the internal organs to the central nervous system?

<p>Visceral sensory neurons (C)</p> Signup and view all the answers

The results of a patients diagnostic tests show changes in nerve insulation. What structure should the nurse explain electrically insulates neurons?

<p>Myelin sheath (B)</p> Signup and view all the answers

A patient has a history of falling. Which part of the brain should the nurse question as being affected?

<p>Cerebellum (B)</p> Signup and view all the answers

When preparing a presentation about the neurological system, what explains the purpose of white matter?

<p>Carries either sensory or motor impulses (B)</p> Signup and view all the answers

A patient with a head injury has unequal pupils. Which term should the nurse use to document this finding?

<p>Anisocoria (C)</p> Signup and view all the answers

Which assessment is most important for the nurse to complete for a patient admitted to the emergency room after a motor vehicle crash?

<p>Glasgow Coma Scale (A)</p> Signup and view all the answers

When assessing a patients pupils for reactivity to light, which cranial nerve (CN) is being tested?

<p>CN III (A)</p> Signup and view all the answers

A neurologist asks a patient to stick out their tongue. Which cranial nerve (CN) is being tested?

<p>XII (hypoglossal) (B)</p> Signup and view all the answers

A patient reports nearly having a motor vehicle crash and states that their heart was pounding and they were breathing heavy and fast. Now heart rate and breathing are normal. Which neurotransmitter has resumed control after the patients incident?

<p>Acetylcholine (C)</p> Signup and view all the answers

For which function, should the nurse expect to assess an abnormality when caring for a patient diagnosed with a cerebral tumor?

<p>Movement and speech (C)</p> Signup and view all the answers

A 22-year-old female patient recovering from a craniotomy begins crying and asking for her mother who is sleeping in the visitors lounge. The patients Glasgow Coma Scale (GCS) of 15 and pupils are equal and reactive. What nursing action would be most appropriate at this time?

<p>Ask the mother to come and stay with the patient. (A)</p> Signup and view all the answers

What intervention should the nurse plan to maintain a patients safety while diagnostic testing is being completed, if they have impaired functioning of the left glossopharyngeal (IX) nerve and the vagus (X) nerve?

<p>Withhold oral fluid or foods. (A)</p> Signup and view all the answers

A patient is scheduled for a computed tomography (CT) scan of the brain because of new onset of headaches. Which statement is most accurate when preparing the patient for the scan?

<p>You will need to hold your head completely still during the examination. (D)</p> Signup and view all the answers

What information should be provided to a patient in preparation for an electroencephalogram (EEG)?

<p>The hair must be clean and dry before the test. (B)</p> Signup and view all the answers

When the neurologist asks the patient to identify different odors during an assessment of a patient with facial muscle weakness, which nerve is being tested?

<p>I (olfactory) (D)</p> Signup and view all the answers

Which action should the nurse take when preparing a patient scheduled for a lumbar puncture?

<p>Assist the patient into a side-lying position. (A)</p> Signup and view all the answers

Which order should the nurse anticipate providing post-procedure care for a patient recovering from a lumbar puncture?

<p>Have the patient lie flat for 6 hours. (B)</p> Signup and view all the answers

What explanation should be provided to the patient and family of a patient who is scheduled for a magnetic resonance imaging (MRI) scan?

<p>An MRI is a noninvasive test that uses magnetic energy to visualize internal parts. (B)</p> Signup and view all the answers

A patient who is severely brain damaged has decerebrate posturing with extended extremities. In which area of the brain should the nurse suspect the patient has sustained damage?

<p>Brain stem (B)</p> Signup and view all the answers

A patient who has had a stroke (brain attack) is unable to understand what the nurse is saying and appears frustrated. What term should the nurse use to document this finding?

<p>Receptive aphasia (D)</p> Signup and view all the answers

What assessment finding should the nurse expect to observe when assisting as a neurosurgeon examines a patient who has a positive Babinski reflex?

<p>The big toe extends when the sole of the foot is stroked. (B)</p> Signup and view all the answers

A patient becomes startled when the alarm rings for a fire drill. After reassuring the patient that there is no danger, an assessment is completed. Which finding may be related to a sympathetic response?

<p>Diminished bowel sounds (A)</p> Signup and view all the answers

When the nurse shines a light in a patients left pupil, both of the pupils constrict. What type of response should the nurse document?

<p>Consensual (D)</p> Signup and view all the answers

Which precaution should the nurse take after noting that an 87-year-old woman, who is recovering from a cerebral vascular accident, has a positive Romberg test?

<p>Institute fall-risk precautions. (D)</p> Signup and view all the answers

After being informed by family members that a patient is deaf and mute after being admitted to the hospital after a motor vehicle accident, which action should the nurse take?

<p>Avoid use of the Glasgow Coma Scale. (B)</p> Signup and view all the answers

A patient opens the eyes to painful stimuli, makes incomprehensible sounds, and withdraws from pain. What should the nurse calculate this patients Glasgow Coma Scale score to be?

<p>8 (B)</p> Signup and view all the answers

Based upon the Glasgow Coma Scale score, the nurse suspects that a patient will be diagnosed as being in a comatose state. What score does the patient need to have to be identified as comatose?

<p>7 (A)</p> Signup and view all the answers

For how many seconds should the nurse explain to a patient, that they will need to hold the position during a Romberg test?

<p>20 (B)</p> Signup and view all the answers

How many pairs of spinal nerves should the nurse explain are contained within the human body when explaining the neurological system to a group of nursing students?

<p>31 (A)</p> Signup and view all the answers

The nurse learns that a patient with a neurological illness has not had a sense of smell for several decades. Which part of the central nervous system should the nurse question as being damaged in this patient?

<p>Temporal lobe (A)</p> Signup and view all the answers

Which part of the neurological system is the nurse referring when the statement rest and digest is included in a seminar on the neurologic system for a community health fair?

<p>Parasympathetic division of the autonomic nervous system (D)</p> Signup and view all the answers

Which findings are considered abnormal in an aging patient and should be reported to the physician?

<p>Depression (A), Fine motor tremors of the hands (E)</p> Signup and view all the answers

Which foods should the nurse remove from patients tray if they have a history of aspiration?

<p>Coffee (E), Fruit juice (F)</p> Signup and view all the answers

What manifestations should the nurse expect the patient to demonstrate if they are experiencing a sympathetic response?

<p>Relaxation of bladder (A), Decrease in peristalsis (B), Dilation of bronchioles (D)</p> Signup and view all the answers

What should be included in pre-procedure preparation for a patient scheduled for a computed tomography (CT) scan with contrast?

<p>Explain to the patient that a sensation of warmth may be felt when dye is injected. (A), Tell the patient to report any nausea, itchiness, or difficulty breathing during the scan. (B), Question the patient about allergies to dye, shellfish, or iodine. (C), Check blood urea nitrogen (BUN) and creatinine levels. (E)</p> Signup and view all the answers

Which structures should the nurse identify as being part of the diencephalon during a review of the neurological system as part of a community health presentation?

<p>Hypothalamus (B), Thalamus (E)</p> Signup and view all the answers

Which actions should the nurse anticipate providing when caring for a patient scheduled for a lumbar puncture?

<p>Assess movement and sensation of lower extremities frequently for several hours after the procedure. (A), Keep the patient on bedrest with the head of the bed flat for 6 hours after the procedure. (B), Ensure that the patient has given informed consent to the procedure. (D), Check the puncture site for swelling or drainage. (E)</p> Signup and view all the answers

A patient does not have a left patellar reflex while observing the neurologist complete a neurological examination. In which areas should the nurse consider the patient has a dysfunction?

<p>Quadriceps femoris muscle (C), Femoral nerve (D), Spinal cord (E)</p> Signup and view all the answers

A patient is surprised to learn that cerebrospinal fluid will be removed during a lumbar puncture and asks the purpose of the fluid. What should the nurse explain to the patient?

<p>Exchanges nutrients and wastes between the blood and neurons (C), Cushions the central nervous system (E)</p> Signup and view all the answers

In which areas should the nurse collect data when using the FOUR tool to assess a patients neurological functioning?

<p>Eye response (B), Breathing pattern (C), Reflexes (D), Motor movement (E)</p> Signup and view all the answers

A patient is experiencing difficulty with fine motor skills and balance. Which area of the brain is MOST likely affected?

<p>Cerebellum (B)</p> Signup and view all the answers

A patient's diagnostic tests reveal demyelination of nerve fibers. Which of the following functions will be MOST directly impaired by this condition?

<p>Speed of nerve impulse transmission (D)</p> Signup and view all the answers

A patient has suffered a stroke affecting the medulla oblongata. Which of the following vital functions is MOST likely to be compromised?

<p>Regulation of heart rate and respiration (D)</p> Signup and view all the answers

A patient is undergoing a neurological assessment. When the nurse tests the patient's ability to feel a light touch on their arm, which type of neuron is PRIMARILY responsible for transmitting this sensory information to the central nervous system?

<p>Somatic sensory neurons (D)</p> Signup and view all the answers

A patient with a spinal cord injury is experiencing exaggerated reflexes below the level of injury. Which of the following mechanisms BEST explains this phenomenon?

<p>Loss of inhibitory control from higher brain centers (A)</p> Signup and view all the answers

Flashcards

Which brain lobe controls voluntary movement?

The frontal lobe is responsible for voluntary movement.

What part of a neuron carries impulses inward?

Dendrites carry impulses towards the cell body.

Which brain part controls heart rate and BP?

The medulla regulates heart rate and blood pressure.

What are the 2 roots of spinal nerves?

Spinal nerves are made up of the dorsal and ventral roots.

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What carries impulses across synapses?

Neurotransmitters carry nerve impulses at synapses.

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Impulses from internal organs are transmitted by what neurons?

Visceral sensory neurons transmit impulses from internal organs to the CNS.

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What insulates neurons?

The myelin sheath electrically insulates neurons.

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Which brain part controls balance?

The cerebellum is responsible for balance and coordination.

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What does white matter do?

White matter carries sensory or motor impulses.

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What is the term for unequal pupil sizes?

Anisocoria is the term for unequal pupils.

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What is the GCS?

The Glasgow Coma Scale assesses level of consciousness.

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Which CN is assessed by pupillary reaction?

CN III (oculomotor) is tested when assessing pupillary reaction to light.

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Which CN is assessed when sticking out tongue?

CN XII (hypoglossal) is tested by tongue movement.

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Which neurotransmitter calms body after stress?

Acetylcholine resumes control after sympathetic activation.

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What functions are affected by a cerebral tumor?

Cerebral tumors can affect movement and speech.

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What is the most appropriate nursing action?

Ask the mother to come and stay with the patient.

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Which intervention maintains pt’s safety?

Withhold oral fluid or foods.

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What should nurse say to prepare a patient for a CT scan?

You will need to hold your head completely still during the examination.

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How should the patient prepare their hair for EEG?

The hair must be clean and dry before the test.

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Which cranial nerve is related to smell?

CN I (olfactory)

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How should you position a patient for lumbar puncture?

Position them in a side-lying position.

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What position post lumbar puncture relieves headache?

Have the patient lie flat for 6 hours.

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How does an MRI visualize the body?

MRI is a noninvasive test that uses magnetic energy to visualize internal parts.

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Where is the brain damage?

Brain stem

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Can't understand what others say?

Receptive aphasia

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What is positive babinski reflex?

Stroking sole causes big toe extension.

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Which is a sympathetic symptom?

Diminished bowel sounds

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Both pupils constrict.

Consensual

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What to do with a positive Romberg?

Fall-risk precautions.

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Mute patient assessment?

Avoid the Glasgow Coma Scale.

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What's their GCS score?

8

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What GCS needed to be comatose?

7

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How long to hold Romberg position?

20

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How many pairs of spinal nerves?

31

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Which lobe affects smell?

Temporal lobe

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Rest and Digest?

Parasympathetic division

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Which is abnormal aging symptom?

A. Depression, E. Fine motor tremors of the hands

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What food should nurse remove?

A. Coffee, C. Fruit juice

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Which of the following is a sympathetic response?

A. Relaxation of bladder, B. Decrease in peristalsis, C. Dilation of bronchioles

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Which are ways to prepare for computed tomography (CT) scan with contrast?

A. Check BUN and creatinine levels, B. Question the patient about allergies to dye, shellfish, or iodine, D. Explain to the patient that a sensation of warmth may be felt when dye is injected, E. Tell the patient to report any nausea, itchiness, or difficulty breathing during the scan

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Which is part of the diencephalon?

C. Thalamus, E. Hypothalamus

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What actions to perform for lumbar puncture?

B. Check the puncture site for swelling or drainage, C. Ensure that the patient is given informed consent to the procedure, D. Keep the patient on bedrest with the HOB flat for 6 hours after the procedure, F. Assess movement and sensation of lower extremities frequently for several hours after the procedure

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What are areas of dysfunction?

A. Spinal cord, B. Femoral nerve, E. Quadriceps femoris muscle

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What is the purpose of cerebrospinal fluid?

C. Cushions the CNS, E. Exchanges nutrients and wastes between the blood and neurons

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What areas to collect for a Four Tool data assessment

A. Reflexes, B. Eye response, D. Motor movement, E. Breathing pattern

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Post-craniotomy patient upset: Best action?

Reassure the patient and stay with her until she is calm, addressing her emotional needs after surgery.

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Study Notes

Frontal Lobe Function

  • Voluntary movement of the right arm is affected by the frontal lobe

Neuron Impulses

  • Dendrites carry impulses toward the cell body

Medulla's role

  • The medulla regulates heart rate and blood pressure

Spinal Nerve Composition

  • Each spinal nerve includes a dorsal and ventral root

Synaptic Nerve Impulses

  • Neurotransmitters carry nerve impulses at synapses

Sensory Neurons

  • Visceral sensory neurons transmit impulses from internal organ receptors to the central nervous system

Nerve Insulation

  • The myelin sheath electrically insulates neurons

Cerebellum Function

  • The cerebellum is related to falls and balance

White Matter Purpose

  • White matter carries either sensory or motor impulses

Unequal Pupils

  • Anisocoria is the term for unequal pupils

Assessing head injuries

  • The Glasgow Coma Scale to assess the severity

Testing Cranial Nerve III

  • Assessing pupil reaction to light tests cranial nerve (CN) III

Testing Cranial Nerve XII

  • Sticking out the tongue tests cranial nerve (CN) XII (hypoglossal)

Post-Stress Neurotransmitter

  • Acetylcholine resumes control after a sympathetic response incident

Cerebral Tumor Effects

  • A cerebral tumor affects movement and speech

Post-Craniotomy Care

  • Reassuring the patient and asking the mother to come and stay with the patient ensures the patients well being

Impaired Glossopharyngeal & Vagus Nerves

  • Withhold oral fluids or foods, because the patient has impaired functioning of the left glossopharyngeal (IX) nerve and the vagus (X) nerve.

Preparing for CT Scan

  • The patient needs to hold their head completely still during a computed tomography (CT) scan

Preparing for EEG

  • Hair must be clean and dry prior to an electroencephalogram (EEG)

Testing Cranial Nerve I

  • Identifying different odors tests cranial nerve I (olfactory)

Preparing for Lumbar Puncture

  • The patient should be assisted into a side-lying position for a lumbar puncture

Post-Lumbar Puncture Care

  • The patient should lie flat for 6 hours after a lumbar puncture

Explaining MRI

  • MRI is noninvasive, using magnetic energy for visualization

Decerebrate Posturing

  • Damage to the brain stem is suspected in a patient presenting decerebrate posturing

Expressive Aphasia

  • Receptive aphasia is diagnosed when a patient cannot understand

Positive Babinski Reflex

  • The big toe extends when the sole of the foot is stroked in a patient with a positive Babinski reflex

Sympathetic Response

  • Diminished bowel sounds may be related to a sympathetic response

Pupillary Response

  • Consensual response: When light is shone in a patients left pupil, both pupils constrict

Positive Romberg Test

  • Institute fall-risk precautions for a patient with a positive Romberg test

Deaf and Mute Patients

  • In a deaf and mute patient avoid use of the Glasgow Coma Scale

Calculating Glasgow Coma Scale

  • Responds to painful stimuli (2) + makes incomprehensible sounds (2) + withdraws from pain (4) = Glasgow Coma Scale score of 8

Comatose State

  • A Glasgow Coma Scale score of 7 indicates a comatose state

Conducting Romberg Test

  • Explain to the patient a Romberg test position will need to be held during 20 seconds.

Spinal Nerve Pairs

  • Human body contains 31 pairs of spinal nerves

Neurological Illness

  • Damage to the temporal lobe causes loss of sense of smell.

Parasympathetic Nervous System

  • "Rest and digest" refers to the parasympathetic division of the autonomic nervous system

Abnormal Findings in Older Patients

  • Depression and fine motor tremors of the hands are abnormal

Foods to Avoid with Aspiration Risk

  • Coffee and fruit juice should be removed from the tray, due to high aspiration risk

Sympathetic Response Manifestations

  • Relaxation of bladder, decrease in peristalsis and dilation of bronchioles are manifestations of the sympathetic response

Pre-Procedure CT Scan Preparation

  • Check BUN and creatinine levels, question allergies, explain warmth sensation, and instruct to report any nausea, itchiness, or difficulty breathing

Diencephalon Structures

  • Thalamus and hypothalamus are part of the diencephalon

Lumbar Puncture Actions

  • Check puncture site for swelling or drainage, ensure informed consent, maintain bedrest with HOB flat for 6 hours, and assess lower extremity movement and sensation

Dysfunction Areas for Absent Patellar Reflex

  • Spinal cord, femoral nerve, and quadriceps femoris muscle

Purpose of Cerebrospinal Fluid

  • Cushions the central nervous system and exchanges nutrients and wastes between the blood and neurons

FOUR Tool Neurological Assessment Areas

  • Reflexes, eye response, motor movement and breathing pattern should be collected when using FOUR tool

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