Don't be Nervous System
REPEAT!
What are you gonna do about it?
Diet and Pills

Ellen Degenerative Disorders
Critical Thinking
100

This part of the brain is the belle of the ball

What is...Cerebellum, the ballerina :)

100

List 4 warning signs of a stroke.

What is...FAST

Facial drooping

Arms drifting

Speech difficulty

Time to call 911

100

A patient with Parkinson's Disease received their dinner. YOU, the nurse caring for this patient opens the patient's meal tray and finds chicken breast, meatball soup, broccoli, and rice. WHAT ARE YOU GONNA DO ABOUT IT?

Send the meal tray BACK to the kitchen and let them know this patient should be avoiding protein while on Sinemet.

100

A patient is rushed into the emergency department. A CT scan was done and evidence of Increased Intracranial Pressure was found. Which two medications should the nurse anticipate for the care of this patient

What is...Mannitol and Lasix

100

A patient with Parkinson's Disease is frustrated and tired of having tremors at a rapid frequency. The nurse knows this symptom will improve during

What is...SLEEP

100

The nurse is caring for a hospitalized patient with a history of seizures who is receiving oral phenytoin sodium. Which would be included in the plan of care for this patient?

A. Monitoring intake and output

B. Providing oral hygiene, especially care of the gums

C. Administering medications 1 hour before food intake

D. Checking the heart rate before administering the phenytoin

B. Providing oral hygiene, especially care of the gums

Gingival hyperplasia is a normal finding when taking phenytoin sodium. Careful with oral care using soft-bristled toothbrush and follow-up visits to the dentist.

200

A nurse assess the patient in the intensive care unit and found a blood pressure of 300/60, a heart rate of 52, and a respiratory rate of 9

What is...Cushing's Triad

200

đŸŽ” stop takin' stop takin' i don't want to take pheny-more, I left my head and my heart on the dance floor stop takin', stop takin' I don't want to take pheny-more
I got my head and my heart on the dance floor. Eh, eh, eh, eh, eh, eh, eh, eh, eh, eh stop telephonin' me đŸŽ”

What is...drug holiday

200

A patient with receptive aphasia is frustrated because she is having difficulty conveying her needs. 

WHAT ARE YOU GONNA DO ABOUT IT?

What is...White board and marker

200

A patient was admitted to the definitive observation unit 1 week after a stroke. The patient has been evaluated by a Speech Language Pathologist and is placed on a mechanical soft diet with thick liquids. How can the nurse prevent aspiration when the patient is eating 

What is...chin tuck

200

A patient reports to the clinic of having ptosis, diplopia, dysarthria, and dysphagia

What is...Myasthenia Gravis

200

A client with a history of seizures is taking phenytoin for seizure control. The client arrives at the health care clinic, and a serum phenytoin drug level is drawn. The laboratory calls the nurse and reports a result of 10 mcg/mL. Which interpretation would the nurse make of this value?

A. The laboratory value represents a toxic level.

B. The laboratory value represents an inadequate drug level

C. The laboratory value is at the low end of therapeutic range

D. The laboratory value is at the high end of therapeutic range.

C. The laboratory value is at the low end of therapeutic range

The therapeutic serum drug level range for phenytoin is 10 to 20 mcg/L. A laboratory result of 10 mcg/mL is at the low end of therapeutic range.


300

A patient Glasgow Coma Scale recovering from head trauma went from 14 four hours ago, but now the patient's GCS score is 7

What is...INTUBATE!

300

The nurse explains the pathophysiology of which disorder involving which cranial nerve that involve unilateral facial flaccidity

What is...Bell's Palsy; CN VII

300

A patient who is on Levetiracetam reports to YOU, the nurse that she is having sudden paresthesias, visual field defects, and disorientation.

WHAT ARE YOU GONNA DO ABOUT IT?

What is...Seizure precautions

300

A patient is prescribed phenytoin (Dilantin) and had a loading dose. The patient's blood was drawn and his phenytoin level is 16. Upon discharge, what should the nurse anticipate for this patient before leaving the unit

What is...ensuring that the patient has someone to drive them home

300

A patient's MRI results present multiple lesions in the brain. Upon assessment, the patient presents nystagmus, ataxic gait, and dysphagia

What is...Multiple Sclerosis

300

The nurse is caring for a client following craniotomy who has a supratentorial incision. The nurse reviews the client's plan of care, expecting to note that the client would be maintained in which position?

A. Prone position

B. Supine position

C. Semi-Fowler's position

D. Dorsal recumbent position

C. Semi-Fowler's position

The client's head usually is elevated 30 degrees to promote venous outflow through the jugular veins.

400
Priority for a patient who has a lumbar spinal cord injury

What is...fiber, fluids, and stool softeners

400

This treatment is contraindicated for patients with hypertension, history of angina pectoris, and a history of a myocardial infarction

What is...Sumatriptan

400

A patient is rushed into the emergency department after a motor vehicle collision. There is evidence of minor scrapes and bruises. The patient was found to have a stroke before the accident. YOU, the nurse assess facial drooping of the left side of the face and arm weakness.

WHAT ARE YOU GONNA DO ABOUT IT?

What is...CT scan

400

Tyramine, nitrates, and MSG are contraindicated for which patient

What is...Headache and Migraines

400

A patient is admitted to the emergency department for having signs and symptoms of chorea, gait deterioration, emotional lability, and psychotic behavior

What is...Huntington's Disease

400

The nurse is caring for a 35-year-old client following a motor vehicle accident (MVA). The client has a complete transection of the cervical spine. Which interventions should the nurse anticipate to implement? (Select all that apply.)

A. Assist the client with repositioning every 2 hours.

B. Insert an indwelling urinary catheter.

C. Apply moisture chamber around each eye.

D. Prepare for immediate intubation.

E. Administer Enoxaparin (Lovenox) 40 mg SC once daily.

A, B, D, E

Choice A is correct because clients with a C7 transection are at increased risk of developing pressure ulcers due to immobility, sensory deficits, and nutritional deficits. Therefore, repositioning the client every two hours and implementing pressure relieving devices are priority interventions that the nurse would most likely implement as part of the client's care plan.

Choice B is correct because an indwelling urinary catheter is necessary to prevent urinary retention and monitor urine output. In addition, bladder distention can lead to autonomic dysreflexia in clients with spinal cord injuries.

Choice D is correct because clients with complete cervical transections require intubation to maintain airway and facilitate breathing in the setting of paralysis of the respiratory muscles.

Choice E is correct because the client with a spinal cord injury is at increased risk of venous thromboembolism (VTE) due to immobility and resulting venous stasis. Enoxaparin is a low molecular weight heparin anticoagulant given via subcutaneous injection to prevent deep vein thrombosis (DVT). The nurse should also expect to implement additional interventions to prevent DVT, including sequential compression devices or compression stockings.

Choice C is incorrect because a moisture chamber is required for clients with facial nerve (cranial nerve 7) injury. The facial nerve exits the base of the skull at the stylomastoid foramen and would not be affected by a cervical cord transection. The facial nerve is responsible for eye closure. When the facial nerve is transected, the client is unable to close the eye on the affected site and requires interventions such as a moisture chamber to prevent exposure keratopathy.

500

A patient is found to have arterial bleeding and blood collecting rapidly between the dura mater and the skull

What is...Epidural Hematoma

500

The nurse uses the Glasgow Coma Scale to assess a client with a head injury. The Glasgow Coma Scale score that indicates the client is in a coma is a score of?

What is...a GCS score of 3 to 8

500

A patient suspected to have Guillain-Barré Syndrome. YOU, the nurse admit this patient immediately and according to YOUR assessment findings, the patient is unable to move his upper extremities.

WHAT ARE YOU GONNA DO ABOUT IT?

What is...assess for airway, lung sounds, and anticipate mechanical ventilation

500

A patient has been recently diagnosed with Myasthenia Gravis and has been prescribed anticholinesterase drugs (neostigmine and pyridostigmine). What other medication order does the nurse anticipate being in the MAR

What is...Atropine

500

A patient with Trigeminal Neuralgia was found to have an artery bulging and compressing on the patient's cranial number what and is to have a what procedure where the surgeon places an object between the offending artery and the cranial nerve to decrease the pain.

What is...CN V; Microvascular decompression

500

Mid conversation with the nurse, an 84-year-old long term resident of a skilled nursing facility suddenly falls silent, then stares across the room and says “I’m not sure when my wife and daughter will be home, but it shouldn’t be too long. Why don’t you wait for them?” The nurse knows the client is widowed and their daughter lives across the country. What action should the nurse take? (Select all that apply). 

A. Measure oxygen saturation.

B. Prepare for a STAT CT scan.

C. Complete a full neurological assessment.

D. Contact the client's daughter to see if a visit is scheduled.

E. Obtain order for blood and urine tests.

A, C, E

Choice A “Measure oxygen saturation” is correct because hypoxia is a major cause of acute onset of confusion, especially in the elderly. If the client is hypoxic, the nurse should apply supplemental oxygen and notify the healthcare provider.

Choice C “Complete a full neurological assessment” is correct because a number of neurological causes (delirium, stroke, TIA, bleed) should be investigated as a potential cause of the client’s change in mental status.

Choice E “Obtain order for blood and urine tests” is correct because the client’s symptoms could be signs of an infection (e.g. a UTI and subsequent delirium) or electrolyte imbalances (e.g. hyponatremia). Obtaining blood and urine samples will aid in determining a cause (and subsequent treatment) of the client’s acute onset of confusion.

Choice B “Prepare for a STAT CT scan” is incorrect because while the client’s symptoms could be a sign of a CVA, TIA, or intracranial hemorrhage, the nurse should complete a full neurological exam first. If the client was confused, and additionally displayed other symptoms on the neurological exam (e.g. facial drooping, slurring of speech, one-sided paralysis), then a STAT CT would be appropriate.

Choice D “Contact client’s daughter by telephone to see if a visit is scheduled” is incorrect because the nurse should recognize that client is experiencing a change in mental status and prioritize interventions focused on assessment and subsequent treatment.

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