Chapter 13: Central and Peripheral Nervous System Disorders Flashcards
An older adult patient is being evaluated following a stroke, which affected the anterior cerebral circulatory system. Which of the following signs/symptoms would be positive in the assessment of this patient?
Disorders in behavior and in cognition
When assessing a patient who complains of a tremor, the nurse practitioner must differentiate essential tremor from the tremor of Parkinson’s disease. Which of the following findings are consistent with essential tremor?
The tremor occurs with purposeful movements
Which of the following assessments are commonly noted in a client with Parkinson’s disease?
Micrographia and bradykinesia
An older adult client with a history of a seizure disorder comes into the clinic for a routine check-up. Although seizure free, the client continues on long-term phenytoin treatment. The nurse practitioner would assess for which of the following long-term effects?
Gingival hyperplasia and nystagmus
An elderly nursing home resident is maintained on phenytoin therapy for a history of a seizure disorder. In addition to periodic serum drug concentrations, which of the following are needed for annual evaluation?
Complete blood count, liver function tests, and platelet count
A 78-year-old female presents with a seizure that occurred over the weekend. In selecting the most important diagnostics for this presentation, it is important to know that the least common site of seizures in the elderly is:
Temporal lobe
An elderly patient has had a CVA in the anterior cerebral circulatory system (frontal lobe). What symptoms are most likely expressed?
Disorders of behavior and cognition
The most common neurological cause of seizures in an older adult is:
Stroke
You are evaluating an elderly patient’s complaint of a new onset of “hand shaking” when he drinks from a cup. The patient is euthyroid and does not drink alcohol. Which of the following signs indicate that this tremor is most likely an essential tremor rather than a Parkinson’s tremor?
It is a moderate amplitude tremor that occurs only with movement/activity
Mr. Andrews experienced a brief onset of right-sided weakness, slurred speech, and confusion yesterday. The symptoms have resolved. What should the nurse practitioner do?
Identify modifiable cardiovascular risk factors
An older male patient is experiencing acute onset of right-sided weakness, slurred speech, and confusion. What should the nurse practitioner do promptly?
Evaluate for stroke and arrange transport to the hospital right away
An older adult female patient had a stroke. What symptoms are not usually expressed by patients who have had a vertebrobasilar stroke?
Monocular blindness
When assessing an elderly client who reports a tremor, which assessment findings would be most reliable in identifying Parkinson’s disease?
Resting tremor, slow unsteady gait, and cogwheel resistance
A 78-year-old man with Parkinson’s disease is being cared for in a nursing home. The nurses observe that he coughs at mealtime; he has the ability to still feed himself with adaptive equipment. He has had no aspirations. Oral exam is normal, except during his swallowing assessment you note there is slight delayed elicitation. You assess that he has only mild dysphagia. You recommend which of the following as the next step in his care?
Provide a trial of foods of differing consistency
Which of the following assessment findings is commonly noted in a client with advanced Parkinson’s disease?
Micrographia
