NUR 211 Neuro Practice Questions WITH CORRECT |/ |/ |/ |/ |/ |/
ANSWERS |/
1.1. Michael is a 24 year old man who presents with a 6 hour history of sudden
|/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/
|/ onset of inability to raise his eyebrow or smile on the right side. He also reports
|/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/
|/ decreased lacrimation in the right eye and difficulty closing the right eyelid.
|/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/
|/ The rest of his health history and physical exam is otherwise unremarkable.
|/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/
|/ This likely represents paralysis of cranial nerve (CN):
|/ |/ |/ |/ |/ |/ |/
a. III.
b. VIII.
c. IV.
d. VII.: Answer: d (KNOW HOW TO ASSESS ALL CRANIAL NERVES)
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2.1. The nurse is evaluates the client who is being treated for DKA. Which
|/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/
|/ finding indicates that the client is responding to the treatment plan?
|/ |/ |/ |/ |/ |/ |/ |/ |/ |/
a. Eyes sunken and skin flushed |/ |/ |/ |/
b. Skin moist with rapid elastic recoil |/ |/ |/ |/ |/
c. Serum potassium level is 3.3 mEq/L |/ |/ |/ |/ |/
d. ABG results are pH 7.25, Paco2 30, HCO3 17: Answer: b - these are signs
|/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/
|/ that the patient is well hydrated
|/ |/ |/ |/ |/
A - incorrect - s/sx of dehydration
|/ |/ |/ |/ |/ |/
C - incorrect - hypokalemia
|/ |/ |/ |/
D - incorrect - you might see these ABG results in the DKA patient when
|/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/
|/ they first present to the hospital
|/ |/ |/ |/ |/
3.1. The nurse is assess the client who has Type II Diabetes. Which findings
|/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/
1 |// |/68
,|/ indicate to the nurse that the client is experiencing HHNS? Select all that
|/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/
|/ apply
a. Serum osmolality 364 mOsm/kg
|/ |/ |/
b. Blood glucose level 160 mg/dL
|/ |/ |/ |/
c. Very dry mucous membranes
|/ |/ |/
d. Blood pressure of 90/42 mm Hg
|/ |/ |/ |/ |/
e. Urine output 500 mL past 8 hours: Answer: a, c & d
|/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/
a. Serum osmolality of 364 is elevated. The extremely high blood
|/ |/ |/ |/ |/ |/ |/ |/ |/
|/ glucose levels in HHNS increase serum osmolality.
|/ |/ |/ |/ |/ |/
b.Blood glucose levels for HHNS are usually over 600 mg/dL
|/ |/ |/ |/ |/ |/ |/ |/ |/
c. Persistent hyperglycemia in HHNS causes osmotic diuresis, a loss of
|/ |/ |/ |/ |/ |/ |/ |/ |/
|/ water and electrolytes and extreme dehydration. Very dry mucous
|/ |/ |/ |/ |/ |/ |/ |/
|/ membranes are a sign of dehydration. |/ |/ |/ |/ |/
d.Hypotension from the loss of water and electrolytes in HHNS |/ |/ |/ |/ |/ |/ |/ |/ |/
e. Urine output of 500 mL in 8 hours is normal. Clients with HHNS
|/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/
|/ experience polyuria. |/
4.1. The client develops SIADH secondary to a pituitary tumor. The client's
|/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/
|/ assessment findings include thirst, weight gain, fatigue, and a serum sodium
|/ |/ |/ |/ |/ |/ |/ |/ |/ |/
2 |// |/68
,of 127 mEq/L. Which intervention, if prescribed should the nurse implement to
|/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/
|/ treat SIADH? |/
a. Elevate the head of the bed 55 degrees |/ |/ |/ |/ |/ |/ |/
b. Administer vasopressin IV |/ |/
c. Restrict fluids to 800-1000 mL per day |/ |/ |/ |/ |/ |/
d. Give 0.3% sodium chloride per IV infusion: Answer: c
|/ |/ |/ |/ |/ |/ |/ |/
a. Incorrect - position client to promote venous return to the heart|/ |/ |/ |/ |/ |/ |/ |/ |/ |/
b.Incorrect - Vasopressin is an ADH and will aggravate the client's problem
|/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/
c. If symptoms are mild and hyponatremia is not severe, treatment
|/ |/ |/ |/ |/ |/ |/ |/ |/
|/ includes fluid restriction to 800-1000 ml/day.
|/ |/ |/ |/ |/
d.Incorrect - Hypertonic saline should be reserved for treatment of |/ |/ |/ |/ |/ |/ |/ |/ |/
|/ severe hypona- tremia |/ |/
5.1. The nurse is assessing the client with a tentative diagnosis of meningitis.
|/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/
|/ Which findings should the nurse associate with meningitis? Select all that
|/ |/ |/ |/ |/ |/ |/ |/ |/ |/
|/ apply
a. Nuchal rigidity |/
b. Severe headache |/
c. Pill-rolling tremor |/
d. Photophobia: Answer: a, b, d |/ |/ |/ |/
All answers are correct except pill-rolling tremors which are associated with
|/ |/ |/ |/ |/ |/ |/ |/ |/ |/
|/ Parkin- son's disease |/ |/
6.1. The nurse is caring for the client with a spinal cord injury at the C6
|/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/
|/ vertebrae. Which findings support the nurse's conclusion that the client may
|/ |/ |/ |/ |/ |/ |/ |/ |/ |/
|/ be experiencing autonomic dysreflexia? Select all that apply
|/ |/ |/ |/ |/ |/ |/
3 |// |/68
, a. Blurred vision |/
b. BP 198/102 |/
c. Heart rate 150 bpm |/ |/ |/
d. Extreme headache |/
e. Sweaty face and arms: Answer: a, b, d, & e |/ |/ |/ |/ |/ |/ |/ |/ |/
a. Blurred vision results from the HTN occurring with autonomic
|/ |/ |/ |/ |/ |/ |/ |/
|/ dysreflexia
b.HTN is a symptom of autonomic dysreflexia from overstimulation of the
|/ |/ |/ |/ |/ |/ |/ |/ |/ |/
|/ SNS
c. Bradycardia (not tachycardia) is a symptom of autonomic dysreflexia |/ |/ |/ |/ |/ |/ |/ |/
d.HA results from the HTN
|/ |/ |/ |/
e. Sweating results from the sympathetic stimulation above the level of
|/ |/ |/ |/ |/ |/ |/ |/ |/
|/ injury
7.7. The nurse learns in report that the client admitted with a vertebral fracture
|/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/
|/ has a halo external fixation device in place. Which intervention should the
|/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/
|/ nurse plan? |/
a. Ensure the traction weight hangs freely |/ |/ |/ |/ |/
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ANSWERS |/
1.1. Michael is a 24 year old man who presents with a 6 hour history of sudden
|/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/
|/ onset of inability to raise his eyebrow or smile on the right side. He also reports
|/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/
|/ decreased lacrimation in the right eye and difficulty closing the right eyelid.
|/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/
|/ The rest of his health history and physical exam is otherwise unremarkable.
|/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/
|/ This likely represents paralysis of cranial nerve (CN):
|/ |/ |/ |/ |/ |/ |/
a. III.
b. VIII.
c. IV.
d. VII.: Answer: d (KNOW HOW TO ASSESS ALL CRANIAL NERVES)
|/ |/ |/ |/ |/ |/ |/ |/ |/
2.1. The nurse is evaluates the client who is being treated for DKA. Which
|/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/
|/ finding indicates that the client is responding to the treatment plan?
|/ |/ |/ |/ |/ |/ |/ |/ |/ |/
a. Eyes sunken and skin flushed |/ |/ |/ |/
b. Skin moist with rapid elastic recoil |/ |/ |/ |/ |/
c. Serum potassium level is 3.3 mEq/L |/ |/ |/ |/ |/
d. ABG results are pH 7.25, Paco2 30, HCO3 17: Answer: b - these are signs
|/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/
|/ that the patient is well hydrated
|/ |/ |/ |/ |/
A - incorrect - s/sx of dehydration
|/ |/ |/ |/ |/ |/
C - incorrect - hypokalemia
|/ |/ |/ |/
D - incorrect - you might see these ABG results in the DKA patient when
|/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/
|/ they first present to the hospital
|/ |/ |/ |/ |/
3.1. The nurse is assess the client who has Type II Diabetes. Which findings
|/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/
1 |// |/68
,|/ indicate to the nurse that the client is experiencing HHNS? Select all that
|/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/
|/ apply
a. Serum osmolality 364 mOsm/kg
|/ |/ |/
b. Blood glucose level 160 mg/dL
|/ |/ |/ |/
c. Very dry mucous membranes
|/ |/ |/
d. Blood pressure of 90/42 mm Hg
|/ |/ |/ |/ |/
e. Urine output 500 mL past 8 hours: Answer: a, c & d
|/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/
a. Serum osmolality of 364 is elevated. The extremely high blood
|/ |/ |/ |/ |/ |/ |/ |/ |/
|/ glucose levels in HHNS increase serum osmolality.
|/ |/ |/ |/ |/ |/
b.Blood glucose levels for HHNS are usually over 600 mg/dL
|/ |/ |/ |/ |/ |/ |/ |/ |/
c. Persistent hyperglycemia in HHNS causes osmotic diuresis, a loss of
|/ |/ |/ |/ |/ |/ |/ |/ |/
|/ water and electrolytes and extreme dehydration. Very dry mucous
|/ |/ |/ |/ |/ |/ |/ |/
|/ membranes are a sign of dehydration. |/ |/ |/ |/ |/
d.Hypotension from the loss of water and electrolytes in HHNS |/ |/ |/ |/ |/ |/ |/ |/ |/
e. Urine output of 500 mL in 8 hours is normal. Clients with HHNS
|/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/
|/ experience polyuria. |/
4.1. The client develops SIADH secondary to a pituitary tumor. The client's
|/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/
|/ assessment findings include thirst, weight gain, fatigue, and a serum sodium
|/ |/ |/ |/ |/ |/ |/ |/ |/ |/
2 |// |/68
,of 127 mEq/L. Which intervention, if prescribed should the nurse implement to
|/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/
|/ treat SIADH? |/
a. Elevate the head of the bed 55 degrees |/ |/ |/ |/ |/ |/ |/
b. Administer vasopressin IV |/ |/
c. Restrict fluids to 800-1000 mL per day |/ |/ |/ |/ |/ |/
d. Give 0.3% sodium chloride per IV infusion: Answer: c
|/ |/ |/ |/ |/ |/ |/ |/
a. Incorrect - position client to promote venous return to the heart|/ |/ |/ |/ |/ |/ |/ |/ |/ |/
b.Incorrect - Vasopressin is an ADH and will aggravate the client's problem
|/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/
c. If symptoms are mild and hyponatremia is not severe, treatment
|/ |/ |/ |/ |/ |/ |/ |/ |/
|/ includes fluid restriction to 800-1000 ml/day.
|/ |/ |/ |/ |/
d.Incorrect - Hypertonic saline should be reserved for treatment of |/ |/ |/ |/ |/ |/ |/ |/ |/
|/ severe hypona- tremia |/ |/
5.1. The nurse is assessing the client with a tentative diagnosis of meningitis.
|/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/
|/ Which findings should the nurse associate with meningitis? Select all that
|/ |/ |/ |/ |/ |/ |/ |/ |/ |/
|/ apply
a. Nuchal rigidity |/
b. Severe headache |/
c. Pill-rolling tremor |/
d. Photophobia: Answer: a, b, d |/ |/ |/ |/
All answers are correct except pill-rolling tremors which are associated with
|/ |/ |/ |/ |/ |/ |/ |/ |/ |/
|/ Parkin- son's disease |/ |/
6.1. The nurse is caring for the client with a spinal cord injury at the C6
|/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/
|/ vertebrae. Which findings support the nurse's conclusion that the client may
|/ |/ |/ |/ |/ |/ |/ |/ |/ |/
|/ be experiencing autonomic dysreflexia? Select all that apply
|/ |/ |/ |/ |/ |/ |/
3 |// |/68
, a. Blurred vision |/
b. BP 198/102 |/
c. Heart rate 150 bpm |/ |/ |/
d. Extreme headache |/
e. Sweaty face and arms: Answer: a, b, d, & e |/ |/ |/ |/ |/ |/ |/ |/ |/
a. Blurred vision results from the HTN occurring with autonomic
|/ |/ |/ |/ |/ |/ |/ |/
|/ dysreflexia
b.HTN is a symptom of autonomic dysreflexia from overstimulation of the
|/ |/ |/ |/ |/ |/ |/ |/ |/ |/
|/ SNS
c. Bradycardia (not tachycardia) is a symptom of autonomic dysreflexia |/ |/ |/ |/ |/ |/ |/ |/
d.HA results from the HTN
|/ |/ |/ |/
e. Sweating results from the sympathetic stimulation above the level of
|/ |/ |/ |/ |/ |/ |/ |/ |/
|/ injury
7.7. The nurse learns in report that the client admitted with a vertebral fracture
|/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/
|/ has a halo external fixation device in place. Which intervention should the
|/ |/ |/ |/ |/ |/ |/ |/ |/ |/ |/
|/ nurse plan? |/
a. Ensure the traction weight hangs freely |/ |/ |/ |/ |/
4 |// |/68
