course point unit 6 Flashcards
1
Q
Select the function of the occipital lobe.
A
Color, motion, and depth perception
2
Q
The pia mater is a connective tissue sheath that covers the spinal cord and primarily contains which body structure?
A
blood vessels
3
Q
A client has just begun to experience an ischemic stroke. The blood supply from the middle cerebral artery is being blocked by a large blood clot. How long before brain cells begin to die due to lack of ATP?
A
4 to 6 minutes
4
Q
The density of voltage-gated channels is greatest in which component of the neuron?
A
Nodes of Ranvier
5
Q
The nurse is performing a neurologic assessment on a client. Which assessment finding would the nurse determine is considered normal?
A
The client is able to swing arms when walking.
6
Q
Which hormone will elicit a more rapid response than the others?
A
Norepinephrine
7
Q
Through what specific component do neurotransmitters exert their action?
A
Specific proteins
8
Q
The nurse measures a blood glucose level of 40 mg/dL (2.22 mmol/L) for a client with type 1 diabetes. Why would it be important for the nurse to institute an intervention to elevate the glucose level in this client?
A
Glucose is not stored in the brain and is a major fuel source for brain function.
9
Q
A client arrives in the clinic after having a tongue piercing performed and is unable to control the movement of the tongue. The nurse is aware that which nerve may have been damaged from the piercing?
A
Hypoglossal
10
Q
Which is the primary component of white matter?
A
Myelinated fibers
11
Q
Which types of cells are supporting cells of the peripheral nervous system?
A
Schwann cells
12
Q
The health care provider is performing a spinal tap on a client with suspected infection. The provider would perform the procedure at:
A
L3 or L4
13
Q
Feelings of dread, high anxiety, or exquisite pleasure can be elicited by stimulation of areas in which structure?
A
Limbic system
14
Q
The nurse is caring for a client who has damage to the facial nerve (CN VII). What complication related to unilateral loss of a branch of the facial nerve function should the nurse closely assess for?
A
Eye dryness with risk for corneal scarring
15
Q
Rapid removal of a neurotransmitter is necessary to maintain precise control of neural transmission. Which transmitter is largely removed by the reuptake process and taken back into the neuron in an unchanged form and reused?
A
Norepinephrine
16
Q
Maintenance of blood gas concentrations, water balance, and food consumption are controlled by which part of the brain?
A
Hypothalamus
17
Q
College students were given various amounts of alcohol within a specified time frame and then asked to drive an obstacle course. The rationale for poor performance in driving as the amount of alcohol intake increased includes, “The blood–brain barrier:
A
allows alcohol, a very lipid-soluble molecule, to rapidly enter the brain.”
18
Q
Which of the meninges provides the major protection for the brain and spinal cord?
A
Dura mater
19
Q
The cerebellum, separated from the cerebral hemispheres by the tentorium cerebelli, lies in the posterior fossa of the cranium. What is one of the functions of the cerebellum?
A
Coordinates smooth and accurate movements of the body
20
Q
Sweating is mediated by which neurotransmitter?
A
Acetylcholine
21
Q
During embryonic development, which structure develops into the central nervous system (CNS)?
A
Neural tube
22
Q
A client has been brought to the emergency department following an overdose of insulin that resulted in unconsciousness. When explaining the rationale for this to the family, the nurse will emphasize that neurons:
A
must rely on glucose from the blood to meet their energy needs.
23
Q
A client asks the nurse if the brain is always receiving oxygen. The best response would be:
A
The brain receives 15% of the body’s resting cardiac output and consumes 20% of its oxygen.
24
Q
What are the main neurotransmitters of the autonomic nervous system (ANS)? Select all that apply.
A
Acetylcholine, Epinephrine, Norepinephrine
25
The density of voltage-gated channels is greatest in which component of the neuron?
Nodes of Ranvier
26
Which is the period during repolarization when a portion of the recovery cycle is where the membrane can be excited, although only by a stronger-than-normal stimulus?
Relative refractory period
27
Which type of reflex is stimulated by a nociceptive stimulus?
Withdrawal reflex
28
Potassium outflow from the cell is characteristic of which phase of the action potential?
Repolarization
29
30
Which nerve exits the pons and conveys the modalities of pain, temperature, touch, and proprioception to the superficial and deep regions of the face?
Trigeminal nerve
31
The perception of “where” a stimulus is in space and in relation to body parts is a function of the:
Parietal lobe
32
Cerebrospinal fluid (CSF) is produced by which structure?
Choroid plexus
33
Neuromodulators can produce slower and longer-lasting changes in membrane excitability by acting on postsynaptic receptors. What do neuromodulators do?
Alter the release of, or response to, neurotransmitters
34
Neurons are characterized by the ability to communicate with other neurons and body cells through pulsed electrical impulses, or:
action potentials.
35
Among the treatments for multiple sclerosis (MS), which medication will reduce the exacerbation of relapsing–remitting MS?
Interferon-β, a cytokine injection
36
Which complication of spinal cord injury is the most preventable in a paraplegic client?
Skin breakdown
37
A nurse is providing education to a client newly diagnosed with Guillain-Barré syndrome. Which statement reflects accurate information about the course of the disease?
The disorder may present with rapid life-threatening symptoms or may present as a slow insidious process.
38
A client with a diagnosis of myasthenia gravis underwent a mastectomy. The surgery was a success, but the client has gone into a myasthenic crisis on postoperative day 1. Which priority measure should the care team initiate immediately?
Respiratory support and protection of the client's airway
39
The transmission of impulses at the neuromuscular junction is mediated by which action?
Release of neurotransmitter acetylcholine from autonomic nerve endings
40
Autonomic dysreflexia (autonomic hyperreflexia) is characterized by which of the following?
Vasospasms and hypertension
41
A nurse is assessing a client with symptoms of botulism. The nurse will question the client regarding ingestion of which food?
Home-grown and canned vegetables
42
Peripheral nerve disorders are not uncommon. What is an example of a fairly common mononeuropathy?
Carpal tunnel syndrome
43
Myasthenia gravis is characterized by muscle weakness caused by antibody-mediated loss of which physiologic function?
Acetylcholine receptors
44
A client with Parkinson disease presents with bradykinesia and an altered gait. These symptoms arise in response to the progressive deterioration of which structure in the brain?
Dopamine nigrostriatal system
45
A nurse is caring for a client experiencing muscle fasciculations. Fasciculations appear as:
spontaneous contractions of muscle fibers presenting as twitching.
46
A nurse caring for a client with multiple sclerosis notes that the client has mood swings. Which cause can best explain this?
Psychological manifestation due to involvement of white matter of cerebral cortex
47
Which disease is thought to be caused by antibody-mediated loss of acetylcholine receptors in the neuromuscular junction?
Myasthenia gravis
48
Death caused by muscular dystrophy in early adulthood is usually due to:
respiratory and cardiac muscle involvement.
49
Reflex activity involves which neurons?
All of the above
50
Nystagmus due to cerebellar dysfunction would most likely interfere with which activity?
Reading
51
While there is no laboratory test that is diagnostic for multiple sclerosis, some clients have alterations in their cerebrospinal fluid (CSF) that can be seen when a portion of the CSF is removed during a spinal tap. What finding in CSF is suggestive of multiple sclerosis?
Oligoclonal patterns
52
Which treatment should take place immediately in a client experiencing autonomic dysreflexia?
Position the client in upright position, and correct the initiating stimulus.
53
Which peripheral nerve injury will likely result in cellular death with little chance of regeneration?
Nerve fibers destroyed close to the neuronal cell body
54
A client's recent diagnosis of Parkinson disease has prompted the care provider to promptly begin pharmacologic therapy. The drugs prescribed will likely influence the client's levels of which substance?
Dopamine
55
Coordinated muscular movement requires proper functioning of four areas of the nervous system. Which system controls posture and balance?
The vestibular system
56
Regarding the pathophysiology of Parkinson disease, which statement is true?
Degeneration of the nigrostriatal dopamine neurons occurs.
57
Neurotoxins such as the botulism organism can produce paralysis by what mechanism?
By blocking release of acetylcholine
58
Disorders of the pyramidal tracts, such as a stroke, are characterized by which physical finding?
Paralysis
59
The nurse is caring for a client with myasthenia gravis. Which symptoms displayed by the client would indicate to the nurse that the client may be experiencing myasthenia crisis?
The client has a sudden onset of severe weakness.
60
The nurse is suctioning a client with a C3 spinal cord injury when the client's heart rate drops from 86 bpm to 42 bpm. What intervention does the nurse understand should be provided prior to suctioning to prevent this vasovagal response from occurring?
Hyperoxygenate prior to suctioning.
61
Which disease can result in symptoms that can occur when a brain tumor causes damage to the nigrostriatal pathway?
Parkinson disease
62
Restoration of the integrity of myelin sheaths would likely result in a slowing or stopping of the progression of:
Multiple sclerosis (MS)
63
Which principle best explains symptoms of amyotrophic lateral sclerosis (ALS), including dysphagia, muscle weakness and spasticity, and dysphonia?
ALS is caused by both an upper motor neuron and lower motor neuron disturbance.
64
A client is devastated to receive a diagnosis of amyotrophic lateral sclerosis (ALS). The symptomatology of this disease is a result of its effects on which region of the brain?
Upper and lower motor neurons
65
Which of these project from the motor strip in the cerebral cortex to the ventral horn and are fully contained within the CNS?
Upper motor neurons
66
A 14-year-old girl has been thrown from the back of a pick-up truck. MRI shows complete cord injury at the level of C2. What is the main significance of an injury at this level of the spinal column?
Cannot breathe on own, needs ventilator assistance
67
The nurse is performing an assessment for a client suspected of having symptoms that correlate with carpal tunnel disorder. The client states he feels a tingling sensation that radiates into the palm of the hand when the nurse lightly percusses over the median nerve. How would the nurse document this finding?
Positive Tinel sign
68
Approximately 6 months after a spinal cord injury, a 29-year-old man has an episode of autonomic dysreflexia. What are the characteristics of autonomic dysreflexia? Select all that apply.
Cool, pale skin, Gooseflesh noted on extremities, BP 200/112
69
The family of a multiple sclerosis client asks, “What psychological manifestations may we expect to see in our mother?” The health care provider informs them to expect which of the following? Select all that apply.
Depression, Forgetfulness, Inattentiveness,
70
The client presents with a traumatic complete spinal cord transection at the C5 level. Based on this injury, the health care worker can expect the client to have control of which body function/part?
Diaphragm
71
An older adult has had a recent decrease in coordination, with gait being described as wide-based, unsteady, and lacking in fluidity, although the client's muscle tone appears normal. This client requires further assessment for which condition that is involved with coordination of movement?
Cerebellar disorder
72
At which level of the cervical spine would a complete cord injury result in the client retaining the ability to flex and extend the fingers?
C8
73
The nurse is caring for a client with a brain tumor when the client begins to vomit. Which intervention should the nurse do first?
Assess for other signs/symptoms of increased intracranial pressure.
74
An emergency room nurse receives a report that a client's Glasgow Coma Scale (GCS) is 3. The nurse prepares to care for a client with which of the following?
flaccid motor response
75
The parent of an infant who developed hydrocephalus while in utero is very concerned that the child will have significant intellectual dysfunction. The best response to the parent would be:
"Because the skull sutures are not fused there may be no brain damage."
76
The nurse caring for a client with a newly diagnosed intracranial tumor anticipates that the neoplasm will be:
Astrocytic neoplasms
77
The nurse is assessing a client who has experienced a seizure. The client describes having a feeling or warning that the seizure would occur. Which term does the nurse use when documenting about this perceived warning?
prodrome
78
The most common cause of an ischemic stroke is which of the following?
Thrombosis
79
The nurse is caring for an older adult client with hemiplegia following a stroke. While planning the client's care, the nurse knows the client is at risk for developing which condition?
Muscle atrophy
80
A client has developed global ischemia of the brain. The nurse determines this is:
inadequate to meet the metabolic needs of the entire brain.
81
The nurse is preparing a client with a possible stroke for radiology. Which diagnostic procedure would be beneficial for this client?
Helical computed tomography angiography
82
A client suffering a thrombotic stroke is brought into the emergency department by ambulance and the health care team is preparing to administer a synthetic tissue plasminogen activator for which purpose?
Thrombolysis
83
The nurse reading a client's lumbar puncture results notifies the physician of findings consistent with meningitis when which sign/symptom is noted?
Large number of polymorphonuclear neutrophils
84
The nurse is explaining to a client’s family how vasogenic brain edema occurs. The most appropriate information for the nurse to provide would be:
The blood–brain barrier is disrupted, allowing fluid to escape into the extracellular fluid.
85
The nurse knows that which treatment plan listed below is most likely to be prescribed after a computerized tomography (CT) scan of the head reveals a new-onset aneurysmal subarachnoid hemorrhage?
Craniotomy and clipping of the affected vessel
86
A nurse at a long-term care facility provides care for a client who has had recent transient ischemic attacks (TIAs). What significance should the nurse attach to the client's TIAs?
TIAs, by definition, resolve rapidly, but they constitute an increased risk for stroke.
87
Global and focal brain injuries manifest differently. What is almost always a manifestation of a global brain injury?
Altered level of consciousness
88
Which client is at least risk for rapid bleeding?
Client with a subdural hematoma
89
Which sign would be considered a late indicator of increased intracranial pressure?
High mean arterial pressure
90
When the suspected diagnosis is bacterial meningitis, what assessment techniques can assist in determining if meningeal irritation is present?
Brudzinski sign and Kernig sign
91
The MRA scan of a client with a suspected stroke reports ruptured berry aneurysm. The nurse plans care for a client with:
Subarachnoid hemorrhage
92
A client's emergency magnetic resonance imaging (MRI) has been examined by the physician and tissue plasminogen activator (tPA) has been administered to the client. What was this client's most likely diagnosis?
Ischemic stroke
93
The emergency room doctor suspects a client may have bacterial meningitis. The most important diagnostic test to perform would be:
Lumbar puncture
94
A teenager has been in a car accident and experienced an acceleration–deceleration head injury. Initially, the client was stable but then started to develop neurological signs/symptoms. The nurse caring for this client should be assessing for which type of possible complication?
Brain contusions and hematomas
95
The nurse is caring for a client experiencing a seizure. During the seizure the nurse notes that the client repetitively rubs his/her clothing. When contacting the client's physician, the nurse notes that the client exhibited:
automatisms.
96
A client has suffered a stroke that has affected his speech. The physician has identified the client as having expressive aphasia. Later in the day, the family asks the nurse to explain what this means. The most accurate response would be aphasia that is:
characterized by an inability to communicate spontaneously with ease or translate thoughts or ideas into meaningful speech or writing.
97
A client has been diagnosed with a cerebral aneurysm and placed under close observation before treatment commences. Which pathophysiologic condition has contributed to this client's diagnosis?
Weakness in the muscular wall of an artery
98
Manifestations of brain tumors are focal disturbances in brain function and increased ICP. What causes the focal disturbances manifested by brain tumors?
Brain edema and disturbances in blood flow
99
The nurse is conducting a community education program on concussions. The nurse will include that the brain is protected from external physical forces by which part of the nervous system?
cerebrospinal fluid
100
Which pathophysiologic process occurs in cases of bacterial meningitis?
Inflammation allows pathogens to cross into the cerebrospinal fluid.
101
The nurse observes a new nurse performing the test for Kernig sign on a client. The new nurse performs the test by providing resistance to flexion of the knees while the client is lying with the hip flexed at a right angle. The nurse should explain to the new nurse that:
resistance should be provided with the knee in a flexed position.
102
The nurse is assessing a client and notes the client is now displaying decerebrate posturing. The position would be documented as:
rigidity of the arms with palms of the hands turned away from the body and with stiffly extended legs and plantar flexion of the feet.
103
The nurse explaining the causes of congenital hydrocephalus to the mother of a child born with hydrocephalus includes:
Aqueductal stenosis
104
Which intracranial volume is most capable of compensating for increasing intracranial pressure?
Cerebrospinal fluid
105
A client suffering global cerebral ischemia a week after a suicide attempt by hanging is in the intensive care unit receiving treatment. The parent asks the nurse why it is necessary to keep the client paralyzed with medications and on the ventilator. The most appropriate response would be that these therapies:
decrease metabolic needs and increase oxygenation.
106
An adult client is admitted to the emergency department reporting a headache, stiff neck and lethargy. Based on the intake interview, the nurse suspects that the client had a seizure the day before. The client's vital signs are within reference range with the exception of a heart rate of 102 bpm and oral temperature of 38.6°C (101.5°F). Which diagnosis is most likely?
Encephalitis
107
Overstimulation of glutamate receptors is the cause of which type of brain injury?
excitotoxic
108
The nurse is planning an inservice on hypoxia versus ischemia in brain-injured clients. The nurse should include which of the following?
Hypoxia produces a generalized depressive effect on the brain.
109
An older adult is brought to the emergency department after experiencing some confusion, slurred speech, and a weak arm. Now the client is back to acting normally. Suspecting a transient ischemic attack (TIA), the health care provider prescribes diagnostic testing looking for which cause of this episode?
Atherosclerotic lesions in cerebral vessels
110
The nurse is preparing a client for oculovestibular reflex assessment (cold caloric test). The nurse explains that the test is used to elicit which of the following?
Nystagmus
111
The nurse is educating parents of a child with arteriovenous malformation. The nurse determines that the parents need additional education when the parents state:
"It is a rare complication of concussions."
112
What term is used to describe a level of consciousness during which a client responds only to vigorous and repeated stimuli and has minimal or no spontaneous movement?
Stupor
113
For which common manifestation of acute meningococcal meningitis should the school nurse be assessing students?
Petechiae
