1 >>The nurse has given the male client with Bell’s palsy instructions on preserving muscle tone in the face and preventing denervation. The nurse determines that the client needs additional information if the client states that he or she will: ?
- (A) Exposure to cold and drafts
- (B) Massage the face with a gentle upward motion
- (C) Perform facial exercises
- (D) Wrinkle the forehead, blow out the cheeks, and whistle
2 >>Female client is admitted to the hospital with a diagnosis of Guillain-Barre syndrome. The nurse inquires during the nursing admission interview if the client has history of: ?
- (A) Seizures or trauma to the brain
- (B) Meningitis during the last 5 years
- (C) Back injury or trauma to the spinal cord
- (D) Respiratory or gastrointestinal infection during the previous month.
3 >>A female client with Guillain-Barre syndrome has ascending paralysis and is intubated and receiving mechanical-ventilation. Which of the following strategies would the nurse incorporate in the plan of care to help the client cope with this illness? ?
- (A) Giving client full control over care decisions and restricting visitors
- (B) Providing positive feedback and encouraging active range of motion
- (C) Providing information, giving positive feedback, and encouraging relaxation
- (D) Providing intravenously administered sedatives, reducing distractions and limiting visitors
4 >>A male client has an impairment of cranial nerve II. Specific to this impairment, the nurse would plan to do which of the following to ensure client to ensure client safety? ?
- (A) Speak loudly to the client
- (B) Test the temperature of the shower water
- (C) Check the temperature of the food on the delivery tray.
- (D) Provide a clear path for ambulation without obstacles
5 >>A female client has a neurological deficit involving the limbic system. Specific to this type of deficit, the nurse would document which of the following information related to the client’s behavior. ?
- (A) Is disoriented to person, place, and time
- (B) Affect is flat, with periods of emotional lability
- (C) Cannot recall what was eaten for breakfast today
- (D) Demonstrate inability to add and subtract; does not know who is president
6 >>A client admitted to the hospital with a subarachnoid hemorrhage has complaints of severe headache, nuchal rigidity, and projectile vomiting. The nurse knows lumbar puncture (LP) would be contraindicated in this client in which of the following circumstances? ?
- (A) Vomiting continues
- (B) Intracranial pressure (ICP) is increased
- (C) The client needs mechanical ventilation
- (D) Blood is anticipated in the cerebrospinal fluid (CSF)
7 >>A client with a subdural hematoma becomes restless and confused, with dilation of the ipsilateral pupil. The physician orders mannitol for which of the following reasons? ?
- (A) To reduce intraocular pressure
- (B) To prevent acute tubular necrosis
- (C) To promote osmotic diuresis to decrease ICP
- (D) To draw water into the vascular system to increase blood pressure
8 >>A client with subdural hematoma was given mannitol to decrease intracranial pressure (ICP). Which of the following results would best show the mannitol was effective? ?
- (A) Urine output increases
- (B) Pupils are 8 mm and nonreactive
- (C) Systolic blood pressure remains at 150 mm Hg
- (D) BUN and creatinine levels return to normal
9 >>Which of the following values is considered normal for ICP? ?
- (A) 1.0 to 15 mm Hg
- (B) 25 mm Hg
- (C) 35 to 45 mm Hg
- (D) 120/80 mm Hg
10 >>Which of the following symptoms may occur with a phenytoin level of 32 mg/dl? ?
- (A) Ataxia and confusion
- (B) Sodium depletion
- (C) Tonic-clonic seizure
- (D) Urinary incontinence
11 >>Which of the following signs and symptoms of increased ICP after head trauma would appear first? ?
- (A) Bradycardia
- (B) Large amounts of very dilute urine
- (C) Restlessness and confusion
- (D) Widened pulse pressure
12 >>Problems with memory and learning would relate to which of the following lobes? ?
- (A) Frontal
- (B) Occipital
- (C) Parietal
- (D) Temporal
13 >>While cooking, your client couldn’t feel the temperature of a hot oven. Which lobe could be dysfunctional? ?
- (A) Frontal
- (B) Occipital
- (C) Parietal
- (D) Temporal
14 >>The nurse is assessing the motor function of an unconscious client. The nurse would plan to use which of the following to test the client’s peripheral response to pain? ?
- (A) Sternal rub
- (B) Pressure on the orbital rim
- (C) Squeezing the sternocleidomastoid muscle
- (D) Nail bed pressure
15 >>The client is having a lumbar puncture performed. The nurse would plan to place the client in which position for the procedure? ?
- (A) Side-lying, with legs pulled up and head bent down onto the chest
- (B) Side-lying, with a pillow under the hip
- (C) Prone, in a slight Trendelenburg’s position
- (D) Prone, with a pillow under the abdomen.
16 >>A nurse is assisting with caloric testing of the oculovestibular reflex of an unconscious client. Cold water is injected into the left auditory canal. The client exhibits eye conjugate movements toward the left followed by a rapid nystagmus toward the right. The nurse understands that this indicates the client has: ?
- (A) A cerebral lesion
- (B) A temporal lesion
- (C) An intact brainstem
- (D) Brain death
17 >>The nurse is caring for the client with increased intracranial pressure. The nurse would note which of the following trends in vital signs if the ICP is rising? ?
- (A) Increasing temperature, increasing pulse, increasing respirations, decreasing blood pressure.
- (B) Increasing temperature, decreasing pulse, decreasing respirations, increasing blood pressure.
- (C) Decreasing temperature, decreasing pulse, increasing respirations, decreasing blood pressure.
- (D) Decreasing temperature, increasing pulse, decreasing respirations, increasing blood pressure.
18 >>The nurse is evaluating the status of a client who had a craniotomy 3 days ago. The nurse would suspect the client is developing meningitis as a complication of surgery if the client exhibits: ?
- (A) A positive Brudzinski’s sign
- (B) A negative Kernig’s sign
- (C) Absence of nuchal rigidity
- (D) A Glascow Coma Scale score of 15
19 >>A client is arousing from a coma and keeps saying, “Just stop the pain.” The nurse responds based on the knowledge that the human body typically and automatically responds to pain first with attempts to: ?
- (A) Tolerate the pain
- (B) Decrease the perception of pain
- (C) Escape the source of pain
- (D) Divert attention from the source of pain.
20 >>During the acute stage of meningitis, a 3-year-old child is restless and irritable. Which of the following would be most appropriate to institute? ?
- (A) Limiting conversation with the child
- (B) Keeping extraneous noise to a minimum
- (C) Allowing the child to play in the bathtub
- (D) Performing treatments quickly
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