course point unit 6

Question 1

Select the function of the occipital lobe.

Answer 1

Color, motion, and depth perception

Question 2

The pia mater is a connective tissue sheath that covers the spinal cord and primarily contains which body structure?

Answer 2

blood vessels

Question 3

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?

Answer 3

4 to 6 minutes

Question 4

The density of voltage-gated channels is greatest in which component of the neuron?

Answer 4

Nodes of Ranvier

Question 5

The nurse is performing a neurologic assessment on a client. Which assessment finding would the nurse determine is considered normal?

Answer 5

The client is able to swing arms when walking.

Question 6

Which hormone will elicit a more rapid response than the others?

Answer 6

Norepinephrine

Question 7

Through what specific component do neurotransmitters exert their action?

Answer 7

Specific proteins

Question 8

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?

Answer 8

Glucose is not stored in the brain and is a major fuel source for brain function.

Question 9

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?

Answer 9

Hypoglossal

Question 10

Which is the primary component of white matter?

Answer 10

Myelinated fibers

Question 11

Which types of cells are supporting cells of the peripheral nervous system?

Answer 11

Schwann cells

Question 12

The health care provider is performing a spinal tap on a client with suspected infection. The provider would perform the procedure at:

Answer 12

L3 or L4

Question 13

Feelings of dread, high anxiety, or exquisite pleasure can be elicited by stimulation of areas in which structure?

Answer 13

Limbic system

Question 14

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?

Answer 14

Eye dryness with risk for corneal scarring

Question 15

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?

Answer 15

Norepinephrine

Question 16

Maintenance of blood gas concentrations, water balance, and food consumption are controlled by which part of the brain?

Answer 16

Hypothalamus

Question 17

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:

Answer 17

allows alcohol, a very lipid-soluble molecule, to rapidly enter the brain.”

Question 18

Which of the meninges provides the major protection for the brain and spinal cord?

Answer 18

Dura mater

Question 19

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?

Answer 19

Coordinates smooth and accurate movements of the body

Question 20

Sweating is mediated by which neurotransmitter?

Answer 20

Acetylcholine

Question 21

During embryonic development, which structure develops into the central nervous system (CNS)?

Answer 21

Neural tube

Question 22

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:

Answer 22

must rely on glucose from the blood to meet their energy needs.

Question 23

A client asks the nurse if the brain is always receiving oxygen. The best response would be:

Answer 23

The brain receives 15% of the body’s resting cardiac output and consumes 20% of its oxygen.

Question 24

What are the main neurotransmitters of the autonomic nervous system (ANS)? Select all that apply.

Answer 24

Acetylcholine, Epinephrine, Norepinephrine

Question 25

The density of voltage-gated channels is greatest in which component of the neuron?

Answer 25

Nodes of Ranvier

Question 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?

Answer 26

Relative refractory period

Question 27

Which type of reflex is stimulated by a nociceptive stimulus?

Answer 27

Withdrawal reflex

Question 28

Potassium outflow from the cell is characteristic of which phase of the action potential?

Answer 28

Repolarization

Question 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?

Answer 30

Trigeminal nerve

Question 31

The perception of “where” a stimulus is in space and in relation to body parts is a function of the:

Answer 31

Parietal lobe

Question 32

Cerebrospinal fluid (CSF) is produced by which structure?

Answer 32

Choroid plexus

Question 33

Neuromodulators can produce slower and longer-lasting changes in membrane excitability by acting on postsynaptic receptors. What do neuromodulators do?

Answer 33

Alter the release of, or response to, neurotransmitters

Question 34

Neurons are characterized by the ability to communicate with other neurons and body cells through pulsed electrical impulses, or:

Answer 34

action potentials.

Question 35

Among the treatments for multiple sclerosis (MS), which medication will reduce the exacerbation of relapsing–remitting MS?

Answer 35

Interferon-β, a cytokine injection

Question 36

Which complication of spinal cord injury is the most preventable in a paraplegic client?

Answer 36

Skin breakdown

Question 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?

Answer 37

The disorder may present with rapid life-threatening symptoms or may present as a slow insidious process.

Question 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?

Answer 38

Respiratory support and protection of the client’s airway

Question 39

The transmission of impulses at the neuromuscular junction is mediated by which action?

Answer 39

Release of neurotransmitter acetylcholine from autonomic nerve endings

Question 40

Autonomic dysreflexia (autonomic hyperreflexia) is characterized by which of the following?

Answer 40

Vasospasms and hypertension

Question 41

A nurse is assessing a client with symptoms of botulism. The nurse will question the client regarding ingestion of which food?

Answer 41

Home-grown and canned vegetables

Question 42

Peripheral nerve disorders are not uncommon. What is an example of a fairly common mononeuropathy?

Answer 42

Carpal tunnel syndrome

Question 43

Myasthenia gravis is characterized by muscle weakness caused by antibody-mediated loss of which physiologic function?

Answer 43

Acetylcholine receptors

Question 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?

Answer 44

Dopamine nigrostriatal system

Question 45

A nurse is caring for a client experiencing muscle fasciculations. Fasciculations appear as:

Answer 45

spontaneous contractions of muscle fibers presenting as twitching.

Question 46

A nurse caring for a client with multiple sclerosis notes that the client has mood swings. Which cause can best explain this?

Answer 46

Psychological manifestation due to involvement of white matter of cerebral cortex

Question 47

Which disease is thought to be caused by antibody-mediated loss of acetylcholine receptors in the neuromuscular junction?

Answer 47

Myasthenia gravis

Question 48

Death caused by muscular dystrophy in early adulthood is usually due to:

Answer 48

respiratory and cardiac muscle involvement.

Question 49

Reflex activity involves which neurons?

Answer 49

All of the above

Question 50

Nystagmus due to cerebellar dysfunction would most likely interfere with which activity?

Answer 50

Reading

Question 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?

Answer 51

Oligoclonal patterns

Question 52

Which treatment should take place immediately in a client experiencing autonomic dysreflexia?

Answer 52

Position the client in upright position, and correct the initiating stimulus.

Question 53

Which peripheral nerve injury will likely result in cellular death with little chance of regeneration?

Answer 53

Nerve fibers destroyed close to the neuronal cell body

Question 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?

Answer 54

Dopamine

Question 55

Coordinated muscular movement requires proper functioning of four areas of the nervous system. Which system controls posture and balance?

Answer 55

The vestibular system

Question 56

Regarding the pathophysiology of Parkinson disease, which statement is true?

Answer 56

Degeneration of the nigrostriatal dopamine neurons occurs.

Question 57

Neurotoxins such as the botulism organism can produce paralysis by what mechanism?

Answer 57

By blocking release of acetylcholine

Question 58

Disorders of the pyramidal tracts, such as a stroke, are characterized by which physical finding?

Answer 58

Paralysis

Question 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?

Answer 59

The client has a sudden onset of severe weakness.

Question 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?

Answer 60

Hyperoxygenate prior to suctioning.

Question 61

Which disease can result in symptoms that can occur when a brain tumor causes damage to the nigrostriatal pathway?

Answer 61

Parkinson disease

Question 62

Restoration of the integrity of myelin sheaths would likely result in a slowing or stopping of the progression of:

Answer 62

Multiple sclerosis (MS)

Question 63

Which principle best explains symptoms of amyotrophic lateral sclerosis (ALS), including dysphagia, muscle weakness and spasticity, and dysphonia?

Answer 63

ALS is caused by both an upper motor neuron and lower motor neuron disturbance.

Question 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?

Answer 64

Upper and lower motor neurons

Question 65

Which of these project from the motor strip in the cerebral cortex to the ventral horn and are fully contained within the CNS?

Answer 65

Upper motor neurons

Question 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?

Answer 66

Cannot breathe on own, needs ventilator assistance

Question 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?

Answer 67

Positive Tinel sign

Question 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.

Answer 68

Cool, pale skin, Gooseflesh noted on extremities, BP 200/112

Question 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.

Answer 69

Depression, Forgetfulness, Inattentiveness,

Question 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?

Answer 70

Diaphragm

Question 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?

Answer 71

Cerebellar disorder

Question 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?

Answer 72

C8

Question 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?

Answer 73

Assess for other signs/symptoms of increased intracranial pressure.

Question 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?

Answer 74

flaccid motor response

Question 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:

Answer 75

“Because the skull sutures are not fused there may be no brain damage.”

Question 76

The nurse caring for a client with a newly diagnosed intracranial tumor anticipates that the neoplasm will be:

Answer 76

Astrocytic neoplasms

Question 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?

Answer 77

prodrome

Question 78

The most common cause of an ischemic stroke is which of the following?

Answer 78

Thrombosis

Question 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?

Answer 79

Muscle atrophy

Question 80

A client has developed global ischemia of the brain. The nurse determines this is:

Answer 80

inadequate to meet the metabolic needs of the entire brain.

Question 81

The nurse is preparing a client with a possible stroke for radiology. Which diagnostic procedure would be beneficial for this client?

Answer 81

Helical computed tomography angiography

Question 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?

Answer 82

Thrombolysis

Question 83

The nurse reading a client’s lumbar puncture results notifies the physician of findings consistent with meningitis when which sign/symptom is noted?

Answer 83

Large number of polymorphonuclear neutrophils

Question 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:

Answer 84

The blood–brain barrier is disrupted, allowing fluid to escape into the extracellular fluid.

Question 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?

Answer 85

Craniotomy and clipping of the affected vessel

Question 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?

Answer 86

TIAs, by definition, resolve rapidly, but they constitute an increased risk for stroke.

Question 87

Global and focal brain injuries manifest differently. What is almost always a manifestation of a global brain injury?

Answer 87

Altered level of consciousness

Question 88

Which client is at least risk for rapid bleeding?

Answer 88

Client with a subdural hematoma

Question 89

Which sign would be considered a late indicator of increased intracranial pressure?

Answer 89

High mean arterial pressure

Question 90

When the suspected diagnosis is bacterial meningitis, what assessment techniques can assist in determining if meningeal irritation is present?

Answer 90

Brudzinski sign and Kernig sign

Question 91

The MRA scan of a client with a suspected stroke reports ruptured berry aneurysm. The nurse plans care for a client with:

Answer 91

Subarachnoid hemorrhage

Question 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?

Answer 92

Ischemic stroke

Question 93

The emergency room doctor suspects a client may have bacterial meningitis. The most important diagnostic test to perform would be:

Answer 93

Lumbar puncture

Question 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?

Answer 94

Brain contusions and hematomas

Question 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:

Answer 95

automatisms.

Question 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:

Answer 96

characterized by an inability to communicate spontaneously with ease or translate thoughts or ideas into meaningful speech or writing.

Question 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?

Answer 97

Weakness in the muscular wall of an artery

Question 98

Manifestations of brain tumors are focal disturbances in brain function and increased ICP. What causes the focal disturbances manifested by brain tumors?

Answer 98

Brain edema and disturbances in blood flow

Question 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?

Answer 99

cerebrospinal fluid

Question 100

Which pathophysiologic process occurs in cases of bacterial meningitis?

Answer 100

Inflammation allows pathogens to cross into the cerebrospinal fluid.

Question 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:

Answer 101

resistance should be provided with the knee in a flexed position.

Question 102

The nurse is assessing a client and notes the client is now displaying decerebrate posturing. The position would be documented as:

Answer 102

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.

Question 103

The nurse explaining the causes of congenital hydrocephalus to the mother of a child born with hydrocephalus includes:

Answer 103

Aqueductal stenosis

Question 104

Which intracranial volume is most capable of compensating for increasing intracranial pressure?

Answer 104

Cerebrospinal fluid

Question 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:

Answer 105

decrease metabolic needs and increase oxygenation.

Question 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?

Answer 106

Encephalitis

Question 107

Overstimulation of glutamate receptors is the cause of which type of brain injury?

Answer 107

excitotoxic

Question 108

The nurse is planning an inservice on hypoxia versus ischemia in brain-injured clients. The nurse should include which of the following?

Answer 108

Hypoxia produces a generalized depressive effect on the brain.

Question 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?

Answer 109

Atherosclerotic lesions in cerebral vessels

Question 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?

Answer 110

Nystagmus

Question 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:

Answer 111

“It is a rare complication of concussions.”

Question 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?

Answer 112

Stupor

Question 113

For which common manifestation of acute meningococcal meningitis should the school nurse be assessing students?

Answer 113

Petechiae