MDC 4 COMPREHENSIVE EXAM UPDATED QUESTIONS AND
SOLUTIONS RATED A+
✔✔what are seizure - ✔✔abnormal and increase in firing of neurons
✔✔what is epilepsy - ✔✔chronic seizures
✔✔what triggers seizures - ✔✔stress, fatigue, coffee
✔✔what are risk factors for seizures - ✔✔infection, trauma, fever, withdrawal,
imbalances
✔✔How do you diagnose siezures - ✔✔EEG (wash hair prior)
✔✔Seizure Precautions - ✔✔- padded bed rails
- O2 and suction at bedside
- IV access
- lowest bed setting
✔✔Types of siezures - ✔✔absence, atonic, tonic clonic, status epilepticus
✔✔Absence Seizures - ✔✔- day dreaming
- LOC for a few seconds
- s/s = pick at clothes, lip smack, blank stare
✔✔Atonic Seizures - ✔✔loss of muscle tone - fall
✔✔Tonic Clonic seizure - ✔✔- tonic = stiffening
- clonic = rhythmic jerking
- postictal phase = coming back to - confused/sleepy
✔✔Status Epilepticus - ✔✔- medical emergency!
- 1 seizure that lasts > 5 mins
- repeat of seizure w/in 30 min
✔✔nursing care during siezure - ✔✔- turn patient on left side (#1)
- loosen restrictive clothing
- note onset and duration
- do NOT insert anything by mouth
✔✔Nursing care after seizure - ✔✔- take vitals
- perform neuro checks
- determine what trigger was
- maintain left lying position
,✔✔Treatment of seizures - ✔✔Phenytoin
- narrow range (10-20), s/s= gingival hyperplasia
Valproic acid
- s/s = hepatotoxic
Carbamazepine
- can cause a rash (Steven Johnson syndrome)
✔✔Education for Seizures and Seizure treatment - ✔✔- medication compliance (abrupt
withdrawal = rebound seizures)
- do not drive
- wear medical alert bracelet
✔✔surgical treatment of seizure - ✔✔- vagal nerve stimulator
- craniotomy
✔✔What is encephalitis? - ✔✔infection & inflammation of the brain tissue
***life threatening
✔✔How is encephalitis diagnosed? - ✔✔CSF analysis or EEG
✔✔What are the s/s of encephalitis? - ✔✔stiff neck, n/v, fever
✔✔What can encephalitis increase risk of? - ✔✔increased ICP
✔✔Nursing care for encephalitis - ✔✔- turn down lights and noise
- keep midline and HOB @ 30 degrees
- avoid straining activities
✔✔What is meningitis - ✔✔inflammation of meninges (around brain and spinal cord)
✔✔what are the two main types of meningitis - ✔✔1. viral - more common
2. bacterial - cause is step
✔✔Prevention of meningitis - ✔✔vaccination
- Hib for baby
- MCV4 for teens
✔✔Diagnosis of meningitis - ✔✔CSF analysis
, ✔✔What does CSF analysis look like for viral meningitis? - ✔✔clear, increased wbc and
protein
✔✔what does CSF analysis look like for bacterial meningitis - ✔✔cloudy, decreased
glucose, increased wbc, and protein
✔✔s/s of meningitis - ✔✔nuchal rigidity, n/v, photophobia, Brudzinski's sign, Kernig's
sign
✔✔What is Brudzinski's sign? - ✔✔After forced flexion of the neck there is a reflex
flexion of the hip and knee and abduction of the leg.
✔✔What is Kernig's sign? - ✔✔After flexing the hip and knee at 90 degree angles, pain
and resistance are noted.
✔✔Nursing care for Meningitis - ✔✔- bacterial = antibiotics
- viral = acyclovir
- steroids (decrease inflammation, increased infection)
- prophylaxis treatment for anyone in contact/exposed
- implement droplet precautions for first 24 hours of treatment
- Decrease ICP risk by elevating HOB, keep body midline, avoid straining activities, turn
everything down
✔✔What is MS? - ✔✔Autoimmune disease with chronic inflammation and no cure; just
periods of relapse and remition
✔✔what is patho of MS - ✔✔- body attacking its own myelin sheath
✔✔what causes MS - ✔✔genetic, autoimmune, infection
✔✔what are risk factors of MS - ✔✔female, white, 20-50 y/o
✔✔diagnosis of MS - ✔✔no 100% way
- MRI
- CSF analysis (increased WBC, proteins, IgG)
✔✔S/S of MS - ✔✔- muscle weakness
- intention tremors
- tinnitus
- vision (diplopia, nystagmus)
✔✔Nursing care for MS - ✔✔- protect from injury
- allow for periods of rest
- help manage stress b/c this can lead to relapse/remit
SOLUTIONS RATED A+
✔✔what are seizure - ✔✔abnormal and increase in firing of neurons
✔✔what is epilepsy - ✔✔chronic seizures
✔✔what triggers seizures - ✔✔stress, fatigue, coffee
✔✔what are risk factors for seizures - ✔✔infection, trauma, fever, withdrawal,
imbalances
✔✔How do you diagnose siezures - ✔✔EEG (wash hair prior)
✔✔Seizure Precautions - ✔✔- padded bed rails
- O2 and suction at bedside
- IV access
- lowest bed setting
✔✔Types of siezures - ✔✔absence, atonic, tonic clonic, status epilepticus
✔✔Absence Seizures - ✔✔- day dreaming
- LOC for a few seconds
- s/s = pick at clothes, lip smack, blank stare
✔✔Atonic Seizures - ✔✔loss of muscle tone - fall
✔✔Tonic Clonic seizure - ✔✔- tonic = stiffening
- clonic = rhythmic jerking
- postictal phase = coming back to - confused/sleepy
✔✔Status Epilepticus - ✔✔- medical emergency!
- 1 seizure that lasts > 5 mins
- repeat of seizure w/in 30 min
✔✔nursing care during siezure - ✔✔- turn patient on left side (#1)
- loosen restrictive clothing
- note onset and duration
- do NOT insert anything by mouth
✔✔Nursing care after seizure - ✔✔- take vitals
- perform neuro checks
- determine what trigger was
- maintain left lying position
,✔✔Treatment of seizures - ✔✔Phenytoin
- narrow range (10-20), s/s= gingival hyperplasia
Valproic acid
- s/s = hepatotoxic
Carbamazepine
- can cause a rash (Steven Johnson syndrome)
✔✔Education for Seizures and Seizure treatment - ✔✔- medication compliance (abrupt
withdrawal = rebound seizures)
- do not drive
- wear medical alert bracelet
✔✔surgical treatment of seizure - ✔✔- vagal nerve stimulator
- craniotomy
✔✔What is encephalitis? - ✔✔infection & inflammation of the brain tissue
***life threatening
✔✔How is encephalitis diagnosed? - ✔✔CSF analysis or EEG
✔✔What are the s/s of encephalitis? - ✔✔stiff neck, n/v, fever
✔✔What can encephalitis increase risk of? - ✔✔increased ICP
✔✔Nursing care for encephalitis - ✔✔- turn down lights and noise
- keep midline and HOB @ 30 degrees
- avoid straining activities
✔✔What is meningitis - ✔✔inflammation of meninges (around brain and spinal cord)
✔✔what are the two main types of meningitis - ✔✔1. viral - more common
2. bacterial - cause is step
✔✔Prevention of meningitis - ✔✔vaccination
- Hib for baby
- MCV4 for teens
✔✔Diagnosis of meningitis - ✔✔CSF analysis
, ✔✔What does CSF analysis look like for viral meningitis? - ✔✔clear, increased wbc and
protein
✔✔what does CSF analysis look like for bacterial meningitis - ✔✔cloudy, decreased
glucose, increased wbc, and protein
✔✔s/s of meningitis - ✔✔nuchal rigidity, n/v, photophobia, Brudzinski's sign, Kernig's
sign
✔✔What is Brudzinski's sign? - ✔✔After forced flexion of the neck there is a reflex
flexion of the hip and knee and abduction of the leg.
✔✔What is Kernig's sign? - ✔✔After flexing the hip and knee at 90 degree angles, pain
and resistance are noted.
✔✔Nursing care for Meningitis - ✔✔- bacterial = antibiotics
- viral = acyclovir
- steroids (decrease inflammation, increased infection)
- prophylaxis treatment for anyone in contact/exposed
- implement droplet precautions for first 24 hours of treatment
- Decrease ICP risk by elevating HOB, keep body midline, avoid straining activities, turn
everything down
✔✔What is MS? - ✔✔Autoimmune disease with chronic inflammation and no cure; just
periods of relapse and remition
✔✔what is patho of MS - ✔✔- body attacking its own myelin sheath
✔✔what causes MS - ✔✔genetic, autoimmune, infection
✔✔what are risk factors of MS - ✔✔female, white, 20-50 y/o
✔✔diagnosis of MS - ✔✔no 100% way
- MRI
- CSF analysis (increased WBC, proteins, IgG)
✔✔S/S of MS - ✔✔- muscle weakness
- intention tremors
- tinnitus
- vision (diplopia, nystagmus)
✔✔Nursing care for MS - ✔✔- protect from injury
- allow for periods of rest
- help manage stress b/c this can lead to relapse/remit
