MEDICAL-SURGICAL NURSING

NEUROSENSORY SYSTEM

1.) The nurse is assessing a patient and notes a Brudzinski’s sign and Kernig’s sign. These are two classic signs of which of the following disorders?
A.)Cerebrovascular accident (CVA)
B.)Meningitis
C.)Seizure disorder
D.)Parkinson’s disease

Answer: B
A positive response to one or both tests indicates meningeal irritation that is present with meningitis. Brudzinski’s and Kernig’s signs don’t occur in CVA, seizure disorder, or Parkinson’s disease.

2.) A patient is admitted to the hospital for a brain biopsy. The nurse knows the most common type of primary brain tumor is:
A.)Meningioma
B.)Angioma
C.)Hemangioblastoma
D.)Glioma

Answer: D
Gliomas account for approximately 45% of all brain tumors. Meningiomas are the second most common, with 15%. Angiomas and hemangioblastomas are types of cerebral vascular tumors that account for 3% of brain tumors.

3.) The nurse should instruct the patient with Parkinson’s disease to avoid which of the following?
A.)Walking in an indoor shopping mall
B.)Sitting on the deck on a cool summer evening
C.)Walking to the car on a cold winter day
D.)Sitting on the beach in the sun on a summer day

Answer: D
The patient with Parkinson’s disease may be hypersensitive to heat, which increases the risk of hyperthermia, and he should be instructed to avoid sun exposure during hot weather.

4.) Joven suffered a cerebrovascular accident that left her unable to comprehend speech and unable to speak. This type of aphasia is known as:
A.)Receptive aphasia
B.)Expressive aphasia
C.)Global aphasia
D.)Conduction aphasia

Answer: C
Global aphasia when all language functions are affected. Receptive aphasia, also known as Wernicke’s aphasia, affects the ability to comprehend written or spoken words. Expressive aphasia, also known as Broca’s aphasia, affects the patient’s ability to form language and express thoughts. Conduction aphasia refers to abnormalities in speech repetition.

5.) Josie complains that her headaches are occurring more frequently despite taking medications. Patients with a history of headaches should be taught to avoid:
A.)Freshly prepared meats
B.)Citrus fruits
C.)Skim milk
D.)Chocolate

Answer: D
Patients with history of headaches, especially migraines, should be taught to keep a food diary to identify potential food triggers. Typical headache triggers include alcohol, aged cheese, processed meats, and chocolates-and-caffeine-containing products

6.) Immediately following cerebral aneurysm rupture, the patient usually complains of:
A.)Photophobia
B.)Explosive headache
C.)Seizures
D.)Hemiparesis

Answer: B
Explosive headache or “worst headache I’ve ever had” is typically the first presenting symptom of a bleeding cerebral aneurysm. Photophobia, seizures, and hemiparesis may occur later.

7.) Which of the following is a cause of embolic brain injury?
A.)Persistent hypertension
B.)Subarachnoid hemorrhage
C.)Atrial fibrillation
D.)Skull fracture

Answer: C
An embolic injury, caused by a traveling clot, may result atrial fibrillation. Blood may pool in the fibrillating atrium and be released to travel up the cerebral artery to the brain. Persistent hypertension may place the patient at risk for a thrombotic injury to the brain. Subarachanoid hemorrhage and skull fractures aren’t associated with emboli

8.) Although Mrs. Torres has a spinal cord injury, she can still have sexual intercourse. Discharge teaching should make her aware that:
A.)She must remove her indwelling urinary catheter prior to intercourse
B.)She can no longer achieve orgasm
C.)Positioning may be awkward
D.)She can still get pregnant

Answer: D
Women with spinal cord injuries who were sexually active may continue having sexual intercourse and must be reminded that they can still become pregnant. She may be fully capable of achieving orgasm. An indwelling urinary catheter may be left in place during sexual intercourse. Positioning will need to be adjusted to fit the patient’s needs.

9.) Josephine, age 25, suffered a cervical fracture requiring immobilization with halo traction. When caring for the patient in halo traction, the nurse must:
A.)Keep a wrench taped to the halo vest for quick removal if cardiopulmonary resuscitation is necessary.
B.)Remove the brace once a day to allow the patient to rest.
C.)Encourage the patient to use a pillow under the ring
D.)Remove the brace so that the patient can shower

Answer: A
The nurse must have a wrench taped on the vest at all times for quick halo removal in emergent situations. The brace isn’t to be removed for any other reason until the cervical fracture is healed. Placing a pillow under the patient’s head may alter the stability of the brace.

10.) Joy was diagnosed with pneumoccocal meningitis. What response by the patient indicates that he understands the precautions necessary with this diagnosis?
A.) “I’m so depressed because I can’t have any visitors for a week”
B.)”Thank goodness, I’ll only be in isolation for 24 hours”
C.)”The nurse told me that my urine and stool are also sources of meningitis bacteria.”
D.)”The doctor is good friend of mine and won’t keep me in isolation.”

Answer: B
Patients with pneumoccocal meningitis require respiratory isolation for the first 24 hours after treatment is initiated.

11.) An early symptom associated with amyotrophic lateral sclerosis (ALS) includes:
A.)Fatigue while talking
B.)Change in mental status
C.)Numbness of the hands and feet
D.)Spontaneous fractures

Answer: A
Early symptoms of ALS include fatigue while talking, dysphagia, and weakness of hands and arms. ALS doesn’t cause a change in mental status, paresthesia, or fractures.

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