Chapter 14: Dizziness
1. A 60-year-old female complains of several episodes of dizziness and nausea that started this
morning. She denies trauma, falling, or loss of consciousness. She has a 5-year history of
hypertension and takes a beta blocker daily. On physical examination, there are no neurologic
deficits or any abnormal findings and ECG is normal. Which of the following tests should be
performed?
A. Test the patient for Kernig’s sign
B. Test the patient for Brudzinski sign
C. Perform the Hallpike maneuver
D. Assess for Babinski’s sign
ANS: A
Delirium can be observed in both elderly and younger patients and is generally defined as an acute
confusional state, affecting all aspects of cognition and mentation. The signs and
symptoms of delirium generally have a more acute or rapidly progressive onset as opposed to the
slow, gradual decline noted in the organic dementias. The acute mental status change is often
associated with other signs or symptoms—such as hallucinations, illusions, incoherent speech, and
constant aimless activity—that help to narrow the differential diagnosis. Electrolyte disturbances,
infection, and polypharmacy are frequent causes of delirium in the elderly.
2. You are an emergency room clinician that assisted with CPR on a 20-year-old trauma patient. The
CPR was unsuccessful, the patient expired, and you need to explain this to the family in the waiting
room. Upon telling the mother about the death of her son, she becomes dizzy and faints. What is the
most likely cause for the woman fainting?
A. Cardiogenic shock
B. Vasovagal response
C. Syncope due to hypoxia
D. Dizziness and vertigo
ANS: B
Neurocardiogenic syncope, also called vasovagal syncope, is a common cause of dizziness and
fainting. It is due to a sudden decrease in blood pressure and heart rate after prolonged standing,
with stress, or from dehydration. It is a result of sympathetic sensitivity, causing a reflexive response
that suddenly causes bradycardia and venous dilation. Hypotension and dizziness result.
3. A client is in the emergency department reporting a brief episode during which he was dizzy,
unable to speak, and felt like his legs were very heavy. Currently the clients neurologic examination
is normal. About what drug should the nurse plan to teach the client?
1. A 60-year-old female complains of several episodes of dizziness and nausea that started this
morning. She denies trauma, falling, or loss of consciousness. She has a 5-year history of
hypertension and takes a beta blocker daily. On physical examination, there are no neurologic
deficits or any abnormal findings and ECG is normal. Which of the following tests should be
performed?
A. Test the patient for Kernig’s sign
B. Test the patient for Brudzinski sign
C. Perform the Hallpike maneuver
D. Assess for Babinski’s sign
ANS: A
Delirium can be observed in both elderly and younger patients and is generally defined as an acute
confusional state, affecting all aspects of cognition and mentation. The signs and
symptoms of delirium generally have a more acute or rapidly progressive onset as opposed to the
slow, gradual decline noted in the organic dementias. The acute mental status change is often
associated with other signs or symptoms—such as hallucinations, illusions, incoherent speech, and
constant aimless activity—that help to narrow the differential diagnosis. Electrolyte disturbances,
infection, and polypharmacy are frequent causes of delirium in the elderly.
2. You are an emergency room clinician that assisted with CPR on a 20-year-old trauma patient. The
CPR was unsuccessful, the patient expired, and you need to explain this to the family in the waiting
room. Upon telling the mother about the death of her son, she becomes dizzy and faints. What is the
most likely cause for the woman fainting?
A. Cardiogenic shock
B. Vasovagal response
C. Syncope due to hypoxia
D. Dizziness and vertigo
ANS: B
Neurocardiogenic syncope, also called vasovagal syncope, is a common cause of dizziness and
fainting. It is due to a sudden decrease in blood pressure and heart rate after prolonged standing,
with stress, or from dehydration. It is a result of sympathetic sensitivity, causing a reflexive response
that suddenly causes bradycardia and venous dilation. Hypotension and dizziness result.
3. A client is in the emergency department reporting a brief episode during which he was dizzy,
unable to speak, and felt like his legs were very heavy. Currently the clients neurologic examination
is normal. About what drug should the nurse plan to teach the client?
