Acoustic Neuroma

Question 1

All of the following are factors that determine the treatment for acoustic neuroma (AN) EXCEPT?

a. Age and life expectancy
b. Location and size of the tumor
c. Rate of tumor growth
d. Ethnicity

Answer 1

d. ethnicity

Question 2

Known risk factors for AN include

a. cell phone use
b. cranial trauma
c. high-dose ionizing radiation exposure
d. a) and b)
e. a) and c)
f. b) and c)

Answer 2

c. high dose ionizing radiation exposure

Question 3

Postoperative care following surgery for AN can include

a. monitoring cranial nerve function
b. monitoring vital signs and maintaining I.V. fluids for hydration
c. monitoring for complications of surgery
d. all of the above

Answer 3

d. all of the above

Question 4

Which of the following is the preferred imaging modality for AN?

a. Audiometric testing
b. CT scan with contrast
c. MRI with gadolinium
d. Auditory brainstem response testing

Answer 4

c. MRI with gadolinium

Question 5

The nurse understands that the most likely treatment option for a 75 years old patient with a small tumor and minor signs and symptoms are?

a. Serial observation
b. Microsurgical removal
c. Stereotactic radiotherapy
d. b) or c)
e. None of the above

Answer 5

a. serial observation

Question 6

Elevated intracranial pressure (ICP) in a patient with AN

a. is unrelated to the AN
b. is the most common sign of AN
c. Can be caused by brainstem compression
d. none of the above

Answer 6

c. can be caused by brainstem compression

Question 7

The patient with an implanted pacemaker is most likely to have which of the following tests ordered to assess for AN?

a. MRI with gadolinium
b. Plain MRI
c. CT scan with contrast
d. Any of the above
e. b) or c) only

Answer 7

c. CT scan with contrast

Question 8

Signs and symptoms of ICP include?

a. Hypothermia
b. Vomiting
c. Vertigo
d. a) and b)
e. a) and c)
f. b) and c)

Answer 8

f. vomiting and vertigo

Question 9

Between 15% and 40% of patients with AN who are initially managed with observation will eventually require surgery.

True
False

Answer 9

True

Question 10

The patient has undergone surgery for AN and complains of facial paralysis and balance dysfunction post operatively. The nurse understands that these symptoms are most likely

a. complications of her surgery
b. imaginary symptoms
c. unrelated to her surgery

Answer 10

a. complications of her surgery

Question 11

A patient with AN who has been scheduled for stereotactic radiotherapy asks the nurse about the outcomes associated with this type of treatment. The nurse should explain that

a. tumor regrowth will not occur
b. tumor regrowth can occur
c. treatment-related morbidity is lower compared with more invasive treatments
d. a) and c)
e. b) and c)

Answer 11

e. tumor regrowth can occur and treatment-related morbidity is lower compared with more invasive treatments

Question 12

The patient is scheduled for microsurgical removal of their AN, and asks the nurse how often ANs recur after complete removal. What figure does the nurse give her?

a. < 1%
b. < 2.5%
c. < 3.75%
d. < 5%

Answer 12

d. < 5%

Question 13

The patients surgery to remove the AN has been completed. Which topics should the nurse discuss the patient upon discharge.

a. prescribed driving prohibition until she is recovered
b. the importance of continued medical surveillance
c. reducing her cell phone use
d. a) and b)
e. a) and c)
f. b) and c)

Answer 13

d. prescribed driving prohibition until she is recovered and the importance of continued medical surveillance

Question 14

Approximately ____ of cases of AN are unilateral.

a. 44%
b. 63%
c. 76%
d. 84%
e. 95%

Answer 14

e. 95%

Question 15

All of the following are signs and symptoms of AN, except

a. facial nerve pain and weakness
b. difficulty swallowing and hoarseness
c. vertigo
d. hypotension
e. impaired coordination

Answer 15

d. hypotension

Question 16

Lumbar spinal drainage can be needed for CSF leaks, and surgery might be necessary to correct leakage from previous surgery.

True
False

Answer 16

True