Exam 4 Flashcards
1
Q
The incidence of fractures of the pelvis is highest in: a. preadolescent boys. b. adolescent boys. c. adolescent girls. d. older adults.
A
d.
older adults.
2
Q
A client is admitted to the hospital with a transverse fracture of the femur. Which statement best describes this type of fracture?
a.
The fracture line is parallel to the bone.
b.
The fracture line is straight across the bone.
c.
The fracture line is perpendicular to the bone.
d.
The fracture line is vertical to the shaft of the bone.
A
b.
The fracture line is straight across the bone.
3
Q
A 70-year-old diagnosed with osteoporosis fell and fractures the left leg at a location of pre-existing abnormality. Which term describes the fracture? a. Fatigue b. Stress c. Pathologic d. Greenstick
A
c.
Pathologic
4
Q
A 32-year-old obese male begins a jogging routine. A week after beginning, he fractures his leg. This is referred to as a what type of fracture? a. Comminuted b. Greenstick c. Fatigue d. Compound
A
c.
Fatigue
5
Q
Transchondral fractures are most prevalent in: a. adolescents. b. older adults. c. infants. d. premenopausal females.
A
a.
adolescents.
6
Q
A 35-year-old suffers a broken clavicle following a motor vehicle accident. X-ray reveals that the bone surfaces in the joint partially lost contact with each other. This condition is called: a. dislocation. b. subluxation. c. distortion. d. nonunion.
A
b.
subluxation.
7
Q
What term is used to describe a torn ligament? a. Sprain b. Strain c. Disunion d. Subluxation
A
a.
Sprain
8
Q
A 36-year-old reports pain and weakness in the elbow. MRI reveals inflammation of the tendon and the presence of microtears where it attaches to bone. This condition is called: a. periostitis. b. muscle strain. c. bursitis. d. epicondylopathy.
A
d.
epicondylopathy.
9
Q
Which clinical finding would be expected in the patient with rhabdomyolysis? a. Sweating b. Dark urine c. Yellow color to the skin d. Lower extremity swelling
A
b.
Dark urine
10
Q
The diagnosis of rhabdomyolysis is based on the measurement of which laboratory value? a. White blood cell count (WBC) b. Antinuclear antibodies c. Aspartate aminotransferase d. Creatine kinase (CK)
A
d. Creatine kinase (CK)
11
Q
A 70-year-old female presents with a hip fracture secondary to osteoporosis. This condition is caused by an increase in bone: a. density. b. formation. c. resorption. d. mineralization.
A
c.
resorption.
12
Q
When a 70-year-old female presents with a hip fracture she is diagnosed with osteoporosis. One factor that most likely contributed to her condition is: a. increased androgen levels. b. decreased estrogen levels. c. strenuous exercise. d. excessive dietary calcium.
A
b.
decreased estrogen levels.
13
Q
Osteomalacia is a result of: a. collagen breakdown in the bone matrix. b. excessive bone resorption. c. crowding of bone marrow by excessive bone growth. d. inadequate bone mineralization.
A
d.
inadequate bone mineralization.
14
Q
A 56-year-old male was admitted to the hospital with a diagnosis of osteomalacia. History reveals that he underwent bariatric surgery 3 years earlier. What is the common link between the surgery and the development of osteomalacia? a. Impaired phosphate absorption b. Increased calcium excretion c. Vitamin D deficiency d. Impaired vitamin C metabolism
A
c.
Vitamin D deficiency
15
Q
A disorder similar to osteomalacia that occurs in growing bones of children is termed: a. Paget disease. b. rickets. c. osteomyelitis. d. osteosarcoma.
A
b.
rickets.
16
Q
The cause of Paget disease is: a. fluoride deficiency. b. unknown at present. c. excess vitamin A. d. osteogenic sarcoma.
A
b.
unknown at present.
17
Q
What is the primary organism responsible for osteomyelitis? a. Staphylococcus aureus b. Salmonella c. Mycobacterium d. Haemophilus influenza
A
a.
Staphylococcus aureus
18
Q
Osteoarthritis, a degenerative joint disease, is characterized by loss of: a. the epiphyses. b. articular cartilage. c. synovial fluid. d. the joint capsule.
A
b.
articular cartilage.
19
Q
Researchers now believe that rheumatoid arthritis (RA) is a result of: a. an ineffective antiviral agent. b. an autoimmune disease. c. a complication of rheumatic fever. d. a superficial joint injury.
A
b.
an autoimmune disease.
20
Q
A 34-year-old female was recently diagnosed with rheumatoid arthritis (RA). Physical examination revealed that inflammation is noted in various: a. synovial membranes. b. short bones. c. subchondral bones. d. bursae sacs.
A
a.
synovial membranes.
21
Q
A 54-year-old male was recently diagnosed with rheumatoid arthritis (RA). Which of the following is the expected treatment of choice? a. Nonsteroidal anti-inflammatory drugs (NSAIDs) b. Gold salts c. Methotrexate d. Colchicine
A
c.
Methotrexate
22
Q
A 21-year-old is diagnosed with ankylosing spondylitis (AS). The most likely joint to be affected would be the: a. sacroiliac. b. carpal. c. shoulder. d. knee.
A
a.
sacroiliac.
23
Q
Which of the following people is at highest risk for the development of gout? a. Men aged 40-50 years b. Premenopausal women c. Male adolescents d. Female children
A
a.
Men aged 40-50 years
24
Q
The inflammatory symptoms of classic gouty arthritis are caused by the crystallization of \_\_\_\_\_ within the synovial fluid. a. purines b. pyrimidines c. monosodium urate d. acetic acid
A
c.
monosodium urate
25
Q
A 46-year-old male diagnosed with gouty arthritis is at high risk for developing: a. cholelithiasis. b. myocarditis. c. renal stones. d. liver failure.
A
c.
renal stones.
26
Q
What is the most common aggravating trigger of gouty arthritis attacks? a. Trauma b. Anemia c. High-fat foods d. Lack of exercise
A
a.
Trauma
27
Q
The chronic stage of gout, characterized by crystalline deposits in cartilage, synovial membranes, and soft tissue, is called: a. monoarticular arthritis. b. tophaceous gout. c. asymptomatic hyperuricemia. d. complicated gout.
A
b.
tophaceous gout.
28
Q
A 32-year-old male was injured in a motor vehicle accident and confined to bed for 3 weeks. During this time, the size and strength of muscle fibers decreased, a condition referred to as: a. myelodysplasia. b. ischemic atrophy. c. disuse atrophy. d. fibromyalgia.
A
c.
disuse atrophy.
29
Q
Fibromyalgia is a chronic musculoskeletal disorder characterized by:
a.
pain resulting from joint and muscle inflammation.
b.
muscle pain in the back and gastrointestinal symptoms.
c.
neurologic pain in the skeletal muscles.
d.
diffuse pain, fatigue, and tender points.
A
d.
diffuse pain, fatigue, and tender points.
30
Q
The most common cause of toxic myopathy is: a. infection. b. a tumor. c. alcoholism. d. osteoporosis.
A
c.
alcoholism.
31
Q
A malignant tumor of striated muscle tissue origin commonly found on the neck is called a: a. myelogenic tumor. b. giant cell tumor. c. rhabdomyosarcoma. d. rhabdomyoma.
A
c.
rhabdomyosarcoma.
32
Q
A 60-year-old male presents with swelling and pain in the knee. CT reveals a tumor has developed from a pre-existing benign bone lesion. This supports which diagnosis? a. Secondary chondrosarcoma b. Rhabdomyoma c. Rhabdomyosarcoma d. Fibrosarcoma
A
a.
Secondary chondrosarcoma
33
Q
Signs and symptoms of subluxation include: (select all that apply) a. Pain b. Swelling c. Hemorrhage d. Limitation of movement e. Joint deformity
A
a. Pain b. Swelling d. Limitation of movement e. Joint deformity
34
Q
What is the term used to identify a pattern of bone destruction indicative of an aggressive malignant tumor? (select all that apply) a. Moth-eaten b. Permeative c. Geographic d. Radial e. Selective
A
a. Moth-eaten b. Permeative c. Geographic
35
Q
To make a diagnosis of fibromyalgia, tenderness must be present in ____ of the 18 points necessary for diagnosis.
A
11
36
Q
When a patient asks what the somatic nervous system controls, how should the nurse respond? It controls: a. the heart. b. the spinal cord. c. skeletal muscle. d. smooth muscle organs.
A
c.
skeletal muscle.
37
Q
A nurse is preparing to teach about nerves. Which information should the nurse include? The axon leaves the cell body at the: a. axon hillock. b. Nissl body. c. node of Ranvier. d. myelin sheath.
A
a.
axon hillock.
38
Q
When a student asks in which region of the neuron do nerve impulses travel the fastest, how should the nurse respond? The: a. large axon. b. axon hillock. c. cell body. d. dendrites.
A
a.
large axon.
39
Q
A neurologist is teaching the staff about motor neurons. Which structural classification identifies motor neurons? a. Unipolar b. Pseudounipolar c. Bipolar d. Multipolar
A
d.
Multipolar
40
Q
An experiment looking at an isolated neuron revealed a sensory nerve with one process containing a dendritic portion extending away from the CNS and an axon extending toward the CNS. Which of the following classifications would this neuron fall into? a. Bipolar b. Multipolar c. Pseudounipolar d. Interpolar
A
c.
Pseudounipolar
41
Q
A cell was isolated from the CNS. A researcher revealed that its main function was to clear cellular debris. What type of cell is the researcher studying? a. Astrocyte b. Ependymal cell c. Microglia d. Schwann cell
A
c.
Microglia
42
Q
Which neurons have the capacity for regeneration? a. Unmyelinated neurons in the brain b. Myelinated neurons in the spinal cord c. Myelinated peripheral neurons d. Postganglionic motor neurons
A
c.
Myelinated peripheral neurons
43
Q
When a presynaptic neuron is stimulated in a patient’s body by an electrical current, neurotransmitters are released from the: a. synapse. b. synaptic bouton. c. synaptic cleft. d. receptor.
A
b.
synaptic bouton.
44
Q
Neurotransmitters interact with the postsynaptic membrane by binding to which structure? a. Receptor b. Nissl body c. Glial cell d. Neurofibril
A
a.
Receptor
45
Q
If a neuron’s membrane potential is held close to the threshold potential by excitatory postsynaptic potentials (EPSPs), the neuron is said to be: a. hyperpolarized. b. facilitated. c. integrated. d. inhibited.
A
b.
facilitated.
46
Q
A patient brought to the emergency room (ER) with severe burns is requesting something for the excruciating pain and is medicated with morphine, which blocks which of the following neurotransmitters, thus reducing the pain? a. Enkephalin b. Dopamine c. Acetylcholine d. Substance P
A
d.
Substance P
47
Q
A 19-year-old college student reports to his primary care provider that he cannot stay awake in class regardless of how much sleep he gets. Under-stimulation of which area of the brain is likely the site of the problem? a. Corpora quadrigemina b. Reticular activating system c. Cerebellum d. Hypothalamus
A
b.
Reticular activating system
48
Q
After rehabilitation for severe brain damage following a motor vehicle accident, a patient reports that her thought processes and ability to concentrate are impaired. Which area does the nurse suspect is damaged? a. Thalamus b. Limbic c. Prefrontal d. Occipital
A
c.
Prefrontal
49
Q
A neurologist is teaching about the region responsible for motor aspects of speech. Which area is the neurologist discussing? a. Wernicke area b. Broca area c. Brodmann area 4 d. Brodmann area 6
A
b.
Broca area
50
Q
A patient is looking at a picture of the brain and points to the convolutions on the surface of the cerebrum. The nurse should tell the patient these are called: a. sulci. b. fissures. c. reticular formations. d. gyri.
A
d.
gyri.
51
Q
Where is the primary visual cortex of the brain located? a. Frontal lobe b. Temporal lobe c. Occipital lobe d. Parietal lobe
A
c.
Occipital lobe
52
Q
A nurse is preparing to teach about functions to maintain homeostasis and instinctive behavioral patterns. Which area of the brain is the nurse discussing? a. Thalamus b. Medulla c. Cerebellum d. Hypothalamus
A
d.
Hypothalamus
53
Q
When a nurse is teaching about the transverse fiber tract that connects the two cerebral hemispheres, what term should the nurse use? a. Peduncle b. Corpus callosum c. Basal ganglia d. Pons
A
b.
Corpus callosum
54
Q
A student nurse asks the nurse what controls reflex activities concerned with heart rate and blood pressure. What is the nurse’s best response? These reflex activities are controlled by the: a. medulla oblongata. b. pons. c. midbrain. d. cerebrum.
A
a.
medulla oblongata.
55
Q
Blockage of which of the following would cause hydrocephalus? a. Cerebral aqueduct b. Inferior colliculi c. Red nucleus d. Tegmentum
A
a.
Cerebral aqueduct
56
Q
A patient presents with altered respiratory patterns following head trauma. Based on the symptoms, which of the following areas does the nurse suspect is injured? a. Cerebrum b. Cerebellum c. Midbrain d. Reticular formation
A
d.
Reticular formation
57
Q
A nurse recalls that characteristics of upper motor neurons include:
a.
directly innervating muscles.
b.
influencing and modifying spinal reflex arcs.
c.
cell bodies located in the gray matter of the spinal cord.
d.
dendritic processes extending out of the CNS.
A
b.
influencing and modifying spinal reflex arcs.
58
Q
A nurse is teaching about the area of the spinal cord that contains cell bodies involved in the autonomic nervous system. Which of the following areas is the nurse discussing? a. Anterior horn b. Ventral horn c. Lateral horn d. Dorsal horn
A
c.
Lateral horn
59
Q
A neurologist is teaching about sensory pathways. Which information should the neurologist include? Sensory pathways in the spinal cord to the thalamus are included in the: a. corticospinal tract. b. pyramids. c. spinothalamic tract. d. anterior column.
A
c.
spinothalamic tract.
60
Q
A nurse is discussing the membrane that separates the cerebellum from the cerebrum. What term should the nurse use to describe this membrane? a. Tentorium cerebelli b. Falx cerebri c. Arachnoid membrane d. Temporal lobe
A
a.
Tentorium cerebelli
61
Q
What term should the nurse use when talking about the outermost membrane surrounding the brain? a. Dura mater b. Arachnoid mater c. Pia mater d. Falx cerebri
A
a.
Dura mater
62
Q
Cerebrospinal fluid (CSF) can accumulate around the brain when there is injury to the sites of CSF reabsorption, which are called the: a. arachnoid villi. b. epidural foramina. c. lateral apertures. d. choroid plexuses.
A
a.
arachnoid villi.
63
Q
Which structure ensures collateral blood flow from blood vessels supplying the brain? a. Carotid arteries b. Basal artery c. Circle of Willis d. Vertebral arteries
A
c.
Circle of Willis
64
Q
What type of cell supports the forming of the blood-brain barrier (BBB)? a. Endothelial b. Schwann c. Oligodendrocyte d. Astrocyte
A
d.
Astrocyte
65
Q
When a patient’s vagus nerve is stimulated, what does the nurse expect to observe? a. Increased gastrointestinal activity b. Increased heart rate c. Pupil constriction d. Vasoconstriction
A
a.
Increased gastrointestinal activity
66
Q
A patient suffers from head trauma that affects cranial nerve I. Which of the following symptoms would the nurse expect? a. Visual disturbances b. Loss of sense of smell c. Loss of ability to taste d. Hearing disturbances
A
b.
Loss of sense of smell
67
Q
Which neurotransmitter is released when a patient’s parasympathetic motor neurons are stimulated? a. Epinephrine b. Serotonin c. Acetylcholine d. Substance P
A
c.
Acetylcholine
68
Q
Which action will occur when a patient’s α1-receptors are stimulated?
a.
Dilation of the coronary arteries
b.
Vasoconstriction of arteries
c.
Increase in the strength of myocardial contraction
d.
Decrease in the rate of myocardial contraction
A
c.
Increase in the strength of myocardial contraction
69
Q
A patient begins taking a new drug that causes pupil dilation, vasoconstriction, decreased gastrointestinal motility, and goose bumps. Which of the following receptors are activated? a. α1 b. Α2 c. β1 d. Β2
A
a.
α1
70
Q
The nurse is assessing the patient with a pen light. The integrity of which cranial nerve is being evaluated? a. Olfactory b. Vagus c. Oculomotor d. Trigeminal
A
c.
Oculomotor
71
Q
Which of the following is a neuroglial cell? (select all that apply) a. Astrocyte b. Oligodendrocyte c. Neuron d. Ependymal cell e. Melanocyte
A
a. Astrocyte b. Oligodendrocyte d. Ependymal cell
72
Q
A nurse remembers the brain receives approximately \_\_\_\_% of the cardiac output. a. 80 b. 40 c. 20 d. 10
A
c.
20
73
Q
A nurse is monitoring intracranial pressure. A nurse recalls the normal upper limit of intracranial pressure is _______ mm Hg.
A
14
74
Q
When a patient wants to know how many vertebrae make up the vertebral column, the nurse responds with _____.
A
33
75
Q
A neurologist explains that arousal is mediated by the: a. cerebral cortex. b. medulla oblongata. c. reticular activating system. d. cingulate gyrus.
A
c.
reticular activating system.
76
Q
A 20-year-old experiences a severe closed head injury as a result of a motor vehicle accident. Which of the following structures is most likely keeping the patient in a vegetative state (VS) 1 month after the accident? a. Cerebral cortex b. Brainstem c. Spinal cord d. Cerebellum
A
b.
Brainstem
77
Q
A 16-year-old’s level of arousal was altered after taking a recreational drug. Physical exam revealed a negative Babinski sign, equal and reactive pupils, and roving eye movements. Which of the following diagnoses will the nurse most likely see on the chart? a. Psychogenic arousal alteration b. Metabolically induced coma c. Structurally induced coma d. Structural arousal alteration
A
b.
Metabolically induced coma
78
Q
The breathing pattern that reflects respirations based primarily on carbon dioxide (CO2) levels in the blood is: a. Cheyne-Stokes. b. ataxic. c. central neurogenic. d. normal.
A
a.
Cheyne-Stokes.
79
Q
A teenager sustains a severe closed head injury following an all-terrain vehicle (ATV) accident and is in a state of deep sleep that requires vigorous stimulation to elicit eye opening. How should the nurse document this in the chart? a. Confusion b. Coma c. Obtundation d. Stupor
A
d.
Stupor
80
Q
A patient experiences a severe head injury hitting a tree while riding a motorcycle. Breathing becomes deep and rapid but with normal pattern. What term should the nurse use for this condition? a. Gasping b. Ataxic breathing c. Apneusis d. Central neurogenic hyperventilation
A
d.
Central neurogenic hyperventilation
81
Q
A patient presents to the emergency room (ER) reporting excessive vomiting. A CT scan of the brain reveals a mass in the: a. skull fractures. b. thalamus. c. medulla oblongata. d. frontal lobe.
A
c.
medulla oblongata.
82
Q
For legal purposes, brain death is defined as: a. cessation of entire brain function. b. lack of cortical function. c. a consistent vegetative state (VS). d. death of the brainstem.
A
a.
cessation of entire brain function.
83
Q
When thought content and arousal level are intact but a patient cannot communicate and is immobile, the patient is experiencing: a. cerebral death. b. locked-in syndrome. c. dysphagia. d. cerebellar motor syndrome.
A
b.
locked-in syndrome.
84
Q
What term is used to describe an explosive, disorderly discharge of cortical neurons? a. Reflex b. Seizure c. Inattentiveness d. Brain death
A
b.
Seizure
85
Q
A patient has memory loss of events that occurred before a head injury. What cognitive disorder does the nurse suspect the patient is experiencing? a. Selective memory deficit b. Anterograde amnesia c. Retrograde amnesia d. Executive memory deficit
A
c.
Retrograde amnesia
86
Q
A 65-year-old patient who recently suffered a cerebral vascular accident is now unable to recognize and identify objects by touch because of injury to the sensory cortex. How should the nurse document this finding? a. Hypomimesis b. Agnosia c. Dysphasia d. Echolalia
A
b.
Agnosia
87
Q
A patient experiences a stroke and now has difficulty writing and producing language. This condition is most likely caused by occlusion of the: a. anterior communicating artery. b. posterior communicating artery. c. circle of Willis. d. middle cerebral artery.
A
d.
middle cerebral artery.
88
Q
A patient with an addiction to alcohol checked into a rehabilitation center as a result of experiencing delirium, inability to concentrate, and being easily distracted. What term would be used to document this state? a. Acute confusional state b. Echolalia c. Dementia d. Dysphagia
A
a.
Acute confusional state
89
Q
The patient is experiencing an increase in intracranial pressure. This increase results in: a. brain tissue hypoxia. b. intracranial hypotension. c. ventricular swelling. d. expansion of the cranial vault.
A
a.
brain tissue hypoxia.
90
Q
A compensatory alteration in the diameter of cerebral blood vessels in response to increased intracranial pressure is called: a. herniation. b. vasodilation. c. autoregulation. d. amyotrophy.
A
c.
autoregulation.
91
Q
A patient is admitted to the neurological critical care unit with a severe closed head injury. When an intraventricular catheter is inserted, the intracranial pressure (ICP) is recorded at 24 mm Hg. How should the nurse interpret this reading? a. Higher than normal b. Lower than normal c. Normal d. Borderline
A
a.
Higher than normal
92
Q
A 70-year-old patient is being closely monitored in the neurological critical care unit for a severe closed head injury. After 48 hours, signs of deterioration occur: pupils are small and sluggish, pulse pressure is widening, and heart rate is bradycardic. These clinical findings are evidence of what stage of intracranial hypertension? a. Stage 1 b. Stage 2 c. Stage 3 d. Stage 4
A
c.
Stage 3
93
Q
The primary care provider states that the patient is experiencing vasogenic edema. The nurse realizes vasogenic edema is clinically important because: a. it usually has an infectious cause. b. the blood-brain barrier is disrupted. c. ICP is excessively high. d. it always causes herniation.
A
b.
the blood-brain barrier is disrupted.
94
Q
The progress notes read: the cerebellar tonsil has shifted through the foramen magnum due to increased pressure within the posterior fossa. The nurse would identify this note as a description of \_\_\_\_\_ herniation. a. supratentorial b. central c. cingulated gyrus d. infratentorial
A
d.
infratentorial
95
Q
An infant is diagnosed with noncommunicating hydrocephalus. What is an immediate priority concern for this patient? a. Metabolic edema b. Interstitial edema c. Vasogenic edema d. Ischemic edema
A
b.
Interstitial edema
96
Q
An adult is diagnosed with communicating hydrocephalus. The form of hydrocephalus in adults is most often caused by: a. overproduction of CSF. b. intercellular edema. c. elevated arterial blood pressure. d. defective CSF reabsorption.
A
d.
defective CSF reabsorption.
97
Q
A 16-year-old male fell off the bed of a pickup truck and hit his forehead on the road. He now has resistance to passive movement that varies proportionally with the force applied. He is most likely suffering from: a. spasticity. b. paratonia. c. rigidity. d. dystonia.
A
b.
paratonia.
98
Q
A patient reports tiring easily, having difficulty rising from a sitting position, and the inability to stand on toes. The nurse would expect a diagnosis of: a. Parkinson disease. b. hypotonia. c. Huntington disease. d. paresis.
A
b.
hypotonia.
99
Q
A patient has paralysis of both legs. What type of paralysis does the patient have? a. Paraplegia b. Quadriplegia c. Infraparaplegia d. Paresthesia
A
a.
Paraplegia
100
Q
Spinal shock is characterized by:
a.
loss of voluntary motor function with preservation of reflexes.
b.
cessation of spinal cord function below the lesion.
c.
loss of spinal cord function at the level of the lesion only.
d.
temporary loss of spinal cord function above the lesion.
A
b.
cessation of spinal cord function below the lesion.
101
Q
A patient has excessive movement. What disorder will the nurse see documented on the chart? a. Hypokinesia b. Akinesia c. Hyperkinesia d. Dyskinesia
A
c.
Hyperkinesia
102
Q
A 40-year-old male complains of uncontrolled excessive movement and progressive dysfunction of intellectual and thought processes. He is experiencing movement problems that begin in the face and arms and eventually affect the entire body. The most likely diagnosis is: a. tardive dyskinesia. b. Huntington disease. c. hypokinesia. d. Alzheimer disease.
A
b.
Huntington disease.
103
Q
A nurse notes that a patient walks with the leg extended and held stiff, causing a scraping over the floor surface. What type of gait is the patient experiencing? a. Spastic gait b. Cerebellar gait c. Basal ganglion gait d. Scissors gait
A
a.
Spastic gait
104
Q
A patient is admitted to the neurological critical care unit with a severe closed head injury. All four extremities are in rigid extension, the forearms are hyperpronated, and the legs are in plantar extension. How should the nurse chart this condition? a. Decorticate posturing b. Decerebrate posturing c. Dystonic posturing d. Basal ganglion posturing
A
b.
Decerebrate posturing
105
Q
A nurse recalls that neural systems basic to cognitive functions include \_\_\_\_\_ systems. (select all that apply) a. attentional b. memory and language c. affective d. sensory and motor e. tactile
A
a. attentional b. memory and language c. affective
106
Q
The nurse is explaining clinical manifestations of alterations in the extrapyramidal system. The nurse would correctly include: (select all that apply)
a.
little or no paralysis of voluntary movement.
b.
normal or slightly increased tendon reflexes.
c.
positive (present) Babinski.
d.
presence of tremor.
e.
rigidity in muscle tone.
A
a. little or no paralysis of voluntary movement. b. normal or slightly increased tendon reflexes. d. presence of tremor. e. rigidity in muscle tone.
107
Q
A nurse is preparing to teach staff about the most common type of traumatic brain injury. Which type of traumatic brain injury should the nurse discuss? a. Penetrating trauma b. Diffuse axonal injury c. Focal brain injury d. Concussion
A
d.
Concussion
108
Q
A coup injury resulting from a blow to the frontal portion of the skull would occur in which region of the brain? a. Frontal b. Temporal c. Parietal d. Occipital
A
a.
Frontal
109
Q
What is the main source of bleeding in extradural (epidural) hematomas? a. Arterial b. Venous c. Capillary d. Sinus
A
a.
Arterial
110
Q
A 69-year-old patient with a history of alcohol abuse presents to the emergency room (ER) after a month-long episode of headaches and confusion. The patient’s history and symptomology support which medical diagnosis? a. Concussion b. Chronic subdural hematoma c. Epidural hematoma d. Subacute subdural hematoma
A
b.
Chronic subdural hematoma
111
Q
Immediately after being struck by a motor vehicle, a patient is unconscious, but the patient regains consciousness before arriving at the hospital and appears alert and oriented. The next morning the patient is confused and demonstrates impaired responsiveness. The patient’s history and symptoms support which medical diagnosis? a. Mild concussion b. Subdural hematoma c. Extradural (epidural) hematoma d. Mild diffuse axonal injury
A
c.
Extradural (epidural) hematoma
112
Q
Which assessment finding by the nurse characterizes a mild concussion? a. A brief loss of consciousness b. Significant behavioral changes c. Retrograde amnesia d. Permanent confusion
A
c.
Retrograde amnesia
113
Q
A CT scan reveals that a patient has an open basilar skull fracture. Which major complication should the nurse observe for in this patient? a. Hematoma formation b. Meningeal infection c. Increased intracranial pressure (ICP) d. Cognitive deficits
A
b.
Meningeal infection
114
Q
A patient diagnosed with a diffuse brain injury (DBI) is at increased risk for which complication? a. Complete loss of vision b. Arrhythmia c. Acute brain swelling d. Meningitis infection
A
c.
Acute brain swelling
115
Q
After falling, a patient’s Glasgow Coma Scale (GCS) was 5 initially and 7 after 1 day. The patient remained unconscious for 2 weeks but is now awake, confused, and experiencing anterograde amnesia. This history supports which medical diagnosis? a. Mild diffuse brain injury b. Moderate diffuse brain injury c. Severe diffuse brain injury d. Postconcussive syndrome
A
b.
Moderate diffuse brain injury
116
Q
Who is most at risk of spinal cord injury because of preexisting degenerative disorders? a. Infants b. Men c. Women d. The elderly
A
d.
The elderly
117
Q
A patient is brought to the ER for treatment of injuries received in a motor vehicle accident. An MRI reveals spinal cord injury, and his body temperature fluctuates markedly. The most accurate explanation of this phenomenon is that:
a.
he developed pneumonia.
b.
his sympathetic nervous system has been damaged.
c.
he has a brain injury.
d.
he has septicemia from an unknown source.
A
b.
his sympathetic nervous system has been damaged.
118
Q
Six weeks ago a patient suffered a T6 spinal cord injury. What complication does the nurse suspect when the patient develops a blood pressure of 200/120, a severe headache, blurred vision, and bradycardia? a. Extreme spinal shock b. Acute anxiety c. Autonomic hyperreflexia d. Parasympathetic areflexia
A
c.
Autonomic hyperreflexia
119
Q
A patient diagnosed with a spinal cord injury experienced spinal shock lasting 15 days. The patient is now experiencing an uncompensated cardiovascular response to sympathetic stimulation. What does the nurse suspect caused this condition?
a.
Toxic accumulation of free radicals below the level of the injury
b.
Pain stimulation above the level of the spinal cord lesion
c.
A distended bladder or rectum
d.
An abnormal vagal response
A
c.
A distended bladder or rectum
120
Q
A patient presents with acute low back pain. There is no history of trauma. An MRI reveals that the vertebra at L5 has slipped forward relative to those below it. Which of the following conditions will be documented on the chart? a. Degenerative disk disease b. Spondylolysis c. Spondylolisthesis d. Spinal stenosis
A
c.
Spondylolisthesis
121
Q
The majority of intervertebral disk herniations occur between which vertebral levels (cervical, C; thoracic, T; lumbar, L; sacral, S)? a. C1-C3 b. T1-T4 c. T12-L3 d. L4-S1
A
d.
L4-S1
122
Q
A 30-year-old white male recently suffered a cerebrovascular accident. Which of the following is the most likely factor that contributed to his stroke? a. Age b. Gender c. Diabetes d. Race
A
c.
Diabetes
123
Q
Which of the following would increase a patient’s risk for thrombotic stroke? a. Hyperthyroidism b. Hypertension c. Anemia d. Dehydration
A
d.
Dehydration
124
Q
Of the following groups, who are at highest risk for a cerebrovascular accident (CVA)? a. Blacks over 65 years of age b. Whites over 65 years of age c. Blacks under 65 years of age d. Whites under 65 years of age
A
a.
Blacks over 65 years of age
125
Q
A 72-year-old patient demonstrates left-sided weakness of upper and lower extremities. The symptoms lasted less than an hour and resolved with no evidence of infarction. The patient most likely experienced a(n): a. stroke in evolution. b. arteriovenous malformation. c. transient ischemic attack. d. cerebral hemorrhage.
A
c.
transient ischemic attack.
126
Q
A major contributing process in CVAs is the development of atheromatous plaques in cerebral circulation. Where do these plaques most commonly form? a. In the larger veins b. Near capillary sphincters c. In cerebral arteries d. In the venous sinuses
A
c.
In cerebral arteries
127
Q
A 60-year-old patient with a recent history of head trauma and a long-term history of hypertension presents to the ER for changes in mental status. MRI reveals that the patient has experienced a subarachnoid hemorrhage. What does the nurse suspect caused this type of stroke? a. Rheumatic heart disease b. Thrombi c. Aneurysm d. Hypotension
A
c.
Aneurysm
128
Q
A 75-year-old patient experienced a lacunar stroke. When looking through the history of the patient’s chart, which of the following would the nurse expect to find? a. An embolus b. An ischemic lesion c. A hemorrhage d. An aneurysm
A
b.
An ischemic lesion
129
Q
Upon autopsy of a 25-year-old, abnormalities in the media of the arterial wall and degenerative changes were detected. Which of the following would most likely accompany this finding? a. Fusiform aneurysm b. Saccular aneurysm c. Arteriovenous malformation d. Thrombotic stroke
A
b.
Saccular aneurysm
130
Q
A 48-year-old patient presents at the ER reporting an acute severe headache, nausea, photophobia, and nuchal rigidity. Which medical diagnosis is supported by these signs and symptoms? a. Diffuse brain injury b. Subarachnoid hemorrhage c. Epidural hematoma d. Classic concussion
A
b.
Subarachnoid hemorrhage
131
Q
A 65-year-old patient diagnosed with a subarachnoid hemorrhage secondary to uncontrolled hypertension appears drowsy and confused with pronounced focal neurologic deficits. This symptomology would place this hemorrhage at which grade? a. I b. II c. III d. IV
A
c.
III
132
Q
A patient presents to a primary care provider reporting fever, headache, nuchal rigidity, and decreased consciousness. History includes a previously treated sinusitis. Which medical diagnosis is best supported by this assessment data? a. Aseptic meningitis b. Bacterial meningitis c. Fungal meningitis d. Nonpurulent meningitis
A
b.
Bacterial meningitis
133
Q
Most causes of encephalitis are which of the following? a. Bacterial b. Viral c. Fungal d. Toxoid
A
b.
Viral
134
Q
A 15-month-old child from Pennsylvania was brought to the ER with symptomology that includes fever, seizure activity, cranial palsies, and paralysis. Which form of encephalitis is best supported by the available assessment data? a. Eastern equine encephalitis b. Venezuelan encephalitis c. St. Louis encephalitis d. West Nile encephalitis
A
a.
Eastern equine encephalitis
135
Q
A patient is newly diagnosed with multiple sclerosis (MS). What physiological change is causing the patient’s symptoms?
a.
Depletion of dopamine in the central nervous system (CNS)
b.
Demyelination of nerve fibers in the CNS
c.
The development of neurofibril webs in the CNS
d.
Reduced amounts of acetylcholine at the neuromuscular junction
A
b.
Demyelination of nerve fibers in the CNS
136
Q
When a patient asks, “What is the cause of multiple sclerosis?” the nurse bases the answer on the interaction between: a. vascular and metabolic factors. b. bacterial infection and the inflammatory response. c. autoimmunity and genetic susceptibility. d. neurotransmitters and inherited genes.
A
c.
autoimmunity and genetic susceptibility.
137
Q
Patient teaching is considered successful regarding myasthenia gravis when the patient identifies its cause as being:
a.
viral infection of skeletal muscle.
b.
atrophy of motor neurons in the spinal cord.
c.
demyelination of skeletal motor neurons.
d.
autoimmune injury at the neuromuscular junction.
A
d.
autoimmune injury at the neuromuscular junction.
138
Q
Patients diagnosed with myasthenia gravis often have tumors or pathologic changes in the: a. brain. b. pancreas. c. thymus. d. lungs.
A
c.
thymus.
139
Q
What are the most common primary central nervous system (CNS) tumors in adults? a. Meningiomas b. Oligodendrogliomas c. Astrocytomas d. Ependymomas
A
c.
Astrocytomas
140
Q
A patient presents with seizures. An MRI reveals a meningioma most likely originating from the: a. dura mater and arachnoid membrane. b. astrocytes. c. pia mater. d. CNS neurons.
A
a.
dura mater and arachnoid membrane.
141
Q
The patient reports generalized muscle weakness. The health care provider orders administration of the medication edrophonium chloride (Tensilon). This medication is used in the diagnosis of: a. amyotrophic lateral sclerosis (ALS). b. myasthenia gravis. c. multiple sclerosis (MS). d. autonomic hyperreflexia.
A
b.
myasthenia gravis.
142
Q
Which information is basic to the assessment findings associated with a patient diagnosed with an aneurysm? a. A headache is the most common symptom. b. The majority are asymptomatic. c. Nosebleeds are an early symptom. d. Epidural hemorrhage occurs in over 80% of patients.
A
b.
The majority are asymptomatic.
143
Q
What is the most common early symptom of a brain abscess? a. Neck rigidity b. Vomiting c. Drowsiness d. Headache
A
d.
Headache
