Bundle
ALL CNRN EXAM (24 Sets) Questions with Verified Answers,100% CORRECT
21 Items
CNRN Exam 39 Questions with Verified Answers,100% CORRECT
CNRN Exam 39 Questions with Verified Answers Where is the Brocas area located? - CORRECT ANSWER Frontal Lobe Where is the Wernickes area located? - C... [Show More] ORRECT ANSWER Temporal Lobe Where is short term memory located? Long term? - CORRECT ANSWER Short- Frontal Long- Temporal Parietal Lobe main characteristic: - CORRECT ANSWER Proprioception What is the gold standard for declaring brain death? - CORRECT ANSWER Cerebral Blood Flow Negative Doll's eyes means... - CORRECT ANSWER Eyes remain fixed when turning head from side to side Parkinson's disease is damage to which part of the brain? - CORRECT ANSWER Basal Ganglia Cerebral contusions may be evident on what kind of scan? - CORRECT ANSWER CT Subdural Hematoma is a what kind of bleed? - CORRECT ANSWER Venous What kind of bleed is an emergency and why? - CORRECT ANSWER Epidural Hematoma; its an arterial bleed Brief or no loss of consciousness followed by a lucid period, then rapid decline in consciousness: - CORRECT ANSWER Epidural Hematoma ICP and CPP monitoring are recommended for GCS less than.. - CORRECT ANSWER 8 Central Cord Syndrome main s/s - CORRECT ANSWER Weakness greater in the arms than legs Brown-Sequard Syndrom s/s - CORRECT ANSWER Motor and Proprioceptive loss on ipsilateral side Pain and temperature loss on contralateral side Flexion injury causes: - CORRECT ANSWER Anterior cord syndrome Hyperextension injury causes: - CORRECT ANSWER Posterior cord syndrome Loss of proprioception occurs with which injury? - CORRECT ANSWER Posterior Syndrome Area where nerves leave the lower spnal cord and travel inside the spinal canal: - CORRECT ANSWER Cauda equina Secondary Spinal Cord Injury (SCI) occurs when? - CORRECT ANSWER 24-2 hours after initial injury Gold standard techniquw for initial immobilixation to temporarily stabilize the cervical spine: - CORRECT ANSWER Garner-Wells tongs Hallmark clinical s/s of neurogenic shock - CORRECT ANSWER Hypotension Bradycardia What spinal injury require continuous mechanical ventilation? intermittent? - CORRECT ANSWER Continuous- C!-3 Intermittent- C3-5 Superior Mesentaric Artery Syndrome: - CORRECT ANSWER Results from compression of the third portion of the duodenum between the aorta and superior mesenteric artery leading to upper GI obstruction; s/s nausea and vomiting When does Autonomic Dysreflexia occur? - CORRECT ANSWER 2-6 MONTHS after acute injury; This is a sympathetic overload What produces CSF? - CORRECT ANSWER Choroid Plexus Why do infants have an increased brain compliance? - CORRECT ANSWER They skull is not fully closed Goal CPP? ICP? - CORRECT ANSWER CPP 60-80 mmHG OCP < 20 mmHG ICP Waveform: P1 - CORRECT ANSWER Percussion wave; sharp peak representing arterial pressure being transmitted into the choroid plexus ICP Waveform: P2 - CORRECT ANSWER Tidal Wave; elevation of this wave form indicated poor compliance and poor outcomes ICP waveform: P3 - CORRECT ANSWER Dicrotic wave; casued by the closure of the aortic valve What are secondary causes of increased ICP? - CORRECT ANSWER Hypoventilation Fever HTN SZ Drugs Altitude S/S of cushing syndrome - CORRECT ANSWER Irregular Respirations Bradycardia Widening pulse pressure How do you calculate CPP? - CORRECT ANSWER MAP-ICP The skull is a fixed box; there is no room for additional contents best describes what? - CORRECT ANSWER Monroe-Kellie Doctorine Pateitns with SAH are at increased risk for what type of hydrocephalus? - CORRECT ANSWER Communicating (there is an absorption problem and not related to an obstruction) What is commonly is confused with dementia? - CORRECT ANSWER Normal pressure hydrocephalus; ability of CSF to be absorbs declines over time (communicating hydrocephalus) Downwards displacement of brain tissue through the tentorial opening: - CORRECT ANSWER Uncal (Lateral transtentorial) This is the classic herniation process High or Low CPP is associated with hypoxic state and tissue ischemia? - CORRECT ANSWER Low Gold standard device to monitor ICP: - CORRECT ANSWER EVD [Show Less]
- Exam
- $9.45
- 0
- 80
CNRN exam 124 Questions with Verified Answers,100% CORRECT
CNRN exam 124 Questions with Verified Answers Specific condition of small vessels that can lead to lacunar strokes - CORRECT ANSWER lipohyalinosis wh... [Show More] at is the greatest risk factor for lacunar strokes - CORRECT ANSWER hypertension tiny areas of ischemic necrosis caused by occlusion of small penetrating arteries - CORRECT ANSWER lacunar strokes what percentage of ischemic strokes do lacunar strokes account for - CORRECT ANSWER 25% what are the 5 classic syndromes of lacunar strokes - CORRECT ANSWER pure motor hemiparesis, ataxic hemiparesis, dysarthria/clumsy hand syndrome, pure sensory stroke, and mixed sensorimotor stroke what is the only non-pain sensitive tissue in the head/brain - CORRECT ANSWER brain parenchyma what is the biggest insurmountable obstacle to effective pharmacological treatments for patients with cluster headaches - CORRECT ANSWER cigarette smoking subdural hematomas most commonly result from what? - CORRECT ANSWER venous bleeding from the tearing of briding veins how is the diagnosis of DAI confirmed - CORRECT ANSWER clinical diagnosis, definitively dx requires microscopice examination of the brain tissue. what are classic signs of autonomic dysfunction syndrome and what's the most common intervention - CORRECT ANSWER hypertension, tachycardia, tachypnea, and fever---iv morphine what is the MOST common source of infection leading to brain abcesses? - CORRECT ANSWER hematogenous spread from distant infected sites, such as PNA, lung abscess, or bacterial endocarditis what group of people have the greatest risk of ICH? - CORRECT ANSWER patients with unruptured intracerebral AVM's what is the most important diagnostic test for the pt having a dull headache, superimposed ice pick sensations on the scalp, jaw claudication, and elevated ESR? - CORRECT ANSWER temporal artery biopsy--r/o giant cell arteritis what is a potential complication of a CSF leak in basal skull fx's? - CORRECT ANSWER the trapping of portions of the frontal meninges b/w the fx edges with a persistent CSF leak requiring surgical intervention what is the best way to accomplish external draining of CSF via an EVD? - CORRECT ANSWER drain a few drops/minute and close the drain after 5min or less what is the Tinel's sign - CORRECT ANSWER most frequently associated with carpel tunnel, gently tap or percuss over the injured nerve to elicit a sensation of tingling or "pins and needles" in the nerve distribution area. what is the Phalen's sign? - CORRECT ANSWER maneuver to diagnose carpel tunnel--hands forced dorsal sides together and wrists flexed to 90deg; positive test causes burning, tingling, or numb sensation over the thumb, index, middle and ring fingers. what is the most common cause of Erb's palsy? - CORRECT ANSWER dystocia or abnormal or difficult childbirth or labor what are the most common sign's of erb's palsy? - CORRECT ANSWER loss of sensation in the arm and paralysis and atrophy of the deltoid, biceps, and brachialis muscles. how is the management of the GI system in a SCI pt intiated in the ED? - CORRECT ANSWER by inserting a NGT d/t the high risk of gastric immotility resulting in distention and an ileus. what is the most common cause of a radial nerve injury - CORRECT ANSWER humerus fracture best treatment options for a woman in 3rd trimester of pregnancy with + Tinel's and Phalen's sign is what? - CORRECT ANSWER wrist splints and rehab modalities best way to prevent the development of peroneal nerve palsy in a recently immobilized pt is what? - CORRECT ANSWER avoiding pressure to the back of the knees during period when pt is immobilized in a recently immbolized pt, they begin to complain of burning on the top of the foot and have unilateral foot drop. what is this - CORRECT ANSWER peroneal nerve palsy what is the major difference b/w subdural hematoma and subdural hygroma - CORRECT ANSWER subdural hematoma is blood, and subdural hygroma is CSF ideal treatment for low serum Na level is what? - CORRECT ANSWER slow normalization w/ 3% saline and lasix to prevent central pontine myelinolysis what is a common alternative approach to preventing the s/s of carpel tunnel syndrome? - CORRECT ANSWER yoga pain upon straight leg raising in a multi trauma patient may indicate what? - CORRECT ANSWER herniated nucleus pulposus severe sharp pain with passive hip flexion may indicated what? - CORRECT ANSWER hip fracture one MOST important discharge education piece to include to parents taking home a baby with Erb's palsy is what? - CORRECT ANSWER PROM exercises for the affected arm trauma pts being dc'd home following frontal bone fractures need education to avoid... - CORRECT ANSWER Food poisoning anosmia - CORRECT ANSWER the inability to perceive odor or a lack of functioning olfaction Battle's sign - CORRECT ANSWER ecchymosis over the temporal bones--develops typically 12-24hrs following the basal skull fracture advised to avoid glucose-containing IVF in pts with TBI b/c it can contribute to... - CORRECT ANSWER neurotoxic acidosis characteristic finding on EEG in a patient experiencing "staring spells" - CORRECT ANSWER irregular 2.5Hz or less spike-wave pattern the MOST common reason people with MS stop working is... - CORRECT ANSWER cognitive impairment affects 60% of people with MS what is a disadvantage to gamma-knife tx for malignant brain tumors? - CORRECT ANSWER it's unable to detect malig cells that may have infiltrated into surrounding normal tissues the few/main type of primary malignant brain tumor responsive to chemo is what? - CORRECT ANSWER oligodendryglioma the incidence of medulloblastoma increases or decreases with age? - CORRECT ANSWER decreases, unlike most other malig and benign tumors that increase with age why should pts taking methotrexate avoid ASA and NSAIDs? - CORRECT ANSWER they increase serum concentration levels of methotrexate, increasing its 1/2 life, and therefore risking toxicity neurofibromatosis is inherited how? - CORRECT ANSWER autosomal dominant fashion, but as many as 1/3 are spontaneous mutations which tumor will most likely present bitemporal hemianopia? - CORRECT ANSWER pituitary adenoma chemotherapy for primary spinal cord tumors is consider to be? - CORRECT ANSWER experimental what is the most common route for metas malignant tumors of other organs to spread to the CNS? - CORRECT ANSWER via blood circulation complications in childbirth attribute to what % of cerebral palsy cases in the 1980's? - CORRECT ANSWER less than 10% what is the primary/first line treatment for spasticity in pts with cerebral palsy? - CORRECT ANSWER physical therapy elevated maternal serum alpha-fetoprotein is a marker for what? - CORRECT ANSWER spina bifida the most common location for a CNS hemangioblastoma is where? - CORRECT ANSWER the posterior fossa what is Von-Hippel Lindau disease? - CORRECT ANSWER autosomal recessive d/o characterized by multiple benign hemangiomas of the CNS. what is the only fully established risk factor for meningomas? - CORRECT ANSWER radiation exposure what is attributed to the greatest improvement in survival rates of pts with metastatic brain CA? - CORRECT ANSWER RADIOSURGERY untreated syringomyelia can expect what type of progression? - CORRECT ANSWER slow progression with slow accumulation of neurological deficits impaired language function (aphagia) out of proportion to other cognitive deficits is characterized by? - CORRECT ANSWER frontotemporal dementias impaired recent memory out of proportion to remote memory is characterized by? - CORRECT ANSWER Alzheimer's disease what is the best strategy to ensue that a patient with middle stages of Alzheimer's dz can carry out complex instructions? - CORRECT ANSWER both verbal and nonverbal cues simultaneously pt's with _____have a predisposition to generalized sz... - CORRECT ANSWER Stage 3 Alzheimer's dz pt's presenting with impaired memory, broad-based magnetic gait, and urinary incontinence display what d/o? what treatment is indicated? - CORRECT ANSWER NPH...normal pressure hydrocephalus...treatment is VP shunt dementia with a temporal step-wise clinical progression is most likely d/t what? - CORRECT ANSWER multi-infarct dementia what is the single greatest risk factor for the development of pseudotumor cerebri - CORRECT ANSWER obesity The inheritance of ALD is mostly r/t what? - CORRECT ANSWER X linked recessive gene Pts with ALD lack what? - CORRECT ANSWER Enzyme that breaks down VLCFAs What is the most common neurological manifestation of HIV dz? - CORRECT ANSWER Peripheral neuropathy Pts rec'g the following therapies (INH, RIF, EMB, PZA) for HIV should receive supplements of what? - CORRECT ANSWER Vitamin B6 (pyridoxine) RLS can affect people of what age group? - CORRECT ANSWER Any age the inheritance of ALD is nearly always.... - CORRECT ANSWER X-linked recessive patients with adrenoleukodystrophy ALD lack: - CORRECT ANSWER an enzyme that breaks down very long chain fatty acids the most common neurologic manifestation of HIV disease - CORRECT ANSWER peripheral neuropathy the best pharmacologic approach to symptoms of RLS is usually - CORRECT ANSWER cyclic deployment of various classes of medications the GREATEST risk factor for progressive multifocal leukoencephalopathy is what? - CORRECT ANSWER AIDS the MOST common natural history of degenerative disc disease w/o radiculopathy in the lumbar spine is: - CORRECT ANSWER gradual improvement over time patients with multiple system atrophy become overheated and are at significant risk for heat stroke because: - CORRECT ANSWER they fail to sweat back and leg pain associated with lumbar spinal stenosis is usually improved how? - CORRECT ANSWER improves somewhat with walking uphill untreated hydrocephalus in newborns: - CORRECT ANSWER has a 50-60% death rate overall the general term for a document that gives directions concerning a person's health care in the event that he/she can no longer make decisions for him/herself is called... - CORRECT ANSWER advance directive triptans should not be used to abort migraine headaches in patients who: - CORRECT ANSWER have HTN or other risk factors for heart attack or stroke the most effective strategy to date for limiting cognitive impairment in patients with multiple sclerosis is: - CORRECT ANSWER early intervention with disease-modifying agents sympathetic blockade can reduce pain associated with: - CORRECT ANSWER postherpetic neuralgia if a person has one parent with Huntington's disease, his chance of also having Huntington's is: - CORRECT ANSWER 50% antibiotic treatment for neurosyphillis should consist of: - CORRECT ANSWER IV aqueous crystalline PCN-G q4h x 10-14 days when a woman giving birth is known to have MS.... - CORRECT ANSWER she should be given the same options for interventions for pain control for all other women the BEST method for preventing subacute sclerosing pan encephalitis (SSPE) is? - CORRECT ANSWER measles vaccinations patients with idiopathic intracranial HTN should be followed with - CORRECT ANSWER quantitative visual field examination it is common for a pt with narcolepsy experiencing an episode to: - CORRECT ANSWER awaken feeling refreshed, although not necessarily for long careful temperature monitoring following an acute CVA is important b/c - CORRECT ANSWER hyperthermia increases the risk of infarct extension pt's with ALS experience extended survival time and extended time not requiring a tracheostomy when treated with ? - CORRECT ANSWER Riluzole the GREATEST risk factor for multi-infarct dementia is? - CORRECT ANSWER HTN the most sensitive marker for neuromyelitis optical is? - CORRECT ANSWER serum NMO IgG antibody the classic triad of fever, focal abnormalities, and increased ICP are seen in ... - CORRECT ANSWER brain abscesses post polio syndrome can cause - CORRECT ANSWER sleep apnea patient presenting with pure mental neuropathy (numb chin syndrome) is MOST likely to have? - CORRECT ANSWER metastatic cancer a young patient presenting with Bell's palsy should always be evaluated for - CORRECT ANSWER diabetes on EMG examination of a patient with post-polio syndrome, you can expect to see - CORRECT ANSWER evidence of anterior horn disease with increased amplitude and duration with the evoked potentials and increased % of polyphasic potentials a patient with post-polio syndrome most likely had what kind of recovery course from the initial illness - CORRECT ANSWER normal or good recovery course young patients presenting with trigemnal neuralgia should also be evaluated for? - CORRECT ANSWER multiple sclerosis prevention of DVT in the patient hospitalized for GB management is best accomplished how? - CORRECT ANSWER mini doses of heparin the goal of blood pressure management in a patient with aneurysmal SAH awaiting treatment is what? - CORRECT ANSWER keep BP high enough to prevent vasospasm, but low enough to prevent aneurysmal rebleeding a person with a severe throbbing Rt sided headache 3 days post MVA, & transient ipsilateral monocular blindness should be monitored for what? - CORRECT ANSWER partial Horner's syndrome a very common manifestation of carotid dissection r/t neck injury - CORRECT ANSWER partial Horner's syndrome the most appropriate nutritional supplement for a patient with MS and his children - CORRECT ANSWER Vitamin D emphasis is on re-establishing normal movement patterns through having the pt experience the sensations of normal movement - CORRECT ANSWER Bobath neurodevelopment approach to rehab a conscious hemiplegic stroke pt should transfer from chair to bed how? - CORRECT ANSWER orienting the chair at an angle and the unaffected side closest to the bed the most common route by which infective agents enter the CNS is how? - CORRECT ANSWER hematogenous spread what pathogen is most commonly responsible for causing bacterial meningitis in adolescents and young adults? - CORRECT ANSWER Neisseria meningitides effective acute treatment for cluster headaches is what? - CORRECT ANSWER 100% O2 via a non-rebreathing face mask cigarette smoking is an insurmountable obstacle in the pharm tx of which class of headaches? - CORRECT ANSWER cluster headaches treating spasticity in pts with syringomyelia should be balanced so as to not: - CORRECT ANSWER inadvertently increase weakness a tremor that occurs most prominently when the hands are in use is r/t? - CORRECT ANSWER benign essential tremor tremors associated with Parkinson's disease occur primarily when? - CORRECT ANSWER at rest cerebellar tremors primarily are associated when? - CORRECT ANSWER at the end of a movement tremors d/t toxic or metabolic abnorms occur when? - CORRECT ANSWER both at rest and with motion treatment of Parkinson's with Carbidopa, the drug helps how? - CORRECT ANSWER inhibits the enzyme dopa decarboxylase the use of anticholinergic meds to treat Parkinson's helps what? - CORRECT ANSWER often reduces tremors and drooling before deep brain stimulation is used in a Parkinson's pt, they should - CORRECT ANSWER dc PD meds the night before surgery dietary supplement most appropriate for patients with Wilson's disease - CORRECT ANSWER Zinc acetate most prevalent focal dystonia - CORRECT ANSWER torticollis dietary modifications necessary for a pt with hypokalemic periodic paralysis - CORRECT ANSWER avoid high carb meals neuropathic pain follows what pattern typically? - CORRECT ANSWER worse in the evening people with Down syndrome have the GREATEST increased risk of: - CORRECT ANSWER dementia a child with Down syndrome in school is having difficulty learning new material & requiring a great deal of repitition; what test should be considered - CORRECT ANSWER polysomnography (r/o sleep apnea) a baby with Down syndrome is likely to need? - CORRECT ANSWER assistance breast feeding or bottle feeding with manual support of chin and throat assists in preventing opiod tolerance - CORRECT ANSWER dextromethorphan symmetric, bilat distribution of sensory and motor deficits, beginning distally and progressing proximally - CORRECT ANSWER diabetic peripheral neuropathy education on the proper use of crutches can help prevent what type of injury? - CORRECT ANSWER radial nerve entrapment injury MS pts being treated with Tysabri require intensive long-term monitoring why? - CORRECT ANSWER there is a 1/1000 risk of developing progressive multifocal leukoencephalopathy [Show Less]
- Exam
- $11.45
- 0
- 132
CNRN Exam 157 Questions with Verified Answers,100% CORRECT
CNRN Exam 157 Questions with Verified Answers Glascow Coma Scale (GCS) - CORRECT ANSWER Used to assess/classify level of consciousness particularly in a... [Show More] cute stages of injury or comatose patients. The scale ranges from 3-15. Score 13-15=mild injury. Score 9-12=moderate injury. Score less than 8=severe brain injury. If patient is unresponsive to auditory cues, tactile stimulation is applied. Begin with gentle touching or gentle shaking, if no response, more pressure or pinching to the upper chest or upper back is applied. Responses include body or limb withdrawal, or pushing the examiner away. GCS score 13-15 - CORRECT ANSWER Mild injury GCS score 9-12 - CORRECT ANSWER Moderate injury GCS score less than 8 - CORRECT ANSWER Severe brain injury Level of Consciousness (LOC) - CORRECT ANSWER Major indicator of neurological change. Consciousness refers to both alertness and cognitive function. The Glascow coma score is most commonly used to numerically rank LOC, but qualitative descriptions are also helpful. Confused patients are disoriented and may have memory deficits. Lethargic patients demonstrate some confusion and slowed responsiveness. Patients in obtundation require stimulation. Stupor is lack of spontaneous movement, or verbalization, and minimal responsiveness. Coma is divided into 3 levels based on response to painful stimuli. Patients in coma are unarousable and have their eyes closed. Complete unresponsiveness=deep coma. Light coma=withdrawal from painful stimuli and brainstem reflexes are intact. Secondary cellular injury - CORRECT ANSWER Primary injury induces damaging secondary processes including ischemia, hypoxia, and secondary axotomy, which activate additional cellular reactions that further perpetuate injury. Injurious cellular cascades include excitotoxicity, which begins with the release of high concentrations of the excitatory neurotransmitters glutamate and aspartate from axotomized or degenerating neurons. Excessive activation of their receptors leads to abnormal influx of calcium ions, which activate intracellular biochemical signaling cascades that lead to cell death. An influx of sodium ions also carries water into the cell causing swelling. Traumatic Brain Injury - CORRECT ANSWER Primary injury is insult caused by direct contact to the head and brain at the time of injury. Low velocity impact limits injury to the scalp (laceration) or skull (fracture), whereas high velocity impacts the brain as well (intracerebral hemorrhage). Primary injury induces damaging secondary events: - CORRECT ANSWER Including intracranial hemorrhage, cerebral edema, and increased intracranial pressure. Brain swelling or intracrainal hematoma can increase intracranial pressure, increasing liklihood of mass effect and herniation. Secondary injuries are generally considered to develop four hours or more later than the initial injury, and a major goal of primary care is to minimize their occurrence. Traumatic cerebral injury - CORRECT ANSWER Classifications: Focal-cerebral contusions, lacerations, and intracranial hemorrhage. Diffuse-concussion and diffuse axonal injury (DAI) Penetrating-usually gunshot contusion and laceration-focal TBI - CORRECT ANSWER terms used to describe visible bruising and tearing of cerebral tissue arachnoid remains intact Mild concussion is characterized by: - CORRECT ANSWER headache, confusion, or gait disturbances NO LOC classic concussion - CORRECT ANSWER Brief loss of consciousness. Amnesia, Headache, and other neuro symptoms more pronounced. Warn patient and family to report deterioration in neurological status. Shearing force causes microscopic axonal and blood vessel tearing along susceptable junctions, leafing to diffuse axonal injury (DAI). Diffuse Axonal Injury (DAI) - CORRECT ANSWER Widespread disruption of axons due to acceleration or deceleration injury. Small, petechial hemorrhages at gray-white junction of cerebral hemispheres and or corpus callosum. Management of patients with severe traumatic brain injury: - CORRECT ANSWER Initial management of patients with severe traumatic brain injury follows the same principles as for spinal cord injury. Primary concerns are for airway patency, respiration, respiration, circulation, and level of consciousness. Emergency department care is focused on stabilization and minimize secondary injury. Monitoring intracranial pressure, oxygen supply, and additional systemic problems continue in the ICU. Ventriculostomy is useful to drain cerebral spinal fluid and lower intracrainial pressure. Sedation can reduce complications from agitation, ventilator asynchrony, and elevated oxygen demand. Drug treatments should take into account potential effects on cerebral blood flow and oxygen metabolism. Euvolemia maintained with hypertonic saline solution regulates intracrainial pressure and blood pressure. Stool softeners prevent constipation to reduce risk of elevated intracranial pressure. Euvolemia - CORRECT ANSWER state of normal body fluid volume hypertonic solution - CORRECT ANSWER A solution in which the concentration of solutes is greater than that of the cell that resides in the solution Treatments for Traumatic Brain Injury - CORRECT ANSWER Noncontrast CTs are useful for identifying (or ruling out) blood accumulation associated with hemorrhage and hematoma, as well as cerebral edema and anoxia. Small hematomas may reabsorb, but larger hematomas, intraventricular and subarachnoid hemorrhages may require surgery. Surgery may not improve the outcome of intracerebral hemorrhage, suppotrting the importance of supportive care. Penertrating gunshot wounds are generally addressed surgically to remove bone and bullet fragments and evacuate hematomas. Diffuse axonal injury is associated with unconsciousness, but trauma is sometimes not evident at the resolution of the CT scan. Increased intracranial pressure is an issue with each of these conditions. Observation is generally the approach to concussion. Contusions and lacerations of the skin require wound care, and skull fractures may necessitate reconstructive surgery. Multisystem management of traumatic brain injury - CORRECT ANSWER Traumatic Brain Injury produces a range of complications in various bodily systems. Assuring respiratory or ventilator function and airway patency are critical. Positioning the patient on their side facilitates drainage, and suctioning clears the airway. Atelectasis, or reduced functional lung volume, can be prevented with chest physical therapy or deep breathing exercises which can also prevent aspiration and pneumonia. Cardiovascular function should be monitored for cardiac arrhythmias and to maintain appropriate blood pressure. Immobility leads to DVT and PE. Elastic stockings, compression boots and heparin may help prevent clot formation. Antacids or other drugs may be used to control gastric pH thereby preventing irritation, ulcers, and GI hemorrhage. Use of higher saline concentrations for fluid replacements for fluid replacement can help prevent hyponatremia which can lead to seizure or coma. Hyperglycemia should be prevented with insulin, as it may worsen ischemic injury. Nutritional needs should be assessed by a dietician and addressed as soon as possible with a feeding tube inserted in the jejunum. Primary headaches - CORRECT ANSWER migraine, tension, cluster, and chronic daily headaches Chronic daily headache CDH - CORRECT ANSWER Headaches that occur ≥ 15 days per month for at least 3 months Two types of CDH: 1. HAs lasting longer than 4 hours (including chronic or transformed migraine, chronic tension-type headache, and hemicrania continua) 2. HAs lasting less than 4 hours duration, including cluster headache, chronic paroxysmal hemicrania, and short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing. neurogenic pain - CORRECT ANSWER Chronic pain caused by nerve damage. Nerve damage caused by spinal cord tumors, spinal stenosis, trauma, nerve entrapment such as carpal tunnel. Complex Regional Pain Syndrome (CRPS) - CORRECT ANSWER Complex regional pain syndrome is an uncommon form of chronic pain that usually affects an arm or leg. Complex regional pain syndrome typically develops after an injury, phantom pain after amputation, surgery, stroke or heart attack, but the pain is out of proportion to the severity of the initial injury, if any. Tx's: - Apply heat and cold: to relieve swelling and sweating. - Topical Analgesics: Creams - PT: Gentle guided ex's to decrease pain and increase ROM and STR. - TENS (nerve stimulation) : Electrical impulses to nerve endings - Biofeedback or Spinal cord stimulation rhizotomy - CORRECT ANSWER destroys the dorsal sensory nerve root, therby removing all sensation cordotomy (chordotomy) - CORRECT ANSWER procedure which interferes with pathways within the spinal cord that control pain produces extensive unilateral analgesia by lesioning the spinothalamic tract peripheral neuropathy - CORRECT ANSWER chronic sensations of pain-tingling, numbness, or other dysesthesias in the periphery, often the hands or feet dysesthesia - CORRECT ANSWER painful sensation Causes of peripheral neuropathy - CORRECT ANSWER Primary cause-Demyelination Diabetes, HIV, and peripheral nerve trauma are all predisposing factors, and increasing age. Peripheral neuropathy may lead to - CORRECT ANSWER Weakness, loss of sensation, difficulty walking, using hands-may need a supportive brace Increased risk for falls Pain is an ongoing concern-primarily managed with pharmacologically Exercise, physical therapy, and proper nutrition can slow functional decline and also help alleviate pain. A patient has been admitted to the hospital for status epilepticus. The patient is currently postictal. Which of the following is the most important nursing consideration for managing the patient? - CORRECT ANSWER Maintain the airway A young child is bought into the hospital for recurrent staring episodes while at school. What is the likely etiology for her symptoms? - CORRECT ANSWER Petit mal seizure An 85 year old woman presents to the emergency department with facial droop, dysarthria(slurred speech), and unilateral weakness that started 6 hours prior to arrival. Her medical history includes HTN, and gallbladder surgery last week. Her blood pressure is 165/85. Which of the following is contraindication for administering tissue plasminogen activator (tPA)? - CORRECT ANSWER Symptom onset Absolute contraindications to tPA - CORRECT ANSWER Within 4.5 hours of stroke symptoms, intracranial hemorrhage, recent head trauma in last 3 months, active internal bleeding, uncontrolled blood pressure (more than 185/100), abnormal clotting factors due to malignancy or anticoagulation (INR more than 1.7, platelet count less than 100,000/mm), glucose less than 50 or more than 400, and seizure at stroke onset. A patient has an external ventricular drain. The intracranial pressure (ICP) ranges from 25-30 mm Hg. Which of the following signs/symptoms would NOT be consistent with these ICPs? - CORRECT ANSWER Tachycardia What nutritional advice is best for a patient who will be discharged at home on warfain (coumadin) to prevent recurrence of embolic stroke? - CORRECT ANSWER Green leafy vegetables are OK in moderation. What is the best dietary advice to give a patient diagnosed with myasthenia gravis? - CORRECT ANSWER Eat 6 small meals a day Which of the following is the most accurate diagnostic test for Chiari Malformation? - CORRECT ANSWER MRI Which position is a patient advised to maintain to minimize symptoms following a lumbar puncture? - CORRECT ANSWER Prone A patient with an external ventricular drain (EVD) has an ICP of 30mmHg. The output of the drain is very sluggish when it is opened. What is the next step? - CORRECT ANSWER Call the attending resident A patient's Tinetti score is 19 prior to a lumbar puncture. After the lumbar puncture, the Tinetti score improves to 28. What is the most likely diagnosis? - CORRECT ANSWER Normal pressure hydrocephalus A patient had a stroke involving the limbic system. What type of deficit is most likely to result? - CORRECT ANSWER Flat affect A patient who has had a stroke is going to be discharged with aspirin (Ecotrin) and ticagrelor (Brilinta). Which of the following side effects of these medications should the family be educated about? - CORRECT ANSWER Bleeding All of the following methods are used to decrease intracranial pressure EXCEPT: - CORRECT ANSWER hyPOtonic intravenous fluids Which of the following interventions would likely be needed in a patient with end-stage Creutzfeldt-Jakob disease? - CORRECT ANSWER Percutaneous endoscopic gastrotomy (PEG) tube The nurse assessing the motor function of an unconscious patient. Which of the following can be used to test the patient's peripherial response to pain? - CORRECT ANSWER Applying nailbed pressure A nurse treating a patient with pneumococcal meningittis. Which of the following are the most important measures to prevent the spread of disease? - CORRECT ANSWER Face mask, gown, and gloves A patient suddenly develops extremity tremors, drooling and eye-rolling. The episode resolves spontaneously and afterward the patient is confused and lethargic. What type of seizure did this patient most likely experience? - CORRECT ANSWER Grand mal seizure An incarcerated patient with a history of HIV develops lethargy, anorexia, vomiting, and high-grade fever. On physical exam the patient has a positive Brudzinski sign. Which if the following tests would not be used to confirm the diagnosis? - CORRECT ANSWER CT of the abdomen and pelvis What is the common primary brain tumor in American Adults? - CORRECT ANSWER Glioblastoma multiforme A 71 year old man is involved in a car accident He denies complaints but undergoes a MRI of the brain, which reveals a 3 mm meningioma. What is the best course of initial treatment? - CORRECT ANSWER Follow-up imaging of the brain A patient is diagnosed with a malignant lesion in the frontal cortex. Which of the following is most likely to be affected? - CORRECT ANSWER Behavior inhibition Which medication is the first-line therapy in treating absence seizures? - CORRECT ANSWER Ethosuximide (Zarontin) A 44 year old woman arrives in the emergency room after being involved in a high speed MVA. A CT scan of the head reveals a convex hypodensity in the right parietal cortex. What is the most likely diagnosis? - CORRECT ANSWER Epidural hematoma A patient's spouse post hemicraniectomy is being discharged to a rehabilitation center. The patient's spouse asks how often he should be wearing his crainiectomy helmet. What is the most appropriate response? - CORRECT ANSWER He should only wear it when he is out of bed. A patient with an EVD has developed a steadily increasing ICP. Which of the following medications should the nurse expect to be given to this patient? - CORRECT ANSWER Mannitol (Osmitrol) A patient admitted for stroke had been given tPA 10 hours ago. The patient failed his swallow evaluation and is due for tricagrelor (Brilinta). What should the nurse do? - CORRECT ANSWER Hold the dose for another 14 hours A patient admitted for a traumatic brain injury has failed his swallow evaluation for 5 days in a row. Which of the following should the nurse suggest to the medical team in regards to the patient's nutrition? - CORRECT ANSWER Tube feeds A patient on warfarin (Coumadin) complains of headache for the past several days after accidentially striking his head against a car door. A CT scan reveals bilateral CONCAVE hypodensities in the temporal lobes. What is the most likely diagnosis? - CORRECT ANSWER Subdural hematoma A patient is admitted with an aneurysmal subarachnoid hemorrhage. Which of the following treatment modalities are the mainstays of therapy? - CORRECT ANSWER Hypertension, hemodilution, hypervolemia A patient complains of chronic back pain that has worsened over the past several weeks. An x-ray shows straightening of the thoracic spine with loss of normal curvature and exaggerated inward curvature of the lumbar spine. What is the most likely diagnosis? - CORRECT ANSWER Lordosis A patient is being discharged from the hospital after being diagnosed with and treated for trigeminal neuralgia. Which of the following is not appropriate recommendation for the nurse to give the patient? - CORRECT ANSWER Chewing gum may help symptoms A patient with traumatic brain injury an a mechanical ventilator has a mean arterial pressure (MAP) of 82 and a cerebral perfusion pressure (CPP) of 26. Which of the following interventions would be most appropriate in this patient? - CORRECT ANSWER Increasing the respiratory rate A patient is admitted to the hospital for an exacerbation of her Meniere disease. What is the most appropriate diet for this patient to help prevent the exacerbation of her symptoms? - CORRECT ANSWER Low sodium What is the most common cause of an ateriovenous malformation (AVM)? - CORRECT ANSWER Idiopathic A 16 year old patient is brought to the clinic by his parents complaining of progressive severe middle and lower back pain. His parents blame his symptoms on poor posture. Imaging reveals a significant outward curvature of the thoracic spine. Which of the following is the most likely diagnosis? - CORRECT ANSWER Scheuermann disease Scheuermann's Disease - CORRECT ANSWER AVN of multiple vertebral endplates. Disc space spared. Juvenile Kyphosis (scheuermann's disease) - CORRECT ANSWER Definition: osteochondrosis of thoracolumbar vertebrae resulting in kyphosis >40 degrees that is not corrected with active hyperextension -anterior wedging of 3+ adjacent vertebral bodies resulting in decreased vertebral space and LBP Incidence: -Boys>girls in 13-16 yo -concurrent scoliosis present 30-40% of time Treatment: -trunk ext strengthening -TL passive trunk extension stretching -core training of deep postural muscles and glutes -LE stretching (HS) -orthotic bracing and/or surgery in severe cases A 21 year old patient with no past medical history arrives at the hospital with a suspected carotid dissection. Which of the following is the most important lab that needs to be sent prior to arteriography? - CORRECT ANSWER Complete blood cell count (CBC) A patient has been brought to the hospital following an assault. A CT scan of the head is negative and the patient is eventually discharged. Two weeks later the patient returns with nausea, vomiting, and lethargy. A CT of the head reveals bilateral CONCAVE HYPODENSITIES in the parietal lobe. What is the most likely diagnosis? - CORRECT ANSWER Subacute subdural hematoma A patient is diagnosed with a 2mm posterior communicating artery unruptured aneurysm. Which of the following is the most appropriate interventions? - CORRECT ANSWER Repeat imaging in 6 months A patient with suspected hypoxic brain injury following a traumatic event has been declining in her neurological exam. She does not take spontaneous breaths on the ventilator or respond to painful stimuli, and her pupils do not react to light. Which of the following is appropriate if the family refuses a palliative care consult? - CORRECT ANSWER Initiate brain death protocol An 89 year old patient with lung cancer with metastases to the bone, liver, and brain is having significant difficulty eating. The speech therapist is recommending that a PEG tube be placed to maintain adequate nutrition. The patient is neurologically intact and refusing PEG tube placement. The patient's spouse wants the PEG tube placed. Which is the most appropriate intervention? - CORRECT ANSWER Order a palliative care consult A 5 year old child is admitted for worsening headaches and seizures. This patient has no past medical history. MRI of the brain reveals a mass in the fourth ventricle. Which of the following is the most likely diagnosis? - CORRECT ANSWER Ependymoma Ependymoma - CORRECT ANSWER malignant, usually children, ependymal cells lining 4th ventricle; presents w/hydrocephalus A young patient presents with cafe au lait spots, bony deformaties, short statue, and macrocephaly. Which of the following is the most appropriate intervention for this child? - CORRECT ANSWER Referral to an audiologist A patient has been diagnosed with ALS. The patient has bilateral muscle atrophy and weakness, but can still perform most ADLs with assistance. He and his wife inquire about goals of medical care. What is the best response? - CORRECT ANSWER The goal is to keep the patient mobile for as long as possible. A patient who had previously sustained multiple facial and sinus fractures several weeks ago now presents with fever, headache, nausea, and vomiting. MRI reveals a ring-enhancing mass. What is the most likely diagnosis? - CORRECT ANSWER Brain abscess A patient develops bilateral lower extremity weakness that has spread to her upper extremities over the past several days. She is also complaining of "pins and needles" sensation in her extremities. She has no significant past medical history other than having an upper respiratory infection several weeks ago. What is the appropriate treatment? - CORRECT ANSWER Plasmapheresis Which of the following is not likely a sign of vertebral artery dissection? - CORRECT ANSWER Frontal headache A patient who has been on aspirin (ecotrin) and plavix for prior transient ischemic attacks has another transient ischemic attack. During his work-up, his carotid Doppler ultrasound reveals 50 percent stenosis of his right carotid artery. What is the next step in management? - CORRECT ANSWER Carotid endarectomy Waht is the most likely complication of an intraventricular hemorrhage? - CORRECT ANSWER Hydrocephalus Which of the following isthe most common cause for lacunar strokes? - CORRECT ANSWER Hypertension A partial seizure only - CORRECT ANSWER one side of the body A pseudoseizure is characterized by - CORRECT ANSWER seizure-like activity but are nonepileptic in etiology. They are usually caused by extreme stress or a desire for attention. Cushing's triad - CORRECT ANSWER Signs of increased intracranial pressure: 1. hypertension 2. bradycardia 3. irregular respirations It is a physiologic nervous system response to persistant increased intracranial pressure (ICP). It is a sign of impending herniation. Other signs and symptoms may include altered mental status, fixed pupils, nausea, vomiting, headache and seizure. Normal ICP - CORRECT ANSWER less than 20 mm Hg myasthenia gravis (MG) - CORRECT ANSWER chronic autoimmune neuromuscular disorder characterized by weakness of voluntary muscles. Antibodies attack acetylcholine receptors. The signature issue is fluctuating muscle weakness. S/S may include facial weakness causing droop or ptosis, dysphagia, extremity weakness, ataxia, impaired speech, visual difficulties, and shortness of breath. Treatments include: immunosuppressive medications, plasmapheresis, and cholinesterase inhibitors. Eat several small meals to prevent aspiration Chiari malformation - CORRECT ANSWER Type I: Sublinical Type II-IV: herniation of cerebellar tonsils through the foramen magnum Presentation: - hydrocephalus - syringomyelia: crossing spinothalamic => "capelike" loss of pain and temp, hand weakness - meningiomyelocele supine position - CORRECT ANSWER lying on back, facing upward The limbic system is responsible for - CORRECT ANSWER emotions and memory The occipital cortex is primarily responsible for - CORRECT ANSWER vision The temporal lobes are primarily responsible for - CORRECT ANSWER Speech The frontal lobes are primarily respnsible for - CORRECT ANSWER decision-making, and impulse control located in the frontal cortex Normal Pressure Hydrocephalus (NPH) - CORRECT ANSWER Most common type of communicating hydrocephalus Characterized by normal intracranial pressures, since CSF increase is slow, allowing gradual increases in ICP to be offset by compression of cerebral hemispheres NPH clinical triad - CORRECT ANSWER Gait apraxia (wide-based, magnetic), Urinary Incontinence, and Dementia Tinetti Performance Oriented Mobility Assessment - CORRECT ANSWER - Asses risk of falling - Sit to stand and stand to sit with an armless chair, immediate standing balance with eye closed, tolerating a slight push in standing, turning 360 degrees, gait speed, step length, step height, step symmetry, and continuity, path, stance during gait, and trunk motion. - Total score less the 19 indicates a high risk for fall Tinetti - CORRECT ANSWER another tool assessing risk for falling. patients with a total score of less than 19 indicates a high risk for a fall. tool has combined max total of 28. Tool used to assess improvement of NPH after lumbar puncture. If Tinetti score improves after lumbar puncture-a ventriculoperitoneal shunt (VPS) will likely be needed. Which is the most accurate statement concerning antibiotic therapy for bacterial meningitis? - CORRECT ANSWER Initial drug selection is based on the most likely organisms and should be reassessed within hours as CSF lab results return. Which of the following is NOT an important nursing intervention in the care of a patient with viral meningitis? - CORRECT ANSWER Maintaining isolation until the patient has been afebrile without antipyretic drugs for at least 24 hours. The most important part of nursing preparation for a patient about to undergo lumbar puncture is to: - CORRECT ANSWER Check platelet and coagulation studies Which is the most important element of patient education for the patient being discharged from hospital after diagnosis and early treatment of Lyme disease? - CORRECT ANSWER Emphasize the necessity to complete the entire course of oral antibiotics. A pt with MS wishes to discontinue therapy because she has noticed neurologic improvement since starting medication 2 yrs ago. The MOST appropriate response: - CORRECT ANSWER Remind her that the goals of therapy are to reduce the frequency and severity of exacerbation and delay the development of disability. A college student comes to ER with severe HA, fever, and strange behavior over the last couple of hours. There are petechiae on the skin and conjunctivae. While pt is being prepared for LP, what supportive measure is MOST urgent? - CORRECT ANSWER Getting IV access The MOST effective way for a patient with MS to cool core body temp during exercise is to: - CORRECT ANSWER drink cool liquids Te most important element in the assessment of the pt hospitalized for care of worsening mysathenia is: - CORRECT ANSWER comprehensive assessment of respiratory function The best dietary advice for pts with myasthenia is to: - CORRECT ANSWER eat a mechanical soft diet and take small meals Pro-active decision making about life supports such as peg tube, or trach is essential for pts with ALS because: - CORRECT ANSWER for ALS pts, feeding tubes and artifical ventilation are not temporary life-saving measures that can be instituted and withdrawn when a crisis resolves. Nursing interventions in the care of pts with Creutzfeldt-Jakob disease include all of the following except: - CORRECT ANSWER isolation precautions Once a pt has become HIV-positive, the most effective way to prevent AIDS dementia complex is to: - CORRECT ANSWER Early and sustained HAART (highly active antiretroviral therapy) The MOST essential element in managing primary fatigue in MS is: - CORRECT ANSWER activity pacing The optimal position for the meningitis pt is: - CORRECT ANSWER neck and head in neutral position For a pt anticoagulated with IV heparin, the MOST important lab parameter to follow IN ADDTION TO the PTT is:i - CORRECT ANSWER the platelet count-to look for early evidence of heparin-induced thrombocytopenia. The MOST important nursing intervention to prevent rebleeding in the patient with subarachnoid hemorrhage (SAH) due to cerebral aneurysm is: - CORRECT ANSWER instituting a bowel program promptly upon admission The goal of blood pressure management in the pt with aneurysmal subarachnoid hemorrhage (SAH) awaiting definitive treatment is: - CORRECT ANSWER keeping blood pressure high enough to prevent vasospasm=rebleed and low enough to avoid repeat aneurismal bleeding The best response to hyponatremia in the aftermath of an intracranial aneurysmal bleed is usually: - CORRECT ANSWER fluid replacement and sodium replacement The most accurate statement concerning patient age and treatment outcomes for cerebral aneurysm is: - CORRECT ANSWER For all accepted types of treatment, outcomes are not correlated with age. Which of the following IS among the eligibility criteria for treatment of acute stroke with thrombolytic therapy: - CORRECT ANSWER Symptoms must be of no more than 4.5 hours duration prior to starting treatment. tPA contraindications - CORRECT ANSWER - serum glucose less than 50 -normal PTT-if on heparin - Unknown time of onset - Stroke/Trauma in past 3 months - Thrombocytopenia/Coagulopathy - Anticoagulation if INR>1.7-if on warfarin Anticoagulants and anti-platelets should NOT be given within 24 hours of giving tPA In the first 24 hours following carotid endarectomy, the MOST important vital sign to monitor and stabilize is: - CORRECT ANSWER blood pressure In response to a patient's loss of self-control and social inhibitions following a stroke, the MOST essential nursing intervention is to: - CORRECT ANSWER explain to the patient and family that these behaviors are involuntary, resulting from brain injury. frontal & temproal lobes. What is the best nutritional advice to give a patient discharged on warfarin to prevent recurrence of embolic stroke? - CORRECT ANSWER Eat leafy green vegetables regularly and in moderation. EARLY definitive laboratory diagnosis of herpes simplex enchalitis is possible with: - CORRECT ANSWER viral DNA in CSF While carefully monitoring the neurologic examination in a pt receiving a continous iv heparin for cerebral venous thrombosis (CVT), the nurse notes an acute neurological deficit. The immediate response should be: - CORRECT ANSWER discontinue the heparin and notify MD Admission to the intensive care unit is standard care for which diagnostic group, independent of neurologic status? - CORRECT ANSWER Acute hemorrhagic cerebral infarction Which of the following statements is correct concerning management of neurologic disease and pregnancy? - CORRECT ANSWER In a woman with a known cerebral ateriovenous malformation (AVM), pregnancy should be delayed until lesion can be definitively treated. labor could cause bleed, increased intracranial pressure. Vaginal delivery is not absolute contraindiction for a woman with AVM. What is the most accurate way to educate a patient conteplating surgery for an unruptured intracerebral arteriovenous malformation (AVM) about his risk of hemorrhage if the lesion is not treated? - CORRECT ANSWER The pt should understand that although the risk of hemorrhage is low during any given yr, the cumulative lifetime risk of hemorrhage is well over 50% Which of the following best characterizes postoperative nursing management of the pt who has just had AVM surgery? - CORRECT ANSWER Mild systemic hypotension is permissible to avoid hemorrhage-until autoregulation of cerebral blood flow is re-established. The MOST important element of prevention of future strokes for the pt who has had lacunar infarcts is: - CORRECT ANSWER management of HTN A 25 yr old man is admitted to the hospital with severe throbbing right-sided HA and transient ipsilateral monocular blindness 3 days after a MVA in which he sustained no blunt trauma. Imaging studies are pending. Periodic nursing assessments should be particularly alert for: - CORRECT ANSWER partial Horner's syndrome-sign carotid disection Carotid dissection - CORRECT ANSWER Painful neck pulsations and a patient who grabs her neck are indicative of a carotid dissection. Can be caused by whiplash, coughing, sneezing, and sexual activity. Cerebral ischemia in the form of stroke or TIA occurs in 75% of patients with carotid dissection. A 23 yr old with dx of hemifacial spasm has had NO benefit from decompression sx. She refuse anti-convulsant medication because she would like to become pregnant. The next step in her management should be: - CORRECT ANSWER MRI with contrast to check for MS Hemifacial spasm - CORRECT ANSWER irritation of cranial nerve 7 by blood vessel A pt with acute intracerebral hemorrhage has remained hypertensive, developed papillary edema, and now is becoming unresponsive. She has no respiratory problems, and her family is questioning preparations for endotracheal intubation. What is the most appropriate way to counsel the family? - CORRECT ANSWER Explain that the pt's increased intracranial pressure has reached a crisis level, putting her at risk for fatal pressure on her brainstem, and artifically inducing her to breathe rapidly can reduce the pressure inside her head by reducing the carbon dioxide concentration in her blood. A patient has hemineglect syndrome following a nondominant parietal lobe stroke. The MOST effective strategy is to: - CORRECT ANSWER approach the pt on the UNaffected side of the body. If you must approach the affected side, help the pt turn his head toward you. Which of the following is the most appropriate nutritional supplement for a pt with MS and for his children? - CORRECT ANSWER Vit. D Vitamin D deficiency has been implicated as a causative factor in: - CORRECT ANSWER numerous autoimmune diseases and malignancies, including MS, rheumatoid arthritis, DM, and cancers of the prostate, colon, ovary, and breast. The best time to initiate ROM following a hemiplegic stroke is: - CORRECT ANSWER when fractures and other medical contraindictions have been ruled out. Which of the following is a correct statement concerning Bobath neurodevelopment approach to rehabilitation following a hemiplegic stroke? - CORRECT ANSWER The emphasis is on re-establishing normal movement patterns through having the patient experience the sensations of normal movement. A fully conscious hemiplegic stroke pt should transfer from chair to bed by: - CORRECT ANSWER orienting the chair at an angle to the bed with the patient's unaffected side closest to the bed. To prevent aspiration, which of the following precautions should be taken in caring for a patient who has had a brainstem stroke? - CORRECT ANSWER Do not offer food or liquid until you have determined that the patient's gag reflex and swallowing reflex are intact. Vascular anomalies are known to be lesions with low-flow states, but may present with hemorrhage: - CORRECT ANSWER Cavernous malformations An elderly pt is admitted to the ICU following carotid stenting. Yhe pt develops a sudden and severe HA with mental status change: - CORRECT ANSWER This could be Hyperperfusion state: Cranial dural ateriovemous malformations receive blood from which of the following: - CORRECT ANSWER Extra-cranial circulation A dural ateriovenous fistula located in the cavernous sinus is likely to cause: - CORRECT ANSWER Diplopia-you see double in the cave The diversion of blood to ateriovenous malformation, away from normal tissue causing ischemia is called: - CORRECT ANSWER Vascular steal phenomenom-veonus malformation is stealing blood from normal tissue TIA defined as - CORRECT ANSWER less than 24 hours 23 yr old with sudden HA, nausea, SZ. VS pulse 84, B/P 190/75 rr 17. Hemohharge in right temporal lobe with underlying AVM. Initial intervention: - CORRECT ANSWER Administer anti-hypertensive. A C1 burst fracture results in ligamentous rupture - CORRECT ANSWER Jefferson fracture A pt presents with humeral fx, difficulty extending wrist, and intrinsic hand weakness. What nerve injury - CORRECT ANSWER Radial nerve After sustaining an unstable T6 burst fracture. Pt should wear: - CORRECT ANSWER A thoracic-lumbar sacral orthotic (TLSO) Increases in intracranial VOLUME can lead to significant increases in intracranial pressure (ICP). This phenomenon is related to: - CORRECT ANSWER Intracranial Compliance Shifting of blood and CSF to compensate for increased intracranial pressure (ICP) is described by which of the following: - CORRECT ANSWER Monro-Kellie doctrine A 21 yr old pt has severe tbi after MVA. Most important to report: - CORRECT ANSWER Urine output 400ml per hr for past 3 hours-diabetes insipidus Thoracic cord lesions typically cause which of the following sensory deficits: - CORRECT ANSWER Hyperesthesia above the level of the lesion hyperesthesia - CORRECT ANSWER increased sensitivity to stimulation such as touch or pain Which is true regarding pain associated with spinal cord tumor? - CORRECT ANSWER Pain is the presenting symptom A tumor present in the temporal lobe causing auditory agnosia: - CORRECT ANSWER Use picture boards with pt Which is the most common complication following Stereotactic Radiosurgery - CORRECT ANSWER Seizures [Show Less]
- Exam
- $11.45
- 0
- 85
CNRN Exam 56 Questions with Verified Answers,100% CORRECT
CNRN Exam 56 Questions with Verified Answers Neurotransmitters - CORRECT ANSWER Chemical substances found in the CNS that excite, inhibit, or modify the... [Show More] response of another cerebral cell(s) Dendrites - CORRECT ANSWER Direct impulses toward the cell body Axon - CORRECT ANSWER Carries impulses away from the cell body Amines: Acetylcholine (ACh) - CORRECT ANSWER Usually excitatory Inhibitory effect on some of parasympathetic nervous system Chief transmitter of the PNS Amines: Serotonin (5-HT) - CORRECT ANSWER Controls body heat, hunger, behavior and sleep. Inhibitor of pain pathway cord; helps to control mood and sleep Cathecholamines: Dopamine (DA) - CORRECT ANSWER Affects control of behavior and fine movement Usually inhibitory Cathecholamines: Norepinephrine (NE) - CORRECT ANSWER Chief transmitter of SNS Usually excitatory can be inhibitory A.A.: Gamma-aminobutyric acid (GABA) - CORRECT ANSWER Excitatory A.A.: Glutamic acid - CORRECT ANSWER Excitatory Glycine - CORRECT ANSWER Inhibitory Substance P - CORRECT ANSWER Excitatory Polypeptides: Enkephalin - CORRECT ANSWER Excitatory to systems that inhibit pain; binds to the same receptors in the CNS that bind opiates drugs Polypeptides: Endorphin - CORRECT ANSWER Binds to opiate receptors in the brain and pituitary gland; excitatory to systems that inhibit pain Epidural space - CORRECT ANSWER Located between the skull & dura mater Subdural space - CORRECT ANSWER Located between the inner dura mater & the arachnoid layer Subarachnoid space - CORRECT ANSWER Located between the arachnoid & pia mater layers. Contains CSF What is the specific gravity of CSF? - CORRECT ANSWER 1.007 Amount of CSF in adults? - CORRECT ANSWER 125-150ml Choroid plexus - CORRECT ANSWER A collection of blood vessels covered by a thin coating of ependymal cells Name the 3 produces of CSF fluid - CORRECT ANSWER Choroid plexus, ependymal cells and blood vessels of the brain What area does the MCA supply? - CORRECT ANSWER Entire lateral surfaces of the hemispheres except for the occipital pole & the inferolateral surface of the hemisphere What are does the ACA supply? - CORRECT ANSWER Medial surface of frontal and parietal lobes What are the major functions of the frontal lobe? - CORRECT ANSWER Perform high level functions: reasoning, abstraction, concentration, and executive control. Voluntary eye movement Storage of memory Influences somatic motor control of activities such as rr, gi activity and bp Broca's area - CORRECT ANSWER Location: frontal lobe of the inferior frontal gyrus. Motor control of speech. ie articulation, speed, & rhythm of speech Wernicke's area - CORRECT ANSWER Location: Temporal lobe. Understanding spoken language. What are the functions of the parietal lobe? - CORRECT ANSWER Sensory input is interpreted to define size, shape, weight, texture. A person's awareness of their body parts What are the functions of the temporal lobe? - CORRECT ANSWER Primary auditory receptive area Where is the interpretive area located? Importance? - CORRECT ANSWER Temporal lobe. Functions: hearing, memory/learning, receptive language What are the functions of the occipital lobe? - CORRECT ANSWER The primary visual cortex. Visual perception,visual reflexes and involuntary eye movements. Basal ganglia - CORRECT ANSWER several masses of subcortical nuclei located deep in the cerebral hemis. Responsible for fine body movements, esp. hands and lower extremities. Thalamus - CORRECT ANSWER Role in conscious pain awareness, in focusing of attention Hypothalamus - CORRECT ANSWER Regulates important physiologically based drives: appetites, sexual arousal, and thirst, temp, water metabolism, hypophyseal secretions, visceral and somatic activities, visible facial expressions, sleep-wake cycle Anterior pituitary gland secretes: - CORRECT ANSWER growth-stimulating hormone, adrenal stimulating hormone, thyroid-stimulating hormone, follicle stimulating hormone and luteinizing hormone. Posterior pituitary gland secretes: - CORRECT ANSWER vasopressin aka ADH, and oxytocin Cerebellum controls: - CORRECT ANSWER fine movement, coordinates muscle groups, and maintains balance through feedback loops Reticular Activating System (RAS) controls: - CORRECT ANSWER sleep-wake cycles, consciousness, focused attention, and sensory perception Limbic system functions to control - CORRECT ANSWER basic instinctual and emotional drives: fear, sexual drive, hunger, sleep and s/t memory Norepinephrine - CORRECT ANSWER Released from adrenal medulla: increases BP. Action in hypothalamus: sympathetic vasodilation resulting in muscle blood flow. Dopamine - CORRECT ANSWER Involved in mental functions Epinephrine - CORRECT ANSWER Regulate autonomic response and BP regulation. Acts as vasodilator in cardiac system. CNI - CORRECT ANSWER Olfactory nerve (sensory): smell CNII - CORRECT ANSWER Optic nerve (sensory): visual acuity & visual fields Anton's syndrome - CORRECT ANSWER cortical blindness. complete loss of vision often with denial or unawareness of the deficit CNIII, IV, VI - CORRECT ANSWER Oculomotor, Trochlear, Abducens (motor): extraocular movements CN V - CORRECT ANSWER Trigeminal nerve (mixed): 3 sensory vectors: ophthalmic, maxillary, mandibular division. Motor component: muscles of mastication. CNVII - CORRECT ANSWER Facial nerve (mixed): sensory: sense of taste. motor: symmetry of the face at rest & deliberate facial movements CNVIII - CORRECT ANSWER Acoustic nerve (sensory): 2 branches Cochlear nerver-hearing. Vestibular nerve-equilibrium, coordination, orientation CN IX and X - CORRECT ANSWER Glossopharyngeal & Vagus. Tested together. Mixed. Function of the pharynx. Gag respsonse. CN XI - CORRECT ANSWER Spinal accessory nerve. Motor. Symmetry of sternocleidomastoid and trapezius muscles by shrugging shoulders and turning head to 1 side & push chin against examiners hand. CN XII - CORRECT ANSWER Hypoglossal. Motor. Movement of tongue. A-E-I-O-U mnemonic for major cause of ALOC - CORRECT ANSWER Alcohol, epilepsy, insulin, opium, and uremia TIPPS mnemonic for major cause of ALOC - CORRECT ANSWER Tumor, injury, psychiatric, stroke and sepsis Fibrillations - CORRECT ANSWER Transitory spontaneous muscle contractions can be detected with EMG Anhidrosis - CORRECT ANSWER inability to perspire. cause: transection of sympathetic nerves. skin will be warm and dry Mass effect - CORRECT ANSWER The shifting of cerebral structures resulting from pressure. There is compression and traction of cerebral tissue that results ischemic horner's syndrome - CORRECT ANSWER unilateral, small pupil; reactive to light & accommodation. Miotic pupil will have ptosis and loss of sweating on affected side [Show Less]
- Exam
- $10.95
- 0
- 82
CNRN Exam-2|50 Questions with Verified Answers,100% CORRECT
CNRN Exam-2|50 Questions with Verified Answers A patient who has had a stroke is being d/c home today. The patient's wife is concerned about caring for ... [Show More] her husband at home. Which of the following is not an appropriate response to the patient's wife? A. Advise her to let him resume activity as tolerated B. Advise her to make a daily to-do list C. Advise bedrest except for bathing or toileting D. Advise to call 911 if there is any change in his behavior - CORRECT ANSWER C. Advise bedrest except for bathing or toileting Which of the following two medications should not be taken together? A. ASA and atorvastatin B. Ticagrelor and warfarin C. ASA and clopidogrel D. Esomeprazole and clopidogrel - CORRECT ANSWER D. Esomeprazole and clopidogrel Which of the following does not need to be avoided when taking warfarin? A. Kale B. Ginger C. Alcohol D. Iceberg lettuce - CORRECT ANSWER D. Iceberg lettuce A 1yo child with no significant past medical hx experiences a febrile seizure. Which of the following is not true statement regarding febrile seizures? A. A febrile seizure is a different than epilepsy B. Febrile seizures are relative common in young children C. Most febrile seizures are harmless D. Anticonvulsants are recommended to prevent future episodes - CORRECT ANSWER D. Anticonvulsants are recommended to prevent future episodes A patient is in the ICU for an intracerebral hemorrhage. Which of the following IV fluids is contraindicated in this patient? A. D5W B. LR C. NS D. Sodium Chloride 3% - CORRECT ANSWER A. D5W A patient remains in a persistent vegetative state following a high-speed car collision. CT scans have shown mild cerebral edema but no other abnormality. MRI of the brain reveals several punctuate hypodensities in addition to cerebral edema. What is the most likely diagnosis? A. SDH B. Diffuse axonal injury C. Multiple sclerosis D. SAH - CORRECT ANSWER B. Diffuse axonal injury Which of the following is consistent with Brown-Sequard syndrome? A. Loss of proprioception on the ipsilateral side of the injury B. Loss of temperature sensation on the ipsilateral side of the injury C. Loss of proprioception on the contralateral side as the injury D. Babinski sign contralateral to the side as the injury - CORRECT ANSWER A. Loss of proprioception on the ipsilateral side of the injury Which of the following is a rare etiology of spondylolisthesis? A. Isthmic B. Degernative disease C. Trauma D. Pathologic - CORRECT ANSWER C. Trauma Which of the following injuries is most likely to need a PEG tube? A. C2 B. C7 C. T2 D. T7 - CORRECT ANSWER A. C2 A patient has a tbi and a skull fracture following an assault. The nurse noted a halo sign on his sheets next to his right ear. Which bone did the patient most likely fracture? A. Frontal B. Temporal C. Parietal D. Occipital - CORRECT ANSWER B. Temporal Which of the following conditions increases the risk of CVA fourfold? A. Morbid obesity B. HTN C. Cocaine abuse D. A-fib - CORRECT ANSWER D. A-fib An incidental hemangioblastoma is found on imaging. What is the most appropriate intervention? A. Chemotherapy B. Radiation C. Serial imaging D. Surgical excision - CORRECT ANSWER C. Serial imaging Which of the following most likely metastasize to the brain? A. Renal cell carcinoma B. Lymphoma C. Colorectal cancer D. Pancreatic cancer - CORRECT ANSWER A. Renal cell carcinoma A patient involved in a diving accident has an injury to his spine. He has impaired function of his arms requiring assistance with oral feeds. He is paraplegic and can operate a motorized wheelchair. He is able to breathe on his own. He is incontinent and requires an indwelling catheter. Which of the following levels is most likely affected? A. C2 B. C7 C. T2 D. T7 - CORRECT ANSWER B. C7 Following the administration of a vaccine 1 week prior, an otherweise healthy child develops HA, N&V, confusion, and visual disturbances. After administration of steroids, the patient's condition gradually improves. What is the most likely diagnosis? A. Acute disseminating encephalomyelitis B. Chronic inflammatory demyelinating polyneuropathy C. Myasthenia gravis D. ALS - CORRECT ANSWER A. Acute disseminating encephalomyelitis A patient presents with a gradually worsening tremor that started in his right arm and traveled to his right leg. He remained conscious throughout the entire episode and was awake and alert following the episode. What type of seizure did he experience? A. Simple partial seizure B. Complex partial seizure C. Petit mal seizure D. Grand mal seizure - CORRECT ANSWER A. Simple partial seizure Which of the following is not true regarding posterior reversible encephalopahy syndrome? A. Malignant HTN may cause PRES B. If left untreated, it can cause hydrocephalus C. CT scan is the best diagnostic scan D. Seizures are the most common presenting symptom - CORRECT ANSWER C. CT scan is the best diagnostic scan A patient is trying to get pregnant and inquires how to help prevent her unborn child from developing spina bifida. What is the most appropriate response? A. having 1-2 glasses of red wine at night B. Eating a low sugar diet C. Drinking 3 glasses of milk per day D. Eating several oranges daily - CORRECT ANSWER D. Eating several oranges daily Which of the following statements regarding acute disseminated encephalomyelitis and multiple sclerosis are false? A. Steroids are used in teh medial care of both MS and ADEM B. ADEM primarily occurs in young adults C. ADEM is an inflammatory demyelinating condition D. MS is a chronic relapsing and remitting disease - CORRECT ANSWER B. ADEM primarily occurs in young adults An obese female with a known history of cocaine abuse is admitted for an acute ischemic stroke. The patient has a known history of sickle cell disease and htn. How man risk factors for stroke does this patient have? A. 2 B. 3 C. 4 D. 5 - CORRECT ANSWER C. 4 A 70yo African american man with a history of tobacco abuse and DM presents to the ER with a right facial droop. He is diagnosed with an acute lacunar infarction and admitted. During his workup he is found to have a blood pressure of 178/98. His hemoglobin A1c is 9.2. His low density lipoprotein is 165. How many non modifiable risk factors does this patient have? A. Two B. Three C. Five D. Six - CORRECT ANSWER B. Three Which test should be ordered for suspected cryptococcal meningitis? A. Western blot B. India ink C. Rapid plasma reagin D. Monospot test - CORRECT ANSWER B. India ink A patient with suspected meningitis has undergone a lumbar puncture. Which of the following CSF results are most consistent with a viral etiology? A. purulent csf, high WBC, elevated protein B. clear csf, high WBC elevated protein C clear csf, normal WBC, normal protein D. purulent CSF, high WBC, elevated protein - CORRECT ANSWER B. clear csf, high WBC, elevated protein When educating a patient about the warning signs of stroke, which of the following best describes the most common symptoms? A. loss of memory, ataxia, urinary incontinence B. hearing loss, facial weakness, ha C. facial droop, asymmetric weakness, dysarthria D. ataxia, resting tremor, muscle rigidity - CORRECT ANSWER C. facial droop asymmetric weakness, dysarthria A patient is placed on warfarin after an embolic stroke. The patient's PTINR is 1.5. The current dosage is 2 mg per day. What should the provider do regarding the dosage? A. increase the dosage to 4mg per day B. increase the dosage to 8mg per day C. maintain the same dosage D. decrease the dosage to 1mg per day - CORRECT ANSWER A. increase the dosage to 4mg per day Which one of these evaluations should be assessed first in a patient who recently had a stroke? A. skin assessment B. coping evaluation C. ability to void D. swallow evaluation - CORRECT ANSWER D. swallow evaluation A patient with an EVD has ICPs ranging from 25-30mmHg. There is no change in the neurological exam. Which of the following is the most appropriate intervention? A. No intervention, monitor patient B. raise the head of bed to 30 degrees C. flush the EVD D. Administer mannitol - CORRECT ANSWER B. raise the head of bed to 30 degrees A patient is being dc home with his family after being hospitalized for a stroke. Which of the following statements indicate the family needs further instruction? A. my family member's symptoms will resolve in a few months B. if my family member develops new symptoms i will call 911 C. i will assist as needed with activities of daily life D. i can expect that my family member and i may get frustrated - CORRECT ANSWER A. my family member's symptoms will resolve in a few months The following interventions are most likely to promote maximum self-care or a patient recovering from a tbi, except: A. allow the pt to ambulate without assistance to promote strength B. provide adaptive equipment as indicated C. educate patient on risks of repeat stroke D. encourage participation in activities of daily living - CORRECT ANSWER A. allow the pt to ambulate without assistance to promote strength A nurse enters a patient's room following a cardiac catheterization and notes that the patient is slurring. Which of the following actions should be done last? A. assess full vitals B. Do a full neurological assessment C. order a CT scan of the brain D. perform a dysphagia evaluation - CORRECT ANSWER D. perform a dysphagia evaluation Which of the following interventions is not appropriate for treating a patient with a chronic SDH? A. Physical therapy evaluation B. serial neurological exams C. give an anticonvulsant drug for prophylaxis D. Cognitive assessment - CORRECT ANSWER C. give an anticonvulsant drug for prophylaxis Which of the following is the most common tbi? A. SDH B. SAH C. concussion D. duffuse axonal injury - CORRECT ANSWER C. concussion A 33yo woman has a ha, slurred speech, coordination difficulties, and visual changes. She undergoes an MRi of the brain, which shows nonspecific white matter lesions consistent with plaque formation. Which of the following is the most appropriate treatment. A. antibiotics B. steroids C. antiplatelet therapy D. NSAIDS - CORRECT ANSWER B. steroids What is the primary nt affected in Parkinson disease? A. epi B. dopamine C. serotonin D. histamine - CORRECT ANSWER B. dopamine Which of the following best describes the etology for Creutzfeldt-Jakob disease? A. Prions B. Autoimmune C. Bacteria D. Unknown - CORRECT ANSWER A. Prions Which of the following diseases would find lewy bodies on brain biopsy? A. parkinson disease B. myasthenia gravis C. multiple sclerosis D. Craniopharyngioma - CORRECT ANSWER A. parkinson disease A patient is brought to the er for ams. She has a bag of medications with her, but cannot recall her medical issues. One of the pill bottles is carbidopa-levodpa. Which medical condition does she have? A. Creutzfeldt-Jakob disease B. Myasthenia gravis C. Multiple sclerosis D. Parkinson disease - CORRECT ANSWER D. Parkinson disease A patient's wife has just been told that her husband, who has been on hospice care for stage IV glioma, just died. She originally denied that he could be dead. She then became angry and started to blame his medical providers. Which of the following is not an appropriate action? A. calling the police B. calling a social worker C. calling a grief counselor D. calling a psychiatrist - CORRECT ANSWER A. calling the police A 29yo man had a new onset seizure after being involved in an assault. He is postictal, but is able to protect his own airway. Which of the following medications is the best initial medications to administer? A. Ethosuximide B. Phenytoin C. Levetriacetam D. Pentobarbital - CORRECT ANSWER B. Phenytoin Which of the following is true regarding craniopharyngiomas? A. they occur in the brain stem B. they are benign tumors C. they primarily occur in children D. There are no known risk factors - CORRECT ANSWER A. they occur in the brain stem A woman whose husband has been diagnosed with Huntington disease inquires how the disease is acquired. Which of the following responses is correct? A. autosomal recessive B. idiopathic C. autosomal dominant D. x-linked recessive - CORRECT ANSWER C. autosomal dominant A pt presents with progressively worsening personality changes and emotional issues. On physical exam the patient has a left facial droop and lef sided weakness. An mri of the rain reveals a glioma. Where is the most likely location of the mass? A. left frontal cortex B. left temporal cortex C. right frontal cortex D. right temproal cortex - CORRECT ANSWER C. right frontal cortex A patient is admitted with progressive neurological chagnes and blindness. A lumbar puncture is perfromed and the culture reveals Treponema pallidum. Which of the following si the most appropriate treatment? A. Penicillin B. Acyclovir C. Amphotericin B D. Sulfamethoxazole/Trimethoprim - CORRECT ANSWER A. Penicillin A pt has suspected aneurysmal SAH, but the CT scan of the brain is negative. What is another test that can confirm the diagnosis? A. skull series B. transcranial doppler C. mri of the brain D. lumbar puncture - CORRECT ANSWER D. lumbar puncture A pt in the ICU is admitted for a ruptured cerebral aneurysm. Which medication should be ordered to help prevent vasospasm? A. Metoprolol B. Nimodipine C. Carvedilol D. Candesartan - CORRECT ANSWER B. Nimodipine A 16yo female patient comes to the clinic with progressively worsening pedunculated masses over her entire body. She states that they are itching and painfu. Several relatives have similar signs and symptoms. Which of the follwoing is the most likey diagnosis? A. ependymoma B. Hemangioblastoma C. Neurofibroma D. astrocytoma - CORRECT ANSWER C. Neurofibroma Which of the following is not true about Bell palsy? A. steroids are the maintstay of treatment B. permanent neurological deficits may occur C. Bell palsy signals a likely future stroke D. The etiology is unknown - CORRECT ANSWER C. Bell palsy signals a likely future stroke A neonate is diagnosed with herpes encephalitis. What is the most likely cause? A. nosocmial infection B. the infant is immunocompromised C. latrogenic cause D. maternal transmission - CORRECT ANSWER D. maternal transmission A neonate is admitted to the hospital for status epilepticus. After the patient is stabilized,, imaging of the brain reveals SDH, retinal bleeding, and cerebral edema. What is the most likely diagnosis? A. encephalitis B. shaken baby syndrome C. meningitis D. acute disseminating encephalomyelitis - CORRECT ANSWER B. shaken baby syndrome A pt is admitted for possible seizure. Her symptoms do not correspond with findings on EEG. Which lab should be ordered to help differentiate between seizure and pseudoseizure? A. Prolactin B. Vitamin D C. Sodium D. Erthrocyte sedimentation rate - CORRECT ANSWER A. Prolactin [Show Less]
- Exam
- $11.45
- 0
- 84
CNRN Practice Samples Exam 235 Questions with Verified Answers,100% CORRECT
CNRN Practice Samples Exam 235 Questions with Verified Answers Which of the following tumor types will have a higher incidence in pediatric populations ... [Show More] and have a decreased incidence with age? A. Glioblastoma B. Pilocytic astrocytoma C. Central nervous system lymphoma D. Metastatic brain tumor - CORRECT ANSWER B Rationale: Both pilocytic astrocytoma and medulloblastoma brain tumors are more commonly found in the younger population. The incidence of these tumors will decrease with age. Glioblastomas are more frequently found in young adults. CNS lymphoma and metastasis will have an increased incidence with age. A patient presents with progressive neurological deficits and has a recent history of transient neurological attack. This patient is most likely experiencing which of the following types of stroke? A. Thrombotic stroke B. Embolic stroke C. Subarachnoid hemorrhage D. Vasospasms - CORRECT ANSWER A Rationale: Thrombotic strokes frequently present as a worsening neurological status over a short period of time. Patients may have experienced episodes of transient ischemic attacks (TIAs) before the onset of the ischemic strokes. Embolic strokes tend to have a more sudden onset without progression in symptoms. Subarachnoid hemorrhages (SAHs) are a sudden onset of headache without the history of transient neurological deficits. Vasospasms are associated with SAH, and symptoms occur most commonly between 7 and 10 days after the SAH. Which of the following best describes a coup injury? A. Injury occurs at the point of impact. B. Injury occurs on the contralateral side of impact. C. It is an acceleration injury. D. It is a deceleration injury. - CORRECT ANSWER A Rationale: A coup injury occurs at the point of impact, and a contracoup injury occurs on the contralateral side. The mechanism of injury for acceleration injuries is commonly defined as a moving object hitting a stationary head, whereas a deceleration injury involves a moving head hitting a stationary object. A patient is admitted to the ICU with persistent epileptic seizures lasting beyond 90 minutes. Which of the following best describes the seizure activity? A. Epileptic seizure B. Epilepsy C. Refractory seizure D. Nonepileptic seizure - CORRECT ANSWER C Rationale: An epileptic seizure, which persists for greater than 90 minutes despite administration of anticonvulsants is called a refractory seizure. An epileptic seizure indicates the presence of EEG wave changes during the seizure activity. Epilepsy refers to repetitive seizures without a reversible cause such as hyponatremia. Nonepileptic seizure is the presence of seizure activity without the EEG changes. Which of the following would be the best technique to use to assess for cerebrospinal fluid in bloody drainage from the nose following a traumatic brain injury? A. Glucose test B. Halo test C. Send to lab for hemoglobin level D. Litmus test - CORRECT ANSWER B Rationale: Halo test (a positive result produces a yellow ring) is more accurate than a glucose test, especially with the presence of bloody drainage. A glucose test has been used to distinguish between sinus drainage and cerebrospinal fluid (CSF) because CSF has glucose but sinus drainage does not. But in this scenario, the drainage was "bloody," and blood has glucose. Bloody drainage may give a false positive with a glucose test. Testing for hemoglobin in the drainage does not determine the presence of CSF. Litmus test is used to test a pH of a fluid and is not used to distinguish CSF from nasal drainage. Which of the following is the most common cause of an embolic stroke? A. Atrial septal defect B. Atrial fibrillation C. Calcified lesion D. Angioplasty - CORRECT ANSWER B Rationale: Atrial fibrillation (AF) is the most common cause of an embolic stroke. Atrial septic defect (ASD) and calcified lesions can also result in embolic strokes but are significantly less common than AF. A complication of angioplasty can be distal embolization but again is not the most common cause of an embolic stroke. Cranial nerve (CN) VII (facial nerve) is commonly involved with Bell's palsy. Where does this CN originate? A. Pons B. Medulla C. Midbrain D. Basal ganglia - CORRECT ANSWER A Rationale: Cranial nerve (CN) V (trigeminal nerve), VI (abducens nerve), VII (facial nerve), and VIII (acoustic nerve) originate from the pons. CNs IX (hypoglossal nerve), X (vagus), XI (spinal accessory nerve), and XII (hypoglossal nerve) originate from medulla. CNs III (oculomotor nerve) and IV (glossopharyngeal nerve) originate from the midbrain. No cranial nerves originate from the basal ganglia. Which of the following electrolyte abnormalities is LESS likely to result in a seizure? A. Hyponatremia B. Hyperkalemia C. Hypocalcemia D. Hypomagnesemia - CORRECT ANSWER B Rationale: Hyponatremia is one of the most common electrolyte abnormalities that can cause a seizure. Hypocalcemia and hypomagnesemia can also cause seizures. Potassium is more likely to affect the myocardial electrical system, resulting in arrhythmias. A patient in the ICU following a severe traumatic brain injury suddenly demonstrates profuse sweating, sustained tachycardia, hypertension, and fever. Which of the following is the most likely cause? A. Neurogenic fever B. Diencephalic seizure C. Paroxysmal sympathetic hyperactivity D. Cerebral salt wasting syndrome - CORRECT ANSWER C Rationale: Traumatic brain injury (TBI) patients can experience "sympathetic storms" called paroxysmal sympathetic hyperactivity. The symptoms include fever, tachycardia, hypertension, profuse sweating, agitation, and increase respiratory rate. The "storm" is thought to be due to intermittent stimulation of the sympathoexcitatory centers located in upper brainstem and diencephalon. Diencephalic seizure is an incorrect term for the symptoms because the EEG is negative. Neurogenic fevers can occur following TBI but is not associated with the other symptoms of hypertension and tachycardia. Cerebral salt wasting syndrome (CSWS) is the loss of sodium through the kidneys and results in hypovolemic hyponatremia. In severe cases of cerebral palsy, there may be a delay in growth and development. Which of the following conditions can occur in these cases? A. Coagulopathy B. Immunocompromise C. Failure to thrive D. Locked-in syndrome - CORRECT ANSWER C Rationale: Failure to thrive is a complication of moderate to severe cerebral palsy (CP). It can result in malnutrition and death. CP is not associated with immunocompromise or coagulopathies. CP involves abnormal motor movements associated with spasticity or flaccidity, but does not develop locked-in syndrome. Which of the following best describes the penumbra in an ischemic stroke? A. Irreversibly damaged tissue B. Normal healthy tissue C. Presence of vasogenic cerebral edema D. Reversible ischemic tissue - CORRECT ANSWER D Rationale: The penumbra is the area surrounding an infarction that is ischemic or reversible ischemic tissue. Irreversibly damaged tissue is the area of tissue infarction and is the core of the infarction. Vasogenic cerebral edema is an increase in interstitial edema or fluid and is typically found surrounding the penumbra. Normal, healthy tissue is the area of brain tissue not affected by the ischemia or injury. A patient is admitted to the trauma ICU following a traumatic brain injury due to vehicle rollover. The patient is hypotensive and tachycardic. Which of the following is the most accurate statement? A. Hypotension following traumatic brain injury (TBI) indicates presence of epidural hematoma. B. Hypotension is sign of blood loss but is not considered a sign of TBI. C. Scalp lacerations can be easily controlled with direct compression. D. Neurogenic shock following TBI results in hypotension. - CORRECT ANSWER B Rationale: Traumatic brain injury (TBI) patients can experience additional systemic injuries. Hypotension indicates hypovolemia from blood loss in trauma patients, but cerebral injury, even epidural hematoma, cannot account for the volume of blood loss. Scalp lacerations bleed profusely and may require sutures or staples to stop the bleeding. Neurogenic shock is associated with spinal cord injuries. Symptoms include hypotension and bradycardia (not tachycardia). Which of the following has been found to be the most effective in preventing embolic strokes due to atrial fibrillation? A. Aspirin B. Low-molecular-weight heparin C. Warfarin (Coumadin) D. Clopidogrel (Plavix) - CORRECT ANSWER C Rationale: Studies have shown warfarin is the best at preventing an embolic stroke but is associated with a greater risk of bleeding. Aspirin is also used in primary prevention of embolic strokes but has less efficacy in preventing embolic strokes. Aspirin has a lower risk of bleeding than anticoagulation therapy. Low-molecular-weight heparin (LMWH) and Plavix are not currently recommended in preventing embolic strokes. Which of the following scales are used to determine the overall prognosis in patients with a brain tumor? A. PedsQL B. Functional Independence Measure C. CHADS2 score D. Karnofsky Performance Status Scale - CORRECT ANSWER D Rationale: Karnofsky Performance Status Scale (KPS) is used to determine overall prognosis in patients with a brain tumor. It is used along with histopathology of the tumor, completeness of resection, presence of necrosis, and tumor size and location. CHADS2 score is used to determine the stroke risk of atrial fibrillation. Functional Independence Measure (FIM) is used to evaluate stroke patients in rehabilitation. PedsQL is a tool used to assess quality of life in pediatric patients with brain tumors but is not used for overall prognosis. Which of the following best describes a radiculopathy? A. Compression of the cord with central stenosis B. Inflammation of bone and cartilage of joint C. Compression of nerve roots with foraminal stenosis D. Symptomatic degenerative changes of osteoarthritis - CORRECT ANSWER C Rationale: Radiculopathy is compression of nerve roots due to the narrowing of foraminal processes. Osteoarthritis is the inflammation of bone and cartilage of the spinal joints. Myelopathy is compression of the spinal cord due to central stenosis. Spondylosis is the symptomatic degenerative change that occurs in osteoarthritis. Your patient presents with left upper extremity weakness and facial droop. Which of the following vessels is most likely involved in this stroke? A. Anterior cerebral artery B. Middle cerebral artery C. Posterior cerebral artery D. Basilar artery - CORRECT ANSWER B Rationale: The middle cerebral artery (MCA) supplies blood to the lateral portion of the cerebral cortex, which is where the motor strip for the upper extremities and face is located. The anterior cerebral artery (ACA) supplies blood to the medial portion of the cerebral cortex, which is where the motor strip for the lower extremities is located (results in lower-extremity weakness). The posterior cerebral artery (PCA) supplies blood to the occipital lobe, which results in visual deficits. The basilar artery is in the posterior circulation (brainstem) and may present with quadriplegia or "locked-in" syndrome. Your patient has sustained a traumatic brain injury and a basilar skull fracture. The physician has ordered a nasogastric tube (NG) be placed. Which of the following is your best response? A. Place the NG according to the physician's order. B. Discuss with the physician the need to place an enteral feeding tube. C. Insert the gastric tube orally. D. Ask the physician to place the NG. - CORRECT ANSWER C Rationale: Never place a gastric tube nasally in a patient with a basilar skull fracture. The nasogastric (NG) tube may go through the cribriform fracture and enter the brain. A gastric tube can be placed orally, just not nasally. An enteral feeding tube may not be indicated at this time. Having the physician place the NG tube is not appropriate because the tube should not be placed nasally. During a stroke assessment, the patient has been found to have a deviated gaze. Which of the following would be the most correct statement regarding the gaze? A. Dysconjugate gaze B. Upward gaze C. Gaze toward the affected side D. Gaze away from affected side - CORRECT ANSWER C Rationale: The gaze abnormality in a middle cerebral artery (MCA) stroke is deviated toward the affected side. Seizures result in gaze away from the affected side. A dysconjugate or upward gaze is frequently associated with cranial nerve abnormalities but not commonly associated with strokes. What type of seizure is an aura classified as? A. Simple partial B. Complex partial C. Generalized D. Nonconvulsive - CORRECT ANSWER A Rationale: An aura is a simple partial seizure typically involving somatosensory symptoms such as hallucinations. People are aware of the aura prior to having a generalized seizure. Complex partial seizures result in a loss of awareness and are frequently manifested as motor or automatism behavior. Generalized seizures occur across both hemispheres at once and are most frequently tonic-clonic. Nonconvulsive seizure patients have epileptic EEGs, but no physical signs of a seizure. Your patient presents with the diagnosis of Guillain-Barré syndrome. Which of the following is the priority of care for this patient? A. Assessment of vital capacity B. Reassurance of the patient C. Preparing for electromyography testing D. Obtaining CT scan of the spine - CORRECT ANSWER A Rationale: Airway and breathing are the priorities of care. The ascending loss of muscle contraction can include the diaphragm and respiratory muscles. Vital capacity is commonly used to assess the effectiveness of ventilation in neuromuscular disorders. Electromyogram (EMG) testing may be ordered; the patient should be reassured, but the priority of care is airway and breathing. A CT of the spine may be ordered to rule out cord compression, but is not a priority over assessment of ventilatory capability. A patient sustained cervical fractures at the C4 and C5 level from a motor vehicle collision. In the ED, initially he was moving all extremities equally. He suddenly became hemiplegic on the left side. Which of the following is the most likely cause for this neurological change? A. Carotid artery dissection B. Spinal cord injury C. Spinal epidural hematoma D. Cerebral edema - CORRECT ANSWER A Rationale: Carotid artery dissections are associated with traumatic injuries at the cervical level. The flexion/extension mechanism of injury that causes vertebral fractures and spinal cord injuries can also cause carotid and vertebral dissections. Carotid dissections can cause cerebral infarctions with symptoms of contralateral motor loss of upper and lower extremities. Spinal cord injury and epidural hematoma would result in paralysis bilateral. There is no justification within the scenario to suspect cerebral edema as the cause of the symptoms. Which of the following therapeutic interventions is frequently recommended to manage a cerebrospinal fluid (CSF) leak? A. Drain CSF with a lumbar drain. B. Administer mannitol. C. Limit fluid intake. D. Maintain head-of-the-bed elevation greater than 30 degrees. - CORRECT ANSWER A Rationale: Cerebrospinal fluid (CSF) leak is frequently managed by placing a lumbar drain to remove CSF. This lowers the CSF pressure and decreases the drainage. Mannitol is used to manage cerebral edema and increased intracranial pressure (ICP). Limiting fluid intake does not affect the CSF leak and is not recommended; head of the bed (HOB) is maintained flat, not elevated, to decrease the CSF leak. The mother of a 6-year-old girl just diagnosed with pilocytic astrocytoma asks the nurse what her child's prognosis is. Which of the following would be the best response by the nurse? A. This type of tumor has a good prognosis and can usually be managed with surgery. B. The tumor is malignant and frequently metastasizes to the spine. C. This tumor is associated with poor prognosis. I would encourage you to speak with a palliative care physician. D. The prognosis is not well known. She will probably require long-term chemotherapy. - CORRECT ANSWER A Rationale: The prognosis of pilocytic astrocytoma is good, with over a 90% survival rate in 10 years. It is commonly located in the cerebellum and can be surgically resected. It may not require follow-up radiotherapy if resection is complete. The tumor is not typically malignant. Which of the following cerebral arteries is most likely involved in the presentation of "locked-in" syndrome during a stroke? A. Anterior cerebral artery B. Posterior communicating artery C. Internal carotid artery D. Basilar artery - CORRECT ANSWER D Rationale: The basilar artery provides blood to the ventral portion of the pons. The basilar artery is involved in the stroke, resulting in locked-in syndrome. The internal carotid artery typically presents with unilateral paresis or paralysis. The posterior communicating artery or anterior cerebral artery does not present with quadriplegia. Following a minor brain injury (concussion), the patient may experience which of the following symptoms over the next 6 months? A. Periods of aphasia B. Swallowing deficits C. Difficulty concentrating D. Ataxia - CORRECT ANSWER C Rationale: Following a minor brain injury (concussion), patients may experience postconcussion syndrome. This is self-limiting, with neurological deficits that may last 6 months to a year after injury. Symptoms of postconcussion syndrome include (but not limited to) memory deficits, emotional outbursts, and difficulty concentrating. Periods of aphasia would be more likely transient ischemia attack. Swallowing deficit and ataxia are not associated with postconcussion syndrome and may indicate another neurological issue. A patient presents with signs of occipital headache and abnormal motor strength. The MRI found herniation of the cerebellar tonsils, vermis, and fourth ventricle. How would this Chiari malformation be classified? A. Type I B. Type II C. Type III D. Type IV - CORRECT ANSWER B Rationale: A type II Chiari malformation is the downward displacement of cerebellar tonsils and inferior vermis, fourth ventricle, choroid plexus, and medulla. The patient presents in the ED with expressive aphasia and paralysis of the right arm and leg. He has a decreased level of consciousness and rapid respiration. Which of the following is your priority of care? A. Obtain a STAT CT scan. B. Administer alteplase immediately. C. Perform a baseline National Institutes of Health Stroke Scale (NIHSS). D. Secure an airway and ensure ventilation. - CORRECT ANSWER D Rationale: Priority of care is always airway and breathing. Patients presenting with a decreased level of consciousness (LOC) may be unable to maintain an airway, requiring the airway to be secured. The patient will need a CT scan and a National Institutes of Health Stroke Scale (NIHSS) assessment and may be a candidate for thrombolytic therapy, but airway and breathing are the priorities of care. A patient presents with low-back pain. Upon review of the spinal radiographs, multiple levels of osteophytes are noted. Which of the following best describes an osteophyte? A. Inflammation of synovial joints B. Degeneration of vertebral body with increased bone formation C. Stenosis of the nerve root as exits lateral foramen D. Compression of lumbar disc - CORRECT ANSWER B Rationale: The degeneration of the vertebral body includes increased bone formation of the subchondral bone adjacent to endplate and is called sclerosis. It is less able to absorb loads and causes formation of osteophytes, bony projections also known as spurs. These may compress on neurological structures and cause symptoms. Synovitis is inflammation of synovial joints. Foraminal stenosis causes the compression of exiting nerve roots. Lumbar disc compression can cause symptoms but is not an osteophyte. Anticholinesterase agents are used to improve myasthenia gravis muscle function through which of the following actions? A. Increase secretion of acetylcholine. B. Prevent breakdown of acetylcholine. C. Increase sensitization postsynaptic receptors. D. Increase number of postsynaptic muscle receptors. - CORRECT ANSWER B Rationale: Anticholinesterase agents prevent the breakdown of acetylcholine by acetylcholinesterase. The effect of the anticholinesterase agents is to prolong the effect of the neurotransmitter acetylcholine. The agents do not increase secretion of the neurotransmitter acetylcholine or sensitize the receptors of acetylcholine. The postsynaptic muscle receptors are destroyed and cannot be regenerated. Which of the following diagnostic studies is considered the most reliable to identify spinal cord and soft-tissue injuries? A. Lateral cervical spine radiographs B. CT scan C. MRI D. Flexion/extension radiographs - CORRECT ANSWER C Rationale: The benefits of MRI in evaluating acute spinal cord injury (SCI) are its ability to identify cord compression, soft-tissue injuries such as herniated disc and epidural hematoma, ligament instability, and intramedullary hematomas. Lateral C-spine radiographic studies can identify vertebral fractures and can assess for misalignment of the cervical spine but cannot identify cord or soft-tissue injuries. CT scans are not considered as beneficial as MRI in identifying injury to the spinal cord, soft tissue, or ligaments. Flexion/extension radiographs are used in certain patients to identify misalignment of the spine (ligament injury) but are not able to identify actual injury to the cord, soft tissues, or ligaments. A patient reports he or she experiences irritability and mood changes days prior to a seizure. What is this period called? A. Preictal B. Aura C. Intraictal D. Postictal - CORRECT ANSWER A Rationale: The preictal state is the "warning" sign of an impending seizure that may occur days prior to the seizure. This may include feelings of general irritability or depression, mood changes, anxiety, headaches, lethargy, change in appetite, and light-headedness. An aura is the actual start of the seizure. Intraictal is the period of time during the seizure. Postictal is after the seizure. Which of the following secondary injuries would be the most important determinants of outcomes in patients following traumatic brain injuries? A. Hyponatremia and tachycardia B. Hypoxia and hypotension C. Hyperglycemia and hypothermia D. Hyperthermia and metabolic acidosis - CORRECT ANSWER B Rationale: Current research has found the two most important determinants of outcome following a traumatic brain injury are hypoxia and hypotension. They both are considered secondary injuries and determine cerebral perfusion. Hyperglycemia, hyperthermia, hyponatremia, and metabolic acidosis are secondary injuries and can affect outcomes but are not as severe as secondary injuries affecting cerebral perfusion. Which of the following would be a contraindication for administering a thrombolytic? A. Patient's home medications include Eliquis B. National Institutes of Health Stroke Scale score of 10 C. Patient on a daily aspirin D. Negative CT scan - CORRECT ANSWER A Rationale: Eliquis is classified as a novel anticoagulant. A National Institutes of Health Stroke Scale (NIHSS) score of 10 is not a contraindication for alteplase. Depending upon other criteria, it would be an indication. Antiplatelet agents, such as aspirin, are not a contraindication to alteplase in acute stroke. An acute ischemic stroke will have a negative CT scan initially. Your patient has a sudden loss of consciousness. An emergency CT is obtained and an intracerebral hemorrhage (ICH) is seen. Which of the following would be the LEAST common cause of an ICH? A. Anticoagulation therapy B. Hypertensive crisis C. Aneurysm rupture D. Vascular tumor - CORRECT ANSWER C Rationale: Aneurysm rupture results in subarachnoid hemorrhages (SAH) and intraventricular hemorrhage (IVH), not primarily intracerebral bleeds. Anticoagulated patients, hypertensive crisis, and vascular tumors will typically cause bleeding into the parenchyma and are called intracerebral hemorrhage (ICH). Which of the following statements is a true regarding cerebral palsy (CP)? A. CP is not preventable. B. CP is a disease found in children but can be cured. C. Most children with CP will die by the age of 10 years. D. CP has no cure. - CORRECT ANSWER D Rationale: There is no cure for cerebral palsy (CP). It is preventable in some cases such as those due to maternal infections (vaccinations) or Rh incompatibility (use of Rhogam). CP can be at birth or acquired at a very young age. CP may shorten life expectancy, but many children with CP live into adult ages. Plasmapheresis is treatment commonly used in managing Guillain-Barré. It involves the: A. Complete exchange of red blood cells B. Removal of antibodies with plasma exchange C. Washing of the white blood cells to clear allergens D. Filtering of the immunoglobulins - CORRECT ANSWER B Rationale: Guillain-Barré is an autoimmune disorder. Plasmapheresis involves the exchange of serum plasma to remove the antibodies. Plasmapheresis does not exchange red blood cells, wash white blood cells, or filter immunoglobulins. Which of the following best describes Moyamoya disease? A. Small, multiple aneurysms in the microcirculation B. Arteriovenous malformations C. Hyperlipidemia deposits of fat in the cerebral vessel wall D. Progressive occlusion of the intracranial internal carotid artery with collateral flow - CORRECT ANSWER D Rationale: Moyamoya disease is the progressive narrowing or occlusion of the internal carotid artery with the development of collateral circulation called Moyamoya vessels. Presence of multiple, small aneurysms in the microcirculation is called Charcot-Bouchard. Hyperlipidemia results in the formation of plaque and the narrowing of the vessel but is not called Moyamoya vessels. Arteriovenous malformations (AVMs) are congenital vascular anomalies in which the arteries feed directly into draining veins. When clearing a cervical spine injury in the acute period following a traumatic event, which of the following is NOT required? A. Maintain cervical immobilization until cleared of ligament injury B. Flexion/extension evaluation in an awake, asymptomatic patient C. Visualization of C1 through T1 on lateral cervical radiographs D. MRI of cervical spine - CORRECT ANSWER D Rationale: MRI of cervical spine can be used to clear a cervical spine injury (C-spine) in certain circumstances but is not required. Maintaining cervical immobilization until ligament injuries can be cleared is required to prevent subluxation and cord compression if an injury is present. Awake, asymptomatic patients require evaluation (radiographs or physical assessment) of flexion and extension capability to determine if potential ligament injury since plain radiographs cannot identify ligament unless some degree of subluxation is noted. Lateral C-spines require visualization of C1-C7 and the tip of T1 to clear the C-spine of bony fractures. Which of the following is a known risk factor for a brain tumor? A. Use of cellular phones B. Exposure to ionized radiation C. Consumption of fish with high mercury levels D. Use of microwaves - CORRECT ANSWER B Rationale: Overall, causes of brain tumors are unknown. Exposure to ionized radiation is a known risk factor, which can be modified. Cell phones produce a very low magnetic radiation and have not been found to increase the risk of brain tumor. Environmental risks such as ingestion of high mercury and food cooked in microwave have not been found to increase risk of brain tumors. Lobar intracerebral hemorrhage frequently presents with which neurological symptom? A. Cranial nerve deficits B. Decreased level of consciousness C. Pinpoint pupils D. Horner's syndrome - CORRECT ANSWER B Rationale: A decrease in level of consciousness is frequently associated with lobar intracerebral hemorrhage. A bleed within the brainstem frequently presents with cranial nerve deficits, pinpoint pupils, and Horner's syndrome. Patients with Mèniére's disease often complain of feelings of aural fullness accompanied by which of the following other symptoms? A. Worst headache of their lives B. Urinary incontinence C. Roaring sound in ears D. Frequent ear infections - CORRECT ANSWER C Rationale: A common complaint by patients is a "roaring" sound in their ears as well as aural fullness. Urinary incontinence is associated with normal-pressure hydrocephalus (NPH). Subarachnoid hemorrhage (SAH) presents with the "worst headache of their life." M`eniére's disease is not associated with frequent ear infections but can have hearing losses. [Show Less]
- Exam
- $12.45
- 0
- 113
CNRN Exam 349 Questions with Verified Answers,100% CORRECT
CNRN Exam 349 Questions with Verified Answers Describe a hangmans fracture - CORRECT ANSWERbilateral fracture through the arch of C2 Tx for hangman... [Show More] s fx? - CORRECT ANSWERHalo or cervical traction Describe a jefferson's fracture - CORRECT ANSWERburst fracture through the arch of c1 Describe anterior cord syndrome - CORRECT ANSWERLoss of motor, pain and temp, but keep deep touch, vibration and position sense Describe brown sequard - CORRECT ANSWERipsilateral motor touch and position loss. Contralateral pain and temp loss What vertebral level of injury requires a vent? - CORRECT ANSWERC4 Respiratory insufficiency is at what level? - CORRECT ANSWERT10 and above (no DBC d.t innervation of abd musc) What is poikliothermia? - CORRECT ANSWERLoss of temp regulation- loss of vasoconstriction, ability to shiver or sweat d/t symp damage What is spinal shock? - CORRECT ANSWERLoss of all reflexes, motor and sensation below the injury How long can spinal shock last? - CORRECT ANSWER2-16 wks When would spinal shock begin? - CORRECT ANSWERimmediately What is neurogenic shock? - CORRECT ANSWERMild hypotension and bradycardia d/t sympathetic interruption, and parasymp runs unopposed. Treatment for spinal shock? - CORRECT ANSWERResolves on it's own Treatment for neurogenic shock? - CORRECT ANSWERIVF & pressors ("rarely necessary" -Joanne) What's the difference between neurogenic shock and hypovolemic shock? - CORRECT ANSWERHypovolemic will have significant hypotension and bradycardia, cool skin and intact reflexes What causes autonomic dysreflexia? - CORRECT ANSWERSympathetic charge above injury and parasympathetic charge below Describe Lennox-Gastaut syndrome - CORRECT ANSWERchildhood form of epilepsy. 3 S/S: frequent sz of multiple types, EEG slowing and mod-severe cog delay What kind of meds work with GABA? - CORRECT ANSWERbenzos, topamax, propofol, phenobarb How fast can you give Dilantin? - CORRECT ANSWERNo Faster than 50mg/min List two rules about giving Dilantin IV - CORRECT ANSWERNot with dextrose and not with TF (decreases absorption) How does a DBS work to tx/prevent sz? - CORRECT ANSWERStimulates the anterior nucleus of the thalamus, modulates brain activity to prevent sz What symptoms would you see with an epidural hematoma? - CORRECT ANSWERIPSILATERAL blown pupil, contralateral weakness What is the best med to prevent embolic CVA? - CORRECT ANSWERanticoagulants are better than antiplatelet What does the Rankin Scale measure? - CORRECT ANSWERDisability caused by stroke Whats the best score on the Rankin Scale? - CORRECT ANSWER0. 6=dead What does the Barthel scale measure? - CORRECT ANSWERIndependence with ADL's in stroke pts Whats the best score on the Barthel scale? - CORRECT ANSWER15 ICA syndrome - CORRECT ANSWERcontralateral weakness, aphasia, visual changes Cerebellar artery syndrome - CORRECT ANSWERn/v, dysarthia/dysphagia, nystagmus, ataxia, vertigo, ipsilateral horners syndrome Vetrebrobasilar artery syndrome - CORRECT ANSWERimpaired LOC, CN palsies, dysarthia/dysphagia, ipsilateral horners syndrome, vertigo, n/v Basilar artery syndrome - CORRECT ANSWERlocked in How long until you can see a CVA on CT? - CORRECT ANSWER12-24hrs Glucose range for TPA admin - CORRECT ANSWER50-400 INR for tpa admin - CORRECT ANSWER>1.7 Giving TPA- can't have surgery within.. - CORRECT ANSWER2 wks Giving TPA- can't have had another CVA within - CORRECT ANSWER3 mos Giving TPA- can't have had an MI within - CORRECT ANSWER3 months Platelet levels for TPA admin - CORRECT ANSWER>100,000 Two major complications of TPA therapy - CORRECT ANSWERICH and angioedema Tx for angio edema? - CORRECT ANSWERSteroids, zantac, and benadryl Don't give mannitol if osmolality is ...? - CORRECT ANSWER>320 What side effect of ICH occurs up to 12hrs post bleed? - CORRECT ANSWERhematoma. can increase substantially up to 12 hrs post bleed, can displace tissues and cause vasogenic edema Three main risk factors for ICH - CORRECT ANSWERHTN, cigarette smoking and alcohol ingestion List three main s/s of ICH - CORRECT ANSWERn/v impaired LOC and headache List some diseases assoc with SAH? - CORRECT ANSWERmoyamoya, AVM, Marfan disease, polycystic kidney, pituitary tumors, neurofibromatosis, Ehlers Danlos syndrome List five classifications of aneurysm - CORRECT ANSWERsaccular/berry, fusiform, giant, mycotic, traumatic List s/s of SAH - CORRECT ANSWERThunderclap headache, decreased LOC, visual changes, vomiting, hemiparesis/plegia What meningial symptoms can you have with SAH? - CORRECT ANSWERnuchal rigidity, blurred vision, photophobia How many stages of the Hunt-Hess grading scale? - CORRECT ANSWER0-5 List four complications of SAH - CORRECT ANSWERlow NA, rebleeds, ischemia d/t vasospasm, increased ICP In a pt w SAH, what would you see on LP? - CORRECT ANSWERRBC that do not clump in the tbe When is the peak incidence of rebleeds? - CORRECT ANSWER12-48hrs When is the peak incidence of VS? - CORRECT ANSWER7-10 days What is triple H therapy? - CORRECT ANSWERHemodilution, hypertension and hypervolemic Describe agnosia - CORRECT ANSWERInability to process sensory information- 26 different types What is apraxia? - CORRECT ANSWERDifficulty preforming motor tasks/movement when asked. They can explain how to preform, but can't do it. List three treatments for AVM - CORRECT ANSWERBP management, surgical resection, SRS or embolization Whats the difference between an AVM and a CVT? - CORRECT ANSWERCVT is in a vein or sinus, AVM is tangle of arteries & Veins List the number one sign of a CVT - CORRECT ANSWERheadache (increasing over a few days, d/t increased ICP)Won't see dilated vents What is moyamoya? - CORRECT ANSWERanastomic vessels around the circle of willis and bilat ICA, progressive stenosis of bilat ICA extending to COW s/s of moyamoya - CORRECT ANSWERtia, headache, seizures, CVA, ICH List three main sinues - CORRECT ANSWERSuperior sag( up occ lobe to frontal), transverse (runs east/west across skull base), and cavernous (lateral to sella turcica) Acute complications from CVT - CORRECT ANSWERhydrocephalus, blindness d/t pressure on optic nerve How many types of Chiari malformations? - CORRECT ANSWER4 What's the worst kind of Chiari malformation & describe? - CORRECT ANSWER4- hypo/aplasia of cerebellum, do not survive infancy What's the best kind of Chiari malformation & describe? - CORRECT ANSWERdownward displacement of cerebella tonsils What type of CM do we see on 8000 & why? - CORRECT ANSWERType 2- bc it usually presents in young adults What is syringomyelia? - CORRECT ANSWERCSF accumulation in the spinal cord List some s/s of Chiari malformation in infants (type 1 & 2): - CORRECT ANSWERapnea (compressed brain stem), decreased gag (compressed CN 9 & 10 in medulla), nystagmus (cerebellar symptom), spasticity s/s of Chiari malform in children? - CORRECT ANSWERnystagmus, spasticity and bulbar dysfunction (medullary symptoms). s/s of Chiari malformation in adults? - CORRECT ANSWERheadache, cerebellar dysfunction ( poor balance, coordination, low muscle tone), n/t in BUE (central cord involvement), spasticity List two chronic complications of Chiari malformation- - CORRECT ANSWERhydrocephalus (if 4th vent has herniated) and chronic headaches List three possible causes of "Aquired CP": - CORRECT ANSWERbrain damage in the first months of life, bacterial meningitis/viral encephalitis, TBI List four fetal development alterations that can cause CP: - CORRECT ANSWER1) periventricular leukomalacia- damage to teh white matter of the brain. May be caused by fetal or maternal infection. 2) cerebral dysgenesis (abnormal development of the brain caused by infection, trauma, or fevers. 3) intracerebral strokes- blood clots from placenta, blood clotting abnormalities, malformed blood vessels, maternal HTN or infection. 4) asphyxia during delivery How to treat CP? - CORRECT ANSWERNo cure, symptomatic tx w muscle relaxants, baclofen pump, Robinul (decrease saliva) List the three types of spina bifida: - CORRECT ANSWER1) occulta- no symptoms or intervention. 2) Meningocele- not many symptoms bc spinal cord develops normally, just the meninges bilge out throw opening in the vertebrae. risk of tethered cord syndrome w repair 3) Myelomeningiocele- spinal column comes out with the meninges. Often child is paralyzed w/ bladder and bowel incontinence, seizures. What medication comes with SE of neural tube defects? - CORRECT ANSWERValproic Acid List three ways to test for SB - CORRECT ANSWERAFP, ultrasound and amnocentesis List three complications of SB: - CORRECT ANSWERTethered cord syndrome, hydrocephalus (bc the CSF doesn't circulate normally), or meningitis What kind of injuries are common in kids w/ SB? - CORRECT ANSWERfracturing of the paraplegic legs (epiphyseal plate abnormalities) What is central neuropathy (central pain)? - CORRECT ANSWERnerve pain d.t a central issue (lesion or disease affecting the central somatosensory system). Central neuropathy can be caused by strokes- where would these be? - CORRECT ANSWERthalamus and parietal lobe (thalamus being the primary pain center of the brain) Damage causes these neurons to misfire. What is CRPS? - CORRECT ANSWERComplex regional pain syndrome- chronic pain condition result of CNS or PNS dysfuncion. What is CRPS type 1 caused by? - CORRECT ANSWERtriggered by injury to soft tissue or bone, no nerve injury. Deep, burning pain that is out of proportion to the injury, patho unclear. What is CRPS type 2 caused by? - CORRECT ANSWERnerve injury. Ex) Nerves get damaged, turns into chronic pain, pt loses motor use, can look deformed/contracted. Color change, or can lose hair. One example- an extravasation can cause severe nerve injury. List three meds used to treat neuropathic pain- - CORRECT ANSWERgabapentin, lyrica, elavil, topamax, liodcaine patches. What chronic disease is assoc. with Trigeminal neuralgia? - CORRECT ANSWERTN can be one of the first signs of MS in a young person. What causes trigeminal neuralgia? - CORRECT ANSWERThe PRESUMED cause of TN is structures pushing on the trigeminal nerve as it exits the brainstem. Could be a blood vessel, tumor, chronic meningitis (scarring of meningies that causes nerve compression) or an aneurysm. How do you treat trigeminal neuralgia? - CORRECT ANSWER1) management of pain w/ neurogenic pain meds: AEDs, and tricyclics (carbamezepine (tegretol), oxcarbazepine ( trileptal), gabapentin, clonazepam. And additionally- baclofen!? 2) Surgery- nerve blocks or ablation, rhizotomy (cut the nerve), SRS (one session only), microdecompression to remove vascular compression from CNV, good success rate. What are two complications of surgical management for TN? - CORRECT ANSWERhearing loss and abnormal sensation around the face. What's another name for the precentral gyrus? - CORRECT ANSWERMotor strip What kind of headaches are assoc with miosis, ptosis? - CORRECT ANSWERCluster (Kendra was asked about this on her test- autonomic symptoms assoc. w cluster headaches) What kind of headaches are assoc with visual disturbances? - CORRECT ANSWERMigraines What kind of headaches are nocturnal? - CORRECT ANSWERCluster What kind of headaches are at the base of the skull? - CORRECT ANSWERTension Ergotamine is a serotonin receptor agonist. What is one serious complication of using it to treat headaches? - CORRECT ANSWERCoronary & peripheral vasoconstricton- serious or life threatening peripheral ischemia when used with macrolide abx. Triptans are the first line drug for what kind of benign headache? - CORRECT ANSWERMigraine List three categories used to PREVENT migraines/benign headaches: - CORRECT ANSWERBeta blockers, tricyclic antidepressants (best with tension or chronic daily), AEDs (gabapentic, topamax, valproic acid), SSRIs. cyproheptadine (periactin- antihistamine with tricyclic structure), CCB (pg 71) T or F- Menieres disease is usually bilateral. - CORRECT ANSWERF- unilateral What are some dietary considerations that might help improve symptoms of menieres? - CORRECT ANSWERLots of fluid intake, avoiding caffeine (makes tinnitus worse), avoiding alcohol, avoiding tyramine, avoiding too much sodium? Why would you have hearing loss with Menieres disease? - CORRECT ANSWERCN8 has two parts (vestibulo (hearing) + coclear (balance), may have dual involvement What causes Menieres disease? - CORRECT ANSWERFluid volume changes in the labyrinth. An increase in the endolymph (fluid) effects the way the nerve receptors (crystals) tell the brain where the body is in relation to space. List three medications used to treat Menieres: - CORRECT ANSWERAntihistamines, anticholinergics (S/E: blurred vision, dry mouth, low HR), antiemetics, sympathomimetics (ephedrine) How to treat Meniers Disease? - CORRECT ANSWER1) Medical: inject gentamicin, into ear to destroy CN8 = destruction of vestibular cells with minimal hearing loss. 2) Surgical: posterior fossa crani to resect CN8 Four of the five meds for AD are what kind of medication? - CORRECT ANSWERAcetylcholinesterase inhibitors. What labs should you watch while a pt is on Aricept (Ache Inhibitor) - CORRECT ANSWER- liver enzymes What other category of meds treat AD? - CORRECT ANSWERNMDA receptor agonist- Memantine (Namenda) How does an NMDA receptor agonist work? - CORRECT ANSWERprevents volume loss by binding to glutamate, which can cause volume loss and thus memory loss. Pts can also be on antipsychotic drugs to curb behaviors- What kind of side effects should you be looking for? - CORRECT ANSWERExtrapyramidal effects List extrapyramidal symptoms: - CORRECT ANSWER(apathy, drooling, dysphagia, tremors, involuntary eye movement, tardive dyskinesia, invol. trunk movements) What two other symptoms are indicative of PD? - CORRECT ANSWERcogwheel rigidity and bradykinesis (trouble initiating or changing movement) What's the difference between primary and secondary PD? - CORRECT ANSWERPrimary has no known cause, secondary is caused by trauma, toxins (carbon monoxide, cyandie, insecticides, agent orange) or medications (thorazine, aldomet)- secondary is usually reversible What parts of the brain are effected by PD? - CORRECT ANSWERbasal ganglia, subthalmic nucleus and substantia negra (produces dopamine)- those are AKA extrapyramidal system Talk about the pathophysiology of PD: - CORRECT ANSWERDestruction of the dopamine producing cells in the substantia negra, creating and increase in muscle tone (pill rolling, tremor, cogwheel & lead-pipe rigidity) bc of too much AchE (opposing force is dopamine) Pg 80 What is the definitive (not clinical) way to diagnose PD? - CORRECT ANSWERLewy bodies in midbrain on autopsy Why are anticholinergic agents used in PD? - CORRECT ANSWERUsed to manage tremors and rigidity, but there is low recommendation for this How do dopaminergic agents work? - CORRECT ANSWERIncrease dopamine in the CNS ex) Sinemet (carbidopa/levopoda)- Levodopa is converted into dopamine List two SE of sinemet: - CORRECT ANSWERorthostatic hypotension, hallucinations/psychosis What syndrome is caused by suddenly stopping sinemet? - CORRECT ANSWERneuroleptic malignant syndrome (AMS, lead pipe muscle rigidity and autonomic dysfunction (diaphoresis, labile BP, high fever) dosage and serum concentrations are usually wnl. How do you treat neuroleptic malignant syndrome? - CORRECT ANSWERStop antipsych meds (usually haldol), and supportive therapy. How does a dopamine Agonist work? - CORRECT ANSWERActivates dopamine receptors to make more dopamine- these are used first to delay need for sinemet. Ex Parlodel, Mirapex, requip MAO-B inhibitors (med called Eldepryl) are the first line drug used in PD, how does it work? - CORRECT ANSWERSlows the progression of early PD, and delays need for sinemet, also Prolongs the half-life of levodopa when added. MAO inhibitors can cause sudden and severe HTN when combined with what? - CORRECT ANSWERTyramine- containing foods, like red wine, cheeses, aged food SRS can be used to treat PD, how? - CORRECT ANSWERaimed at destroying parts of the BG to relieve tremors and rigidity Where would YOU put a DBS to treat PD? - CORRECT ANSWERUnilateral or bilateral subthalmic nucleus (part of the basal ganglia) How does a DBS work? - CORRECT ANSWERadds electrical current to the subthalmic nucleus to pt can improve dopamine usage. List two syndromes in children that can cause congenital hydrocephalus? - CORRECT ANSWERChiari malformations and spinal bifida List two (of the many) ways a person could get acquired hydrocephalus? - CORRECT ANSWERMeningitis, IVH, tumors, encephalitis Decompensated congenital hydrocephalus will present similar to what other syndrome? - CORRECT ANSWERNormal pressure hydrocephalus (decompensated congenital hydroceph is not acute, and there is no rise in ICP) List three s/s of acute hydrocephalus. - CORRECT ANSWERnausea/vomiting, headache, AMS, papilledema What is an endoscopic third ventriculostomy? - CORRECT ANSWEREndoscopic procedure that creates an opening between the third ventricle and basal cisterns (surgery to bypass obstruction b.c most common site for obstruction is between 3rd and 4th vent) ou can get NPH as an older adult, but you can also acquire it from... ? - CORRECT ANSWERSAH, trauma or meningitis. These can block reabsorbtion of CSF in the arachnoid villi How much CSF would you take off in a lumbar tap for NPH? - CORRECT ANSWER40-50cc. List two environmental hazards which could give someone a brain tumor. - CORRECT ANSWER1) Chemical agents (pesticides, formaldehyde), 2) low-frequency electromagnetic fields (low evidence of this), 3) ionizing radiation (radiation therapy, x-ray) What's the difference between extraaxial and intraaxial brain tumors? - CORRECT ANSWERExtraaxial tumors originate within the skull, meninges, cranial nerves, and pituitary gland ex) pit tumors or meningiomas. Intraaxial are inside the cranium, originate in glial cells, ex) GBM Tumors arise from two types of nervous cells, name these. - CORRECT ANSWERGlial cells (5 times more numerous than neurons) and neurons. List three glial cell types that can form tumors. - CORRECT ANSWERAstrocytes, Oligodendrocytes, and Ependymal cells. What is the job of astrocytes? - CORRECT ANSWERMake up the blood brain barrier. They extend into the pia-glial membrane next to sub arachnoid space. What's the most common type of glial tumor? - CORRECT ANSWERAstrocytoma What's the second most common type of glial tumor? - CORRECT ANSWERmeningioma List five types of tumors that are more common in kids. - CORRECT ANSWER1) Pilocytic (cerebellar) astrocytoma, 2) subependymal giant cell astrocytoma 3) brain stem glioma and ependyomas. 4) medulloblastoma 5) craniopharyngioma Where would you find a craniopharyngioma? - CORRECT ANSWERsella turcica, pituitary. Excellent prognosis with microsurgery, Presents with increased ICP, vision changes or pit/hypothal dysfunction Children usually have neurofibromatosis- how do you get it? - CORRECT ANSWERAutosomal dominant disorder- three types. NF1- brown spots on body, usually benign. NF2- BILATERAL schwanomma AKA acoustic neuroma, NF3 AKA schwanommatosis, painful schwanommas develop on spinal and peripheral nerves. Ependymomas arise along the ventricles and spinal cord central canal. This makes the pt susceptible to what? - CORRECT ANSWERCSF dissemination and systemic metastasis What's the most common type of neuroma? - CORRECT ANSWERAcoustic neuroma (Schwannoma) Acoustic neruomas are usually located at the cerebellopontine angle. This location makes it likely that it would compress which structure? - CORRECT ANSWERpons. If the tumor grows large enough it will eventually compress the brain stem and cerebellum (also CN IV-X) Pt may also have hydroceph d/t obstruction of CSF flow What other cranial nerve damage would you expect with an acoustic neuroma? - CORRECT ANSWERdamage to CN V and VII (all in the midbrain) What type of symptoms would a patient with acoustic neuroma present with? - CORRECT ANSWERtinnitus, dizziness, loss of balance, vertigo, loss of facial sensation, nystagmus, unilateral hearing loss. If the tumor grows larger, may also have facial weakness/numbness, hydrocephalus and bulbar symptoms Acoustic neuromas are the most common type of neuroma. List two other examples of a neuroma. - CORRECT ANSWERPineal tumors (rare) and pituitary adenomas A person with a brain tumor has endocrine dysfunction, which type of tumor would you expect they had? - CORRECT ANSWERpituitary adenoma List two common complications of transphenoidal resection of a pit adenoma. - CORRECT ANSWERCSF leak and Diabetes insipidus List three different hormones that a pituitary tumor can secrete- - CORRECT ANSWERGrowth hormone, prolactin, and adrenocorticotropic hormone (idk, kendra listed these- hard to know if we need to know this or not. pg 100 on her outline) A pituitary tumor that is secreting growth hormone can cause which two syndromes? (Either one or the other) - CORRECT ANSWERGigantism if before puberty, Acromegaly if after puberty (bc the growth plates have sealed) What symptoms would you see in a pt with a pit tumor that was secreting TSH? - CORRECT ANSWERweight loss, high HR, irritability, excessive sweating Cortisol secreting pituitary hormone can cause which syndrome? - CORRECT ANSWERCushings disease Where would you find a hemangioblastoma? - CORRECT ANSWERCerebellum, usually curable with surgery. assoc wiht von Hippel Lindau disease Describe the pathophysiology of Von Hippel Lindau disease- - CORRECT ANSWERautosomal dominant gene mutation, causing tumors (hemangioblastomas, pheochromocytoma, renal cell carcinoma), strokes, heart attacks, cardiovascular disease and visual problems. Your patient has a metastasis to the brain. List three places the primary source could be. - CORRECT ANSWERLung, breast, kidney, malignant melanoma Signs of brain tumors depend on where the tumor is. List three symptoms you might see in a frontal lobe tumor: - CORRECT ANSWERAMS, inappropriate behavior, emotional lability, speech changes, motor dysfunction, incontinence Temporal lobe mass symptoms? - CORRECT ANSWERreceptive aphasia, generalized psychomotor seizures, visual field changes, personality changes, ataxia Parietal lobe mass symptoms - CORRECT ANSWERsensory deficits, motor and sensory focal seizures, speech deficits, paresthesias, apraxi Occipital lobe mass symptoms? - CORRECT ANSWERheadache, visual changes, field cuts, visual hallucinations, focal or generalized seizures Pituitary/hypothalamus brain tumor symptoms? - CORRECT ANSWERvision changes (d/t optic atrophy & paralysis of one or more extraocular muscles), headache, hormonal dysfunction, water imbalance, sleep pattern problems Lateral and 3rd ventricle brain tumor symptoms: - CORRECT ANSWERheadache, vomiting, symptoms of increased ICP. 4th ventricle tumor symptoms: - CORRECT ANSWERheadache, vomiting, nuchal rigidity, sudden death d/t compression of the medulla Cerebellar tumor symptoms: - CORRECT ANSWERunsteady gait, falling, ataxia, incoordination, tremors, nystagmus, decreased corneal reflex, CN8-12 dysfunction Brainstem tumor symptoms- - CORRECT ANSWERvertigo, dizziness, nystagmus, vomiting, CN4-12 dysfunction, List three ways (illnesses) you could get a CNS infection.cture - CORRECT ANSWERMiddle ear infections, sinusitis, mastoiditis, fracture to frontal or facial bones, post op craniotomy, basal skull fra What CNS infection is spread by droplet transmission? - CORRECT ANSWERmeningococcal meningitis, or hemophilus influenza meningitis What bacteria causes meningococcal meningitis? - CORRECT ANSWERneisseria meningitides If you've had pneumonia, what kind of meningitis are you at risk for? - CORRECT ANSWERPnuomococcal meningitis (this is the most common type) What cranial nerves are most likely to be damaged by meningitis? - CORRECT ANSWERCN8, 3,4 and 6 (dysconjugate gaze and hearing loss) True or False- you can get meningitis from TB. - CORRECT ANSWERTrue. May have tuberculomas on brain and spinal cord What type of meningitis can you get from soft cheeses? - CORRECT ANSWERListeria, may also have brain abscesses What kind of meningitis would you likely see in a patient with otitis media or pharyngitis? - CORRECT ANSWERHemophilus influenza List the key changes you'd see on a CSF analysis on a pt w bacterial meningitis? - CORRECT ANSWERLow glucose, high protein and elevated PMNs and NEUTROPHILS Viral meningitis on CSF looks like: - CORRECT ANSWERmild elevation of protein, and lymphocytes List three possible complications of meningitis. - CORRECT ANSWEREncephalitis, abscess formation and chronic hydrocephalus requiring VPS (pg 107) A brain abscess will commonly present as what other cerebral infection syndrome? - CORRECT ANSWERmeningitis How would you treat an abscess caused by mycobacterium tuberculosis? - CORRECT ANSWERburr hole or crani to drain abscess, then anitbiotics How is CJD different from vCJD? - CORRECT ANSWER"Variant CJD" is a newer type, initial symptoms are different and occurs in younger pts. Psychosis first, then ataxia. Regular CJD is the opposite. 237) List three cool ways a pt might get CJD? - CORRECT ANSWERHereditary, spontaneously, or transmission from an infected animal List three symptoms of CJD: - CORRECT ANSWERpersonality changes, myoclonus, ataxia, psych changes, confusion, memory problems, hallucinations, incontinence, slurred speech, dysphagia What is one safe way to diagnose CJD? - CORRECT ANSWEREEG, MRI or LP Define encephalopathy. - CORRECT ANSWERGeneralized cortical dysfunction" Describe the pathophysiology of uremic encephalopathy- - CORRECT ANSWERwith acute or chronic kidney disease (GFR of less than 15), high calcium levels cause brain dysfunction, usually responds well with hemodialysis. List three of the (MANY) possible causes of encephalopathy: - CORRECT ANSWERalcohol induced, wernickes, hepatic, hypertensive encephalopathy, toxic/metabolic encephalopathy, hasmimotos encephalopathy, infection, drug induced. Describe the pathophysiology of malignant hypertension- - CORRECT ANSWERIncrease in HTN causes cerebral edema, either acute (malignant) or chronic (chronic HTN). Malignant hypertension is also called what? - CORRECT ANSWERPRES Wernickes encephalopathy is caused by what vitamin deficiency? - CORRECT ANSWERB1 (thiamine) It's important to remember NOT to give this with thiamine replacement. - CORRECT ANSWERDextrose! Can make thiamine levels go down Describe the pathophysiology of hepatic encephalopathy: - CORRECT ANSWERLiver disease is so bad that body turns to portosystemic shunting- basically circulation skips the liver all together, and the toxins that WOULD HAVE been filtered out end up in the brain, causing impaired function. AKA take your lactulose. BUT- "High ammonia levels do not add to the grading, severity or prognosis of hepatic encephalopathy." -Kendra pg 115 Describe the pathophysiology of MS. - CORRECT ANSWERPlaques are formed in the CNS, immune system sees plaques as foreign and attack, unfortunately this process damages the myelin sheath. What would you see in CSF on an MS pt? - CORRECT ANSWERincreased IgG, mild protein elevation, mild increase in lymphocytes, and oligoclonal bands List two motor symptoms of MS: - CORRECT ANSWERweakness, paralysis, spasticity, positive babinski reflex (hyperreflexia), abnormal deep tendon reflexes List cranial nerve symptoms of MS: - CORRECT ANSWERblurred vision, diplopia, dysconjugate gaze, dulbar symptoms, facial weakness, eyeball pain List sensory involvement of MS: - CORRECT ANSWERparesthesias, numbness, pain and LHERMITTES sign (electric/shock sensations down spine and into arms or legs) What causes Lhermittes? - CORRECT ANSWER"Probably a buckling effect on the dorsal roots of the posterior columns from sclerotic plaques." Hickey 698 Cerebellar symptoms of MS: - CORRECT ANSWERdysarthria, tremors, ataxia, vertigo, fatigue True or False- MS pts may have cognitive decline. - CORRECT ANSWERTrue- short term memory deficits, WFD, short attention span, mood alteration What is the McDonald criteria? - CORRECT ANSWERTwo or more attacks, and two or more lesions in different locations. Remember- remyelination may occur, so these lesions on an MRI can come and go. What other immune disorders are assoc. with Myesthenia Gravis? - CORRECT ANSWERThymoma (tumor OR hyperplasia), lupus, RA, b12 deficiency Describe the pathophysiology of MG- - CORRECT ANSWERantibodies destroy Ache receptors in the post synaptic membrane, decreasing the effectiveness of Ache What factors might worsen MG? - CORRECT ANSWERStress, emotional upset, systemic illness, pregnancy, menstrual cycle, extremes in temperature What type of symptoms are usually reported first with MG? - CORRECT ANSWERVisual- ptosis and diplopia, inability to close eyelid, blurred vision, and brain stem symptoms: dysarthria, dysphagia, dysphonia How do diagnose MG? - CORRECT ANSWEREMG. Also cholinesterase inhibitor drug testing- give the drug (like Edrophonium, Tensilon or Neostigmine), and pt gets way better within 5-10 min. Also can do blood work (look for Ache-R antibody) How does Mestinon work? - CORRECT ANSWERSlow the breakdown of Ach by inhibiting Ache (breaks down Ach) = anticholinesterase medication Two other types of medications can help MG. What are they? - CORRECT ANSWERcorticosteroids and immunosuppressants How would plasmaphoresis help a pt with MG? - CORRECT ANSWERremoves AchR antibodies with the exchange of plasma, for short term sudden worsening of symptoms True or False- IVIG can also be used to treat MG. - CORRECT ANSWERTrue List medications that could interfere w MG/ make weakness worse - CORRECT ANSWERlocal anesthetics, antiarrhythmics, aminoglycoside antibiotics, clindamycin, lincomycin, morphine, beta blockers, CCB, antacids, laxatives, and many others. What's the difference between cholinergic crisis and myasthenia crisis? - CORRECT ANSWERCholinergic crisis is d/t overmedication, myasthenia crisis is usually d/t infection. How can you tell the difference between a cholinergic crisis and a myasthenia crisis? - CORRECT ANSWERCholinergic crisis = slow onset, excessive pulmonary secretions, and abdominal cramping/diarrhea present for some time before worsening. Myasthenia crisis is a sudden relapse of symptoms after (commonly) infection Treatment for cholinergic crisis? - CORRECT ANSWERpossible intubation and holding of Ache medications. Treatment for myasthenia crisis? - CORRECT ANSWERpossible intubation and holding of Ache medications Acute inflammatory polyradiculoneuropathy (AIDP) and chronic inflammatory polyradiculoneuropathy (CIDP) are also known as what? - CORRECT ANSWERGuillain Barre Describe the pathophysiology of GBS. - CORRECT ANSWERDemyelination of peripheral nerves, causing bilateral, ascending paralysis. Usually d/t virus effecting myelin on peripheral nerves, causing immune system to damage MS along with virus. Most GBS pts have motor and sensory symptoms. Also can have brain stem involvement- list brain stem symptoms a GBS pt might experience: - CORRECT ANSWERbilateral facial weakness, weakness with EOM, dyspnea, dysphagia, dysarthria GBS can also cause autonomic symptoms. These are: - CORRECT ANSWERorthostatic hypotension, heart block, tachycardia, cardiac arrythmias, bladder atony, GI dysmotility Why isn't there muscle atrophy with GBS? - CORRECT ANSWERusually too sudden of onset for atrophy to kick in CSF on GBS pt will show: - CORRECT ANSWERincreased protein, CSF pleocytosis How do we treat GBS? - CORRECT ANSWERSupportive therapies + plasmophoresis OR IVIG, not both. Describe the pathophysiology of ALS- - CORRECT ANSWERDamage to and reduction of motor neurons in the anterior horn cells of the spinal cord, motor nuclei of the brain stem, (esp CN 7 and 12), corticospinal tracts and frontal lobe. List four functions of the brain that are spared by ALS. - CORRECT ANSWERCognition, sensory function, EOM (CN 2, 4 and 6 intact), and hearing. List the two types of symptoms you will see in ALS - CORRECT ANSWERupper AND lower motor symptoms List two ways we can diagnose ALS. - CORRECT ANSWERMRI or EMG mostly. no specific blood workup for ALS. There's one medication that FDA has approved for ALS, it slows the progression of the disease. What is it called? - CORRECT ANSWERRiluzole (Rilutek) List three drugs used to treat benign essential tremor- - CORRECT ANSWERpropranolol, mysoline (AED), Diamox (carbonic anhydrase inhibitors), klonopin, Botox. Also gabapentin, CCB, Topamax, Remeron. Lymes disease has three stages. List symptoms from Stage 2- - CORRECT ANSWERcardiac conduction abnormalities, arthritis, fatigue, fever, peripheral neuropathy, possibly meningitis? List symptoms from stage 3 of Lyme's disease: - CORRECT ANSWERimpaired memory and concentration, fatigue, encephalopathy What's the treatment plan for Lymes disease? - CORRECT ANSWERCeftriaxone (2-4weeks) What causes Bell's palsy? - CORRECT ANSWERinflammation within the fallopian canal, trauma during surgery, trauma to face, viral (Cytomegalovirus, Epstein Barr, rubella, HIV, mumps) or bacterial infections (Most common) List a situation in which only part of CN7 would be effected in bells palsy - CORRECT ANSWERInflammation/infections usually effect CN7 before it exits the skull and branches out, meaning that the whole CN7 is effected (the whole face). Sometimes w trauma during surgeries, only part of the CN7 is nicked/damaged, so only part of the face would be effected. List some symptoms of Bell's Palsy- - CORRECT ANSWERMuscle weakness, impossible or difficult to blink, nasal drips/stuffiness, difficulty speaking/eating/drinking, facial swelling, ear pain, drooling What is the treatment for Bell's Palsy? - CORRECT ANSWER1) remove cause of damage to nerve, corticosteriods, antivirals (treat within 7days for best results) How long does it take to get better from BP? - CORRECT ANSWERdays to a few months, 60-80% recover within a short time. How can we diagnose neurocysticercosis? - CORRECT ANSWERCSF studies (increased pressire, pleocytes w/ eosinophils or lymphocytes, elevated protein and IgG, low glucose) or MRI or CT scan Where would you find a neurofibroma? - CORRECT ANSWERAnywhere, but can be along the peripheral nerves, causing pain or numbness. What genetic disorder is assoc. with neurofibromas? - CORRECT ANSWERneurofibramitosis type 1 Describe patho for carpal tunnel syndrome - CORRECT ANSWERmedian nerve compression d.t edema from repetitive movements. The carpal tunnel is a narrow tunnel which the median nerve passes through, if there is narrowing of the tunnel the movement of the nerve and muscles is compromised. List sx of CPS - CORRECT ANSWERsensory loss in first three fingers, pain/paresthesias in wrist and hand (often at night), paresis or wasting of the hand muscles. What is tinel's sign? - CORRECT ANSWERpain and tingling elicited by tapping over median nerve @ wrist What is phalen's sign? - CORRECT ANSWERPain and tingling occurs in the wrists when they are flexed at right angles for 1 minute How to confirm carpal tunnel syndrome dx? - CORRECT ANSWERDx by EMG/nerve conduction studies Tx for Carpal tunnel syndrome? - CORRECT ANSWERNSAIDS, corticosteriod injections, immbolization of the wrist w. splints, rehab or surgery What surgery would tx CPS? - CORRECT ANSWERsurgical decompression to free the median nerve of compression Miller Fisher syndrome is a type of what? - CORRECT ANSWERGBS. Seen as triad of ophthalmoplegia, ataxia and areflexia. How to tell the difference between vestibular or cerebellar dizziness? - CORRECT ANSWERvestibular dizziness is like swirling, but cerebellar dysfunction feels like walking on a boat (side to side) Cochlear = - CORRECT ANSWERhearing vestibular = - CORRECT ANSWERequilibrium/coordination/orientation in space Rhinnes test is for what? - CORRECT ANSWERto eval. air and bone conduction Weber's test is for what? - CORRECT ANSWERto evaluate lateralization (hearing in one ear better than another) What is conduction deafness? - CORRECT ANSWERproblem conduction sound waves along the outer ear (ex hearing loss d.t middle ear infection) What is sensorineural deafness? - CORRECT ANSWERcaused by damage to the inner ear or nerve (ex aging) Define Papiledema - CORRECT ANSWERoptic disc swelling caused by increased ICP, pt has normal vision What is Marfan syndrome? - CORRECT ANSWERAutosomial dominant genetic disorder effecting connective tissue. pts usually tall with long limbs/fingers. Pts at risk for AVM, SAH, thin dura along spine (dural ectasia), aortic aneurysm, MVR Define Ehlers Danlos syndrome - CORRECT ANSWERGenetic connective tissue disorder causing hyperflexible/unstable joints, loose skin, aortic dissection & osteoarthritis Also at risk for CPS and Chiari? What is mirtazapine for? - CORRECT ANSWERantidepressant- noradrenergic and specific serotonergic antidepressant List two types of SSRI - CORRECT ANSWERFluoxetine (Prozac) Sertraline (Zoloft) Paroxetine (Paxil) Escitalopram (Lexapro) Citalopram (Celexa) List two tricyclic antidepressants - CORRECT ANSWERAmitriptyline (Elavil) Nortriptyline (Pamelor, Aventyl) List two atypical antidepressants - CORRECT ANSWERBupropion (Wellbutrin) Duloxetine (Cymbalta) Venlafaxine (Effexor) Mirtazapine (Remeron) Trazodone (Desyrel) Name two MAOI - CORRECT ANSWERPhenelzine (Nardil) Tranylcypromine (Parnate) meds for tic douloureux - CORRECT ANSWERcarbamezepine (monitor liver enzymes) baclofen, phenytoin, gabapentinlamotrigine, zolpidem and tizanidine What neuropathies would you see in a pt with HIV? - CORRECT ANSWERDistal sensory polyneuropathy (DSP). Burning in soles of feet, worsened by pressure. Tx: tricyclic antidepressants, carbamazepine, phenytoin, topical capsaicin or lidocaine Meds to treat diabetic neuropathy - CORRECT ANSWERamitriptyline, nortriptyline, carbamazepine, phenytoin, gabapentin. or NSAIDS, methadone if NSAIDS fail? Define Charcot-Marie-Tooth disorder - CORRECT ANSWERHereditary motor and sensory neuropathies of the PNS. Shows up early adulthood- pt w musc wasting, foot droop (usually 1st sx), and loss of sensation in the feet and hands. C2 sensory= - CORRECT ANSWERoccipital/back of head C3 sensory= - CORRECT ANSWERneck C4 sensory= - CORRECT ANSWERneck/upper shoulders C6 sensory= - CORRECT ANSWERThumb, radial aspect of arm, index finger C7 sensory= - CORRECT ANSWERmiddle finger/palm/back of hand C8 sensory= - CORRECT ANSWERRing and little finger, ulnar forearm T4 sensory= - CORRECT ANSWERnipple T1-2 sensory - CORRECT ANSWERInner aspect of arm and shoulder blade T7 sensory - CORRECT ANSWERLower costal margin T10 sensory= - CORRECT ANSWERumbilical T12-L1 sensory= - CORRECT ANSWERgroin L2 sensory= - CORRECT ANSWERanterior thigh L3-4 sensory - CORRECT ANSWERAnterior knee and lower leg L5 sensory= - CORRECT ANSWEROuter aspect of lower leg, dorsum of foot, big toe S1 sensory- - CORRECT ANSWERsole of foot/Four remaining toes S3 sensory= - CORRECT ANSWERmedial thigh S4-5 sensory - CORRECT ANSWERGenitals/saddle C1-4 motor - CORRECT ANSWERneck flexion/extension/rotation C3-5 motor - CORRECT ANSWERdiaphragm C5 motor - CORRECT ANSWERShoulder movement, flexion/supination of elbow C6 motor - CORRECT ANSWERPronation of elbow, wrist flexion C7 motor - CORRECT ANSWERExtension of forearm and wrist, hand intrinsics C8 motor - CORRECT ANSWERHand intrinsics, grasp and let go T1-12 motor - CORRECT ANSWERControl of thoracic, abdominal, and back muscles L1-3 motor - CORRECT ANSWERflexion of the hip L2-4 motor - CORRECT ANSWERExtension of leg, adduction of thigh L4-5 motor - CORRECT ANSWERAdduction of thigh, flexion of knee, dorsiflexion of foot L5-S1 motor - CORRECT ANSWERplantar flex S2-4 - CORRECT ANSWERperineal area and sphincters List some dietary triggers for Menieres disease - CORRECT ANSWERTriggers for Meniere disease may include high salt intake, caffeine, alcohol, nicotine, stress, monosodium glutamate (MSG), and allergies. An aura is what type of seizure? - CORRECT ANSWERSimple partial List the three types of seizures - CORRECT ANSWERSimple partial, complex partial and generalized Define simple partial seizure - CORRECT ANSWERfocal sz with no LOC Define complex partial seizure - CORRECT ANSWERfocal seizure with LOC Define generalized seizure - CORRECT ANSWERneuronal discharges between two hemispheres What kind of seizure is absence seizure - CORRECT ANSWERGeneralized (really!) What kind of event will present as wandering confused - CORRECT ANSWERSE List four "disease modifying" meds for MS - CORRECT ANSWERGlatiramer acetate, natalizumab, interferobs, fingolimod How does glatiramer acetate work? - CORRECT ANSWERenhances remyelination, regulates T cells List two symptoms to manage with MS - CORRECT ANSWERspasticity and fatigue How does natalizumab work for MS? - CORRECT ANSWERreduces relapses and slows disease progression List three meds you would give during an MS flare - CORRECT ANSWERdecadron, corticotrophin (stimulates body to make own cortisol), and interferon beta (avonex, decreases severity of flare) Where is the ANS control center? - CORRECT ANSWERhypothalamus Name the three structures within the brainstem - CORRECT ANSWERmidbrain, medulla and pons What is the number one sign of heparin induced thrombocytopenia? - CORRECT ANSWERDrop in platelets How much alcohol is okay to drink w coumadin? - CORRECT ANSWERGo on a bender! jk don't- it's NONE. Okay to go off your MS meds when you're pregnant? - CORRECT ANSWERYes- most people have an improvement in symptoms while pregnant How long will you see xanthrochromia in CSF after SAH? - CORRECT ANSWER2 weeks. Good for diagnosing if a person HAD a SAH It's cool to smoke with cluster headaches, right? - CORRECT ANSWERNO> How often do you want you SCI pt to have a BM? - CORRECT ANSWER1-3 days, doesn't matter if it's at the same time every day What nerve injury/symdrome is common with pregnancy? - CORRECT ANSWERCPS You wouldn't treat lesions <4cm with this... why? - CORRECT ANSWERGamma knife radiation- it can't see undetected cells that have infiltrated normal tissue List two meds you can't take with Methotrexate & why - CORRECT ANSWERNSAIDS & ASA. What vitamin should you take with Methotrexate? - CORRECT ANSWERFolic Acid What's the most common source of a brain abscess? - CORRECT ANSWERhematogenous spread from other infected sites like lung abscess, or endocarditis Define lipohyalinosis - CORRECT ANSWERcondition of small vessels that leads to lacunar CVA No glucose containing IVF in a pt with TBI, bc glucose can contribute to... - CORRECT ANSWERneurotoxic acidosis Define DESD, and who gets it? - CORRECT ANSWERDetrusor-external sphincter dyssynergia (DESD) is characterized by involuntary contractions of the external urethral sphincter during an involuntary detrusor contraction. Pt's w MS, SCI, TM. Why would you insert an NG in a pt with SCI? - CORRECT ANSWERParalytic bowel!!!!!! Pt is at risk for ileus. List some s/s of autonomic storm - CORRECT ANSWERHTN, fever, tachycardia, pupil dilation & posturing, decreased LOC Meds for autonomic storm? - CORRECT ANSWERmorphine (#1), then inderal, catapres or throazine Why should TF be started on a TBI pt right away? - CORRECT ANSWERPt is in hypermetabolic state, needs nutrition by day 7 at least. Oxygen consumption rises approx 10% for every ___ degree elevation in temp - CORRECT ANSWER1 degree celcius What is a hygroma? - CORRECT ANSWERcollection of CSF in the subdural space, caused by a tear in the arachnoid mater Define Erbs Palsy - CORRECT ANSWERdamage to C5-6 nerve/brachial plexus d/t shoulder dystocia @ birch. Tx: Will resolve on own over mos, rehab, or surgery Lifetime risk for an AVM bleeding is.. - CORRECT ANSWERhigh. 105-pt age at dx = lifetime risk that AVM will bleed What's the risk a CVT will have hemorrhagic transformation? - CORRECT ANSWER30% What's one risk factor for getting a meningioma? - CORRECT ANSWERradiation Treatment for intramedullary tumor? - CORRECT ANSWEROR Where would you find an intramedullary tumor? - CORRECT ANSWERspine Treatment for bells palsy? - CORRECT ANSWERantivirals alone, not in addition to steriods Seizures can be found in what stage of AD? - CORRECT ANSWER3 pseudotumor cerebri is also known as what? - CORRECT ANSWERidiopathic intracranial hypertension or benign intracranial hypertension Describe patho for pseudotumor cerebri - CORRECT ANSWERgradual increase in ICP, s/s headache, n/v, tinnitus, double vision. Assoc w/ obesity, oral contraceptives and toxic levels of Vit A, lithium. permanent blindness d/t pressure on optic nerve How does levodopa work? - CORRECT ANSWERLevodopa is able to cross the BBB, then converts into dopamine How does carvidopa work? - CORRECT ANSWERinhibits enzymes that break down levodopa, allowing levodopa to cross BBB What chronic disease is assoc w. downs syndrome? - CORRECT ANSWERDementia #1 neuro symptom in pts with HIV? - CORRECT ANSWERperipheral neuropathy- either AIDP (earlier) or DSPN (later), or mononeuropathy multiplex What MS med is assoc with progressive multifocal leukoencephalopathy (PML)? - CORRECT ANSWERnatalizumab Describe patho for PML - CORRECT ANSWERinflammation of the white matter of the brain, caused by JC virus (usually kept in check by a healthy immune system) progresses over weeks/months, 30-50% mortality. treatment aims at boosting immunity, we're unable to treat the infection What chronic disease is assoc w bells palsy? - CORRECT ANSWERDM What elecrtolyte would you watch while rewarming a pt? - CORRECT ANSWERK You shouldn't take triptans if you have a hx of this - CORRECT ANSWERheart disease, CVA, or risk factors for these [Show Less]
- Exam
- $12.95
- 0
- 83
CNRN: Cerebrovascular Exam 20 Questions with Verified Answers,100% CORRECT
CNRN: Cerebrovascular Exam 20 Questions with Verified Answers Thrombotic strokes - CORRECT ANSWER More common Due to plaque formation May be precede... [Show More] d by TIAs Often occurs during sleep, "wake up" strokes Deficits worsen Embolic strokes - CORRECT ANSWER Occur when blood clots or atheromatous debris become lodged into cerebral circulation Atrial fib most common source Abrupt onset Often seen in younger patients Predominantly MCA involvement CT shows multiple V-shaped infarcts in different vascular territories Ischemic stroke risk factors - CORRECT ANSWER Age > 65 Male AA race Southern states HTN Heart disease DM Smoking Previous stroke/TIA Afib Hyperlipidemia Atypical stroke presentation symptoms - CORRECT ANSWER Pain, mental status changes, generalized neurological symptoms (hiccupping, nausea, vomiting) What does the ACA supply? - CORRECT ANSWER Medial aspect frontal, parietal, temporal lobes **hair portion of a Mohawk** What does the MCA supply? - CORRECT ANSWER Lateral aspect frontal, parietal, temporal lobes **bald portion of Mohawk** What does the PCA supply? - CORRECT ANSWER Occipital lobe ACA syndrome symptoms - CORRECT ANSWER Impaired gait Paralysis of contralateral foot & leg Flat affect Mental impairment Urinary incontinence Gaze deviation TO affected side Aphasia MCA syndrome symptoms - CORRECT ANSWER Hemiplegia and sensory impairment contralateral face & arm Aphasia Hemineglect (nondominant hemisphere) Gaze deviation toward affected side Dysarthria PCA syndrome symptoms - CORRECT ANSWER Contralateral homonymous hemianopsia Visual deficits Memory deficits Receptive aphasia (Wernicke's) ICA syndrome symptoms - CORRECT ANSWER Paralysis and sensory deficits contralateral arm, leg, and face Homonymous hemianopsia (loss of medial vision in one eye and lateral vision in other) What is homonymous hemianopsia? - CORRECT ANSWER Loss of medial vision in one eye, lateral vision in other Cerebellar artery syndrome symptoms - CORRECT ANSWER Nausea & vomiting Dysphagia Dysarthria Loss of pain and temperature on contralateral side Horizontal nystagmus Ipsilateral Horner's syndrome Ataxia Vertigo Vertebrobasilar artery syndrome symptoms - CORRECT ANSWER Impaired LOC CN palsies Dysarthria (bulbar symptom) Dysphasia (bulbar symptom) Ipsilateral Horner's syndrome Nystagmus Vertigo Nausea & vomiting Contralateral paresis or paralysis extremities Ataxia Sensory deficits ipsilateral face and contralateral body Basilar artery syndrome symptoms - CORRECT ANSWER Quadriplegia Weakness in face, tongue, and pharyngeal muscles Possible locked in syndrome Stroke mimic rule outs - CORRECT ANSWER Postictal state CNS infections Tumor Toxic-metabolic disturbances Hypo/hyperglycemia Migraines Bulbar symptoms Multimodal MRI options - CORRECT ANSWER Diffusion weighted imagery (DWI), perfusion weighted imagery (PWI), MR angio gradient echo Diffusion weighted imagery - CORRECT ANSWER Detection of ischemia within 30 minutes Able to differentiate reversible from irreversible Perfusion weighted imagery - CORRECT ANSWER Focus correlation between ischemic volume with acute clinical deficits or with volume of chronic infarct MR gradient echo - CORRECT ANSWER used to increase accuracy of MRI in detecting intraparenchymal hemorrhage within 6 hours onset Capability of detecting silent microbleeds which increase risk of hemorrhage with thrombolytics [Show Less]
- Exam
- $8.95
- 0
- 104
CNRN Exam 72 Questions with Verified Answers,100% CORRECT
CNRN Exam 72 Questions with Verified Answers Cerebral circulation - CORRECT ANSWER completely dependent on glucose for metabolism anterior lobe of pi... [Show More] tuitary gland - CORRECT ANSWER GSH ACTH TSH Prolactin FSH LH posterior lobe of pituitary gland - CORRECT ANSWER vasopressin and oxytocin and antidiuretic hormone pons - CORRECT ANSWER sleep and arousal RAS location frontal lobe - CORRECT ANSWER A region of the cerebral cortex that has specialized areas for movement, abstract thinking, planning, memory, and judgement parietal lobe - CORRECT ANSWER A region of the cerebral cortex whose functions include processing information about touch. -body orientation, vision and language temporal lobe - CORRECT ANSWER A region of the cerebral cortex responsible for hearing and language wernikes area - CORRECT ANSWER auditory receptive area Broca's area - CORRECT ANSWER Controls language expression - an area of the frontal lobe, usually in the left hemisphere, that directs the muscle movements involved in speech. -word finding difficulties -nonfluent aphasia Frontal lobe syndrome - CORRECT ANSWER -memory deficits -slowed mental process/reaction time -difficulty with problem solving/synthesis of ideas/insight -lack of iniative -lack of self control locked in syndrome - CORRECT ANSWER Condition in which a patient is aware and awake but cannot move or communicate verbally because of complete paralysis of nearly all voluntary muscles except the eyes. -blinking/eye movements as form of communication vegatative state: intact - CORRECT ANSWER RAS (sleep/wake), autonoic fx partial or complete, pupillary/corneal/gas response, possible spontanous eye movement temporal lobe dysfunction - CORRECT ANSWER • Disturbance of auditory sensation • Selective hearing and vision • Problems with visual perception • Impaired organization of verbal input Wernicke's area -problems with comprehension of language (fluent aphasia) occipital lobe - CORRECT ANSWER A region of the cerebral cortex that processes visual information occipital lobe dysfunction - CORRECT ANSWER Cortical blindness: damage to both sides of the occipital lobe; eyes remain functional Anterior lobe injury: difficulty recognizing faimilar objects/faces --Slow visual processing difficulty interpreting what is being seen Word blindness: Lose the ability to read or the ability to understand what the basic words mean Thalamus - CORRECT ANSWER relays messages between lower brain centers and cerebral cortex --where impulses are PROCESSED -concious pain awareness, attention, RAS, limbic system Hypothalamus - CORRECT ANSWER A neural structure lying below the thalamus; it directs several maintenance activities (eating, drinking, body temperature), helps govern the endocrine system via the pituitary gland, and is linked to emotion and reward. Brainstem - CORRECT ANSWER responsible for automatic survival functions: HR, respirations, eye movements -Pons -midbrain -medulla Cerebellum - CORRECT ANSWER A large structure of the hindbrain that controls fine motor skills, coordinates muscle groups, maintains balance through feedback loops Brain death - CORRECT ANSWER no sign of brain activity and no response to any stimulus -no movement or change in VS to pain -absence of Brainstem reflexes: oculocephalic reflex (doll eyes), pupil reaction, vestibular - ocular reflex, gag/cough/corneal, grimace -apnea test -100% o2 via suction cath (cant breath independently) -abg q5 min: if PaCO2 inc by 20 points or >60 neurogenic shock - CORRECT ANSWER Circulatory failure caused by paralysis of the nerves that control the size of the blood vessels, leading to widespread dilation; seen in patients with spinal cord injuries. -hypotension, bradycardia, warm/dry skin --maintain adequate perfusion, give fluids, vasopressors, facilitate venous return Autonomic Dysreflexia - CORRECT ANSWER (potentially life threatening emergency!) SCI above T6 -s/s: severe hypotension, bradycardia, HA, diaphoresis, flushing, blurred vision, nasal obstruction -tx: HOB elevate 90 degrees, loosen constrictive clothing, assess for full bladder or bowel impaction, (trigger) administer antihypertensives (may cause stroke, MI, seizure) spondylosis - CORRECT ANSWER a degenerative disorder that can cause the loss of normal spinal structure and function spondylolisthesis - CORRECT ANSWER forward slipping of a lumbar vertebra usually L5-S1 Spondylolysis - CORRECT ANSWER the breaking down of the vertebral structure spinal stenosis - CORRECT ANSWER narrowing of the spinal canal with compression of nerve roots Normal pressure hydrocephalus - CORRECT ANSWER "wet, wobbly, and wacky" Does NOT result in increase of subarachnoid space volume; ventricles expand and distorts the radiation fibers causing the clinical triad: Dementia Ataxia (magnetic gait) Urinary incontinence TX: VP shunt (If improvement with LP and LD) aphasia - CORRECT ANSWER difficulty in producing or comprehending language -naming, writing, speaking, repetition, word retrevial, reading (alexia), word fluency, auditory comprehension Broca's aphasia - CORRECT ANSWER condition resulting from damage to Broca's area (typically the L frontal lobe) -causing the affected person to be unable to speak fluently, to mispronounce words, and to speak haltingly -comprehension intact --> frustrationwith errors -poor word retrieval -fragmented sentences -poor grammar Wernicke's aphasia - CORRECT ANSWER condition resulting from damage to Wernicke's area (temporal lobe) -causing the affected person to be unable to understand or produce meaningful language (unaware of errors -fluent speech with normal rate/grammar/syntax/intonation -doesnt make sense/jargon global aphasia - CORRECT ANSWER When both production and understanding of language is damaged -L MCA occlusion conduction aphasia - CORRECT ANSWER The inability to conduct between listening and speaking is disrupted -impaired repetition Dysarthria - CORRECT ANSWER neuromotor damage to the CNS or PNS -abnormalities in strength (slurred), tone, range, accuracy of speech movements apraxia of speech - CORRECT ANSWER impaired motor planning for the production of speech -lesions of L hemisphere --co-occur with Brocas aphasia -inconsistent articulation errors, equal stress on syllables, repetition of sounds, syllables or words -frequently restarts -slow rate meningitis - CORRECT ANSWER inflammation of the meninges of the brain and spinal cord -viral -fungal -bacterial (**most common pathogen: Strep pneumoniae) -encephalitis (**inflammation of brain tissue) viral meningitis - CORRECT ANSWER RNA: polio, MMR, coxsackie, influenza A and B, HIV/AIDs DNA: HSV, chicken pox (varcella zoster), mono, CMV, adenovirus, progressive multifocal leukoencephalopathy Bacterial Meningitis - CORRECT ANSWER common pathogens: strep pneumoniae, neisseria, meningococcal, HIB meningitis -s/s: high fever, change in loc, nuchal rigidity meningeal signs (positive kernig and brudzinski signs) ***classic triad: fever 38-39.5, nuchal rigidity (meningeal irritation), HA** -- treat with antibiotics CJD - CORRECT ANSWER spread through infected brain tissue or spinal fluid -s/s: progressive demnetia --> focal neuro signs and myoclonus Bell's Palsy - CORRECT ANSWER temporary paralysis of the seventh cranial nerve that causes paralysis only on the affected side of the face (unilateral) tx: underlying condition: infection, herpes, stress increased ICP - CORRECT ANSWER goal <20 -sluggish pupils, subtle weakness/pronator drift --> Cushings triad (opposite s/s of shock) herniation - CORRECT ANSWER unarousable, unilateral blown pupils, cushings triad (hypotension, bradycardia, bradypnea Cushings triad - CORRECT ANSWER three classic signs—bradycardia, hypertension, and bradypnea—seen with pressure on the medulla as a result of brain stem herniation Exclusion for tpa - CORRECT ANSWER -head trauma past 3 months -signs of subarachnoid hemorrhage -prev stroke or DM -hypertension: >185 -active bleeding -low platelet <100,000 -INR >1.5 or PT >15 -use of anticoagulant -GI/GU hemmorrhae w/in 21 days -major surgery w/in 2 weeks >80 yo L MCA stroke symptoms - CORRECT ANSWER R sided deficits, aphasia, L gaze deviation R MCA syndrome - CORRECT ANSWER L sided deficits, dysarthria, R gaze deviation vasospasm - CORRECT ANSWER involuntary contraction of a blood vessel: usually w/in 4-14 days of injury -s/s: wax/wan neuro exam, new focal neuro deficit (EMERGENCY!), gradual dec in LOC, increased HA -TX: Triple H therapy (hemodiluation, hypervolemia, hypertension -- midbrain - CORRECT ANSWER A small part of the brain above the pons that integrates sensory information and relays it upward. Pons - CORRECT ANSWER A brain structure that relays information from the cerebellum to the rest of the brain Medulla - CORRECT ANSWER the base of the brainstem; controls heartbeat and breathing Watershed stroke - CORRECT ANSWER An ischemia, or blood flow blockage, that is localized to the border zones between the territories of two major arteries in the brain. Watershed locations are those border-zone regions in the brain supplied by the major cerebral arteries where blood supply is decreased. Chiari malformation type 1 - CORRECT ANSWER This is going to be cerebellar tonsil below the foramen magnum (3-5mm) -not dx until adulthood Chiari II malformation - CORRECT ANSWER Type II is usually associated with spina bifida and myelomeningocele, and is often diagnosed in childhood • cerebellar vermis and medulla herniation through foramen magnum • hydrocephalus d/t aqueductal stenosis Chiari III malformation - CORRECT ANSWER malformations, cervicalmeningocele are present at birth and these infants have a poor prognosis. spina bifida - CORRECT ANSWER Also known as spinal dysraphism, this condition is the failure of the neural tube to fuse properly during development that leads to abnormal formation of the spinal column -inc vit C to help prevent during preg complex partial seizure - CORRECT ANSWER Involves only parts of the brain. Consciousness is impaired, and patients display automatisms, or involuntary repetitive motor activity. craniopharyngiomas - CORRECT ANSWER Occur in the brainstem. They often present during childhood with mass and visual defects . Neurofibroma - CORRECT ANSWER benign fibrous tumors composed of nervous tissue - autosmal dominant, causes itching and painful masses all over body Brown-Sequard syndrome - CORRECT ANSWER Damage to half of spinal cord Loss of pain and temperature sensation on contralateral side of body Loss of proprioception and discriminatory touch on ipsilateral side of body. hemangioblastoma - CORRECT ANSWER von hippel lindau syndrome, foamy cells with high vascularity, produce EPO secondary polycythemia Hemangioblastoma treatment - CORRECT ANSWER surgical excision, which is curative Meningioma - CORRECT ANSWER Benign, very slow -growing arise from the meninges. Attached to meninges. May be calcified. Astrocytoma - CORRECT ANSWER Glioma derived from astrocytes. Astrocytomas are frequently found in the cerebrum, cerebellum, hypothalamus, optic nerve, pons, and also the spinal cord. Low grade astrocytomas tend to occur more often in children. Oligodendrocytoma - CORRECT ANSWER Slow growing lesions that usually arise in the cerebrum and have a tendency to calcify - seizures are common first symptom Oligodendrocytoma TX - CORRECT ANSWER surgical resection and radiation therapy Ependymoma - CORRECT ANSWER malignant, usually children, ependymal cells lining 4th ventricle (cerebellum); presents w/hydrocephalus Schwannomas treatment - CORRECT ANSWER These can be treated with stereotactic radiosurgery Schwannomas - CORRECT ANSWER tumors of the peripheral nervous system that arise from Schwann cells. Myathenia Gravis (MG) - CORRECT ANSWER chronic autoimmune neuromuscular disorder characterized by weakness of voluntary muscles.Antibodies attack acetylcholine receptors.The signature issue is fluctuating muscle weakness.S/S may include facial weakness causing droop or ptosis, dysphagia, extremity weakness, ataxia, impaired speech, visual difficulties, and shortness of breath.Treatments include:immunosuppressive medications, plasmapheresis, and cholinesterase inhibitors.Eat several small meals to prevent aspiration Gullian-Barre Syndrome (GBS) - CORRECT ANSWER is a rare neuromuscular disease. Inflammatory disorder characterized by abrupt onset of symmetrical paresis (weakness) that progresses to paralysis amyotrophic lateral sclerosis (ALS) - CORRECT ANSWER condition of progressive deterioration of motor nerve cells resulting in total loss of voluntary muscle control; symptoms advance from muscle weakness in the arms and legs, to the muscles of speech, swallowing, and breathing, to total paralysis and death; also known as Lou Gehrig disease -goal to keep pt as mobile as possible for as long as possible Bell's Palsy - CORRECT ANSWER temporary paralysis of the seventh cranial nerve that causes paralysis only on the affected side of the face -can cause loss of sensation in 2/3 of tongue on affected side Lacunar stroke - CORRECT ANSWER a stroke resulting from occlusion of a small penetrating artery with development of a cavity in the place of the infarcted brain tissue Cause hemiparesis, ataxic hemiparesis, dysarthria/clumsy hand syndrome, pure sensory stroke, and mixed sensorimotor stroke. -HTN greatest risk factor [Show Less]
- Exam
- $11.45
- 0
- 142
CNRN EXAM RATIONALES 24 Questions with Verified Answers,100% CORRECT
CNRN EXAM RATIONALES 24 Questions with Verified Answers Chiari malformation - CORRECT ANSWER Malformation of bones of base of skull cause cerebellar ... [Show More] tonsils into foramen magnum. Sometimes syringomyelia. HA, numbness hands feet, impaired motor in hands. Can misdiagnose as MS. spina bifida risk factors - CORRECT ANSWER Maternal obesity, diabetes, folic acid deficiency, hyperthermia in early pregnancy, some meds (Valproic Acid). Female, white/Hispanic. Spina Bifida maternal marker - CORRECT ANSWER Elevated alpha-Fetoprotein. Related to protein albumin. Associated with cancers in adults. Syringomyelia - CORRECT ANSWER Fluid filled cavity or cyst in SC. Spasticity, weakness, pain. Slow progressive accumulation of neurological deficits over many years. Surgery can halt but not reverse deficits. MRI to differentiate between MS. Frontotemporal Dementia symptoms - CORRECT ANSWER Aphasia and personality changes Cholinesterase inhibitors - CORRECT ANSWER Delay worsening symptoms of Alzheimer's. Don't take with Huperzine A. How to instruct patients with alzheimers - CORRECT ANSWER Provide both verbal and nonverbal cues. No written. Stage 3 Alzheimer's can cause - CORRECT ANSWER Seizures Normal pressure hydrocephalus s&s - CORRECT ANSWER Impaired memory, broad-based magnetic gait and incontinence. Enlarged ventricles. A VPS shunt is needed. Dementia with stepwise increase in severity =? - CORRECT ANSWER Multiple silent cerebral infarcts Pseudotumor cerebri greatest risk factor - CORRECT ANSWER Increase in intracranial pressure for no obvious reason. Obesity is greatest risk factor Pseudotumor cerebri complication - CORRECT ANSWER Visual loss bc build up of pressure in optic nerve sheath. Surgical densest ration of sheath may be needed to preserve eyesight. Levodopa crosses BBB for Parkinson's - CORRECT ANSWER Depletion in dopamine is solved. Levodopa can cause psychosis, anorexia, n/V. Role of carbidopa in parkinson's treatment? - CORRECT ANSWER To inhibit the enzyme dopa decarboxylase. Prevents levodopa from being converted to dopamine. Diet for Parkinson's disease - CORRECT ANSWER Will need to be ground coarsely and supervised feeds bc aspiration risk and have a hard time handling secretions. Protein needs to be separated from carbidopa- levodopa! Decreases effectiveness. Before DBS placement for Parkinson's, how do you handle meds? - CORRECT ANSWER Discontinue the night before. To avoid medication induced dyskinesia. GCS Scale: Mild Injury score - CORRECT ANSWER 13-15 GCS Scale: Moderate Injury score - CORRECT ANSWER 9-12 GCS Scale: Severe Brain Injury score - CORRECT ANSWER <8 What Is: Primary TBI - CORRECT ANSWER An insult caused directly by contact to the head and brain at the time of injury What Is: Secondary TBI - CORRECT ANSWER Primary injury induces damaging secondary events including intracranial hemorrhage, cerebral edema, and increased ICP. Fill in blank: "Blunt trauma patients with high ______ or low ______ are more likely to sustain hypoxia and ischemia, which can lead to ____." - CORRECT ANSWER "Blunt trauma patients with high *ICP* or low *BP* are more likely to sustain hypoxia and ischemia, which can lead to *coma*." Secondary TBI injuries generally develop how many hours after injury? - CORRECT ANSWER 4 or more hours. Fill in blank: "Traumatic cerebral injuries are classified as _____, _____, or ______ (depending on mode and extent of damage)." - CORRECT ANSWER "Traumatic cerebral injuries are classified as _____, _____, or ______ (depending on mode and extent of damage)." [Show Less]
- Exam
- $9.45
- 0
- 76
CNRN Terms Exam 277 Questions with Verified Answers,100% CORRECT
CNRN Terms Exam 277 Questions with Verified Answers Post-concussion syndrome - CORRECT ANSWER Short-term memory loss, emotional lability, and mental fat... [Show More] igue. Headache, dizziness, fatigue, irritability, anxiety, insomnia, loss of concentration, poor memory and light and noise sensitivity. Uncal herniation syndrome - CORRECT ANSWER form of herniation that involves downward displacement of the uncal portion of the temporal lobe, which is the most common type of herniation syndrome. Findings are indicative of Cushing's reflex, which are late findings of deterioration and indication of herniation. ipsilateral pupil dilation and contralateral motor deficits. Cushing's reflex - CORRECT ANSWER hypertension, bradycardia, and abnormal respiratory pattern CPP formula - CORRECT ANSWER MAP-ICP = CPP. [(DBP x2) + SBP)]/3 = MAP Normal CPP levels - CORRECT ANSWER 50-70 mmHg cortical visual impairment - CORRECT ANSWER complete or partial visual loss, with normal pupillary responses, and no other ocular abnormalities. Usually caused by hypoxia/ischemia (stroke, cardiac arrest), drugs/toxins (CO poisoning), and trauma (hemorrhage) Bitemporal hemianopsia - CORRECT ANSWER associated with optic chiasm compression (ex pituitary tumor), aka hemianopia, manifests as loss of view to both temporal fields or "tunnel vision." classic epidural hematoma - CORRECT ANSWER characterized by sudden, brief, loss of consciousness (concussion), followed by a lucid interval (resolving concussion). The patient then becomes progressively more confused, agitated, and unresponsive as the hematoma expands and ICP increases Sympathetic storm - CORRECT ANSWER - Stress response elicited by hypothalamic stimulation of the sympathetic nervous system and adrenal glands, causing an increase in the level of circulating corticosteroids and catecholamines. - Symptoms= agitation, increased posturing, hypertension, hyperthermia, tachycardia, tachypnea, and diaphoresis. Simple partial seizures - CORRECT ANSWER With preserved consciousness. Symptoms interfere with sensory and motor. Means only one hemisphere affected, usually small portion Complex partial seizure - CORRECT ANSWER - Begins with behavior arrest, consciousness is impaired. - Followed by staring, automatisms, posturing and postictal confusion. Automatisms - CORRECT ANSWER Lip smacking, chewing, mumbling, fumbling with hands. Involuntary repetitive motor activity Absence seizures - CORRECT ANSWER - Brief impairment of consciousness without unconsciousness, no aura, no postictal confusion. - Staring or blanking out spells. - May exhibit rapid blinking, chewing or aimless movements of head or limbs. - Lasts 2-15 seconds - Occurs more often in children. Generalized tonic-clonic seizures - CORRECT ANSWER - "Grand mal seizures" - entire cerebral cortex is involved - aura present - generalized tonic extension of extremities lasting a few seconds - followed by clonic rhythmic movements with hyperventilation and profuse salivation - prolonged postictal confusion doesn't feel, see, or remember anything during seizure - lasts 1-2 min, sleep for several hrs after. - Valproic acid first choice Generalized myoclonic seizures - CORRECT ANSWER - Generalized jerking of an extremity - Less than 5 seconds - Brief, easy to miss period of unconsciousness - Occurs in clusters Atonic Seizures - CORRECT ANSWER - Known as "drop attack" - Occurs in persons with clinically significant neurologic abnormalities, associated with falls and injuries Left vagus nerve stimulation (VNS) - CORRECT ANSWER - Implanted electrode that reduces seizure frequency in epileptic patients with medically refractory seizures. - It is automatically programmed to fire for 30 seconds every 5 minutes, but can be manually set as a patient needs change. - Alterations are made by a magnet, which is placed over the generator in order to temporarily stop stimulation. - Because of the proximity to the laryngeal nerve, voice changes are a major side effect of vagal nerve stimulation. Turning the VNS off while speaking prevents vocal changes Generalized Convulsive Status Epilepticus (SE) - CORRECT ANSWER - Condition of prolonged or frequent seizures - Incomplete recovery in between seizures, continuous overlapping recovery - Lasts greater than 5 minutes, medical emergency - 10% mortality rate - Benzodiazepines are the initial drug of choice. If the seizure continues, and for ongoing prophylaxis, either phenytoin (Dilantin) or fosphenytoin (Cerebyx) are administered next. Refractory SE - CORRECT ANSWER Seizures occurring >90 min after administration of anticonvulsant medications Nonepileptic event - CORRECT ANSWER - Resembles a seizure, no EEG changes when comparing to audio-video monitoring - Onset is dramatic, bizarre, gradual, in the presence of witness, after an emotional upset, screaming throughout with eyes closed. - Lasts longer than a real seizure Cluster Headache - CORRECT ANSWER - Age of onset= middle age - Gender= males at higher risk - Onset, evolution= rapid - Time course= clusters in time, daily for weeks, nocturnal - Quality= steady and sharp - Location= orbit, temple and cheek - Associated features- Ipsilateral lacrimation, rhinorrhea, Horner's syndrome. Tension headache - CORRECT ANSWER - Chronic lasts at least 15 days a month for at least 16 months - Age of onset= all ages - Gender= females - Onset/evolution= slow to rapid - Time course= episodic, may become constant - Quality= dull, aching - Location= bilateral temporal - Associated features= none Chronic daily headache - CORRECT ANSWER - Occurs >15 days a month or daily for 3 months - Age of onset= middle age, 30-40 years old - Gender= females - Time course= constant to near constant - Quality= variable - Location= variable - Associated features= none Cluster headaches - CORRECT ANSWER - Extremely severe for short duration, high frequency (up to 8 daily) for several months - treatments= prednisone, lithium, methysergide, Ca channel antagonists, valproate. - Acute attacks managed with oxygen, sumatriptan, ergotamin Tension Headaches - CORRECT ANSWER - Most common type of headache. - Mild to moderate bilateral headache - Tight band or pressure around head - Chronic= 15 days per month - Ice, ASA, NSAIDS, best managed with tricyclic antidepressants (amitriptyline, naproxen) - Avoid long-term use of antihistamines, tranquilizers, caffeine, ergot alkaloids. Communicating reabsorptive hydrocephalus - CORRECT ANSWER - CSF is absorbed through arachnoid villi into venous sinuses, decreasing reabsorption of CSF - Subarachnoid hemorrhage, meningitis - Treatment= ventricular drain, lumbar drain, ventriculoperitoneal shunt Non-communicating obstructive hydrocephalus - CORRECT ANSWER - Obstruction of CSF flow - Most common site is Aqueduct of Sylvius (between 3rd & 4th ventricles) - Tumor, edema, mass, infection - Treatment= remove obstruction if applicable. Ventricular drain, lumbar drain, VP shunt Normal Pressure hydrocephalus - CORRECT ANSWER - Symptoms= confusion, ataxia, incontinence. "Wet, whacky, wobbly" - Determine VP shunt placement. 72 hours of drainage with improved gait. Assess for infection 1 month after Pseudotumor Cerebri - CORRECT ANSWER - Known as idiopathic intracranial hypertension - Condition where pressure around brain increases, causing headaches and vision problems - Known as false brain tumor due to symptoms - Increased ICP may result from problems with CSF absorption process. - Treatment= weight loss, limiting fluids or salt, diuretics, spinal tap or shunt placement Neuropathic pain - CORRECT ANSWER - Tingling, shooting, burning, aching, throbbing, sharp - Sensitive to light touch - Neurontin is first line treatment - Tricyclic antidepressants is second-line treatment - Intrathecal/intraventricular opioid and local anesthetics Thalamic pain syndrome - CORRECT ANSWER - stroke of thalamus or parietal lobe. - Ischemic injury causing neurons to misfire, can be any time after stroke and increases in severity over time Peripheral Neuropathy - CORRECT ANSWER - Chronic numbness, pain, tingling - Caused by impact, chemical toxins (HIV), drugs, demyelination - DANG THE RAPIST- Drugs, Alcohol, Nutritional, Guillian-Barre, Traumatic, Hereditary, Endocrine, Renal, Amyloid, Porphyria, Psychiatric, Pseudoneuropathy, Infectious (Hansen's disease), Sarcoidosis, Toxins - Treatment= control diabetes, lidocaine patches, Pregablin, Amitriptyline, PT/OT Trigeminal neuralgia - CORRECT ANSWER - aka tic douloureux, prosopalagia - Sudden, recurrent, severe/intense burning pain, comes and goes. Sensitive to temperature stimuli. - Disruption of 1+ branches of CN V (MRI shows vessel compression) - Unilateral, not responsive to opioids - Occurs for few seconds over weeks, decreases. - Treatment= anticonvulsants (Carbamazepine. Monitor for liver toxicity), microvascular decompression, rhizotomy, nerve block, alcohol injections (relief for 8-16 mo) Alzheimer's - CORRECT ANSWER - Not disease, collection of symptoms. - Onset= 80 years old. - Genetic markers= ApoE e4 - MRI= Neural atrophy - Conclusive dx only done per autopsy (amyloid plaques and neurofibrillary tangles post-mortem) - Aspiration pneumonia is cause of death Alzheimer's Stage I Manifestations - CORRECT ANSWER - Short-term memory loss, loss of spontaneity. - Sporadic loss of words - Easy to anger - Less discrimination with choices Alzheimer's Stage II Manifestations - CORRECT ANSWER - Stage where patient is disoriented, difficulty in making decisions, impaired judgment - Rummaging/pillaging, avoid new situations. - Impaired communication - Loss of impulse control, decreased concentration - Wandering, sundown syndrome, personality changes Alzheimer's Stage III Manifestations - CORRECT ANSWER - Sundowning, catastrophic reactions. - Failure to recognize family an friends - Preservation, latency - Agnosia, apraxia Alzheimer's Stage IV Manifestations - CORRECT ANSWER - Inability to communicate - No recognition of others - Total dependence Alzheimer's treatment - CORRECT ANSWER - Anticholinesterase- promotes cholinergic activity. - Cognitive treatment= Donepezil (Aricept) Ropinirole (Requip), Rivastrigmin (Exelon), Reminyl (Galantamine), Memantine (Namenda)- NDMA-type glutamate receptor antagonist side effects= hallucinations, confusion, dizziness Vascular Dementia - CORRECT ANSWER - Dementia due to series of small lacunar strokes- focal neurological deficits, hemiparesis. - Frontal lobes infarcted, mainly white matter - Risk factors= High BP, high cholesterol, DM, increased age. - Symptoms= decline in executive function, trouble focusing, magnetic gait, pseudobulbar effect Diffuse white-matter dementia - CORRECT ANSWER - Binswanger's disease - Subcortical atherosclerotic encephalopathy - Confusion, apathy, forgetfulness. Behavioral changes, gait disorders, urinary incontinence, difficulty speaking Lewy bodies - CORRECT ANSWER deposits of proteins in nerve cells in area of brain associated with cognitive and motor function Lewy body dementia - CORRECT ANSWER - Second most common type of dementia, > age 60, males - generally retain short-term memories, but forget events in the distant past with a continuous, gradual, progressive decline in mental status. - Amyloid plaques in most cases with minimal neurofibrillary tangles - Symptoms fluctuate frequently, slow progression, dizziness, falls constipation - Visual hallucinations, rapid eye movement, sleep behavior disorder, Parkinsonism (muscle rigidity, tremors, slow movement) - Treat agitation with cholinesterase inhibitors (Rivastigmine, donepezil, galantamine, carbidopa/levodopa) Sundown syndrome - CORRECT ANSWER - Disruption in circadian rhythm - Symptoms are anger depression, anxiety, fear, delusions, emotional outbursts, paranoia. - treatment is benzodiazepines, low potency antipsychotics, hypnotics, managing agitation. Delirium - CORRECT ANSWER - Acute confusional state, fluctuates in level of consciousness. - Symptoms are hyperactive, hypoactive, and mixed. Decline in cognitive function. Prevention is early mobilization. - Antipsychotics haloperidol Parkinson's disease - CORRECT ANSWER - Motor disorder with degenerative loss of basal ganglia. -Decrease in dopaminergic cells in substantia nigra. - decreased thalamic excitation of motor cortex. - Symptoms tremor, rigidity, akinesia/bradykinesia (slow motor movement), posture. Drooling, orthostatic hypotension, sleep disturbance, decreased smell (anosmia) Parkinson's disease treatment - CORRECT ANSWER - Dopaminergics- converts into dopamine, increases dopamine. Levodopa (Sinemet). Side effect is dyskinesia, orthostatic hypotension, hallucinations. - dopamine agonist- improves effect of dopamine by acting directly on the postsynaptic dopamine receptors. Side effects are orthostatic hypotension and hallucinations. Addictive behavior. - COMT inhibitors- Comtan (Entacapone), Tasamer (Tolcapone) - Anticholinergics- Congentin (Benztropin), Artane (Trihexyphenidyl) Deep Brain Stimulation - CORRECT ANSWER - Parkinson's treatment to improve motor symptoms, tremors and rigidity. - Awake throughout procedure. Hold meds prior - Stimulator placed in sub-thalamic nucleus Pallidotomy - CORRECT ANSWER - Surgical removal of globus pallidus internus, regulates function of motor signal pathways for Parkinson's disease - Fewer complications but not adjustable Dystonia - CORRECT ANSWER - Nervous sustem dysfunction of cerebral cortex and basal ganglia involved - Persistant involuntary muscle contractions - Twisting, repetitive movement, abnormal posture affecting any part of body. - Tx: botox injections, anticholinergics, antispasmotics, dopaminergic. DBS or surgical denervation Oromandibular dystonia - CORRECT ANSWER - Jaw & tongue, leads to deformation of mouth Spasmodic dystonia - CORRECT ANSWER larynx affected, causes whispering Oculogyric crisis - CORRECT ANSWER eyes, neck and jaw dystonia causing eyes to look up and converge. Neck flexion, jaw open or clenching Focal dystonia - CORRECT ANSWER segmental dystonia affecting specific muscle groups such as neck, eyes, eyelids and jaw primary dystonia - CORRECT ANSWER idiopathic or genetic Secondary Dystonia - CORRECT ANSWER has attributed cause such as trauma or medication side effect cervical dystonia - CORRECT ANSWER Rotation and flexion of neck. Eyes blink uncontrollably or remain shut causing blindness or blepharospasm Restless leg syndrome - CORRECT ANSWER - Pain and paresthesia in legs while at rest, especially in evening, periodic jerking. - Movement relieves pain causing difficulty sleeping and daytime exhaustion - Genetic and related to iron deficiency anemia - Tx: Requip and Mirapex, carbidopa, tramadol, cyclobenzapine, gabapentin, iron replacement Benign essential tremor - CORRECT ANSWER - Most common tremor in adults - High frequency, oscillatory movements, bilateral - Posture is maintained. - Tx= Primidone, propanolol Degenerative Disc Disease - CORRECT ANSWER - Due to dehydration of intervertebral discs and loss of blood supply, causing deterioration of disc and increased risk of disc herniation & vertebral slippage. - Decreased height and volume of nucleus pulposus from aging and degeneration of annulus fibrosis (outer disc) - Treat with NSAIDs and spinal fusion Spondylolisthesis - CORRECT ANSWER - Anterior shifting of vertebral body from front to back - Usually between L5-S1 or L4-L5. - Causes= hyperthyroidism, osteoporosis, tumors, spinal cord injury - Tx: rest, surgery, back support Spinal stenosis - CORRECT ANSWER - Narrowing of spinal foramina causing pressure on spinal nerves, usually in lumbar region - Pain in back/buttocks, when leaning forward and standing - Develops from intervertebral disc degeration, osteoarthritis, spondylolisthesis - Tx: laminectomy or surgical decompression Lumbar level herniated disc - CORRECT ANSWER - L4-L5, L5-S1, sometimes L3-L4. - Pain on hip, groin, side of thigh and calf, top of foot (first 3 toes), foot drop, difficulty walking on heels - L5-S1= Pain on gluteus back of thigh, calf, lateral outer foot herniated nucleus pulposus (HNP) - CORRECT ANSWER - affects lumbar area, most common on L4-L5, C6-C7 - 50% of herniation due to trauma - Tx: bedrest, injection therapy Peripheral nerve injury - CORRECT ANSWER - Seddon or Sunderland classification. - Neuropraxia: no nerve/connective tissue injury - Axontmesis- nerve damage, connective tissue in tact - Wallerian degeneration- connective tissue allows regeneration of nerves, connective tissue in tact carpal tunnel syndrome (CTS) - CORRECT ANSWER - "Entrapment neuropathy" - Pain in hand, may extend to elbow. Difficulty gasping and pinching - Associated with occupational overuse and repetitive movement syndromes - Tx: Exercises that hyperextend fingers and hand, steroid injections, micro decompression. - Open carpal tunnel release= incision to decompress nerve Thrombotic stroke - CORRECT ANSWER - Large vessel disease (carotid or MCA) - Obstruction due to atherosclerosis Embolic stroke - CORRECT ANSWER - Small vessel disease. - Obstruction due to clot. - Occurs during activity or from atrial fibrillation or patent foramen oval. - MCA will affect arms and present with lower facial droop - ACA stroke will present with leg dysfunction - Cerebellar arteries will present with ataxia, dizziness, nystagmus - Give tPA if within window Lacunar stroke - CORRECT ANSWER - Affects small penetrating vessels, deep arteries (small vessels, large deficits) - Usually found in basal ganglia, thalamus, internal capsule and pons. - Leticulostriate arteries - Vascular dementia - Presents with cognitive decline - Control risk factors (HTN, diabetes, smoking) - Tx: thrombolytic therapy, carotid endarctectomy, aspirin within 48 hrs of onset Penumbra - CORRECT ANSWER - Area outside of ischemic area - Located around irreversible area of infarct - Amendable to reversal from ischemia - Tx: O2, blood pressure and glucose management Wernicke-Korsakoff (W-K) syndrome - CORRECT ANSWER - non-reversible encephalopathy associated with atrophy of specific brain regions. - Consists of two distinct syndromes: Wernicke encephalopathy is characterized by a confusional state that is often reversible, whereas Korsakoff dementia causes chronic memory loss. - Classic findings of syndrome include visual disturbances, gait abnormalities, balance problems, apathy, hallucination, agitation, and confabulation (the spontaneous production of false memories). - It can be prevented by administering thiamine (vitamin B1) prior to 50% dextrose infusion. rt-PA administration - CORRECT ANSWER - Within 3-4.5 hrs from onset of symptoms - perform NIHSS - Negative non-contrast CT scan - Contraindication= anticoagulation within 48 hrs, INR >1.7, platelet count <100,000, recent history of surgery, GI bleed, TBI, spinal surgery - Dose= 0.9 mg/kg, max 90 mg - Admin 10% of dose by bolus over 1 min - remainder of dose via IV pump over 1 hr - Complications= angioedema (2%), ICH (6%) Contraindications of TPA administration - CORRECT ANSWER - Anticoagulation within 48 hrs - INR >1.7, platelet count <100,000 - recent history of surgery - GI bleed - TBI - spinal surgery Large vessel occlusion - CORRECT ANSWER - MCA obstruction (affects upper body, face and arms) - Treat with endovascular thrombectomy and/or intra-arterial thrombolytic (thrombolytic first if possible) - Up to 24 hours from last known well time - Use stent retriever to grab and remove clot Assessment post-thrombolytic administration - CORRECT ANSWER - Monitor for 24 hours - Every 15 min for 2 hrs - Every 30 min for 6 hrs - Every hour for 16 hours Stroke blood pressure management - CORRECT ANSWER - Ischemic stroke NON-thrombolytic candidates: <220/120 - Ischemic stroke thrombolytic therapy candidates: <185/110 - Ischemic stroke post-thrombolytic : <180/105 - Treat with labetalol then Nicardipine Intracerebral hemorrhage (ICH) - CORRECT ANSWER - Common cause= hypertension, coagulopathies - Symptoms= HA, decreased LOC, HTN, vomiting, seizures - Location= Basal ganglia (most common), thalamus, lobarm pons, cerebellum - Rupture of cerebral artery with accumulation of blood in parenchyma - Steady worsening of initial symptoms as blood accumulates. - Increase in ICH volume up to 12 hrs post-bleed - Vasogenic edema occurs hours to days, shift/herniation may occur - Poor prognosis with intraventricular extension - Tx: treat underlying cause, VTE once bleeding stops. ICH nursing care - CORRECT ANSWER - Airway and breathing - SBP <160 mmHg - Use prothrombin complex concentrate (PCC) for INR reversal - Fever management first 72 hrs - Glucose management [Show Less]
- Exam
- $12.45
- 0
- 89
Certified Neuroscience Nurse Review 54 Questions with Verified Answers,100% CORRECT
Certified Neuroscience Nurse Review 54 Questions with Verified Answers Key characteristics of the frontal lobe? - CORRECT ANSWER -Emotions & Personali... [Show More] ty *-Motor Function, Broca's area (language production* -Social and Sexual behaviors (initiation, judgement, impulse control, problem solving) -Memory What type of aphasia does damage to the broca's area cause? - CORRECT ANSWER *Expressive Aphasia* Damage to the broca causes the inability to perform the motor aspects of speech Key characteristics of the temporal lobe? - CORRECT ANSWER -Auditory ability -Long term memory -Wernicke's Area Damage to what lobe (and laterality of the lobe) will cause Wernicke's aphasia? - CORRECT ANSWER Temporal Lobe (Left in 90% of the population) What is Wernicke's aphasia? - CORRECT ANSWER Receptive aphasia due to damage to the temporal lobe (primarily left). Interprets the meaning of spoken/written word (processing issue) How does broca's aphasia present? - CORRECT ANSWER Patient can understand you but cannot form words. They follow verbal commands and appropriate execute requests, but they cannot verbally construct their words. How does wernicke's aphasia present? - CORRECT ANSWER The patient CAN form normal words, but when they do it is incoherent and inappropriate. They do not follow verbal commands but may follow if the command is demonstrated. The reason for this is because they cannot process language. Key characteristics of the parietal lobe? - CORRECT ANSWER -Visual-Spatial information/orientation -Sensory interpretation -Voluntary movements (goal directed) -Object manipulation Definition of dysphonia? - CORRECT ANSWER -Inability to speak secondary to laryngeal damage/paralysis (laryngeal inflammation, thickening of the vocal cords, or nerve paralysis) Definition of dysarthria? - CORRECT ANSWER -Inability to articulate words (slurred speech) Definition of aphasia? - CORRECT ANSWER -When damage to the language centers of the brain occur BUT the motor speech muscles (on face) are intact What is global aphasia? - CORRECT ANSWER When there is damage to the expressive (broca) and receptive (wernicke) areas of the brain Key characteristics of the occipital lobe? - CORRECT ANSWER -Primary Visual Cortex (visual input processing) -Secondary Visual Cortex (interprets meaning of written word) -Optic tract end point Where is the primary visual cortex? What does it do? - CORRECT ANSWER The Occipital lobe It processes primary visual input such as objects, colors, etc Where is the secondary visual cortex? What does it do? - CORRECT ANSWER The Occipital lobe It interprets the meaning of written words Key characteristics of the cerebellum? - CORRECT ANSWER -Coordination of voluntary movements -Balance and equilibrium Key characteristics of the brainstem? - CORRECT ANSWER *BASICS OF LIFE* -Breathing -Heart rate -Autonomic nervous system Components of the brain stem? (3) - CORRECT ANSWER Midbrain, Pons, Medulla Oblongata Key functions of the midbrain? - CORRECT ANSWER -CN-III & CN-IV function -Eye/trunk movement in response to visual input (reaction time) Key function of the Pons? - CORRECT ANSWER -CN-V through CN-VIII Function -Awakening & Respiratory center Key functions of the medulla oblongata? - CORRECT ANSWER -CN-IX through CN-XII functions -Autonomic functions -Relays information between somatic system and brain What is the definition of brain death? - CORRECT ANSWER Loss of all brain and brainstem function *spinal reflexes may stay intact* What is the gold standard for determining brain death? - CORRECT ANSWER Cerebral flood flow exam What are the common brain death testing tests? - CORRECT ANSWER -Cerebral Blood Flow -Doll's eyes -Cold caloric testing -Apnea Test What is the occulocephalic reflex? - CORRECT ANSWER -"dolls eyes" reflex -Open eye lids and turn head from side to side. The normal response is that the eyes fixate and do not move with head. ABNORMAL = Eyes follow the direction of the head What is the corpus callosum? - CORRECT ANSWER The single pathway of nerves that connect hte left and right hemispheres of the brain. It is a thick band of nervous fibers that facilitates the communication and transfers motor, sensory, and cognitive information What is the Basal Ganglia? - CORRECT ANSWER -It is the link between the thalamus and motor cortex -It coordinates muscle contractions related to posture and is part of the extrapyramidal system that regulates autonomic movement and suppressing unwanted movements. Where is the extrapyramidal system located? - CORRECT ANSWER The basal ganglia Functions of the limbic system? - CORRECT ANSWER -Primitive behaviors (sex, rage, fear, biological rhythms) -Emotional control -Filters extraneous stimuli Structures inside of the diencephalon? (3) - CORRECT ANSWER Thalamus, Hypothalamus, Pituitary Gland Key function of the thalamus? - CORRECT ANSWER Relay center for major nerve tracts Key functions of the hypothalamus? - CORRECT ANSWER -Eating/Hunger -Hormone regulation Key functions of the pituitary gland? - CORRECT ANSWER -Hormonal regulation Components of the GCS? - CORRECT ANSWER -Eye Opening _Verbal Response -Motor Response Eye Opening Response GCS? - CORRECT ANSWER 4) Spontaneous 3) To voice 2) To pain 1) None Verbal Response GCS? - CORRECT ANSWER 5) Alert and oriented 4) Confused 3) Incomprehensible words 2) Incomprehensible sounds (no words) 1) None Motor Response GCS? - CORRECT ANSWER 6) Normal 5) Location to pain 4) Withdraws to pain 3) Decorticate posturing (to core) 2) Decerebrate posturing (extension) What is the most sensitive indicator of change in neurological status in an baseline intact patient? - CORRECT ANSWER Level of consciousness What are some causes of pinpoint pupils? - CORRECT ANSWER -Narcotics -Pon issues Cranial Nerve 1 - CORRECT ANSWER Olfactory (sensory) -Sense of smell Test by having patient smell distinctive smells Cranial Nerve 2 - CORRECT ANSWER Optic (sensory) -Controls central and peripheral -Test by having patient read Cranial Nerve 3 - CORRECT ANSWER Oculomotor (motor) -Pupillary response -Test via cardinal fields (upwards) Cranial Nerve 4 - CORRECT ANSWER Trochlear (motor) -Moves eyes towards tip of nose -Test via cardinal fields (nose) Cranial Nerve 5 - CORRECT ANSWER Trigeminal (both) +Three Deviations of Nerve+ -V1; Ophthalmic -V2; Maxillary -V3; Mandibular -Test by having patient chew (mastication) AND facial sensation on forehead, maxilla, and mandible Cranial Nerve 6 - CORRECT ANSWER Abducens (motor) -Innervates the lateral rectus (Lateral movement of eyes) -Test by having patient move their eyes from ear to ear (Horizontal field of gaze) Cranial Nerve 7 - CORRECT ANSWER Facial Nerve (both) -Motor to facial muscles for expression -Sensory of anterior 2/3rds of tongue -Test by having patient wrinkle forehead, raise eyebrows, close eyes tightly shut, show teeth, and puff out cheeks Cranial Nerve 8 - CORRECT ANSWER Vestibulocochlear (sensory) -Sensory for hearing. -Test by rubbing fingers together by patients ear Cranial Nerve 9 - CORRECT ANSWER Glossopharyngeal (both) -Sensory to the posterior 2/3rds of the tongue, larynx an pharynx to mediate the *gag reflex* -Motor to uvula -Test by having patient say "ahh" while watching for uvula rise. Cranial Nerve 10 - CORRECT ANSWER Vagus (both) -Branches from the vagus innervate organs and structures throughout the body and have both motor and sensory functions (vagal down) -Test by having patient cough Cranial Nerve 11 - CORRECT ANSWER Spinal "Accessory" Nerve (motor) -Motor movement of the neck and shoulders -Test by having patient shrug their shoulders and turn their head from side to side Cranial Nerve 12 - CORRECT ANSWER Hypoglossal Nerve (motor) -Movement of the tongue -Test by having patient stick out their tongue -Left dysfunction will cause left deviation -Right dysfunction will cause right deviation Definition of antalgic? - CORRECT ANSWER A gait movement characterized by side-to-side jerkiness with decreased hip rotation and pain while walking -Primary cause is arthritis of the hip joint Definition of hemiparetic? - CORRECT ANSWER A gait movement characterized by the paralysis of one side of the body and is characterized by dragging of the paralyzed leg and flexion of the elbow and wrist Definition of ataxia? - CORRECT ANSWER Imbalanced movement that is most commonly seen with alcoholic intoxication [Show Less]
- Exam
- $10.95
- 0
- 98
CNRN Week 1 Neurological Anatomy, Physiology, & Assessment Review Questions with Answers,GRADED A
CNRN Week 1 Neurological Anatomy, Physiology, & Assessment Review Questions with Answers How many cranial bones are there? Name them - CORRECT ANSWER 8 ... [Show More] Cranial Bones Frontal, Parietal x2, Temporal x2, Occipital, Sphenoid, Ethmoid What are the thickest cranial bones? - CORRECT ANSWER Frontal and Occipital What is the Monroe-Kellie Hypothesis? - CORRECT ANSWER - The skull is a fixed box - Made of 3 components - Brain (80%) - CSF (10%) - Blood (10%) - It maintained homeostasis - Meaning that an increase in one needs to decrease one or two of the other. What are the 3 components of the meninges? - CORRECT ANSWER Dura mater Arachnoid mater Pia mater Dura Mater - CORRECT ANSWER - Thickest - Outer layer lining skull - Non elastic - Under the bone - Vascular Arachnoid Mater - CORRECT ANSWER - Middle layer - Subarachnoid space - Consist of blood vessels and CSF - Arachnoid villi - reabsorb CSF - None vascular Pia Mater - CORRECT ANSWER - Innermost layer - Adheres to the brain - Choroid plexus - produces CSF - Vascular - Thicker in spine Cerebral Spinal Fluid (CSF) - CORRECT ANSWER - Functions as a cushion - Produced by choroid plexus - Absorbed by arachnoid villi and dumped back into circulation via venous sinuses How much CSF is produced daily? And where is it produced? - CORRECT ANSWER 500 mL produced Produced by the choroid plexus What is the CSF flow pathway? - CORRECT ANSWER - Foramen of monro - 3rd ventricle - Cerebral Aqueduct - 4th ventricle - Out through subarachnoid space - Down into spinal arachnoid space Gray Matter - CORRECT ANSWER Cell bodies Unmyelinated Where synapsis occur Thinking area of the brain - Cognition, memory, through and personality 95% of oxygen in the brain goes through here Alcoholics and smokers have decrease in this type of matter due to atrophy White Matter - CORRECT ANSWER Neurons Myelinated Network of fibers that enable the gray matter of the brain to communicate with each other Corpus Collosum - CORRECT ANSWER Relays information between the right and left hemispheres Only connection point Thick band of nerve fibers Primary function is to integrate motor, sensory, and cognition from on side to the other. Allows for seizures to travel from one side of the brain to the other Frontal Lobe - CORRECT ANSWER - Characteristics: - Personality - Judgement - Inhibition - Short-term memory - Allows us to have socially acceptable behavior (when injured, people stop having filters) - Broca's area of speech - Dominant side - Expressive aphasia - Motor aspect of speech - End with motor strip - Cerebral perfusion - MCA (middle cerebral arteries) & ACA (Anterior cerebral arteries) - Boss of the brain Where does motor homunculus come from? - CORRECT ANSWER Frontal Lobe Where does sensory homunculus come from? - CORRECT ANSWER Thalamus Parietal Lobe - CORRECT ANSWER - Characteristics: - Proprioception (sensing body's position) - Spatial perception - Sensory interpretation - Begins with sensory strip - Cerebral perfusion - MCA: medial and lateral portions - ACA: superior portions Temporal Lobe - CORRECT ANSWER - Characteristics: - Long-term memory - Hearing, interprets sound (L side is dominant for most people) - Wenicke's area (Receptive aphasia and speech comprehension) - Cerebral perfusion - MCA: Superior to medial portion - PCA: Inferior and posterior portion - People with insult in this are should be on anti epileptic and slowly wean off. Which lobe deals with short term memory and which one deals with long term memory? - CORRECT ANSWER - Frontal Lobe - Short term - Temporal Lobe - Long term Name which arteries provide perfusions for each lobe - CORRECT ANSWER - Frontal Lobe - MCA (middle cerebral arteries) & ACA (Anterior cerebral arteries) - Parietal Lobe - MCA (medial and lateral portions) & ACA (superior portions) - Temporal Lobe - MCA (superior to medial portion) & PCA (posterior cerebral artery)(Inferior and posterior portion) - Occipital Lobe - PCA - Cerebellum - PICA (posterior inferior cerebellar artery), AICA (anterior inferior cerebellar artery), SCA (superior cerebellar artery) Occipital Lobe - CORRECT ANSWER - Characteristics: - Visual processing - Convergent end points of optic tracts - Homonymous Hemianopia - Happens when occipital lobe damage from tumor or stroke - Cerebral perfusion - PCA Cerebellum - CORRECT ANSWER - Characteristics: - Motor coordination, ataxia - Balance - Lies in posterior fossa - 10% of brain mass - Contains 50% of neurons - Cerebral perfusion - PICA (posterior inferior cerebellar artery), AICA (anterior inferior cerebellar artery), SCA (superior cerebellar artery) - Receives information from sensory and motor cortex - Injury needs to be monitor for 72-96 hours Which lobe of the brain is Wernicke's area located? a) Frontal b) Parietal c) Temporal d) Occipital - CORRECT ANSWER c) Temporal lobe What is the basal ganglia? - CORRECT ANSWER - Deep, subcortical tissue - Coordinates detailed movements - Suppression of unwanted movements - i.e. tremor, Parkinson's - Has both input and output nerves - Neuro transmitters present - Substantia nigra (dopamine site) - Perfused by the lenticulostriate arteries off the MCA - Collection of subcortical nuclei, cluster of nerve cells the contain gray and white matter - Found on both side of the thalamus, deep within the brain tissue. Thalamus - CORRECT ANSWER - Relays sensation, spatial sense (including pain), and motor signals - Regulates consciousness, sleep, and alertness - Surrounds third ventricle - PCA stroke which perfuses the thalamus the pt might be very sleepy, especially if bilateral Hypothalamus - CORRECT ANSWER Controls: - Body temperature - Hunger - Thirst - Fatigue - Sleep - Circadian cycles - Autonomic nervous system Pituitary Gland - CORRECT ANSWER - "Master Gland" - Houses and secretes hormones - Regulates growth and metabolism - Abnormalities come from noncancerous tumor which causes to overproduce or underproduces What of the 3 components of the Diencephalon? - CORRECT ANSWER 1) Thalamus 2) Hypothalamus 3) Pituitary Gland Name the Pituitary Hormones and where they are produced - CORRECT ANSWER Includes: - Thyroid Stimulating Hormone (TSH) - Thyroid gland - Luteinizing hormone/Follicle stimulating hormone (LH/FSH) - Testis & Ovary - Antidiuretic hormone (ADH) - Kidney tubules - ACTH (Adrenocorticotropic hormone) - Adrenal cortex - GH (Growth Hormone) - Bone - PRL (Prolactin) - Mammary Glands - Oxytocin - Muscles of uterus Internal capsule - CORRECT ANSWER - It provides rapid transmission of information - High concentration of sensory and motor fiber Limbic System - CORRECT ANSWER - Primitive behaviors - Filter for concentration - Amygdala and hippocampus What are the 3 components of the brainstem? - CORRECT ANSWER 1) Midbrain 2) Pons 3) Medulla What is the function of the brainstem? - CORRECT ANSWER - Regulates pulse, BP, breathing - Connects cerebrum with spinal cord - Cerebral perfusion - Vessels from the basilar artery - Routes motor and sensory input coordinating them to get send to the body Midbrain - CORRECT ANSWER Movements coordinated with visual input CN III and IV Pons - CORRECT ANSWER Arousal Respiratory centers CN V - VIII Medulla - CORRECT ANSWER Autonomic function, vasomotor Relay between brain and spinal cord CN IX - XII How is the brainstem used to determined brain death? - CORRECT ANSWER When a person loses function on these (midbrain, pons, or medulla) that person loses permanent ability for consciousness and capacity to breath Cerebral circulation - CORRECT ANSWER Brain uses 20% of the circulating volume Uses glucose and oxygen for metabolism but there's no reserves for either Cell death occurs within minutes when deprived of glucose and oxygen It has the highest demand of oxygen anywhere in the body How much of the circulating blood volume does the brain use at a time? - CORRECT ANSWER 20% Name the arteries that form the Circle of Willis and which supply the back of the brain and which supply the front of the brain? - CORRECT ANSWER Back of the brain: - Vertebral Artery (VA) - Basilary Artery (BA) Front of the brain: - Internal Carotid Arteries (ICA) - Anterior Cerebral Artery (ACA) - Anterior Communicating Artery (ACOM) - Middle Cerebral Artery (MCA) - Posterior Cerebral Artery (PCA) - Posterior Communicating Artery (PCOM) Circle of Willis - CORRECT ANSWER Collateral circulation Connection of blood vessels that helps preserve cerebral blood flow Anterior Cerebral Circulation - CORRECT ANSWER 80% of CBF (Cerebral blood flow) Internal Carotid Arteries (ICA) - CORRECT ANSWER Includes: - Middle cerebral artery (MCA) - Anterior cerebral artery (ACA) - Anterior communicating artery (ACOM) connects both hemispheres providing collateral blood flow Middle Cerebral Artery (MCA) - CORRECT ANSWER - Includes largest branch off of ICA - Areas supplied: - Majority of the frontal lobe - Anterior portion parietal lobe - Majority of temporal lobe - Lenticulostriate arteries - Perfuses the basal ganglia - Site for hypertensive hemorrhages Anterior Cerebral Artery (ACA) - CORRECT ANSWER - Areas supplied - Frontal lobe: superior aspect - Portion of motor strip that controls lower extremities Anterior Communicating Artery (ACOM) - CORRECT ANSWER Bilateral ACAs connected by ACOM Posterior Cerebral Circulation - CORRECT ANSWER 20% of cerebral blood flow Vertebrobasilar system - VAs pass through the base of the skull and converge to form the basilar at the level of the pons Basilar artery branches to form PCAs connecting ICA via the PCOM Basilar Artery - CORRECT ANSWER Essential to perfuse the posterior portion of the brain Areas supplied: - Portions of cerebellum AICA, SCA - Brainstem; pontine perforators Posterior Cerebral Artery - CORRECT ANSWER - Areas supplied: - Occipital lobes - Temporal lobes: inferior, lateral portions - Thalamus, midbrain, visual cortex - Posterior Communicating Artery - Connects posterior to anterior circulating via ICA While having her morning coffee, a 63-year-old female drops the cup from her right hand and has difficulty communicating with her husband. What cerebral blood vessel is most likely affected? a) Right ACA b) Left ACA c) Right MCA d) Left MCA - CORRECT ANSWER d) Left MCA Cerebral Venous Sinuses - CORRECT ANSWER Form the major venous drainage pathways for the brain - Lies within the dura; valveless Function - Receive blood from brain through cerebral veins and CSF from the SA space and empty into the jugular veins to reenter systemic circulation Olfactory nerve - CORRECT ANSWER CN I Sense of smell Optic nerve - CORRECT ANSWER CN II Sense of sight Central and peripheral vision Carries information from retina to the brain Oculomotor nerve - CORRECT ANSWER CN III Pupillary reaction (CN II, III) Trochlear (Superior Oblique) Nerve - CORRECT ANSWER CN IV Downward and outward (adduction) eye movement Eye movement toward nose SO4 Trigeminal nerve - CORRECT ANSWER CN V VI, V2, V3 Facial sensation Sensory and motor components Abducens (Lateral rectus) nerve - CORRECT ANSWER CN VI Abduction of the eye Eye movement towards ears LR6 Facial nerve - CORRECT ANSWER CN VII Facial movement Mouth, facial, forehead Fxn of salivary gland Vestibulocochlear nerve - CORRECT ANSWER CN VIII Sense of hearing and balance Glossopharyngeal - CORRECT ANSWER CN IX Controls uvula and pharynx Taste Vagus - CORRECT ANSWER CN X Cough, bear-down reflexes Spinal accessory nerve - CORRECT ANSWER CN XI Sternocleidomastoid muscle Neck, shoulder movement Hypoglossal nerve - CORRECT ANSWER CN XII Tongue Movement Which CN affect swallowing? - CORRECT ANSWER CN IX, X, and XII While performing a neurological assessment, the nurse notes the presence of homonymous hemianopia. What vessel perfuses the occipital lobe? 1) PCA 2) ACA 3) MCA 4) ICA - CORRECT ANSWER PCA How do you identify a pronator drift and what does a positive test mean? - CORRECT ANSWER - Arms out in front of body, palms up, and eyes closed - Drift present (+ test) - subtle sign of upper motor neuron weakness What are the 4 main dermatomes? - CORRECT ANSWER C2, C3 - Posterior head and neck T4 - Nipple T10 - Umbilicus What are the upper extremity dermatomes? - CORRECT ANSWER C6 - Thumb C7 - Middle finger C8 - Little finger T1 - Inner forearm T2 - Upper inner forearm What are the lower extremity dermatomes? - CORRECT ANSWER L3 - Knee L4 - Medial malleolus L5 - Dorsum of foot L5 - Toes 1-3 SI - Toes 4 and 5; lateral malleolus What is clonus? - CORRECT ANSWER Involuntary contractions and relaxations Associate with upper motor neuron lesions Decorticate posturing - CORRECT ANSWER Flexion Decerebrate posturing - CORRECT ANSWER Extension [Show Less]
- Exam
- $11.95
- 0
- 107
CNRN-Tumors Exam 21 Questions with Verified Answers,100% CORRECT
CNRN-Tumors Exam 21 Questions with Verified Answers Astrocytoma - CORRECT ANSWER Star-shaped glioma derived from astrocytes (maintain health of nerve ... [Show More] cells). Astrocytomas are frequently found in the cerebrum, cerebellum, hypothalamus, optic nerve, pons and also the spinal cord. Several types: Brain stem gliomas - rare, in adults and hard to cure Pineal Astrocytic tumors - form around the Pineal Gland Pilocystic astrocytomas - Mostly in children and young adults (and those with neurofibromatosis) Diffuse astrocytomas - mostly in young adults (especially with those Li-Fraumeni syndrome) Anaplastic astrocytomas and glioblastomas - Most common in adults. Mixed gliomas are composed of two types of tumor cells (astrocytes and oligodendrocytes) Low grade astrocytomas tend to occur more often in children. Chordoma - CORRECT ANSWER Tumor derived from embryonic notochord cells. Rare; usually found at the base of the spine; invade both bone and soft tissues, causing pain. Dermoid - CORRECT ANSWER Teratoma; Benign Cyst; Most occur in young adults, found in sacrococcygeal area, associated with spina bifida. Ependymoma - CORRECT ANSWER Primary glioma derived ependymal cells that line the ventricles. Typically found in the cerebrum, but can also spread to the spine via the CSF; occur in children and young adults; Often occur in the fourth ventricle and lead to obstructive hydrocephalus. Spinal ependymomas occur more often in men. Glioma - CORRECT ANSWER Tumor derived from the glial tissue. Glia include astrocytes, oligodendrocytes and ependymal cells. Gliomas are the most common type of primary brain tumor. Spinal gliomas are usually cervical. Meningioma - CORRECT ANSWER Tumor that arises from the meninges; spinal meningiomas occur more often in women. They originate in the arachnoid layer and are often attached to the dura. Most are slow-growing and benign and do not elicit any symptoms. They do however, compress brain and spinal cord tissue and may block the flow of CSF and/or erode into bone. With faster-growing, malignant meningiomas, symptoms are pronounced. Brain meningiomas tend to be located between the cerebral hemispheres or uner the top of the skull, whereas spinal meningiomas are found along the spinal column. Neurofibroma - CORRECT ANSWER Heterogenous tumor derived from Schwann cells surrounding peripheral nerves; cannot be resected without damage to the underlying nerve; infiltrates surrounding tissues; genetic origin; in the spine most are located above L1. Neurofibromatosis Type I - CORRECT ANSWER Genetic disorder in which neurofibromas develop on peripheral nerves and also in the skin. Also called Von Recklinghausen's Disease; genetic disorder associated with a mutation on chromosome 17. Skin hyperpigmentation, brwon or tan patches, may be apparent at birth or develop within a few years. Tumors associated with problems occur in childhood and are found in the iris of the eye or along the optic nerve and are associated with visual disturbances. Neurofibromas in the periphery affect bone, casuing disfigurement, including scoliosis. Many of these children also have learning disabilities. Neurofibromas tend to be resistant to radiation. Neurofibromatosis Type II - CORRECT ANSWER Genetic disorder in which a schwannoma develops on the acoustic (vestibulocochlear) nerve. Also called an acoustic neuroma; auditory and vestibular symptoms arise such as hearing loss, tinnitus and vertigo. If the tumor spreads beyond the auditory area, function of the facial, trigeminal, glossopharyngeal and vagus nerves may also be affected. Prognosis is generally good, however hearing and facial sensation may be permanently affected. Oligodendroglioma - CORRECT ANSWER Glioma derived from oligodendrocytes. Found in the cerebrum; tumors are often calcified; seizure is often the first symptom. Sarcoma - CORRECT ANSWER Tumor derived from the connective tissue or bone; typically extradural. Embryonic Brain Tumor - CORRECT ANSWER Consists of rapidly growing cells in masses, originating in the embryonic or fetal tissue of the brain and spinal cord during fetal development. Most are malignant; however some may be benign. Meningeal Brain Tumor - CORRECT ANSWER These tumors form in the thin tissue layers covering the brain and spinal cord. They are most common in adults and include three grades of tumors: 1) Grade I Tumors - Most common, prevalent in women; benign and slow-growing; typically form in the dura mater covering the brain near the skull. 2) Grade II and III Tumors - Prevalent in men and include rare, malignant, fast-growing tumors that spread within the brain and spinal cord. Capillary Hemangioblastoma - CORRECT ANSWER Classified as WHO grade I and associated with von Hippel-Lindau (VHL) disease, which is a familial tumor syndrome. Occurs sporadically, typically in adults at an average of 29 years. May develope in various sites of the central nervous system such as the cerebellum, the brain stem and the spinal cord. Median life expectancy of a patient with VHL disease is 49 years; the capillary hemangioblastoma is the most likely cause of death. Pineal Parenchymal Brain Tumor - CORRECT ANSWER Tumor originating in the pineocytes or parenchymal cells and classified into three types: 1) Pineocytomas - WHO Grade II; slow-growing with variable prognosis, occuring primarily in young adults 2) Pineoblastomas - WHO Grade IV; rare, primative embyonal tumors that are highly malignant, rapid-growing and more likely to spread, often with a grim prognosis compared to pineocytomas; occuring primarily in children 3) Pineal tumors of intermiediate differentiation, which are considered diverse, monomorphous tumors that are difficult to assign a prognosis becuase of their unpredictable clinical behavior and growth; they occur in all age groups. Lymphoma - CORRECT ANSWER Arise from lymphatic cells, occuring at nodes, but also in other areas of lymph distribution or the brain. More common in immunocompromised patients such as organ transplant recipients and AIDS patients. Usually malignant, often recur after treatment and do occur in children. Hemangioblastoma - CORRECT ANSWER Derived from capillary endothelial cells and typically occur in the cerebellum. They occur sporadically or as part of von Hippel-Lindau disease, which is an inherited syndrome in which tumors develop in several other tissues including the kidneys and adrenal glands. Pituitary Tumors - CORRECT ANSWER Tumors of this origin may secrete hormones, and tend to do so excessively. Non-secretory tumors cause symptoms due to compression of adjacent nerves, most notibly the optic nerve, causing visual disturbances (scotoma, optic atrophy, paresis of extraocular muscles). Most common secretion is prolactin, which can cause infertility and amenorrhea. Growth hormone oversecretion can giantism or acromegaly. Prolactin, groth hormone and cortisol levels are tested in the diagnosis of pituitary hormone. Brain and Spinal Cord Metasteses - CORRECT ANSWER Metastatic brain tumors originate away from the cells of the brain; usually composed of cells that escaped from lung tumors, or sometimes breast, GI or skin tumors. Most brain tumors do not metastesize elsewhere in the body, but medulloblastomas may migrate to the spinal cord. Spinal Cord tumors may come from the lungs, breast, prostate, colon, kidneys or uterus. The location of the primary organ tends to determine the location of the spinal metastesis because invasion occurs through adjacent vertebrae (the thoracic area is most commonly involved). Craniopharyngioma - CORRECT ANSWER Congenital tumor arising from Rathke's puch of the pituitary. It occurs predominantly in children , but is sometimes viewed in adults. Like other pituitary tumors, it affects endocrine function and may compromise the optic nerve. Often impinges the third ventricle, which may hinder CSF flow and lead to increased ICP. Spinal Cord Tumors - CORRECT ANSWER May be Extramedullary or Intramedullary Extramedullary Tumors - situated outside of the spinal cord; may be extradural or intradural; Most extradural-extramedullary primary tumors are chordomas or sarcomas. Intradural-extramedullary primary tumors include meningiomas and neurofibromas. This category comprises the highest percentage of spinal cord tumors and they can be treated by surgical incision alone. [Show Less]
- Exam
- $9.45
- 0
- 123
CNRN Week 2 Medicines for Epilepsy Exam 29 Questions with Verified Answers,100%CORRECT
CNRN Week 2 Medicines for Epilepsy Exam 29 Questions with Verified Answers Ativan -CORRECT ANSWER Generic Name: Lozarepam Average adult daily dose:... [Show More] 1mg-10mg SE: Drowsiness, sleepiness, fatigue, poor coordination, unsteadiness, behavior changes Banzel -CORRECT ANSWER Generic Name: Rufinamide Average adult daily dose: 3200mg SE: Drowsiness, vomiting, headache, fatigue, loss of appetite, dizziness Carbatrol -CORRECT ANSWER Generic Name: Extended released carbamazepine Average adult daily dose: 600mg-1200mg SE: Dizziness, drowsiness, blurred or double vision, nausea, skin rashes, abdominal blood counts (rare) Depakene -CORRECT ANSWER Generic Name: Valproate Average adult daily dose: 1750mg-3000mg SE: Upset stomach, altered bleeding time, liver toxicity, hair loss, weight gain, tremor Depakote -CORRECT ANSWER Generic Name: Divalproex sodium Average adult daily dose: 1750mg-3000mg SE: Upset stomach, altered bleeding time, liver toxicity, hair loss, weight gain, tremor Depakote ER -CORRECT ANSWER Generic Name: Extended release divalproex sodium Average adult daily dose: 2000mg-3500mg SE: Upset stomach, altered bleeding time, liver toxicity, hair loss, weight gain, tremor Diamox Sequels -CORRECT ANSWER Generic Name: Extended release acetazolamide Average adult daily dose: 250mg-1000mg SE: Appetite loss, frequent urination, drowsiness, confusion, numbness of extremities, kidney stones Dilantin -CORRECT ANSWER Generic Name: Phenytoin Average adult daily dose: 200mg-400mg SE: Clumsiness, insomnia, motor twitching nausea, rash, gum overgrowth, hairiness, thickening of features Felbatol -CORRECT ANSWER Generic Name: Felbamate Average adult daily dose: 1200mg-3600mg SE: Anorexia, vomiting, insomnia, nausea, headache, liver and blood toxicity Gabitril -CORRECT ANSWER Generic Name: Tiagabine Average adult daily dose: 36mg-56mg SE: Tremor, dizziness, nervousness, difficulty concentrating, sleepiness, weakness Keppra -CORRECT ANSWER Generic Name: Levetiracetam Average adult daily dose: 1000mg-3000mg SE: Sleepiness, fatigue, poor coordination, loss of strength, dizziness Keppra XR -CORRECT ANSWER Generic Name: Extended release levetiracetam Average adult daily dose: 1000mg-3000mg SE: Sleepiness, fatigue, poor coordination, loss of strength, dizziness Klonopin -CORRECT ANSWER Generic Name: Clonazepam Average adult daily dose: 1.5mg-20mg SE: Drowsiness, sleepiness, fatigue, poor coordination, unsteadiness, behavior changes Lamictal -CORRECT ANSWER Generic Name: Lamotrigine Average adult daily dose: 100mg-500mg SE: Dizziness, headache, blurred vision, clumsiness, sleepiness, nausea, skin rash Lyrica -CORRECT ANSWER Generic Name: Pregabalin Average adult daily dose: 150mg-600mg SE: Dizziness, blurred vision, weight gain, sleepiness, difficulty concentrating, swelling of hands and feet, dry mouth Mysoline -CORRECT ANSWER Generic Name: Primidone Average adult daily dose: 250mg-1000mg SE: Clumsiness, dizziness, appetite loss, fatigue, drowsiness, hyper irritability, insomnia, depression, hyperactivity (children) Neurotin -CORRECT ANSWER Generic Name: Gabapentin Average adult daily dose: 900mg-3600mg SE: Sleepiness, dizziness, clumsiness, fatigue, twitching Phenobarbital -CORRECT ANSWER Generic Name: Phenobarbital Average adult daily dose: 15mg-100mg SE: Drowsiness, irritability, hyperactivity (children), behavioral problems, difficulty concentrating, depression Phenytek -CORRECT ANSWER Generic Name: Extended phenytoin sodium Average adult daily dose: 200mg-400mg SE: Clumsiness, insomnia, motor twitching, nausea, rash, gum overgrowth, hairiness, thickening of features Sabril -CORRECT ANSWER Generic Name: Vigabatrin Average adult daily dose: 2000mg-4000mg (adults) 50-150mg/kg/day (children with infantile spasms) SE: Permanent vision loss, abnormal MRIs, anemia, sleepiness, fatigue, numbness of extremities, weight gain, swelling, hyperactivity Tegretol -CORRECT ANSWER Generic Name: Carbamazepine Average adult daily dose: 600mg-1200mg SE: Dizziness, drowsiness, blurred or double vision, nausea, skin rashes, abnormal blood counts (rare) Tegretol XR -CORRECT ANSWER Generic Name: Extended released carbamazepine Average adult daily dose: 600mg-1200mg SE: Dizziness, drowsiness, blurred or double vision, nausea, skin rashes, abnormal blood counts (rare) Topamax -CORRECT ANSWER Generic Name: Topiramate Average adult daily dose: 200mg-400mg SE: Confusion, sleepiness, dizziness, clumsiness, difficulty thinking or talking, tingling sensation of the skin, nausea, decreased appetite Tranxene -CORRECT ANSWER Generic Name: Clorazepate Average adult daily dose: 15mg-45mg SE: Drowsiness, sleepiness, fatigue, poor coordination, unsteadiness, behavior changes Trileptal -CORRECT ANSWER Generic Name: Oxcarbazepine Average adult daily dose: 600mg-2400mg SE: Difficulty concentrating, sleepiness, fatigue, dizziness, double vision, nausea, unsteadiness, rash Vimpat -CORRECT ANSWER Generic Name: Locasamide Average adult daily dose: 200mg-400mg SE: Dizziness, headache, nausea, vomiting, double vision, blurred vision, walking difficulty, drowsiness, diarrhea, falls, unintentional rapid eye movement, tremor Zarontin -CORRECT ANSWER Generic Name: Ethosuximide Average adult daily dose: 500mg-1500mg SE: Appetite loss, nausea, drowsiness, headache, dizziness, fatigue, rash, abnormal blood counts (rare) Zonegran -CORRECT ANSWER Generic Name: Zonisamide Average adult daily dose: 100mg-600mg SE: Sleepiness, dizziness, loss of appetite, headache, nausea, irritability, difficulty concentrating, unsteadiness, fever, kidney stones, rash (should not be used in individuals allergic to sulfa drugs) Diastat Acudial -CORRECT ANSWER Generic Name: Diazepam rectal gel Average adult daily dose: 0.2-0.5mg/kg a single dose SE: Drowsiness, sleepiness, fatigue, poor coordination, unsteadiness, behavior changes [Show Less]
- Exam
- $10.45
- 0
- 83
Tumors of the Brain and Spinal Cord Exam 90 Questions with Verified Answers,100% CORRECT
Tumors of the Brain and Spinal Cord Exam 90 Questions with Verified Answers A brain tumor that originates in the CNS and consists of CNS cells is call... [Show More] ed? - CORRECT ANSWER primary brain tumor Most common cause of secondary brain tumors. - CORRECT ANSWER lung cancer What is the most recognized environmental exposure known to cause primary brain tumors? - CORRECT ANSWER ionizing radiation What is the autosomal-dominant disorder that is characterized by the development of tumors along the nerve shaft? - CORRECT ANSWER neurofibromatosis type 1 What is neurofibromatosis type 1? - CORRECT ANSWER genetic disorder affecting the genes which are responsible for the production of a proteins that suppresses tumor cells along the nerves Which of the glial cells line the ventricles in the brain? - CORRECT ANSWER ependymal cells An ependymoma commonly presents with... - CORRECT ANSWER obstructive hydrocephalus Which glial cells form the blood-brain barrier? - CORRECT ANSWER astrocyte cells Which of the glial cells are responsible for the formation and repair of the myelin sheaths that surround the neurons? - CORRECT ANSWER oligodendrocytes Which of the glial cells do not multiply to for a tumor? - CORRECT ANSWER microglial cells What do microglial cells do? - CORRECT ANSWER macrophages that migrate to the sites of inflammation, degeneration, and injured brain cell Which is the most common location for a CNS tumor to be found? - CORRECT ANSWER meninges What is the most common malignant CNS tumor? - CORRECT ANSWER glioma When a tumor is termed extra-axial, where is it located? - CORRECT ANSWER outside of the brain issue Brain tissue is... - CORRECT ANSWER glial cells Is a grade I-II benign or malignant? - CORRECT ANSWER benign If a spinal tumor is described as intramedullary, where would the tumor be located? - CORRECT ANSWER within the spinal cord The most common site for metastatic spine tumor origination is... - CORRECT ANSWER bone A glial cell can develop into what type of primary brain tumor? - CORRECT ANSWER glioma Where is the most common location in the brain for a glioma to develop? - CORRECT ANSWER frontal lobe Where is the least common location in the brain for a glioma to develop? - CORRECT ANSWER occipital lobe What is a tumor originating from neurons commonly called? - CORRECT ANSWER neuroma What are responsible for the impulses in the brain? - CORRECT ANSWER neurons The tumors invading the peripheral nerve sheath is called a... - CORRECT ANSWER schwannoma What grade of glioma tumor is called an anaplastic tumor? - CORRECT ANSWER grade III What grade of glioma tumor is called an glioblastoma? - CORRECT ANSWER grade IV What grade of glioma tumor is called an diffuse astrocytoma? - CORRECT ANSWER grade II What is the primary mechanism for the complication if hydrocephalus with brain tumors? - CORRECT ANSWER obstruction of CSF flow A brain tumor can invade the ventricles or compress the ventricular system, resulting in... - CORRECT ANSWER hydrocephalus What is a common CNS tumor that produces hydrocephalus? - CORRECT ANSWER ependymoma What is the most common location of a tumor that results in seeding of the tumor cells throughout the CNS? - CORRECT ANSWER leptomeninges and subarachnoid space What is the most common CNS neuroma? - CORRECT ANSWER acoustic neuroma Which area of the brain does a craniopharyngioma commonly affect? - CORRECT ANSWER hypothalmus Would a patient presenting with hemiparesis be considered to have generalized or localized symptoms? - CORRECT ANSWER localized Generalized symptoms of brain tumors include... - CORRECT ANSWER altered LOC, seizures, and cognitive behavior changes Increases ICP symptoms include... - CORRECT ANSWER headache, altered LOC, vomiting, and papilledema Symptoms of brainstem lesions commonly involve which set of CNS nerves? - CORRECT ANSWER cranial nerves CNs that originate in the midbrain... - CORRECT ANSWER III and IV CNs that originate in the pons... - CORRECT ANSWER V, VI, VII, and VIII CNs that originate in the medulla... - CORRECT ANSWER IX, X, XI, and XII A pt presents in the ER with an appearance of being "drunk" and has been diagnosed with a brain tumor. Which is the most likely location of this tumor? - CORRECT ANSWER cerebellum What controls coordination of movement, fine motor skills, and gait? - CORRECT ANSWER cerebellum A pituitary tumor often presents with visual deficits. Is the medial or lateral vision most likely to be affected in both eyes? - CORRECT ANSWER lateral same side = - CORRECT ANSWER ipsilateral opposite side = - CORRECT ANSWER contralateral Which hormone produced by the pituitary gland can result in acromegaly in a pituitary adenoma? - CORRECT ANSWER growth hormone What is commonly the first presentation of an acoustic neuroma? - CORRECT ANSWER dizziness/vertigo A pt presents with symptoms of N/V, headache, and mental status change. the CT scan found a leptomeningeal tumor. What is the most likely cause of the pt's symptoms? - CORRECT ANSWER hydrocephalus An 8-year-old child presents with N/V, listlessness, morning headache, and ataxia. What is the most likely location and type of tumor? - CORRECT ANSWER medulloblastoma in the posterior fossa What is a unique symptom of a brain tumor in an infant who still has open cranial fontanels? - CORRECT ANSWER tense and bulging anterior fontanel What is the most common symptom of a pt with a spinal tumor? - CORRECT ANSWER pain Which radiographic diagnostic examination is commonly ordered initially in an acute setting? - CORRECT ANSWER CT What is the "gold standard" radiographic study used to identify the tumor location, characteristic, and mass effects? - CORRECT ANSWER MRI Which advanced MRI imaging can be used to map eloquent areas of the brain prior to brain tumor surgical resection? - CORRECT ANSWER functional magnetic resonance imaging (fMRI) What is a potential complication of the use of gadolinium contrast in the MRI imaging? - CORRECT ANSWER AKI Which diagnostic study measures glucose uptake of the brain tissues? - CORRECT ANSWER PET What does an increased glucose uptake indicate in a PET scan? - CORRECT ANSWER higher malignancy Tumors located in the sellar region require which diagnostic test to evaluate the hypothalamic-pituitary axis? - CORRECT ANSWER lab results Which is the most diagnostic for determining the brain tumor type and classification? - CORRECT ANSWER brain biopsy What is the CSF result that would be considered the gold standard for establishing the presence of leptomeningeal tumor? - CORRECT ANSWER presence of malignant cells in CSF What lab value should be monitored closely when a pt is on a steriod? - CORRECT ANSWER serum glucose levels In high-grade gliomas, radiation therapy is commonly used in conjunction with which modality of medical management? - CORRECT ANSWER chemotherapy What chemotherapy delivery system is used to deliver the chemotherapy drug carmustine directly to the tumor bed? - CORRECT ANSWER wafers A leptomeningeal tumor may be treated with IV chemotherapy drugs used to treat the original tumor cell type. What is different is these tumors regarding the ability to use larger variety of systemically administered drugs that when treating a glioma? - CORRECT ANSWER disruption of the BBB What is present in CSF with a leptomeningeal tumor? - CORRECT ANSWER elevated protein What medical management is used to treat a prolactinoma? - CORRECT ANSWER dopamine agonist therapy What prohibits prolactin secretions? - CORRECT ANSWER dopamine What preoperative intervention may be used in highly vascular tumors to lower the risk of hemorrhage during surgical resection of the tumor? - CORRECT ANSWER embolization What is the purpose of performing an awake craniotomy and cortical brain mapping? - CORRECT ANSWER to identify eloquent areas if brain and prevent injury What surgical approach is used to remove a pituitary tumor? - CORRECT ANSWER Transphenoidal surgery What is a potential reason for an incomplete surgical excision of a tumor? - CORRECT ANSWER invasion into an eloquent area of brain Area of the brain with a specific function is called an... - CORRECT ANSWER eloquent area What is the primary recommendation for a pt presenting with an acute loss of motor function due to a spinal tumor? - CORRECT ANSWER surgical resection of tumor What is a common complication of a posterior fossa surgery for tumor resection? - CORRECT ANSWER CSF leak Surgical resection of a tumor adjacent to Broca's area can result in which deficit? - CORRECT ANSWER expressive aphasia Broca's area in the frontal lobe controls... - CORRECT ANSWER one's ability to speak The frontal lobe controls... - CORRECT ANSWER one's memory and personality Wernicke's area in the temporal lode controls... - CORRECT ANSWER one's ability to receive/interpret information The parietal lobe controls... - CORRECT ANSWER one's sensation and position Which tumors locations is more likely to present with seizures? - CORRECT ANSWER cortical gray matter The progression of the brain tumor, cerebral edema, or hemorrhage may cause what? - CORRECT ANSWER seizures Which type of glial tumor is most likely to develop the complication of hydrochephalus? - CORRECT ANSWER ependymoma in the ventricles A meningioma is most commonly a grade I tumor. What is the complication of an atypical or anaplastic meningioma? - CORRECT ANSWER brain tissue invassion A pt is on the unit following a pituitary adenoma removal sing the transphenoidal approach. He develops a sudden increase in urine output. What is the most likely complication experienced by this pt? - CORRECT ANSWER DI Increased urine output, hypernatremia, serum hyperosmolality, and decrease in urine specific gravity indicates what? - CORRECT ANSWER diabetes insipidus What complication can occur with a tumor causing spinal nerve root compression? - CORRECT ANSWER bladder dysfunction 5TH TO 7TH DECADES OF LIFE - CORRECT ANSWER PEAK INCIDENCE OF BRAIN TUMORS OCCURS MEN - CORRECT ANSWER HIGHER INCIDENCE OF BRAIN TUMORS THAN IN WOMEN. GENETIC OR HEREDITARY FACTORS - CORRECT ANSWER MAYBE CAUSED BY SOME TUMORS. CANCERS OF THE LUNG 35%, BREAST 20%, SKIN 10%, KIDNEY 10% AND GI 5% - CORRECT ANSWER METASTATIC TUMORS TO BRAIN MOST COMMONLY ARISE FROM - [Show Less]
- Exam
- $12.45
- 0
- 80
Environmental Health and Public health Nursing 67 Questions with Verified Answers,100% CORRECT
Environmental Health and Public health Nursing 67 Questions with Verified Answers All that is external to the human host with which the hos is in consta... [Show More] nt interaction: - CORRECT ANSWER Environment What does a built environment refer to? - CORRECT ANSWER Refers to buildings and community spaces created by humans that influence health behaviors and health outcome What are problems with overcrowding? - CORRECT ANSWER Diseases are transmitted rapidly More pollution Higher stress levels Why do trees help our environment? - CORRECT ANSWER Tress deposit O2 into our air and cleans the air of carbon monoxide What is the problem with clearing the land? - CORRECT ANSWER A decrease in trees lead to more pollution What is the second leading cause of lung cancer? - CORRECT ANSWER Radon Where is Radon found? - CORRECT ANSWER Major concern in Kentucky; found in homes -Home buyers have the right to make seller check for high level of radon -You can buy a radon detection kit What is a common source of carbon monoxide in homes? - CORRECT ANSWER Gas heaters What are s/s of carbon monoxide poisoning? - CORRECT ANSWER N/V Fatigue What is recommended to help monitor carbon monoxide levels? - CORRECT ANSWER Monitors that you can place in your home that will help detect high levels of carbon monoxide When and where is lead poisoning more common? - CORRECT ANSWER In young children; in old houses built before 1978 related to lead in the paint What affect does lead have on us? - CORRECT ANSWER It is neurotoxic; it 1st affects them cognitively that later symptoms are seen on the neuro development of children When talking about cooking vapors, it is important to to assess what? - CORRECT ANSWER Assess ventilation; concerned about gas stoves What is volatile organic compound found (VOC)? - CORRECT ANSWER Found in new furniture, new carpet, paint, glues, and cleaning supplies Long term exposure to VOC can lead to what? - CORRECT ANSWER Asthma What are recommendations for people who are affected by VOC when getting new carpet or furniture? - CORRECT ANSWER Move out of the house for a little while -Only buy used furniture Sick building syndrome causes what type of symptoms? - CORRECT ANSWER Headache Fatigue Exacerbation of allergies These symptoms of sick building syndrome often result from what? - CORRECT ANSWER Poor ventilation and building operations, hazardous building materials, furniture and carpeting substances, and cleaning agents Who are we concerned about with anthrax exposure? - CORRECT ANSWER Worried about farmers and vets who work closely with cattle and sheep because they are carriers of anthrax. What is recommended for workers working with cattle and sheep? - CORRECT ANSWER Get vaccinated for anthrax What are examples of work-related exposures? - CORRECT ANSWER Chemical exposures Physical hazards Exposure to physical agents Particulate inhalation Toxic gases and vapors Heavy metal poisoning Biological agents What is the highest cause of nursing injuries? - CORRECT ANSWER Musculoskeletal injuries What are other work-related hazardous exposures among nurses? - CORRECT ANSWER Chemical: Disinfectants and sterilizing chemicals, medications (antiretroviral and chemotherapeutic agents) Physical: Musculoskeletal and needle stick injuries Particulate inhalation: Chemotherapeutic agents and anesthetic gases Heavy Metal Poisoning: mercury Biological agents What is important to note about medication to hep prevent hazardous exposures? - CORRECT ANSWER Always know the drug you are using, the appropriate way to administer and potential risks/how you can be exposed If you are exposed to chemicals of product, what can you reference to know how to properly handle your exposure? - CORRECT ANSWER Material Safety Data Sheet (MSDS) Material Safety Data Sheet provides information on what things? - CORRECT ANSWER Product physical and chemical properties Health hazard info include short and long term exposure effects Permissible exposure limits and symptoms of overexposure A description of how to safely handle the substance under normal and emergency situations A description of what first aid and medical treatment is appropriate if excessively exposed What is the greenhouse effect? - CORRECT ANSWER A rise in temp due to increase in carbon dioxide (CO) and other gases in air that trap sun's energy The greenhouse effect is caused by what? - CORRECT ANSWER An increase in human emission of CO and a decreased consumption of CO secondary to deforestation Most radiation from the sun is filtered out by what? - CORRECT ANSWER The ozone layer Ozone depletion - CORRECT ANSWER Depletion in ozone layer in earth's stratosphere; this increases exposure to the sun Due to ozone depletion, what is seen in certain parts of the world? - CORRECT ANSWER All kids at school must wear sun screen and hats Ozone depletion leads to an increase in what? - CORRECT ANSWER Melanoma What is ozone depletion caused by? - CORRECT ANSWER Chloroflourocarbons emissions from refrigerants, aerosols, and air conditioners What is smog caused by? - CORRECT ANSWER Caused by sunlight interacting with air pollutants, particularly ground level ozone and VOC Ground level ozone originated from what? - CORRECT ANSWER Vehicle CO emission You can recommend for what type of patients to look are the air quality index? - CORRECT ANSWER Patients with asthma; if the air quality is bad for the day, you may want to stay inside if you have asthma When looking at UK index forecast, you see that their is a high UV index. What action may you wan to take? - CORRECT ANSWER Put sunscreen on Is it easy or hard for us to clean medication out of our water system? How does medication get in our water system? - CORRECT ANSWER Hard; Meds get into the system through flushing them down the toilet or from our bodily fluids after taking the medications What type of poisoning is seen in fish? - CORRECT ANSWER Mercury poisoning; limit fish intake to 3 portions a week What patient must be extremely cautious with their fish intake? - CORRECT ANSWER Pregnant women What are routes of transmission for waterborne illnesses? - CORRECT ANSWER Ingestion Dermal contact Inhalation When are waterborne illness most common? - CORRECT ANSWER In the summer months What is the annual water quality report? - CORRECT ANSWER Consumer Confidence Report What does the consumer confidence report tell you? - CORRECT ANSWER Provides information on local drinking water quality What are major concerns with food safety? - CORRECT ANSWER Contamination by herbicided, pesticides, or microbial Food additives Antibiotic overuse Genetic modified foods Increasing food allergies Transportation, storage, handling, and preperation What is the problem in relation to antibiotic overuse? - CORRECT ANSWER Our meats are containing traces of antibiotics due to the animals being treated with antibiotics What are the largest proportion of foodborne disease caused by? - CORRECT ANSWER Growth of bacteria/toxin formation due to preparing food several hours prior to consumption and storing at improper temperatures Insufficient cooking or reheating food Cross contamination Poor personal hygiene handling the food Communities with little to no access to healthy foods: - CORRECT ANSWER Food deserts What are the four golden rules of food safety? - CORRECT ANSWER Clean Separate Cook Chill It is important to use what when cooking meats? - CORRECT ANSWER Thermometer What is the problem seen today with non biodegradable plastics? - CORRECT ANSWER The plastic is being emptied into the ocean; the sun is digesting the plastic and then fish is eating it ultimately leading to use consuming plastic through the fish we are eating What are major concerns in relation to waste management? - CORRECT ANSWER Non biodegradable plastics Inefficient recycling programs Unlicensed waste dumps Inadequate sewage systems for growing populations Unsafe or illicit dumping of industrial toxins Exportation of radioactive medical waste Non-enforcement of environmental regulations What are different exposures to sources? - CORRECT ANSWER Air, water, soil, and food What are the different pathways to exposure? - CORRECT ANSWER ingestion, inhalation, or dermal absorption Is Radon considered acute, chronic, or latent? - CORRECT ANSWER Chronic exposure What are different aspects to assess? - CORRECT ANSWER Agent Exposure Host susceptibility Health effect What type of exposure leads to neurotoxicity? - CORRECT ANSWER Mercury exposure What is included in the diagnoses? - CORRECT ANSWER Health effect or associated risk Population Related environmental factors What is included in the plan/implement part of the nursing process? - CORRECT ANSWER Stabilize Reduce/Eliminate Exposure Provide immediate treatment Ongoing intervention Public health reporting Take a critical approach How can you reduce/eliminate exposure? - CORRECT ANSWER Initiate protective measures Remove person from environment Decontaminate persons affected Remove substance from environment Eliminate/control ongoing exposure What are the different ways to render substance harmless? - CORRECT ANSWER Eliminate the agent Reverse the effect Block the absorption Initial intervention is generally based on what? - CORRECT ANSWER Generally based on route of exposure and agent effects How do you treat someone who is asymptomatic but has possibly been exposed to the agent? - CORRECT ANSWER Treat them through observation What do nurses play a huge role in with ongoing interventions? - CORRECT ANSWER Monitoring long-term consequences Prevent continuing exposure Educate What is a source of asbestosis? - CORRECT ANSWER Insulation in elementary schools What must be reported in the state of Kentucky? - CORRECT ANSWER Lead Asbestosis Coal Worker's Pneumonoconiosis Silicosis How can you take a critical approach? - CORRECT ANSWER Ask critical questions Take a stand Advocate for change Facilitate community involvement Form coalitions Use collective strategies [Show Less]
- Exam
- $11.45
- 0
- 132
CNRN Review Exam Questions with Verified Answers,100% CORRECT
CNRN Review Exam Questions with Verified Answers Focal Seizures: Non-motor - CORRECT ANSWER Behavioral arrest, autonomic, emotional, cognitive, sensor... [Show More] y Vestibulocochlear (VIII) - CORRECT ANSWER sense of hearing/balance Hemorrhagic stroke risk factors - CORRECT ANSWER hypertension, cocaine use, tobacco use Stroke types - CORRECT ANSWER ischemic, hemorrhagic Chiari s/sx - CORRECT ANSWER neck pain, chronic headache, cerebellar sx (dizziness, ataxia, N/V) Seizure Management: Ongoing - CORRECT ANSWER EEG, AED titration (mono vs. poly therapy, labs/levels), additional imaging (fMRI, PET, Wada's test), Neuropsych testing, ~surgical eval, ~keto diet Ischemic Stroke: Treatment Options - CORRECT ANSWER Antiplatelets, TPA, Endovascular treatment (thrombectomy, intracerebral stenting) Vasospasms treatment - CORRECT ANSWER Triple H therapy (hemodilution, hypertension, hypervolemia), Cerebral balloon angioplasty, Intra-arterial Ca channel blocker Extra-axial Brain Tumors: Pituitary Adenoma (grade, s/sx, treatment, ~complications) - CORRECT ANSWER Benign; Hormonal disturbance, bitemporal hemianopsia, obstructive hydrocephalus; Surgical resection, ~nasal precautions Myasethenia Gravis s/sx - CORRECT ANSWER muscle weakness that increases with activity and improves with rest CNS tumors: complications and management - CORRECT ANSWER -Edema (expected): high-dose steroids, mannitol - Hemorrhage: strict BP control - Sz: prophy AEDs post-op - Stroke (r/t hypercoag. state d/t tumor) - Hydrocephalus: shunt - Herniation - Infections (r/t wafers, radiation) phenytoin vs fosphenytoin - CORRECT ANSWER Phenytoin: risk of arrhythmias and hypotension Fos: decreased risk pain/phlebitis, decreased risk of arrhythmias and hypotensiona [Show Less]
- Exam
- $8.95
- 0
- 99
CNRN 160-174 Exam Questions with Verified Answers,100% CORRECT
CNRN 160-174 Exam Questions with Verified Answers 170. The greatest risk factor for progressive multifocal leukoencephalopathy (PML) is - CORRECT ANSW... [Show More] ER AIDS -Patients at highest risk are people with depressed cellular immunity. Antiretroviral treatments have contributed to a declining incidence of PML along patients with HIV disease. -Organ transplantation and leukemia also predispose patients to PML but AIDS is the greatest risk factor -MS is not directly associated but patients being treated with Natalizumab have a 1/1000 risk 174. Before embarking on treatment with a time-contingent regimen of a sustained-release opiod medication for chronic non-cancer pain it is essential to - CORRECT ANSWER Have the patient and doctor sign an agreement that specifies their mutual expectations and parameters of treatment 173. People with Meniere's disease are at increased risk for - CORRECT ANSWER falls, accidents while driving vehicles or operating machinery, and depression -Extremely important to educate on necessary lifestyle changes necessary for safety 172. At onset of an attack of vertigo associated with meniere's disease it is best to - CORRECT ANSWER Lie down and rest until the attack has completely subsided -Activites such as reading and watching TV and bright lights/loud noises can exacerbate the vertigo 171. Fibromyalgia is fundamentally - CORRECT ANSWER a neurologic disorder -The existence of fibromyalgia as a legitamate medical disorder has been disputed because of the absence of an objective diagnositc test. MRI shows hyperexcitability in central pain pathways, and reduced activity in descending central pain inhibitory pathways lending the understading fibromyalgia is a disorder of the CNS 169. MS patients treated with natalizumab (Tysabri) require intensive long term monitoring because - CORRECT ANSWER they have a 1/1000 risk of developing progressive mutlifocal leukoencephalopathy. -Although the statistical risk of progressive PML is relatively small, this diease is progressive, debilitating, and almost always fatal. For this reason it is reserved for patients whose MS has been unresponsive to standard treatment with interferons and glatiramer acetate who have made a thoroughly considered and informed choice 168. The best approach to pharmacologic management of symptoms of restless leg syndrome is usually - CORRECT ANSWER cyclic deployment of various classes of medication -The most characteristic feature of their medication response is that no agent seems to be effective for very long. Therefore cyclic deployment is known to be effective in a regimen tailored to each individuals -gabapentin, opioids, benzodiazepines, muscle relaxers -tricyclic antidepressants and anti-nausea drugs often worsen symptoms of RLS 167. Restless leg syndrome affects - CORRECT ANSWER people of all ages -Can begin at any age. Often the diagnosis is missed in early childhood and dismissed as growing pains. Symptoms often increase with age 166. When children with ADHD enter their teenage years - CORRECT ANSWER their risk for auto accidents is greater than the risk of other teens 165. A patient with HIV disease is taking isoniazid (INH), rifampin (RIF), ethambutol (EMB) and pyrazinamide (PZA). The nutritional supplement most important to include in this patient's regimen is - CORRECT ANSWER Pyridoxine (Vitamin B6) -INH can cause Pyridozine deficiency; patients hshould be instructed to take only as directed as this can be toxic at high concentrations. 164. The most common neurologic manifestation of HIV is - CORRECT ANSWER Peripheral neuropathy -Typically AIDS neuropathy is distal symmetrical polyneuropathy (DSPN) associated with advanced immunosupression and or toxicity of antiretroviral medications. Generally occurs early on in disease progression 163. Women are three times more likely than men to develop - CORRECT ANSWER carpal tunnel syndrome -realted to fluid retention in the carpal tunnel during pregnancy, diabetes, hypothyroidism, RA, and celiac disease 162. Patients with adrenoleukodystrophy lack - CORRECT ANSWER an enzyme that breaks down very long chain fatty acids -The myelin sheath in the brain is damaged by excessive amounts of very long chain fatty acids as well as the adrenal cortex 161. The family of a child with adrenoleukodystrophy (ALD) is seeking genetic counseling. Along with the requested referral, the family can be told that the inheritance of ALD is - CORRECT ANSWER Nearly always X linked recessive. -Female carriers who have one abnormal allele on one x chromosome and one normal allele on the other x chromosome are generally asymptomatic ; however they can have mild syndrome of progressive spasticity, weakness, and ataxia 160. A patient being issued crutches for any reason should be instructed in their correct use in order to avoid - CORRECT ANSWER radial nerve entrapment injury [Show Less]
- Exam
- $8.95
- 0
- 116
Nervous System Career Specialties Questions with Verified Answers,100% CORRECT
Nervous System Career Specialties Questions with Verified Answers The nervous system is a complex network of tissues that uses chemical and electrical s... [Show More] ignals to carry messages between the brain and the rest of the body. - CORRECT ANSWER A cell is the basic structural and functional unit of life. Tissues are similar cells that work together. An organ is a group of tissues that perform a specific task. The brain is the organ that acts as the control center of the nervous system. The spinal cord is a bundle of tissues that relays signals between the brain and the rest of body, to coordinate the body's activity. Neurology is the study of the nervous system and disorders in the nervous system. Careers in neurology include: - CORRECT ANSWER neuro technician. neuroscience nurse. neuro physical therapist. neuroscientist. neurologist. neurosurgeon Neuro technicians assist other medical professionals by collecting information about a patient's neurological disease or disorder. An electroneurodiagnostic technician uses equipment to monitor and record the electrical activity of the brain, spinal cord, and other parts of the nervous system. - CORRECT ANSWER Electroneurodiagnostic technicians perform tests on patients, often to diagnose diseases and disorders in the nervous system. A neuroscience nurse cares for individuals with nervous system disorders. Neuroscience nurses assist other healthcare professionals, such as doctors and technicians. - CORRECT ANSWER Neuroscience nurses perform many tasks. They can monitor patients recovering from brain surgery, provide specialized care to people who have lost the ability to move, and help patients learn to adapt to the neurological conditions they may have. Neuroscience nurses perform many tasks. They can monitor patients recovering from brain surgery, provide specialized care to people who have lost the ability to move, and help patients learn to adapt to the neurological conditions they may have. - CORRECT ANSWER Many diseases and disorders in the nervous system affect movement. Patients suffering from conditions such as Parkinson's disease - a disease that inhibits movement and causes shaking muscles - can benefit from physical therapy. A neuroscientist carries out research on the nervous system. There are different types of research-based careers in neurology. - CORRECT ANSWER A neuroanatomist studies the structure and organization of the nervous system. A neurochemist studies the chemicals in the nervous system and how they interact. A neurobiologist studies how the nervous system functions. Research done by neuroscientists helps pharmaceutical companies develop more effective treatments for neurological conditions. A physician is a medical doctor. Physicians can specialize in different areas; one of these areas is neurology. - CORRECT ANSWER A neurologist is a medical doctor who specializes in and treats diseases of the nervous system. Symptoms are the effects of a disease or disorder that a patient experiences. By analyzing symptoms and using information collected through medical tests, a neurologist diagnoses a patient with a specific neurological disease or disorder. A neurosurgeon performs surgical procedures on patients to correct disorders of the nervous system. Surgical procedures are medical procedures that make physical changes to a part of the body using special instruments. Common surgeries include brain and spinal cord procedures. - CORRECT ANSWER Sometimes neurosurgery can resolve a neurological condition. For example, a tumor - an abnormal growth that appears as a lump or a mass - in the brain or spinal cord can cause neurological problems. A neurosurgeon can surgically remove the tumor and cure the patient. X-rays of the brain can help neurosurgeons diagnose disorders and injuries. Education is the starting point for career pathways in neurology. A major difference between careers is often the level of education required. - CORRECT ANSWER An associate degree is a two-year degree at a university or community college. A bachelor's degree is typically a four-year degree at a university. A master's degree typically requires two years of study after a bachelor's degree. A doctorate degree is the highest academic degree, and typically requires four years or more after a master's degree. Anyone wanting to become a neuro technician must pursue a neurology technician course and earn an associate degree. Neurology technician programs focus on how to use electrodiagnostic machinery, and can take twelve to twenty-four months to complete. - CORRECT ANSWER To qualify for a neurology technician program, a high school diploma or equivalent is required. Some schools also require practical experience working or volunteering with patients suffering from nervous system conditions. To apply for certification as a neuroscience nurse, an individual must already be certified as a registered nurse. There are three main ways to become a registered nurse: obtain a bachelor's degree in nursing, an associate degree in nursing, or a diploma from a nursing program. Every nurse also must pass a national licensing exam. - CORRECT ANSWER To specialize as a neuroscience nurse, a registered nurse must have at least two years of full-time nursing experience in neurology. To pursue a career as a physical therapist, a bachelor's degree and a master's degree are required. In some cases, you must have a doctorate degree. - CORRECT ANSWER To specialize as a neuro physical therapist, many hours of specialized nervous system clinical training are needed. This involves practical experience working with patients suffering from nervous system diseases and disorders. To become a neuroscientist, a doctorate degree is required. Before you can obtain a doctorate, you must first receive a bachelor's degree and a master's degree in a health science discipline. - CORRECT ANSWER To apply for a doctorate program, it is important to have previous experience in lab work and research. Research for the doctorate must be focused on an area related to neurology, such as neuroanatomy or neurobiology. To become a physician in the area of neurology, such as a neurologist or neurosurgeon, you must obtain a bachelor's degree, followed by a degree as a doctor of medicine, or MD, which is a degree granted to medical doctors by a medical school. - CORRECT ANSWER You also must complete a clinical residency, which is a multiyear, on-the-job training program that follows medical school and prepares new physicians to work in their chosen specialty. It typically requires: three to four years for neurologists. six to seven years for neurosurgeons. The training for neurosurgeons is significantly longer because they must study general surgery before focusing specifically on surgery of the nervous system. In addition to classroom learning, a neuro technician must complete clinical training. This includes practical experience in a healthcare setting, observing other neuro technicians, and working under their supervision. The last step to becoming a neuro technician is to take a state board exam to obtain certification. The requirements for certification can vary from state to state. - CORRECT ANSWER To become an EEG or EP technologist, you must be certified by the American Board of Registration of Electroencephalographic and Evoked Potential Technologists An electroencephalogram (EEG) is a test used to measure and record the electrical activity in the brain. An evoked potential (EP) test measures the time it takes for the nervous system to respond to stimulation. A neuroscience nurse must first obtain licensure as a registered nurse (RN). This requires successful completion of the National Council Licensure Examination - Registered Nurse (NCLEX-RN). - CORRECT ANSWER While pursuing RN status, you should take courses related to neuroscience. After two years of experience working as an RN in an area related to neurology, you can take an exam to obtain status as a Certified Neuroscience Registered Nurse (CNRN). To become a neuro physical therapist, you must have a master's or doctorate degree, and many hours of practical experience with patients suffering from neurological conditions that require physical therapy. After taking these steps, you are eligible to take the National Physical Therapy Exam (NPTE), which is a licensing test to become a licensed physical therapist. - CORRECT ANSWER You also need to pass the Neurologic Certified Specialist Exam (NCSE), which is a certification test. In addition, a neuro physical therapist must successfully complete an exam to obtain certification in Neurologic Physical Therapy from the American Board of Physical Therapy Specialties. Throughout the years of education required to become a neuroscientist, it is important to seek out opportunities to research the nervous system, through volunteer work or on the job. When completing a doctorate degree, students focus on a particular area of study and research. - CORRECT ANSWER After obtaining a doctorate degree, some neuroscientists pursue a post-doctorate fellowship. This is time for them to explore their area of neuroscience more deeply. After obtaining a doctor of medicine degree (MD) and completing a residency in a neurology specialty, neurologists and neurosurgeons need to become licensed in the state where they intend to practice. Licensing requirements can vary by state, but you typically need to provide transcripts from schools and training programs, as well as pass a licensure exam. - CORRECT ANSWER Medical licenses need to be renewed, and most states require a specified amount of continuing medical education annually. Some doctors also seek certification from a specialty board, which is an organization for physicians in a particular specialty. For doctors specializing in neurology, the American Board of Psychiatry and Neurology (ABPN) provides a testing process and a certificate. [Show Less]
- Exam
- $8.95
- 0
- 119
Week 2: Professional Socialization 48 Questions with Verified Answers,100% CORRECT
Week 2: Professional Socialization 48 Questions with Verified Answers Profession - CORRECT ANSWER An occupation that requires extensive education, or ... [Show More] a calling that requires special knowledge, skill, and preparation Distinguished from other occupations by: -the requirement of prolonged, specialized training to acquire a body of knowledge pertinent to the role to be performed -and an orientation of the individual toward service, either to a community or to an organization How Professions are distinguished from other occupations - CORRECT ANSWER The requirement of prolonged, specialized training to acquire a body of knowledge pertinent to the role to be performed And an orientation of the individual toward service, either to a community or to an organization Nursing Profession Criteria - CORRECT ANSWER Well-defined body of specific and unique knowledge Strong service orientation Recognized authority by a professional group Code of ethics Professional organization that sets standards Ongoing research Autonomy and self-regulation Professionalism - CORRECT ANSWER Refers to a set of attributes or way of life that implies responsibility and commitment This is seen through ways of actions and socialization Professional actions - CORRECT ANSWER Include showing respect for others at all times, acting with integrity, demonstrating professional character and spirit This builds a form of professionalism Professionalization or Professional Socialization - CORRECT ANSWER Acquiring characteristics and learning the ways of the "professional" group in order to become a functioning participant "the process of becoming a professional" includes moving from novice to expert This builds a form of professionalism As a novice nurse, you have entry level knowledge & skills but as you gain experience overtime, you become an expert Professional behavior - CORRECT ANSWER Often developed through belonging to, supporting, and participating in nursing organizations How can a nurse learn what it takes to be a professional and become involved? - CORRECT ANSWER Through Professional Organizations Professional Nursing Organizations Examples - CORRECT ANSWER American Nurses Association (ANA) National League for Nursing (NLN) International Council of Nurses (ICN) Sigma Theta Tau International Honor Society National Student Nurses Association (NSNA) And other Specialty Nursing Organizations Professional Organization - CORRECT ANSWER An (__) of practitioners who judge one another as professionally competent and who have banded together to perform social functions which they cannot perform in their separate capacities as individuals. Nursing (__) must perform the following functions for the preservation and development of the profession Nursing Organizations must perform these for the preservation & development of the profession - CORRECT ANSWER 1) Define & regulate the profession through setting and enforcing standards of education and practice for the generalist and the specialist 2) Develop the knowledge base for practice in its broadest and narrowest components 3) Transmit values, norms, knowledge, and skill to new members of the profession/specialization 4) Communicate & advocate the values and contributions of the field to several publics and constituencies (i.e. participate actively in formulating health legislation & policy) 5) Attend to the social and general welfare of their members. (Professional organizations give social and moral support to members to perform their roles as professionals and to cope with professional problems and their association journals disseminate updated knowledge, new ideas, and professional concerns) American Nurses Association (ANA) - CORRECT ANSWER Founded as the Nurses Associated Alumnae of the U.S. and Canada in 1896; became this in 1911 Purpose: foster high standards of practice, promote a safe and ethical work environment, bolster the health and wellness of nurses, and advocate on health care issues that affect nurses and the public. Journal: American Nurse Today; The Online Journal of Issues in Nursing (OJIN) Can become member through state nurses association National League for Nursing (NLN) - CORRECT ANSWER Organization of both individuals and agencies -includes nurse and non-nurse members Purpose: to foster the development and improvement of all nursing services and nursing education Services: Nursing Schools - helps set educational standards & providing accreditation of nursing programs based on their ability to meet these standards Individuals - providing the ability to continue their education programs & providing scholarships to assist w/ educational aid Journal: Nursing Education Perspectives International Council of Nurses (ICN) - CORRECT ANSWER Established in 1899, it is a federation of national nurses' associations, representing nurses in more that 120 countries. Purpose to ensure: -quality nursing care for all -sound health policies globally -the advancement of nursing knowledge -the presence worldwide of a respected nursing profession and a competent and satisfied nursing workforce Objectives: -To improve the standards and status of nursing -To promote the development of strong national nurses' associations -To serve as the authoritative voice for nurses and the nursing profession worldwide. This Code for Nurses is the foundation for ethical nursing practice throughout the world Journal = International Nursing Review Sigma Theta Tau International Honor Society - CORRECT ANSWER Founded in 1922 ... greek letters stand for "love, courage, and honor" Membership = students in baccalaureate programs in nursing and nurses in master's, doctoral, and postdoctoral programs are eligible to be selected for membership. Focus = scholarship and nursing research to guide practice Mission: provide leadership and scholarship in nursing practice, education, and research to enhance the health of all people Became incorporated in 1985 as "(__)l, Inc." to support and connect the global community of nursing scholars -Supports the learning and professional development of its members who strive to improve nursing care worldwide Journal = Journal of Nursing Scholarship Continuing Education for Nursing - CORRECT ANSWER A responsibility of each practicing nurse Key Objectives of (__)Programs: -update nurses of new techniques & knowledge -help nurses attain expertise in a specialized area of practice -provide information essential to nursing practice Differs from "In-service Education" Credentialing & Certification: a recognition of excellence and commitment to professional development Specialty certifications ... CCRN, CNRN, CEN, CNOR, CRRN, CPNP, CDE, NCSN, CWOCN, etc. Continuing Education - CORRECT ANSWER The professional development experiences designed to enrich nurse's contribution to health Offered to nurses everywhere Hospitals, facilities, & private groups offer this through courses, seminars, & workshops This is required for an RN to maintain their license in most states In-Service Education - CORRECT ANSWER Many hospitals & health care facilities provide education and training for employees of their institution or organization Designed to increase the knowledge & skills of the nursing staff Nursing Demands - CORRECT ANSWER U.S. Department of Labor identifies nursing as a "hazardous occupation" Nurses must be alert to: -Compassion fatigue -Burnout -Secondary traumatic stress Important to find your work-life balance and know how to best manage stress Compassion fatigue - CORRECT ANSWER Nurses have a loss of satisfaction from providing good patient care Job becomes exhausting, no sense of reward Burnout - CORRECT ANSWER An accumulative state of frustration with the work environment that develops over time Can occur in any job, but still should be aware of it Secondary Traumatic Stress - CORRECT ANSWER Feeling of despair that's caused by transfer of emotional distress from a victim/patient to the caregiver Tips to Prevent Burnout - CORRECT ANSWER Identify early stress Take steps to reduce stress Avoid procrastination Accept time to relax Practice assertiveness Be involved in constructive change Assertiveness - CORRECT ANSWER Form of behavior characterized by a confident declaration or affirmation of a statement without the need of proof To compel recognition of one's rights or position without either aggressively transgressing the rights of another and assuming a position of dominance or submissively permitting another to deny one's rights or rightful position Nursing - CORRECT ANSWER A profession focused on assisting people, families, & communities to attain, recover & maintain health & function from birth to old age Acts as a bridge between a vulnerable public & healthcare resources that can make the difference between life, death, health, disease, etc. It's a blend of science & art: the knowledge base for the care that's given & the skilled application of the knowledge to help other achieve max. health & quality of life Nursing (Cont.) - CORRECT ANSWER From Latin: "Nutrix"- "To nourish" A person who nourishes, fosters & protects and is prepared to take care of sick, injured, aged & dying Integrates knowledge form patient's experience Focuses on the patient receiving care physically, emotionally, social, and via spiritual dimensions of that patient Nursing from Early Civilizations to 16th Century - CORRECT ANSWER Most believed illnesses had supernatural causes Believed in the Theory of Animism Temples became centers for medical care in Ancient greek Believed illnesses were caused by god's anger Ancient Hebrews developed rules through the 10 Commandments Deaconesses made the first organized visits to people Hospitals were then built for the increasing # of pilgrims needing health care -Societies shifted from more of a religious orientation to an expansion of knowledge Nursing from 19th-21st Century - CORRECT ANSWER Florence Nightingale's care during the Civil War created better education for nurses Hospitals saw this as an eco. advantage to having their own schools to teach nurses -Organized to have easily controlled & less $$ staff, resulting in vague guidelines for nursing service/edu. WWII left a huge effect on nursing: -Large #'s of women left home to work (more indep.& assertive) -Created a need for more nurses, knowledge exploration in medicine & tech. After war, efforts were made to educate nurses -Led to creating degrees & schools Florence Nightingale - CORRECT ANSWER Founder of modern nursing Born in 1820 to a $$ family Established 1st training school for nurses Theory of Animism - CORRECT ANSWER Belief that tried to explain the cause of changes in body functions Based on the belief that everything in nature was alive w/ invisible forces & endowed w/ power Good spirits - health, bad spirits-illness/death Medicine man was the health care provider while mothers were nurses Seen in early civilizations Professional Nursing Organizations - CORRECT ANSWER 1 criteria of a profession is having these to set standards for practice and education These are concerned with current issues in nursing, health care, & influence health care policy and legislation Benefits: Networking with colleagues, having a voice in legislation affecting nursing, & keeping current with trends and issues with nursing Wide variety for nurses to join International Nursing Organization - CORRECT ANSWER Founded in 1899 1st International Organization of women Provides a way for national nursing organizations to work together Shares a commitment to maintaining high standards of nursing service & education by promoting ethics National League for Nurses - CORRECT ANSWER Founded in 1952 Organization open to all people interested in nursing -Includes non-nurses & facilities Mission: To foster development & improvement of all nursing services & edu. Conducts one of the largest professional testing services in U.S. -Includes pre-testing for potential students Primary source of research data about nursing edu. American Association of Colleges of Nursing - CORRECT ANSWER Compromised of baccalaureate & higher nursing edu. programs Mission: Creating quality edu. standards, improve health care & increase public support of BSN/graduate education, research & nursing practice National Student Nurses Association - CORRECT ANSWER Founded in 1952 with the help of the ANA and NLN Mission: To prepare students for the licensure by self-discipline, advocate for student/patient rights & take collective, responsible action on social/political views Voluntary to join Guidelines for Nursing Practice - CORRECT ANSWER These are practiced through: Standards of practice, nurse practice acts, licensure, the ANA's Code of Ethics for Nurses, professional values, & the use of nursing process Each nurse of accountable for their own quality of practice & is responsible to use these standards to ensure safety All nurses must be aware of their state's specific nurse practice acts Standards - CORRECT ANSWER Allow nurses to carry out professional roles, serving as protection for the nurse, patient & the institution where health care is provided Code of Ethics & Professional Values - CORRECT ANSWER Provide the foundation for nursing practice & guide your interactions w/ patients, colleagues & the public AACN ID'd 5 values that a professional nurse has: Altruism, autonomy, human dignity, integrity, & social justice Nursing Process - CORRECT ANSWER Includes essential activities: assessing, diagnosing, planning, implementing, & evaluating -Uses both the art & science of nursing Used by nurse to ID the patient's health care needs/strengths, to create & carry out a plan to meet those needs, & to evaluate the effectiveness of the plan to meet estimated outcomes Uses critical thinking/reasoning when providing care that is individualized & holistic Critical challenges to nursing in 21st century - CORRECT ANSWER An increase in older patients who are acutely ill, increase in health care costs, & needing to stay current w/ rapid advances in medical knowledge & technology -Health care now financially focuses on acute care from assorted clinicians rather than coordinating an accurate, longer term care Shortage in nurses/aging in nurse workforce Nursing shortages will offer unique opportunities Job opportunities are expanding outside the hospital & into communities Technology's role will increase in practice Nurses will collaborate more w/ other health care providers Many Americans find it extremely difficult to figure out the health care system- "medically homeless" 10 trends in nursing education (ID'd by NLN) - CORRECT ANSWER 1) Changing demographics & increasing diversity 2) Technology rapidly expanding 3) Globilization of the world's economy & society 4) The era of an educated consumer/patient, alternative therapists, & genomic and palliative care 5) Shift from pop-based care & increasing complexity of patient care 6) The $$ of health care & the challenge of managed care 7) The impact of health policy & regulation 8) The increasing need for interdisciplinary education & for collaborative practice 9) Current nursing shortage, & opportunities for life-long learning & workforce development 10) Sign. Advances in nursing science & research The Campaign of Action - CORRECT ANSWER Goal is to guarantee everyone in America a healthier life, supported by nurses as essential partners in providing care & promoting health Working for every state to mobilize nurses, health care providers, consumers, educators, etc. to strengthen nursing on mult. Fronts Id'd 7 issues to form a better health care system in America: -Improving Access to Care, Promoting Nursing Leadership, Fostering Interprofessional Collaboration, Transforming Nursing Education, Increasing Diversity in Nursing, Healthier Communities, Collecting Workforce Data ANA Code of Ethics for Nurses - CORRECT ANSWER Defines the ethical scope of nursing practice Tells us our primary concern is to care for the patient, but nurses owe the same care duties to themselves This includes taking care of their own health & safety, maintain wholeness of character & integrity, maintain competence, & continue personal/professional growth Can also have a balance of synergy of physical and spiritual, social Healthy Self-Care Practices - CORRECT ANSWER Stress reduction training, the use of relaxation techniques, time management, assertiveness training, work-life balances, meditation, etc Mindfulness - CORRECT ANSWER The capacity to intentionally bring awareness to present-moment experience w/ an attitude of openness & curiosity Make sure to pause, focus on present, and listen Breathing exercises help tremendously "STOP" Technique - CORRECT ANSWER Helps reduce stress & be able to respond more skillfully Stop & take a step back Take a few breaths Observe inside yourself Proceed after you pause BP-T-P-R Technique - CORRECT ANSWER BP- Being Present -Have I cultivated the art of being truly present in each human encounter? Tracking -Am I tracking the # most important to my health- Blood pressure, weight, blood sugar, lipid levels? Practicing health & wellness behaviors -Am I a model of healthy behaviors? Refueling -Do I get adequate sleep and using energy properly in my life? How do I refuel when I am on empty? Personal Identity - CORRECT ANSWER Describes a person's conscious sense of who he or she is Useful when assessing self-concept, the info. Needed first is the patient's description of self [Show Less]
- Exam
- $11.45
- 0
- 152
Purchase the bundle to get the full access instantly
- 3 Million+ Study Documents
- 100% Money Back Guarantee
- Immediate Download Access
Add To Cart
Reviews 0
Bundle Details
$31.45
- Trusted by 800,000+ Students
- 24/7 Money Back Guarantee
- Download is directly available
127
0
Seller Details
