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NCLEX REVIEW > Nervous System > Flashcards

Nervous System Flashcards

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1
Q

What is apraxia?

A

the inability to perform purposive movements, although there is no sensory or motor impairment; it affects ADLs

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2
Q

Why do diabetics have decreased vision?

A

because there is gradual deterioration of the retinal vessels

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3
Q

How do you perform a Rinne’s test?

A

The stem of the vibrating tuning fork is held against the mastoid bone until the child indicates that she can no longer hear the sound. Then the tuning form is moved in from of the auditor canal.

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4
Q

Pts with pituitary dwarfism will appear _______

A

younger than chronologically aged

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5
Q

Corneal abrasion occurs when __________

A

pt is unable to close eye voluntarily; when facial nerve (cranial nerve VII) is affected, the lacrimal gland will no longer supply secretions that protect the eye.

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6
Q

A great way to assess the neurosensory cerebellar functioning is to ________

A

have pt stand with eyes closed and observe for swaying. Coordination is governed by cerebellum.

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7
Q

_________can occur in a person who has been paralyzed from a spinal cord injury.

A

Clonic jerks in the foot

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8
Q

What is chorea?

A

involuntary dancing or writhing (twisting) of the limbs or facial muscles

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9
Q

What is Huntington’s chorea?

A

chorea in the upper and lower extremities; it results from atrophy of parts of the brain

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10
Q

Rupture lumbar disc (lumbar lesion) can cause the following:

A
  1. Paresthesia in the affected leg
  2. Pain
  3. Muscle weakness
  4. Atrophy in the lower extremities
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11
Q

What is tardive dyskinesia?

A

neurological syndrome marked by involuntary movements of the face and jaw

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12
Q

Cranial nerve I - Olfactory

A

Sense of smell

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13
Q

When do you do a sense of smell test?

A
  1. it pt reports loss of smell
  2. head trauma
  3. pt has abnormal mental status
  4. when intra-cranial lesions is suspected
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14
Q

What does noxious mean?

A

harmful

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15
Q

What is anosmia?

A

loss of smell

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16
Q

Unilateral loss of smell in the absence of nasal disease is __________

A

neurogenic anosmia

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17
Q

Cranial nerve 2

A

Optic

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18
Q

What is papilledema?

A

swelling of the optic nerve caused by ICP; often due to a tumor in the brain pressing on the optic nerve, blindness may result

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19
Q

Cranial nerve 3, 4 and 6

A

Oculomotor, trochlear and abducens nerves

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20
Q

Cranial nerves 3, 4 and 6 all control ________

A 
eye movements
opening of eyelid
constriction of pupil
focusing
proprioception (awareness of posture & changes in equilibrium
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21
Q

Palpebra pertains to _________

A

eyelid

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22
Q

Palpebra fissures are __________

A

equal in width

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23
Q

How do you check extra-ocular movements?

A

you use cardinal position of gaze

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24
Q

If a pt has nystagmus, you check for the _________.

A

severity

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25
Q

Ptosis (drooping) of the eyes occurs with ________ (3 things)

A
  1. myasthenia gravis
  2. dysfunction of cranial nerve 3
  3. Horner Syndrome
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26
Q

What is myasthenia gravis?

A

an auto immune disease in which antibodies attack the neuromuscular junctions and bind ACh receptors together in clusters

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27
Q

Horner syndrome occurs from __________

A

lesion that interrupts the sympathetic innervations of the head

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28
Q

Horner syndrome is characterized by (5 things)

A
  1. unilateral papillary constriction
  2. sagging eyelid
  3. withdrawal of the eye into the orbit
  4. flushing of the skin
  5. lack of facial perspiration
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29
Q

Cranial nerve 5 - Trigeminal (has three divisions)

A
  1. Ophthalmic division (controls sensory of upper face
  2. Maxillary (controls sensory of lower face)
  3. Mandibular (controls sensory of lower face with mastication)
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30
Q

How can the muscles of mastication be assessed?

A

with palpation of the temporal muscle and masseter muscles

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31
Q

Cranial nerve 7

A

facial

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32
Q

Cranial nerve 8

A

Acoustic (hearing acuity test is done)

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33
Q

Cranial nerve 9 and 10

A

Glossopharyngeal and vagus nerves

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34
Q

Cranial nerve 11

A

Spinal accessory

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35
Q

Cranial nerve 12

A

Hypoglossal (tongue movement of speech and food manipulation)

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36
Q

What is fasciculation?

A

involuntary contraction of twitching

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37
Q

A late sign of brainstem damage is?

A

decerebrate posturing

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38
Q

A fixed dilated pupil represents ________

A

a neurological emergency

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39
Q

__________is effective in maintaining blood levels to alleviate the pain associated with cancer.

A

Around the clock administration of analgesics

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40
Q

Hallucinations are _______perceptions.

A

sensory

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41
Q

5 things to know about myelogram:

A
  1. ask if pt is allergic to contrast
  2. encourage fluids before and after test
  3. pt must be NPO for 4 - 6 hrs
  4. elevate head to 30 degrees for 24 hours
  5. bed rest may be maintained for as long as 24 hours
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42
Q

5 things to know about viral conjunctivitis:

A
  1. extreme tearing
  2. redness
  3. foreign body
  4. highly contagious
  5. child should be restricted from school until symptoms have resolved, 3 to 7 days
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43
Q

___________ is a sign of deterioration in pt’s condition. This should be reported.

A

Withdrawing from pain

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44
Q

__________ helps reduce frequency and degree of phantom pain.

A

Activity

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45
Q

What is an oculogyric crisis?

A

a spasm of involuntary deviation and fixation of the eyeballs

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46
Q

With Bell’s palsy (cranial nerve 7), the face must be protected from cold drafts because of ________

A

trigeminal hyperesthesia

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47
Q

6 things to know about Bell’s palsy:

A
  1. pt should place an eye shield over the affected eye at bedtime
  2. use of artificial tears is useful
  3. should use heat on affected side to promote blood flow
  4. Isometric exercises are helpful during recovery process
  5. pt may have steroid and analgesic therapy.
  6. it is not permanent
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48
Q

What is trigeminal neuralgia (cranial nerve 5)?

A

a painful disease marked by brief attacks of lightning-like stabs

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49
Q

What meds can be given for trigeminal neuralgia?

A

Carbamazepine (Tegretol), an anticonvulant

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50
Q

What 2 things can be done to treat trigeminal neuralgia:

A
  1. pt may need to be injected with alcohol to the nerve, to destroy the nerve
  2. pt may need surgery to decrease pressure on the nerve from blood vessels
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51
Q

Patient with trigeminal neuralgia should be taught to use _______ on face to prevent trigger.

A

Tepid (lukewarm) water

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52
Q

Pts with trigeminal neuralgia should eat _________ to prevent stimuli to the area.

A

soft and warm foods

53
Q

What is acoustic neuroma?

A

a neuroma (tumor) of the 8th cranial nerve

54
Q

What is Guillain-Barre Syndrome?

A

A condition in which the immune system attacks the nerves.

55
Q

4 things to know about Guillain-Barre Syndrome:

A
  1. pt will be given steroid therapy
  2. pt will be given aggressive respiratory care
  3. pt will be given physical therapy
  4. pt will be given eye care
56
Q

3 things Guillain-Barre Syndrome may cause:

A
  1. respiratory failure
  2. flaccid paralysis
  3. urinary retention
57
Q

What is oculocephalic reflex?

A

the deviation of a person’s eyes to the opposite side when the head is rapidly rotated; normal for neonates, sign of coma for adults

58
Q

How can you avoid eliciting the gag response?

A

depress the tongue slightly off center

59
Q

Why are cotton applicators not safe for the inner ear?

A

they can force earwax further in blocking the canal

60
Q

Why should a toddler not blow with one nostril closed?

A

because it can push foreign material into the Eustachian tube and damage the inner canal.

61
Q

When a side of the body is paralyzed from a CVA, what is the most common injury?

A

Shoulder dislocation

62
Q

What is the most common side effect of spinal anesthesia?

A

hypotension; hydrate patient to avoid hypotension

63
Q

Multiple sclerosis causes: (5 things)

A
  1. Alteration in innervations of the bladder
  2. Decreased sensitivity to pain
  3. Decreased temperature perception
  4. Hyperreflexia of extremities
  5. Decreased concentration
64
Q

3 things that ginkgo does:

A
  1. it is an anti platelet agent
  2. it is a CNS stimulant given for dementia syndromes
  3. it increases the risk of bleeding when given with NSAIDs.
65
Q

________ and _________ are pain distracters.

A

Anxiety and fatigue

66
Q

What is meniere’s disease?

A

a syndrome that causes hearing loss, tinnitus, vertigo and may lead to deafness

67
Q

How can Meniere’s disease be controlled?

A

It requires a low sodium diet (2000 mg/day) to decrease fluid retention. Nurse needs to assess pt’s diet.

68
Q

Meniere’s disease is associated with cranial nerve _______.

A

8

69
Q

What medications are used for Meniere’s disease?

A

Meclizine (Antivert), antihistamines and antiemetics.

70
Q

What else should be avoided with Meniere’s disease?

A

alcohol, nicotine and caffeine

71
Q

What is parkinson’s disease?

A

a degeneration of the CNS that produces movement disorders and changes in cognition and mood.

72
Q

Pts with parkinson’s disease should avoid __________

A

flexion of the neck and shoulders. Sleep on firm mattress without a pillow to prevent flexion of the spine.

73
Q

A warming tray is for a pt with parkinson’s disease because _______

A

it keeps the foot hot, safe and appealing during the slow eating process due to slowed body movements, tremors and difficulty chewing and swallowing.

74
Q

Patients with parkinson’s disease have problems with communication, primarily related to _________

A

speaking in a way that others can hear and understand

75
Q

Same muscles are used for speaking and __________

A

swallowing

76
Q

Parkinson’s disease is an irreversible disease that leads to _________

A

permanent physical limitations.

77
Q

2 symptoms of parkinson’s disease:

A
  1. muscle tone and rigidity

2. propulsive gait (a walk with a forward momentum)

78
Q

A pt at stage 4 parkinson’s disease means __________

A

that the pt is immobile

79
Q

Pts with parkinson’s disease should do _________

A

ROM exercises to all extremities four times a day

80
Q

What to avoid after detached retina repair (3 things):

A
  1. jarring movements of the head, because is will increase ICP
  2. first week avoid rapid eye movement; reading and writing
  3. stooping and straining
81
Q

If gas or oil is used to reattach the retina, pt should sleep in what position?

A

abdomen with affected eye down for several days

82
Q

Why is gas or oil used to reattach the retina?

A

a gas bubble, silicone oil or perfluorocarbon and liquids may be infected into the vitreous cavity to help push the sensory retina up.

83
Q

After a retina attachement pt may ___________

A
  1. see flashes of light
  2. have blurred or “sooty” vision
  3. loss of vision, may see floaters
84
Q

What is autonomic dysreflexia?

A

a state in which a pt with spinal cord injury at T7 or above experiences a life threatening uninhibited sympathetic response of the nervous system to noxious stimulus

85
Q

Symptoms of autonomic dysreflexia (4 things):

A
  1. pounding headache
  2. profuse sweating
  3. nasal congestion
  4. hypertension
86
Q

Autonomic dysreflexia is precipitated by __________

A

full bladder or bowel

87
Q

What is the Glasgow coma scale?

A

a quantitative tool that is useful in testing consciousness in aging persons

88
Q

Glasgow coma scale give a numerical value of (3 things):

A
  1. pt’s response in eye opening
  2. pt’s best verbal response
  3. pt’s best motor response
89
Q

A score of 15 in the Glasgow coma scale represents _______

A

a fully alert and normal pt

90
Q

A score of 7 or less in the Glasgow coma scale represents _________

A

pt is in a coma

91
Q

For a pt with severe head injury/severe brain damage the glasgow score is ________

A
92
Q

For a pt with moderate head injury, the glasgow score is

A

between 9 - 12

93
Q

For a pt with mild head injury the glasgow score is

A

between 13 - 15

94
Q

If a pt’s pupil is 2mm dilated and the other is 8 mm dilated, this is a sign of __________

A

a head injury and it demonstrates ICP and direct result from pressure on the affected oculomotor nerve

95
Q

An unequal and dilated pupils indicates __________

A

brainstem damage

96
Q

After a minor head injury, pt should have no________

A

strenuous activity for the next 48 hours

97
Q

After a minor head injury, pt may have (3 things):

A
  1. dizziness for 24 hours
  2. complaints of nausea
  3. headaches, but not intense
98
Q

After a minor head injury, pt should not (5 things):

A
  1. be vomiting; if vomiting occurs notify physician
  2. have blurred vision
  3. have no drainage from ear or nose
  4. slurred speech
  5. weakness
99
Q

A decreased level of consciousness indicates ________

A

intracranial bleeding

100
Q

1 things to know about a lumbar puncture:

A
  1. vital signs must be obtained; change in vital signs can indicate ICP
101
Q

What position should a pt be in after a lumbar puncture?

A

remain supine position for 8 hours to prevent a headache and the leaking of CSF at the puncture site

102
Q

__________ is a common side effect of the lumbar puncture.

A

Headache

103
Q

During a lumbar puncture a child must be ________, to prevent trauma to the child during the procedure.

A

restraint

104
Q

Early signs of ICP (4 things):

A
  1. Confusion
  2. Restlessness
  3. Papillary changes
  4. Alteres LOC
105
Q

Nursing care for a pt that has ICP includes:

A

minimizing ICP; its are sensitive to sudden stimuli such as touching, jarring, loud noise and bright lights, which can all increase ICP

106
Q

ICP can adversely affect _________

A

the cough and gag reflex and increase the possibility of aspiration

107
Q

__________ and _________ can mask symptoms of ICP

A

drugs and alcohol

108
Q

How should a pt be positioned if they have ICP?

A

pt’s head should not flex or rotate. Elevate the head of the bed to 30 degrees, pts neck should be in the midline position to increase venous return

109
Q

If a pt has ICP, the nurse should avoid _________

A

frequent suctioning

110
Q

________ and _____________ indicates an increase in ICP.

A

an increase in systolic pressure and a widening pulse pressure

111
Q

Injuries at level T1 -T6 results in ___________

A

decrease respiratory reserve; pt should be fully dependent in self care and in wheelchair

112
Q

___________ is a common problem in paraplegics.

A

UTI

113
Q

____________ should be kept away from pts that have seizures.

A

a padded tongue blade

114
Q

___________ decreases the chance of a seizure occurring.

A

Darkening a room

115
Q

__________ stops seizures activity.

A

Diazepam (Valium)

116
Q

If a pt has a seizure, the nurse should (4 things):

A
  1. protect the pt from injury
  2. provide oxygen
  3. establish an IV access
  4. loosen restrictive clothing
117
Q

It is a good to make a seizure chart to identify seizure triggers, such as: (9 things)

A
  1. alcohol
  2. stress
  3. caffeine
  4. constipation
  5. loud noise
  6. music
  7. flickering lights
  8. prolonged reading
  9. drugs
118
Q

Increase in seizure may occur during _________

A

menses

119
Q

__________ and __________ checks the pt’s ability to swallow.

A

Glossopharyngeal and vagus nerves

120
Q

If a pt has a concussion, there is nothing wrong with ________

A

waking up the pt from sleeping every 3 hours and orient them x3

121
Q

_________ should never be given to a pt that has experienced a concussion.

A

Aspirin

122
Q

_________ and ________ is encouraged if a pt has experienced a concussion.

A

resting and eating lightly

123
Q

If a pt had a concussion, 6 symptoms require immediate attention:

A
  1. blurred vision
  2. double vision
  3. difficulty walking
  4. weakness
  5. numbness
  6. clumsiness
124
Q

If a pt suffered a concussion, the pt should not be involved in any ___________

A

strenuous activities for at least 2 days

125
Q

4 symptoms of Amyotrophic lateral sclerosis (ALS):

A
  1. difficulty swallowing and my aspirate
  2. fatigue while talking, tongue atrophy and weakness in the hands and arms
  3. fasciculation (twitching) of the face
  4. Does not cause changes in mental state
126
Q

If a pt has amyotrophic lateral sclerosis, a pt retains control of _________ and ________.

A

bowel and bladder

127
Q

Meningitis is caused by ____________ and __________

A

Haemophillus influenza and Neisseria meningitidis

128
Q

Pt must be placed in what kind of precaution (for 24 hours) whether or not meningitis diagnosis is confirmed or not?

A

droplet

129
Q

When can isolation be stopped for a pt with meningitis?

A

24 hours after the start of antibiotic therapy

NCLEX REVIEW (10 decks)

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