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Health Assessment > PrepU Cognition > Flashcards

PrepU Cognition Flashcards

1
Q

Lesions in the temporal lobe (lateral and superior portions) may result in which type of agnosia?

A

Auditory

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2
Q

Lesions in the occipital lobe may result in which type of agnosia?

A

Visual

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3
Q

Lesions in the parietal lobe may result in which type of agnosia?

A

Tactile

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4
Q

Lesions in the parietal lobe (posterioinferior regions) may result in which types of agnosia?

A

relationships and body parts

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5
Q

A client inquires about any diet-related prerequisites before an EEG. Which diet-related advice should I give the client?

A

Avoid taking sedative drugs or drinks that contain caffeine for at least 8 hours before the test. (may interfere with EEG results)

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6
Q

A child found unconscious at home is brought to the hospital by a rescue squad. In the ICU, I check the client’s oculocephalic (doll’s eye) response by:

A

turning the client’s head suddenly while holding eyelids open. The eyes should turn from side to side when the head is turned. Abnormal response would be if eyes remain fixed.

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7
Q

What does the oculocephalic (doll’s eye) response detect?

A

cranial nerve compression

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8
Q

What do I do to test the oculovestibular response?

A

Introduce ice water into the external auditory canal: normal response = eyes deviate to the side of ice water introduction

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9
Q

How do I elicit the corneal reflex response, revealing brain stem function?

A

touch client’s cornea with a wisp of cotton. Normal response = blinking

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10
Q

Which action helps me to evaluate brain stem and cranial nerve III function?

A

Shining a bright light into the client’s pupil. Normal = client’s pupil responds by constricting.

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11
Q

What must I examine for if a client is not alert or able to follow commands to determine level of consciousness (LOC)?

A

-eye opening
-verbal response
-motor response stimuli
-type of stimuli needed to obtain a response
*inability to follow commands does not necessarily denote an absolute lack of consciousness

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12
Q

A client admitted with exacerbation of MS is assessed by me. When I have the client stick out the tongue and move it back and forth, what am I assessing?

A

Function of the hypoglossal nerve (12th cranial nerve)
= responsible for movement of tongue.

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13
Q

The spinal cord is composed of 31 pairs of spinal nerves. How many pairs of thoracic nerves are contained within the spinal column?

A

12

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14
Q

How many pairs of lumbar and sacral nerves are within the spinal column?

A

5

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15
Q

How many pairs of cervical nerves are within the spinal column?

A

8

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16
Q

How many pairs of coccygeal nerves are within the spinal column?

A

1

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17
Q

To assess for hearing difficulty, I am assessing the function of which cranial nerve?

A

VIII = vestibulocochlear/ auditory/ acoustic nerve
responsible for hearing a balance.

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18
Q

Which cranial nerve is the optic nerve?

A

II

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19
Q

Which cranial nerve is responsible for eye movement?

A

VI = abducens nerve

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20
Q

Which nerve is involved with head and shoulder movement?

A

XI: spinal accessory nerve

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21
Q

How long should anticonvulsant agents, tranquilizers, stimulants, and depressants be withheld before an EEG?

A

24-48 hours (can mask abnormal wave patterns of seizure disorders)

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22
Q

To increase the chances of recording seizure activity, what activity is sometimes recommended by the client the night before the EEG?

A

Sleep deprivation

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23
Q

Why are meals not omitted before an EEG?

A

Altered blood glucose concentration can cause changes in wave patterns.

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24
Q

How long does a standard EEG take?

A

45-60 minutes

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25
Q

How long does a sleep EEG last?

A

12 hrs

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26
Q

What is a priority intervention when it comes to client preparation of an MRI?

A

Remove all metal-containing objects off of the client

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27
Q

Before what type of puncture is a client instructed to void?

A

lumbar puncture

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28
Q

What does the Romberg test test for?

A

balance

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29
Q

What does the ct. do during a Romberg test screen?

A

Stands with feet together and arms at the side- first with eyes open and then with both eyes closed for 20-30 seconds.
Slight swaying is normal. Loss of balance is abnormal = positive Romberg test

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30
Q

Which lobe of the brain may indicate damage when a ct. has changes in personality and affect?

A

Frontal lobe

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31
Q

Major functions of the frontal lobe:

A

-concentration
-abstract thought
-information storage/memory
-motor function
-person’s affect
-judgment
-personality
-inhibitions

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32
Q

The Broca’s area, located in the frontal lobe, in the inferior left hemisphere, is critical for?

A

motor control of speech
(expressive speech center)

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33
Q

What is the parietal lobe responsible for?

A

-person’s awareness of body position in space
-size and shape discrimination
-right-left orientation

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34
Q

Function of cranial nerves IX and X?

A

swallowing.

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35
Q

Functions of cranial nerve III:

A

-extraocular eye movement
-eyelid elevation
-pupil constriction

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36
Q

Motor function of cranial nerve V?

A

-chewing

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37
Q

motor movement of cranial nerve VI

A

-lateral eye movement

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38
Q

Which test assesses function of the auditory/acoustic/vestibular nerve?

A

Whisper test

39
Q

Which action tests the vagus nerve (x)?

A

Having ct. say “ah”

40
Q

What tests the function of the facial nerve (VII)?

A

Observation of symmetry when the client performs facial movements

41
Q

How is the olfactory nerve (cranial nerve I) tested?

A

By having ct. identify specific odors

42
Q

What would be expected of a client’s muscle tone with a lower motor neuron lesion?

A

Decreased muscle tone/ flaccid muscles

43
Q

What would be expected of observation of a client with an upper motor neuron lesion?

A

Hyperactive reflexes and muscle spasticity

44
Q

A nurse and I are caring for a client recovering from a lumbar puncture yesterday. The client reports a headache despite being on bedrest overnight. The HCP plans an epidural blood patch this morning. How will this help with the headache?

A

The blood will seal the hold in the dura and prevent further loss of cerebral spinal fluid.

45
Q

Symptom of loss of CSF?

A

Headache- may indicate epidural blood patch if headache persistent

46
Q

How is an epidural blood patch performed?

A

blood is withdrawn from the antecubital being and injected into the site of the previous puncture.

47
Q

Where is the needle inserted with an epidural blood patch?

A

below the level of the spinal cord, preventing damage to the cord.

48
Q

Which neurotransmitter demonstrates inhibitory action, helps control mood and sleep, and inhibits pain pathways?

A

serotonin

49
Q

Which areas of the CNS are sources of serotonin?

A

Brain stem, hypothalamus, & dorsal horn of the spinal cord.

50
Q

Which neurotransmitter is excitatory and is associated with pleasurable sensations?

A

Enkaphalin

51
Q

Which neurotransmitter is usually excitatory and affects mood and overall acitivy?

A

Norepinephrine

52
Q

Which neurotransmitter is excitatory but parasympathetic effects are sometimes inhibitory?

A

Acetylcholine

53
Q

I am caring for a client with an injury to the central nervous system. When caring for a client with a spinal cord insult that is slowing transmission of motor neurons, what would I anticipate as a delayed reaction?

A

Response due to interrupted impulses from the central nervous system. (motor neurons transmit impulses from the CNS).

54
Q

The sensory forms of agnosia

A

visual, auditory, & tactile

55
Q

Which condition refers to organic loss of intellectual function?

A

dementia

56
Q

Ataxia:

A

inability to coordinate muscle movements
EX: difficulty walking

57
Q

Aphasia:

A

inability to express oneself or to understand language.

58
Q

A client undergoes a scheduled EEG. What post-procedure activity should I carry out for the client?

A

Allow client to rest and shampoo their hair.
-ensuring rest for the sleep-deprived ct.
-shampoo to remove glue used to affix electrodes to the scalp.

59
Q

A decrease in which neurotransmitter can lead to myasthenia gravis?

A

acetylcholine (reduced binding to muscle cells)

60
Q

Which disease is caused by a depletion of dopamine?

A

Parkinson’s disease

61
Q

Decreased levels of GABA may cause what?

A

seizures

62
Q

Which cranial nerve is the glossopharyngeal nerve?

A

IX

63
Q

Where is the motor strip located in the frontal lobe?

A

posterior portion

64
Q

Where is the sensory strip located in the parietal lobe?

A

anterior

65
Q

What essentially occurs in myasthenia gravis and what is the manifestations?

A

Breakdown occurs in communication between nerves and muscles = weakness of extremities and difficulties with speech and chewing.

66
Q

Excessive serotonin activity in the brain can cause a variety of mild to severe symptoms such as:

A

-high BP
-shivering
-confusion
-high fever

67
Q

Defects in the expression of acetylcholine receptors is indicative of which condition?

A

ALS “amyotrophic lateral sclerosis)
-affects motor neurons directly

68
Q

To evaluate a client’s cerebellar function, what should I ask?

A

Do you have any problems with balance? (balance and coordination)

69
Q

What is the cerebellum responsible for?

A

-coordination of all movement
-fine movement; balance; position (postural) sense or proprioception (awareness of where each part of the body is), and integration of sensory input

70
Q

Which cranial nerves are assessed when asking a client if they have any difficulty speaking or swallowing?

A

IX, X, XII

71
Q

A ct. with damage to the frontal cortex will display a deficit in intellectual functioning. Questions designed to assess this capacity might include questions surrounding what?

A

-ability to recognize similarities: “how are a mouse and a dog alike?”

72
Q

The Romberg test assesses balance, which has to do with what two brain area influences on the motor system?

A

cerebellar and basal ganglia

73
Q

Intentional tremors and muscle strength have to do with what system?

A

motor system

74
Q

I am assisting during a lumbar puncture. How should I position the ct. for this procedure?

A

Lateral recumbent, with thighs flexed - maximizes space between the vertebrae.

75
Q

Where is the needle inserted for a lumbar puncture?

A

Between L4 and L5

76
Q

After a lumbar puncture, what important postprocedure nursing intervention should I perform to maximize the client’s comfort?

A

Encourage ct. to drink liberal amounts of fluids. = helps to restore volume of cerebrospinal fluid extracted.
-Keep the room dark and quiet
-encourage rest, because sensory stimulation tends to magnify discomfort

77
Q

What should I inspect for after a lumbar puncture is performed?

A

inspect injection site for swelling or hematoma

78
Q

Ct. comes to emergency department with severe pain in face stimulated by brushing teeth. What cranial nerve do I understand can cause this type of pain?

A

CN V “trigeminal nerve”
-innervates forehead, cheeks, and jaw

79
Q

A client with an absent gag reflex indicates dysfunction to which cranial nerve?

A

X “vagus”

80
Q

I am assessing the client’s pupils following a sports injury. Which assessment findings indicates a neurologic concern?

A

-unequal pupils
-pinpoint pupils
-absence of pupillary response

81
Q

Which nervous system is responsible for the digestion of food and eliminating body wastes?

A

parasympathetic- division of the autonomic nervous system; works to conserve body energy
-slows heart rate as well

82
Q

During a routine physical exam to assess a client’s deep tendon reflexes, I should make sure to:

A

support the joint where the tendon is being tested (prevents attached muscle from contracting)
-Use the flat end of the reflex hammer
-hold hammer loosely between the thumb and fingers so it can swing in an arc

83
Q

what is the pointed end of a reflex hammer used for?

A

to strike over small areas

84
Q

meaning of flacid:

A

non-responsive (motor assessement)

85
Q

To assess gait, I ask the client to take a few steps; with each step, the client’s feet make a half circle. What word would I use to document the client’s gate?

A

Helicopod

86
Q

What type of gait is staggering and unsteady?

A

ataxic

87
Q

Which type of gait is when a ct. waddles with the legs far apart?

A

dystrophic

88
Q

Which type of gait is when the feet and toes rise high of the floor and the heel comes down heavily with each step?

A

steppage

89
Q

Which cranial nerve is affected with decreased visual fields and acuity?

A

cranial nerve II (optic)

90
Q

What cranial nerves are the three sensory nerves?

A

I: olfactory
II: vision
VIII: taste?

91
Q

——- occurs when reflexes are hyperactive when the foot is abruptly dorsiflexed

A

clonus

92
Q

A teen has sustained 5 concussions from contact sports again. After their last injury, the client began experiencing episodes of double vision. The client was told that they had most likely incurred damage to which cranial nerve?

A

VI (Abducens) = supports movement of the eye laterally.

93
Q

What can damage to the abducens nerve (VI) cause?

A

double vision

94
Q

Which cranial nerve does the Snellen eye chart assess for?

A

CN II (optic nerve)

Health Assessment (4 decks)

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