Adult neuro

Question 1

a) what is TIA?
b) Positive Romberg test for? feet together and eyes open then close.
c) irrigate pt’s ear for impacted with cerumen, what action?

Answer 1

a) caused by a temporary reduction of O2 supply
NO cerebral edema. stroke-like attack
b) cerebellar dysfunction
c) instilling 5ML-10ml of fluid with each irrigation(warm-up 37 degrees)
pull upward and backward then apply gentle but continuous pressure

Question 1

a) otitis media s/s?
b) pt who has encephalitis d/t west Nile virus. what action?
c) what is West Nile virus?
d) what is encephalitis?

Answer 1

a) low-pitched sound heard
feeling fullness in the ear
cracking sound when yawning
b) vital q2
assess neuro q4
keet the pt’s room darkened
c) after bitten by a mosquito. standard precaution
d)inflammation of the brain/HOB 30 degress

Question 2

a) pt traumatic brain injury. what s/s indicate inc intracranial pressure
b) pt has a clonic seizure while lying in bed. why do we remove the pillow?
c) presbyopia, what EF?

Answer 2

a) dilates pupils
b) protects the airway
c) heard to read the newspaper 老眼

Question 3

manifestation
a) cataracts
b) angled-closure glaucoma
c) retinal detachment
d) macular degeneration

Answer 3

a) clouding,dec periphela and central vision d/t opacity of the lens
blurried vision
white pupils
b) emergency, sudden severe pain, reduce vision
open-angle gradual loss of vision
c) curtain pulled over the visual field with flashes of light,floating dark spots
d) lose of vision in the center of the visual fiels
Inc intake deep wellow and orange vege

Question 4

a) pt fall off of a roof. What indication of a basilar skull fracture?
b) pt who has closed traumatic brain injury experiencing inc ICP, this d/t?
c) ALS early s/s?

Answer 4

a) clear fluid coming from the nares
open traumatic brain injury
b) Rigid skull containing cranial contents
c) weakness of the distal extremities
they don’t affect visual, sensory nervous and temp regulation

Question 5

a) pt received sedation. When the nurse applies nailbed pressure, the pt withdraws his hand. what document of this?
b) pt who has myasthenia gravis, what supplies should the nurse place the pt’s bedside?
c) repetaed middle ear infections d/t obstraction of the structure that connects the middles ear to the throat. what is this?

Answer 5

a) aroudal(response sensory stimulation)
b) oral-nasal suction(weakness of the skeletal muscles
c) eustachian tube

Question 6

pre-ope teaching about laser-assisted in situ keratomileusis(LASIK)?

Answer 6

need glasses after surgery/eye surgery
no drive home/will have blurry vision
not wear contact for 2-3 weeks
complete healing is about 4 weeks
ADR is dry eye

Question 7

a) teaching about open-angled glaucoma

Answer 7

a) driving can be dangerous d/t loss of peripheral vision
laser surgery can help reestablish the flow of aqueous humor
eye drop will not help improve vision but reduce intraocular pressure

Question 8

a) mastoiditis s/s?
b) multiple scleosis(MS) s/s?

Answer 8

a) selling behind the affected ear
b) remissions(減少) and exacerbations
including vision loss, pain, fatigue, and impaired coordination

Question 9

Manifestation
Right side stroke

Answer 9

-Left side neglect
-impaired judgment
-lmparied impulse control
-impaired time
-Short attention span

Question 10

Manifestation
left side stroke

Answer 10

-Paralysis on right side
-Impaired speech/language
(Left=Language) aphasia
-Slow, cautious
-Aware of deficits/depression

Question 11

which part of the brain is affected?
a) aphasia(speaking)
b) vision
c) understand speech
d) memory

Answer 11

a) frontal
b) occipital
c) temporal
d) limbic

Question 12

a) pt who has autonomic dysreflexia d/t a C5 spinal cord injury. After checking pt’s vital signs, what should do first?
b) pt received mannitol for inc ICP. what indicates therapeutic effect?

Answer 12

a) Place the pt in a high fowler’s position
b) serum osmolarity is 310(because mannitol is osmotic diuretic/normal 275 to 295)
dilated pupils,bradycardia,restlessness,widened pulse pressure are inc ICP

Question 13

a) difficult to arouse means?
b) pt has a brain tumor and has CT. what factors affect the manner of preparing the CT?
c) EGG, what position and how long?

Answer 13

a) difficult to awake
b) development of hives when eating shrimp
cause CT uses contrast media(selfish allergy)
c) lying still eyes closed
45mins to 2hrs

Question 14

a) pt had a head injury from a fall at work, the nurse did ABC then what?
b) what memory? ask provider’s name he saw in past few day or how the pt arrive at the apointment with whom?
c) ask pt’s city of birth or the school he attended?
d) give 3 unrelated words and ask him to repeat
e) mother’s maiden name or specific important date in pt’s history

Answer 14

a) immobilize the pt’s cervical spine
b) recent, recall
c) remote
need to verify
d) immediate
f) past

Question 15

a) pt who has a traumatic brain injury and assumes a decerebrate posture in response to noxious stimuli.
what reactions should the nurse anticipate when drawing a blood sample?

Answer 15

a) rigidly extends and pronates the 4 extremities and externally rotates the wrists.severe brain stem injury

decorticate posturing internally flexes the wrists and arms and extends and plantar flexes the legs

Question 16

color of tag
a) dilated pupils that are fixed or nonreactive to light
b) life-threatening injuries but a high possibility of survival once they are stabilized
c) major injuries that are not yet life-threatening
d) minor injuries that are not life-threatening and do not need immediate attention

Answer 16

a) black/die naturally/class 4
b) red/class 1
c) yellow/class2
d) green/class 3

Question 17

a) after cataract surgery, what should be avoided?

Answer 17

a) bending over,lifting, coughing, performing the Valsalva maneuver
=limit houskeeping activities
attempt of exhalation against a closed airway, usually done by closing one’s mouth and pinching one’s nose shut while expelling air out as if blowing up a balloon

Question 18

a) cranial nerve 2 affected what?
b) cranial nerve involment?
c) Guillain-Barre syndrome, EF?

Answer 18

a) optic nerve, some visual challenges so provide an obstacle-free path for ambulation
b) dysphagia
c) weakness of the lower extremities

Question 19

after surgery of detached retina
a) how soon return vision?
b) what activity should avoid?
c) how long should wear eye shields?

Answer 19

a) over several weeks
b) reading or anything can cause rapid movement of the eye
c) 2-6weeks even during sleep

Question 20

a) cranial nerve X=10. what test was performed?
b) Sclerosis of the ossicles causes what?
c) postoperative following a frontal craniotomy. What positon should be?

Answer 20

a) have the pt open his mouth and say aah
b) Tinnitus, hearing loss
c) semi-fowler’s for prevent inc ICP

Question 21

a) complication of cranial nerve 8 VIII
b) what EEG measure?
c) adolescent who has recurrent external otitis. what instruction does the nurse teach?

Answer 21

a) dizziness and hearing loss
b) records the electrical activity of the brain cells
c) instill a diluted alcohol solution into the ear after swimming(just drop)
DO NOT insert anything smaller than finger!

Question 22

a) what is receptive aphasia?
b) what is expressive aphasia?
c) as name all of his children, their ages and bday os what memory?

Answer 22

a) cannot understand words or sentences they hear
b) cannot name simple objects or formulate sentences
c) remote

Question 23

a) stage 2 Alzheimer’s disease. what teaching to the family?
b) manifestation of autonomic dysreflexia?
c) which one is action first to protect head or put him on side while the seizure?

Answer 23

a) limit choices offered
b) report severe headache, flushing face and neck,bradycardia, extreme hypertension
c) protect head

Question 24

a) pt multiple sclerosis, what EF?
b) pt who has a spastic bladder following spinal cord injury. what to do?

Answer 24

a) intention tremors
at risk for motor dysfunction, with intention tremors, poor coordination, and loss of balance.
a) stroke the pt’s inner tigh
Other techniques include pinching the skin above the groin and providing digital anal stimulation.

Question 25

a) pt epilepsy and taking phenytoin. what to teach?
b) care for viral meningitis

Answer 25

a) take at consistent time each day to maintain therapeutic blood levels
client to continue taking antiepileptic medications even in the absence of seizures. Stopping the medication can lead to the return of seizures or the complication of status epilepticus.
b) check capillary refill at least q4

Question 26

a) pt who has right-sided homonymous hemianopsia. What to teach?

Answer 26

a) look consciously at both sides of their meal tray
Clients who have right-sided homonymous hemianopsia have lost the right visual field of both eyes and might only eat the food they are able to see on the left half of the meal tray. Therefore, the nurse should remind the client to look at both sides of his meal tray to help compensate for the visual loss.