QUIZ: CHAPTER 53, CARE OF THE
PATIENT WITH A NEUROLOGIC
DISORDER
What is the earliest sign of increased intracranial pressure? - ANSWER - Change in
level of consciousness (LOC)
A change in LOC is the earliest sign of increased intracranial pressure. This change
in LOC may include disorientation, restlessness, or lethargy. Widening pulse
pressure occurs because of an increased systolic blood pressure (resulting from
excitation of vasoconstrictor fibers from ischemia of the vasomotor center)
coupled with a stable diastolic blood pressure. This occurs later in the process of
increased intracranial pressure, when herniation is imminent. Ipsilateral pupil
dilation will occur as a result of compression of cranial nerve III (oculomotor)
when the lesion is in one hemisphere. This occurs later in the process of increased
intracranial pressure, when herniation is imminent. An ataxic breathing pattern is
an irregular and unpredictable breathing pattern with random, shallow, and deep
breaths and occasional pauses. This will occur very late in the process of increased
intracranial pressure.
When taking the history of a patient with a migraine headache, what features of a
migraine headache is the patient likely to report? Select all that apply. - ANSWER -
The headache is usually unilateral.
The headache is preceded by an aura.
The headache is usually triggered by foods, such as chocolate.
Migraine headaches are usually unilateral and are usually preceded by an aura,
which can be a visual, sensory, or motor phenomenon. The headache can be
,triggered by certain foods, including chocolate, cheese, tomatoes, onions, and
oranges. Migraine headaches may last from 4 hours to 72 hours. The nature of
the headache is not sharp and stabbing but rather steady and throbbing.
A nurse is assessing a patient using the Full Outline of UnResponsiveness (FOUR)
score coma scale. Which categories will the nurse use to evaluate the patient's
status? Select all that apply. - ANSWER - Respiration
Eye response
Motor response
Brainstem reflexes
The FOUR score coma scale uses respiration, eye response, motor response, and
brainstem reflexes to measure the patient's level of consciousness and coma
status. Verbal response is a part of the Glasgow Coma Scale.
What neurotransmitter primarily affects motor function and is involved in gross
subconscious movements of the skeletal muscles? - ANSWER - Dopamine.
The neurotransmitter that primarily affects motor function and is involved in
gross subconscious movements of the skeletal muscles is dopamine. Dopamine
also plays a role in emotional responses. In Parkinson disease, there is a deficiency
of dopamine and the patient develops tremors or involuntary trembling
movements. Acetylcholine plays a role in nerve impulse transmission; it spills into
the synapse area and speeds the transmission of the impulse. Norepinephrine has
an impact on maintaining arousal, dreaming, and regulation of mood. Serotonin
induces sleep, affects sensory perception, controls temperature, and has a role in
the control of mood.
, A patient with a history of cluster headaches is planning to travel overseas by air.
What advice should the nurse give to this patient to decrease the likelihood of
such attacks during air travel? - ANSWER - Take ergotamine before the flight takes
off.
Cluster headache attacks may occur at high altitudes with low oxygen levels
during air travel. Ergotamine, taken before the plane takes off, may decrease the
likelihood of these attacks. Patients with cluster headaches can travel by air with
precautions to avoid the headaches. Consumption of food items including
chocolate, cheese, or tomatoes is not related to cluster headaches, but it may
trigger migraine headaches. Massaging and applying moist hot packs to the neck
and head can help a patient with tension-type headaches, but it may not help
relieve cluster headaches.
A patient with multiple sclerosis is prescribed with a prophylactic dose of
macrodantin (nitrofurantoin) and is asked to drink at least 2000 mL of fluids per
day. What is the rationale for this prescription? Select all that apply. - ANSWER -
To prevent urinary tract infections.
To prevent difficulty in defecation.
Patients with multiple sclerosis have frequent bladder and bowel problems due to
neuronal degeneration. An adequate amount of fluids (at least 2000 mL/day)
should be taken to prevent difficulty in defecation. Patients with multiple sclerosis
are at a higher risk of developing urinary tract infections (UTI) and are therefore
prescribed with a prophylactic dose of macrodantin (nitrofurantoin) to prevent
the occurrence of UTIs. Patients who take medication for multiple sclerosis are at
a higher risk for cardiac compromise. However, a prescription for macrodantin
(nitrofurantoin) and the intake of fluids is unrelated to the prevention of cardiac
problems. Patients with multiple sclerosis do not develop respiratory infections;
therefore, the medication and fluid intake is completely unrelated to respiratory
infection. Patients with multiple sclerosis do not develop liver disorders.
PATIENT WITH A NEUROLOGIC
DISORDER
What is the earliest sign of increased intracranial pressure? - ANSWER - Change in
level of consciousness (LOC)
A change in LOC is the earliest sign of increased intracranial pressure. This change
in LOC may include disorientation, restlessness, or lethargy. Widening pulse
pressure occurs because of an increased systolic blood pressure (resulting from
excitation of vasoconstrictor fibers from ischemia of the vasomotor center)
coupled with a stable diastolic blood pressure. This occurs later in the process of
increased intracranial pressure, when herniation is imminent. Ipsilateral pupil
dilation will occur as a result of compression of cranial nerve III (oculomotor)
when the lesion is in one hemisphere. This occurs later in the process of increased
intracranial pressure, when herniation is imminent. An ataxic breathing pattern is
an irregular and unpredictable breathing pattern with random, shallow, and deep
breaths and occasional pauses. This will occur very late in the process of increased
intracranial pressure.
When taking the history of a patient with a migraine headache, what features of a
migraine headache is the patient likely to report? Select all that apply. - ANSWER -
The headache is usually unilateral.
The headache is preceded by an aura.
The headache is usually triggered by foods, such as chocolate.
Migraine headaches are usually unilateral and are usually preceded by an aura,
which can be a visual, sensory, or motor phenomenon. The headache can be
,triggered by certain foods, including chocolate, cheese, tomatoes, onions, and
oranges. Migraine headaches may last from 4 hours to 72 hours. The nature of
the headache is not sharp and stabbing but rather steady and throbbing.
A nurse is assessing a patient using the Full Outline of UnResponsiveness (FOUR)
score coma scale. Which categories will the nurse use to evaluate the patient's
status? Select all that apply. - ANSWER - Respiration
Eye response
Motor response
Brainstem reflexes
The FOUR score coma scale uses respiration, eye response, motor response, and
brainstem reflexes to measure the patient's level of consciousness and coma
status. Verbal response is a part of the Glasgow Coma Scale.
What neurotransmitter primarily affects motor function and is involved in gross
subconscious movements of the skeletal muscles? - ANSWER - Dopamine.
The neurotransmitter that primarily affects motor function and is involved in
gross subconscious movements of the skeletal muscles is dopamine. Dopamine
also plays a role in emotional responses. In Parkinson disease, there is a deficiency
of dopamine and the patient develops tremors or involuntary trembling
movements. Acetylcholine plays a role in nerve impulse transmission; it spills into
the synapse area and speeds the transmission of the impulse. Norepinephrine has
an impact on maintaining arousal, dreaming, and regulation of mood. Serotonin
induces sleep, affects sensory perception, controls temperature, and has a role in
the control of mood.
, A patient with a history of cluster headaches is planning to travel overseas by air.
What advice should the nurse give to this patient to decrease the likelihood of
such attacks during air travel? - ANSWER - Take ergotamine before the flight takes
off.
Cluster headache attacks may occur at high altitudes with low oxygen levels
during air travel. Ergotamine, taken before the plane takes off, may decrease the
likelihood of these attacks. Patients with cluster headaches can travel by air with
precautions to avoid the headaches. Consumption of food items including
chocolate, cheese, or tomatoes is not related to cluster headaches, but it may
trigger migraine headaches. Massaging and applying moist hot packs to the neck
and head can help a patient with tension-type headaches, but it may not help
relieve cluster headaches.
A patient with multiple sclerosis is prescribed with a prophylactic dose of
macrodantin (nitrofurantoin) and is asked to drink at least 2000 mL of fluids per
day. What is the rationale for this prescription? Select all that apply. - ANSWER -
To prevent urinary tract infections.
To prevent difficulty in defecation.
Patients with multiple sclerosis have frequent bladder and bowel problems due to
neuronal degeneration. An adequate amount of fluids (at least 2000 mL/day)
should be taken to prevent difficulty in defecation. Patients with multiple sclerosis
are at a higher risk of developing urinary tract infections (UTI) and are therefore
prescribed with a prophylactic dose of macrodantin (nitrofurantoin) to prevent
the occurrence of UTIs. Patients who take medication for multiple sclerosis are at
a higher risk for cardiac compromise. However, a prescription for macrodantin
(nitrofurantoin) and the intake of fluids is unrelated to the prevention of cardiac
problems. Patients with multiple sclerosis do not develop respiratory infections;
therefore, the medication and fluid intake is completely unrelated to respiratory
infection. Patients with multiple sclerosis do not develop liver disorders.
