ICP
Seizures
cva
TBI
SCI
MS
Meningitis
Parkinsons
Extra
100
What is the earliest symptom of increased ICP
Deceberate posturing
Change in LOC
Weakness
Cheyne- stokes respirations
Change in LOC
100
Status epilepticus is a chronic disorder
Epilepsy is a chronic disorder
100
A patient has had a CVA in the left hemisphere of the brain. The patient experiences dysphasia, hemianopia, and hemiparesis. Which of the following interventions would be appropriate?
Only allowing the patient thickened liquids
Asking the patient open-ended questions
Approaching the patient from the right side
Placing the patient's items on the left side of the bed
Placing the patient's items on the left side of the bed
100
Most common cause of TBI
MVA
100
You know that young males (16-30) are at greater risk for a spinal cord injury. Which sport is most-likely to cause spinal cord accidents?
Diving
100
If the myelin sheath is damaged what happens to the nerve impulses?
They become slow
They become uncoordinated
They become fast
They no longer transmit
They become slow
100
True or false: Viral meningitis is more likely to cause ICP than bacterial
False bacterial = increase ICP
100
When would be the best time to interview a patient with Parkinson's
Encourage communication when meds are at peak
100
A comatose patient would get a GCS of ____ and a dead patient would get____
8,0
8, 3
12, 0
10,3
8, 3
200
Which of the following is most concerning?
ICP 10
ICP 15
CPP 70
CPP 35
CPP 35
200
What position is ideal to maintain the airway for a patient having a seizure
Place on side with head extended to protect airway only if airway is compromised…otherwise, wait until seizure has finished
200
A patient comes to the ER with left sided weakness, nausea, and stating this is "the worst headache of my life". The patient has gone to CT and a hemorrhagic stroke. Which of the following would be inappropriate treatment?
TPA
FFP
Vitamin K
Metoprolol
TPA
200
A patient was hit in the face with a baseball and sustained a contracoup fracture/ injury. Where would the injury be located?
Temporal
Occipital
Mastoid
Frontal
Occipital
200
A patient with a T2 spinal injury sustained a week prior is experiencing a headache, looks flushed, and is sweating. He sounds a little anxious and tells you he would like his PRN tylenol because he thinks he has a fever. What should you tell him?
Yes! That will help your headache and any possible fever
I'd like to get some labs to see if an infection has started
Let me check your blood pressure and heart rate first
Yes! I will also get you a cooling blanket to help with the sweating
Let me check your blood pressure and heart rate first
Autonomic dysreflexia
200
Oculomotor(III) nerve is responsible for ______
Optic nerve (II) is responsible for _______
optic nerves relay messages from your eyes to your brain to create visual images
The oculomotor nerve helps to adjust and coordinate eye position during movement.
200
Location of lumbar puncture select all
L1-L2
L2-L3
L3-L4
L4-L5
subarachnoid space, L3, L4, L5
200
Which of the following is incorrect regarding Parkinson's? Select all that apply
Parkinson's leads to a temporary loss of dopamine- producing nerve cells
Degenerative disorder of substantia nigra
Most common degenerative neuro disease
Results in depleted dopamine and increased acetylcholine
Parkinson's leads to a temporary loss of dopamine- producing nerve cells (permanent )
Most common degenerative neuro disease (Alzheimers)
200
A patient with a spinal cord injury had a bout of spinal shock 2 months ago. They are now experiencing spasticity below the level of injury. Which of the following would be an inappropriate intervention.
Perform passive range of motion
Administer Benzodiazepines
Administer Baclofen
Explain to the patient that these are due to increased muscle tone and uncontrolled muscle contraction
Administer Benzodiazepines
300
ventriculostomy is the gold standard. What is our main worry due to this procedure?
Infection!
300
Which of the following are important patient education related to anti-epileptic medications
Should avoid grapefruit juice
Be aware of sedation
Lie down if you feel an aura
decreases the effectiveness of OC
Do not abruptly stop medication
Should avoid grapefruit juice
Be aware of sedation
Lie down if you feel an aura
decreases the effectiveness of OC
Do not abruptly stop medication
300
Which of the following orders would be questions for a patient with stroke- like symtoms
CT with contrast
Administration of TPA
Coordination of possible transfer to comprehensive stroke center
Warfarin target INR 2.0-3.0
CT with contrast
300
What is the name of the condition that is most common in football players that is similar to Alzheimers and can cause personality changes; memory impairment; speech and gait disturbances
Chronic Traumatic Encephalopathy (CTE)
300
A patient is being wheeled into the ED after sustaining a suspected spinal injury in the field. The patient's BP is 90/p, pulse is 62, which of the following interventions should be done?
Blankets
IV NSS
Oxygen via nasal cannula
Vasopressors
Metoprolol
Blankets
IV NSS
Oxygen via nasal cannula
Vasopressors
300
Exposure to which of the following can increase the risk for the development of MS.
Anthrax
Measles
Epstein-Barre virus
Influenza
Herpes simplex virus
Measles
Epstein-Barre virus
300
When entering the room of a patient with bacterial meningitis health care providers should use what precautions?
Standard
Droplet
Contact
None
Droplet
300
What scan is used to detect how the brain produces and uses dopamine?
MRI
SPECT Scan
PET scan
CT
Spinal tap
SPECT Scan
300
The nurse is aware that the preferred drug to administer to a patient in status epilepticus is:
A. carbamazepine
B. valproate
C. lorazepam
D. phenobarbita
C. lorazepam
400
Which combination is indictive of cushings triad?
100/ 60, 72, 12 rr irregular
158/52, 52, 20 rr irregular
85/60, 150, 24 rr labored
160/82, 120, 32 rr labored
158/52, 52, 20 rr irregular
1. systolic hypertension w/ widening pulse pressure
2. bradycardia (bounding pulse)
3. respirations irregular
400
A patient is scheduled for an EEG which teaching would show the patient requires further education? Select all
I slept so well last night, I am ready for my test
I'm starving, I haven't been able to eat since lunch yesterday for this test
I understand that for this test I couldn't take my xanax for the last 2 days
I will be asked to watch bright flashing lights
I slept so well last night, I am ready for my test
I'm starving, I haven't been able to eat since lunch yesterday for this test
400
Which of the following is consistent with a left sided CVA.
Difficulties with time
Difficulties with math
Aware of deficits
Impulsive
Spatial deficits
Aware of deficits Aware of deficits
Paralyzed right side, hemiplegia
Impaired speech/ language aphasia
Impaired right/ left discrimination
Slow performance, cautions
Aware of deficits: depression/ anxiety
Impaired comprehension related to language and math
400
Prioritize the patient:
Intracerebral hematoma
Epidural hematoma
Subdural hematoma
Cerebral contusions
Epidural hematoma- arterial bleed
400
Which of the following would a C5 injury be able to do independently/ with assistive devices? Select all
Drive a car
Use a lightweight wheelchair
Feed themselves
Use an electric wheelchair
Transfer to wheelchair
None of the above, they will be on a ventilator
Feed themselves
Use an electric wheelchair
400
Which of the following would be incorrect regarding MS?
Often patients experience an intention tremor
Goal of treatment is to slow the disease progression
Swallowing and feeding must be monitored
Gold standard of diagnosis is lumbar puncture
Gold standard of diagnosis is lumbar puncture
400
Bacterial meningitis will show up in a spinal puncture with ____ WBC, ____ Protein, _____ Glucose
while viral meningitis will show ____ WBC, ____ Protein, _____ Glucose
Increase, Increase, Decrease
Increase, normal, normal
400
Which of the following should be addressed first in your patient with parkinson's
Dysphonia
Ensuring the patient's walker is within reach
Administration of Sinemet
Drooling
Drooling
400
A client with MS has been admitted to the hospital following an acute exacerbation. When planning the client's
care, the nurse addresses the need to enhance the client's bladder control. What aspect of nursing care is most
likely to meet this goal?
A. Avoid foods that change the pH of urine.
B. Perform intermittent catheterization q6h
C. Administer anticholinergic drugs as prescribed
D. Establish a timed voiding schedule
D. Establish a timed voiding schedule
500
Which of the following would be correct and most important for a patient with increased ICP?
Administration of acetaminophen
Neuro assessment q 2
Bolus of NSS due to decreased UO
Repositioning every 4 hours
Administration of acetaminophen
500
Which of the following are important for the use of phenytoin (Dilantin)
Adverse effects include: severe bradycardia (if given too fast), gingival hyperplasia, leukopenia
Never mix with dextrose….NSS only
Never give faster than 50mg per minute or severe bradycardia may occur
Monitor serum blood levels with this drug
Adverse effects include: severe bradycardia (if given too fast), gingival hyperplasia, leukopenia
Never mix with dextrose….NSS only
Never give faster than 50mg per minute or severe bradycardia may occur
Monitor serum blood levels with this drug
500
Which of the following would be a good candidate for TPA? Select all
A patient with bp of 190/ 100
A 90 year old with symptom onset of 3 hours
A 40 year old with INR of 1.2
A 12 year old experiencing a CVA
A patient who had a knee replacement 1 week prior
A patient who has stroke like symptoms following a TBI after a MVA
A 90 year old with symptom onset of 3 hours
A 40 year old with INR of 1.2
500
Your patient is an 18 year old man who has sustained a concussion. The patient has had a headache. While conduction a q 2 check the nurse notices that the patient now has sluggish pupillary response and slurred speech. What should the nurse do?
Administer TPA
Prepare the client for CT
Nothing these are normal symptoms of a concussion
Go tell the physician
Prepare the client for CT
500
A nurse witnesses a MVA on their way to work. The driver of the vehicle is complaining of numbness in the extremities. Which of the following would be appropriate?
Get out of the vehicle, MVA can cause a car fire
Look at me, I would like to check your pupils
Keep your head and neck still, I am going to hold stabilization until EMS arrives
Come lay down on this backboard, it will keep your spine in line
500
Your patient is a 35 year old female who has MS and has been admitted after a fall at home. She is currently on flexeril and acetaminophen Which of the following would raise most concern?
Urinary hesitancy
Fatigue
Tingling in her lower extremities
Sleeping, not responsive to verbal stimuli
Sleeping, not responsive to verbal stimuli
Sedated!
500
After a lumbar puncture which of the following would be inappropriate
Encourage PO fluids
Observe for headache
Observe for bleeding/ leakage of csf
Encourage the patient to get up out of bed to avoid stiffness
Encourage the patient to get up out of bed to avoid stiffness
Flat for 1-2 hours (possibly longer- 4 hours)
Then HOB 30-45
Encourage PO fluids
Observe for headache or leakage of CSF or bleeding at site
500
Which of the following is true about Sinemet. Select all that apply
Carvitopa allows levodopa to get to the brain
Levodopa stimulates dopamine producing cells that have been affected by the disease
Sinement is affective when used long-term
Tardive Dyskinesia is a side effect
During a drug holiday the patient should be monitored more closely
Tardive Dyskinesia is a side effect
Carvitopa allows levodopa to get to the brain
During a drug holiday the patient should be monitored more closely
500
A nurse is caring for a client diagnosed with a hemorrhagic stroke. When creating this client's plan of care, what
goal should be prioritized?
A. Relieve anxiety and pain
B. Maintain and improve cerebral tissue perfusion
C. Prevent complications of immobility
D. Relieve sensory deprivation
B. Maintain and improve cerebral tissue perfusion