CH 66 PrepU MEDSURG
Chapter 66: Management of Patients With Neurologic Dysfunction
Question 1 See full question
A nurse is working on a neurological
... [Show More] unit with a nursing student who asks the difference between primary and
secondary headaches. The nurse's correct response will include which of the following statements?
You Selected:
"A secondary headache is associated with an organic cause, such as a brain tumor."
Correct response:
"A secondary headache is associated with an organic cause, such as a brain tumor."
Explanation:
A secondary headache is a symptom associated with an organic cause, such as a brain tumor or an aneurysm. A
primary headache is one for which no organic cause can be identified. These types include migraine, tension,
and cluster headaches. Secondary headaches can be located in all areas of the head.
Reference:
Hinkle, J.L., and Cheever, K.H. Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 13th ed.
Philadelphia: Lippincott Williams & Wilkins, 2014, Chapter 66: Management of Patients With Neurologic
Dysfunction, p. 1967.
Question 2 See full question
The nurse is completing an assessment on a client with myasthenia gravis. Which of the following historical
recounting provides the most significant evidence regarding when the disorder began?
You Selected:
Drooping eyelids
Correct response:
Drooping eyelids
Explanation:
Ptosis is the most common manifestation of myasthenia gravis. Muscle weakness varies depending on the
muscles affected. Shortness of breath and respiratory distress occurs later as the disease progresses. Muscle
spasms are more likely in multiple sclerosis. Photophobia is not significant in myasthenia gravis.
Reference:
Hinkle, J.L., and Cheever, K.H. Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 13th ed.
Philadelphia: Lippincott Williams & Wilkins, 2014, Chapter 69: Management of Patients With Neurologic
Infections, Autoimmune Disorders, and Neuropathies, p. 2041.
Question 3 See full question
A client with newly diagnosed seizures asks about stigma associated with epilepsy. The nurse will respond with
which of the following statements?
You Selected:
"Many people with developmental disabilities resulting from neurologic damage also have epilepsy."
Correct response:
"Many people with developmental disabilities resulting from neurologic damage also have epilepsy."
Explanation:
Many people who have developmental disabilities because of serious neurologic damage also have epilepsy.
Epilepsy is not associated with intellectual level. It is not synonymous with mental retardation or illness.
Reference:
Hinkle, J.L., and Cheever, K.H. Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 13th ed.
Philadelphia: Lippincott Williams & Wilkins, 2014, Chapter 66: Management of Patients With Neurologic
Dysfunction, p. 1962.
Question 4 See full question
The school nurse notes a 6-year-old running across the playground with his friends. The child stops in midstride,
freezing for a few seconds. Then the child resumes his progress across the playground. The school nurse
suspects what in this child?
You Selected:
An absence seizure
Correct response:
An absence seizure
Explanation:
Absence seizures, formerly referred to as petit mal seizures, are more common in children. They are
characterized by a brief loss of consciousness during which physical activity ceases. The person stares blankly;
the eyelids flutter; the lips move; and slight movement of the head, arms, and legs occurs. These seizures
typically last for a few seconds, and the person seldom falls to the ground. Because of their brief duration and
relative lack of prominent movements, these seizures often go unnoticed. People with absence seizures can
have them many times a day. Partial, or focal, seizures begin in a specific area of the cerebral cortex. Both
myoclonic and tonic-clonic seizures involve jerking movements.
Reference:
Hinkle, J.L., and Cheever, K.H. Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 13th ed.
Philadelphia: Lippincott Williams & Wilkins, 2014, Chapter 66: Assessment of Neurologic Function, p. 1960.
Question 5 See full question
A patient with epilepsy is having a seizure. Which of the following should the nurse do after the seizure?
You Selected:
Keep the patient to one side.
Correct response:
Keep the patient to one side.
Reference:
Hinkle, J.L., and Cheever, K.H. Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 13th ed.
Philadelphia: Lippincott Williams & Wilkins, 2014, Chapter 66: Management of Patients With Neurologic
Dysfunction, p. 1960.
Question 1 See full question
A nurse assesses the patient’s LOC using the Glasgow Coma Scale. What score indicates severe impairment of
neurologic function?
You Selected:
3
Correct response:
3
Explanation:
LOC, a sensitive indicator of neurologic function, is assessed based on the criteria in the Glasgow Coma Scale:
eye opening, verbal response, and motor response (Barlow, 2012). The patient’s responses are rated on a scale
from 3 to 15. A score of 3 indicates severe impairment of neurologic function, brain death, or pharmacologic
inhibition of the neurologic response. A score of 15 indicates that the patient is fully responsive (see Chapter
68).
Reference:
Hinkle, J.L., and Cheever, K.H. Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 13th ed. Philadelphia:
Lippincott Williams & Wilkins, 2014, Chapter 66: Management of Patients With Neurologic Dysfunction, p.
1937.
Question 2 See full question
Which of the following is one of the earliest signs of increased ICP?
You Selected:
Decreased level of consciousness (LOC)
Correct response:
Decreased level of consciousness (LOC)
Explanation:
Decreasing LOC is one of the earliest signs of increased ICP. Headache is a symptom of increased ICP, but
decreasing LOC is one of the earliest signs of increased ICP. Cushing’s triad occurs late in increased ICP.
Decreasing LOC is one of the earliest signs of increased ICP. If untreated, increasing ICP will lead to coma.
Decreasing LOC is one of the earliest signs of increased ICP.
Reference:
Hinkle, J.L., and Cheever, K.H. Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 13th ed.
Philadelphia: Lippincott Williams & Wilkins, 2014, Chapter 66: Assessment of Neurologic Function, p. 1943.
Question 3 See full question
An osmotic diuretic, such as mannitol, is given to the patient with increased intracranial pressure (IICP) for
which of the following reasons?
You Selected:
To dehydrate the brain and reduce cerebral edema
Correct response:
To dehydrate the brain and reduce cerebral edema
Explanation:
Osmotic diuretics draw water across intact membranes, thereby reducing the volume of brain and extracellular
fluid. Antipyretics and a cooling blanket are used to control fever in the patient with IICP. Chlorpromazine
(Thorazine) may be prescribed to control shivering in the patient with IICP. Medications such as barbiturates are
given to the patient with IICP to reduce cellular metabolic demands. [Show Less]