Neurological Disorders
Neurological Disorders
Neurological Disorders
STROKES
Diabetes
100
Q. Client reports numbness and tingling & blurred vision. CT scan show disruption in myelin sheath in the CNS. The nurse knows that the client has?
A. Multiple Sclerosis
B. Parkinson Disease
C. Viral Meningitis
D. Bacterial Meningitis
A. Rationale: MS is a chronic CNS disorder in which myelin and nerve axons in brain and spinal cord are destroyed.
100
A client is admitted with Parkinson's disease. The client's face is expressionless and monotone speech. Which of the following observation of the nurse is most accurate?
A. Client is most likely depressed and should be left alone
B. These are common symptoms of Parkinson's that produce an undesired fasade of an alert and responsive individual
C. The client's antipsychotic med may need to be adjusted
D. The client probably has dementia
B. Rationale: The nurse should recognize these are common symptoms of Parkinson's disease.
100
Turn the patient to his/her side
Have suction equipment ready
Time the episode
Prevent injury to the patient
Provide privacy
What are Seizures?
100
A nurse is planning care for a client who has dysphagia and a new dietary prescription. Which of the following should the nurse include in the plan of care?
A. Allow the autonomy to eat unsupervised if they say they are able
B. Have suction equipment available for client
C. Assign an assistive personnel to feed client slowly
D. Allow patient's family to bring in the patient's favorite foods from home to increase nutrition
B. Have suction equipment available for client
100
The nurse is reviewing laboratory results for the clinic patients to be seen today. Which patient meets the diagnostic criteria for diabetes mellitus?
a. A 48-year-old woman with a hemoglobin A1C of 8.4%
b. A 58-year-old man with a fasting blood glucose of 111 mg/dL
c. A 68-year-old woman with a random plasma glucose of 190 mg/dL
d. A 78-year-old man with a 2-hour glucose tolerance plasma glucose of 184 mg/d
a. A 48-year-old woman with a hemoglobin A1C of 8.4%
200
Name the neurodegenerative disorder that affects predominately dopamine-producing (“dopaminergic”) neurons in a specific area of the brain called substantia nigra?
A. MS
B. Huntington's Disease
C. Myasthenia Gravis
D. Parkinson Disease
D Rationale: Parkinson is a neurodegenerative disorder that affects predominately dopamine-producing (“dopaminergic”) neurons in a specific area of the brain called substantia nigra.
200
When evaluating the extent of Parkinson's disease, a nurse observes for which condition?
A. Bulging eyeballs
B. Diminished distal sensation
C. Increase dopamine levels
D. Muscle rigidity, stooped posture and resting tremors
D. Rationale: Parkinson's is characterized by the slowing of voluntary muscle movement. Muscular rigidity, and resting tremors.
200
A nurse is providing discharge instructions to a client who has a prescription for phenytoin. Which of the following information should the nurse include?
A. Consider taking an antacid when on this medication
B. Watch for receding gums when taking the medication
C. Take the medication at the same time every day
D. Continue to take oral contraceptives as prescribed
C. Take the medication at the same time every day
200
A nurse is assessing a client who has experienced a left-hemispheric stroke. Name three symptoms you expect to see
Right-sided weakness or paralysis and sensory loss
Problems with speech and understanding language (aphasia)
Vision problems, including the loss of the right field of vision in both eyes
Not as able to do math, or to organize, reason, or analyze
Behavior changes, such as being cautious and hesitant
Depression
Impaired ability to read, write, and learn new information
Memory problems
200
A 54-year-old patient admitted with type 2 diabetes asks the nurse what "type 2" means. What is the most appropriate response by the nurse?
a. "With type 2 diabetes, the body of the pancreas becomes inflamed."
b. "With type 2 diabetes, insulin secretion is decreased, and insulin resistance is increased."
c. "With type 2 diabetes, the patient is totally dependent on an outside source of insulin."
d. "With type 2 diabetes, the body produces autoantibodies that destroy β-cells in the pancreas
b. "With type 2 diabetes, insulin secretion is decreased, and insulin resistance is increased."
300
A nurse is caring for a client who just experienced a generalized seizure. Which of the following actions should the nurse perform first?A. Parkinson's Disease
A. keep the client in a side-lying position
B. document the duration of the seizure
C. reorient the client to the environment
A. keep the patient in a side-lying position
300
A client with Parkinson's disease is at risk for falls because of an abnormal gait. The nurse assesses the client, expecting to observe which type of gait? A. Unsteady and staggering
B. Shuffling and propulsive
C. Broad-based and waddling
D. Accelerating with walking on the toes
B. Rationale: The parkinsonian gait is characterized by short, accelerating, shuffling steps. The client leans forward with the head, hips, and knees flexed and has difficulty starting and stopping. An ataxic gait is unsteady and staggering. A dystrophic gait is broad-based and waddling. A festinating gait is accelerating with walking on the toes.
300
A nurse is planning care for a client who is experiencing status epilepticus. What concepts should the nurse include in the plan of care?
A. The seizure should only last 1-2 minutes and you should fully recover after
B. This will be an absent seizure
C. Status epileptics is repeated seizure activity within a 30-min time frame or a single prolonged seizure lasting more than 5 minutes
D. Anticipate not administering any mediation immediately, the physician will want to know how long each seizure lasts
C. Status epilepticus is repeated seizure activity within a 30-min time frame or a single prolonged seizure lasting more than 5 minute
300
A new graduate nurse is teaching a client recovering from a cerebrovascular accident (CVA) on ways to prevent pressure ulcers. Which statement made by the new graduate nurse should be corrected by the nurse preceptor?
A. “Good nutrition is a key component in preventing pressure ulcers.”
B. “You will be repositioned every 2 hours when you are in bed.”
C. “You should restrict movement to prevent injury"
D. “A thorough skin assessment will be performed daily to identify any redness or other problems.”
C. “You should restrict movement to prevent injury”
300
The nurse is evaluating a 45-year-old patient diagnosed with type 2 diabetes mellitus. Which symptom reported by the patient is considered one of the classic clinical manifestations of diabetes?
a. Excessive thirst
b. Gradual weight gain
c. Overwhelming fatigue
d. Recurrent blurred vision
a. excessive thirst
400
Inflammation of the fluid and membranes surrounding your brain and spinal cord.
The swelling of the membranes typically triggers signs and symptoms such as headache, fever, nuchal rigidity and photophobia.
A. Meningitis
B. Myasthenia Gravis
C. Multiple sclerosis
D. Huntington's Disease
B. What is Meningitis?
400
The nurse will do these to detect which disorder
What is Meningitis?
400
Name three "types" of seizures (descriptive types)
Clonic
Tonic
Tonic Clonic
Absent
Partial/Focal
Myoclonic
Atonic
400
A patient has experienced a transient ischemic attack (TIA), and asks you describe what is happening. How will you respond?
A TIA is a brief interruption of blood flow to the brain.
400
A college student is newly diagnosed with type 1 diabetes. She now has a headache, changes in her vision, and is anxious, but does not have her portable blood glucose monitor with her. Which action should the campus nurse advise her to take?
a. Eat a piece of pizza.
b. Drink some diet pop.
c. Eat 15 g of simple carbohydrates.
d. Take an extra dose of rapid-acting insulin.
c. Eat 15 g of simple carbohydrates.
500
A client is admitted with an exacerbation of multiple sclerosis. The nurse is assessing the client for possible precipitating risk factors. Which factor, if reported by the client, should the nurse identify as being unrelated to the exacerbation?
A. Acute stress
B. Drink 1-2L of fluids a day
C. They are female
D. A recent period of extreme outside ambient temperatures
B. Drinking 1-2L fluid a day
500
To look for this sign in your client
- Lie him face up.
- Flex his knee and hip in a 90˚ angle while slowly extending his knee.
- If client feels either resistance or pain report it to the physicia
What is kernig sign?
500
Name the stages of a generalized seizure (4)
1. Aura
2. Tonic
3. Clonic
4. Postictal
500
What does B. E. F. A. S. T. stand for?
Balance
Eyes
Face
Arms
Speech
Time
500
What are the two major complications associated with Type 1 & Type 2 diabetes, and which is associated with each type?
DKA - Type 1
HHS - Type 2