NSG 233 MED SURG 2 EXAM 2
LATEST EDITION 2025/26 WITH EXACT
QUESTIONS AND CORRECT
ANSWERS|GRADED A+
A client has a history of diabetes mellitus. After assessing the client,
the primary healthcare provider confirms damage to the sensory
limb of the bladder spinal reflex arc. Which clinical manifestations
could confirm this condition?
1. Incomplete voiding
2. Overdistention of bladder
3. Lack of control on micturition
4. Infrequent voiding of large residual volumes - ANSWER-4.
Infrequent voiding of large residual volumes
Damage to the sensory limb of the bladder spinal reflex arc is a type
of sensory neurogenic bladder where the client lacks the sensation of
needing to urinate. This is usually seen in clients with multiple
sclerosis and diabetes mellitus. Its clinical manifestation is infrequent
voiding of large residual volumes. Incomplete voiding is a symptom of
reflexic neurogenic bladder. Overdistention of the bladder and lack of
control on micturition are the symptoms of areflexic neurogenic
bladder.
,What are the reasons for performing a lumbar puncture on a client?
Select all that apply.
1. Confirming spinal cord injuries
2. Assessing sensory nerve problems
3. Measuring blood flow in many areas
4. Reading cerebrospinal fluid pressure
5. Injecting contrast medium for diagnostic study - ANSWER-4.
Reading cerebrospinal fluid pressure
5. Injecting contrast medium for diagnostic study
A lumbar puncture is the insertion of a spinal needle into the
subarachnoid space between the third and fourth lumbar vertebrae;
it can be used to obtain cerebrospinal fluid readings with a
manometer. Using a lumbar puncture, contrast medium or air is
injected for diagnostic study. Evoked potentials measure the
electrical signals to the brain generated by sound, light, or touch, and
are used to confirm neurologic conditions like spinal cord injuries and
multiple sclerosis. Evoked potentials are also used to assess sensory
nerve problems. Cerebral blood flow evaluation is used to measure
blood flow in many areas using radioactive substances.
The nurse is conducting a neurologic assessment on a client brought
to the emergency room after a motor vehicle accident. While
assessing the client's response to pain, the client pulls his arms
upward and inward. The nurse recognizes that this response
represents an injury to what part of the brain?
1. Frontal lobe
2. Midbrain
,3. Pons
4. Brainstem - ANSWER-2. Midbrain
Decorticate posturing [1] [2] [3] is a sign of significant deterioration in
a client's neurologic status and is manifested by rigid flexing of
elbows and wrists. This can represent an injury to the midbrain.
Damage to the frontal lobe would affect motor function, problem
solving, spontaneity, memory, language, initiation, judgment, impulse
control, and social and sexual behavior. The pons (which is part of the
brainstem) and brainstem help control breathing and heart rate,
vision, hearing, sweating, blood pressure, digestion, alertness, sleep,
and sense of balance. Damage to this area would manifest itself as
abnormal responses in the above listed areas.
A nurse completes an admission assessment on a client who is
diagnosed with myasthenia gravis. Which clinical finding is the nurse
most likely to identify?
1. Problems with cognition
2. Difficult swallowing saliva
3. Intention tremors of the hands
4. Nonintention tremors of the extremities - ANSWER-2. Difficulty
swallowing saliva
Facial muscles innervated by the cranial nerves often are affected;
dysphagia, ptosis, and diplopia are present. Myasthenia gravis is a
neuromuscular disease with altered neuromuscular junction and
receptors, not central nervous system symptoms (problems with
cognition). Intention tremors of the hands are associated with
, multiple sclerosis. Nonintention tremors of the extremities are
associated with Parkinson disease.
The nurse is caring for a client who underwent surgery for a brain
tumor. On assessment, the nurse suspects meningitis in the client.
Which finding would help confirm the nurse's suspicion?
1. Positive Kernig's sign
2. Glasgow coma scale: 10
3. Absence of nuchal rigidity
4. Negative Brudzinski sign - ANSWER-1. Positive Kernig's sign
Meningitis may occur secondary to surgical procedures on the brain.
It is highly probable when Kernig sign is positive. The Glasgow coma
scale is used as a reliable way of recording the conscious state of the
client, but it is not used to diagnose meningitis. A meningitis
diagnosis is highly probable with a positive Brudzinski sign and the
presence of nuchal rigidity (e.g., stiff neck).
A client comes into the emergency room (ER) after hitting his head
while playing basketball. He is alert and oriented. Which is a priority
nursing intervention?
1. Assess full range of motion (ROM) to determine extent of injuries.
2. Call for an immediate head computed tomography (CT).
3. Immobilize the client's head and neck.
4. Open the airway with the head-tilt chin-lift maneuver. - ANSWER-3.
Immobilize the client's head and neck.
LATEST EDITION 2025/26 WITH EXACT
QUESTIONS AND CORRECT
ANSWERS|GRADED A+
A client has a history of diabetes mellitus. After assessing the client,
the primary healthcare provider confirms damage to the sensory
limb of the bladder spinal reflex arc. Which clinical manifestations
could confirm this condition?
1. Incomplete voiding
2. Overdistention of bladder
3. Lack of control on micturition
4. Infrequent voiding of large residual volumes - ANSWER-4.
Infrequent voiding of large residual volumes
Damage to the sensory limb of the bladder spinal reflex arc is a type
of sensory neurogenic bladder where the client lacks the sensation of
needing to urinate. This is usually seen in clients with multiple
sclerosis and diabetes mellitus. Its clinical manifestation is infrequent
voiding of large residual volumes. Incomplete voiding is a symptom of
reflexic neurogenic bladder. Overdistention of the bladder and lack of
control on micturition are the symptoms of areflexic neurogenic
bladder.
,What are the reasons for performing a lumbar puncture on a client?
Select all that apply.
1. Confirming spinal cord injuries
2. Assessing sensory nerve problems
3. Measuring blood flow in many areas
4. Reading cerebrospinal fluid pressure
5. Injecting contrast medium for diagnostic study - ANSWER-4.
Reading cerebrospinal fluid pressure
5. Injecting contrast medium for diagnostic study
A lumbar puncture is the insertion of a spinal needle into the
subarachnoid space between the third and fourth lumbar vertebrae;
it can be used to obtain cerebrospinal fluid readings with a
manometer. Using a lumbar puncture, contrast medium or air is
injected for diagnostic study. Evoked potentials measure the
electrical signals to the brain generated by sound, light, or touch, and
are used to confirm neurologic conditions like spinal cord injuries and
multiple sclerosis. Evoked potentials are also used to assess sensory
nerve problems. Cerebral blood flow evaluation is used to measure
blood flow in many areas using radioactive substances.
The nurse is conducting a neurologic assessment on a client brought
to the emergency room after a motor vehicle accident. While
assessing the client's response to pain, the client pulls his arms
upward and inward. The nurse recognizes that this response
represents an injury to what part of the brain?
1. Frontal lobe
2. Midbrain
,3. Pons
4. Brainstem - ANSWER-2. Midbrain
Decorticate posturing [1] [2] [3] is a sign of significant deterioration in
a client's neurologic status and is manifested by rigid flexing of
elbows and wrists. This can represent an injury to the midbrain.
Damage to the frontal lobe would affect motor function, problem
solving, spontaneity, memory, language, initiation, judgment, impulse
control, and social and sexual behavior. The pons (which is part of the
brainstem) and brainstem help control breathing and heart rate,
vision, hearing, sweating, blood pressure, digestion, alertness, sleep,
and sense of balance. Damage to this area would manifest itself as
abnormal responses in the above listed areas.
A nurse completes an admission assessment on a client who is
diagnosed with myasthenia gravis. Which clinical finding is the nurse
most likely to identify?
1. Problems with cognition
2. Difficult swallowing saliva
3. Intention tremors of the hands
4. Nonintention tremors of the extremities - ANSWER-2. Difficulty
swallowing saliva
Facial muscles innervated by the cranial nerves often are affected;
dysphagia, ptosis, and diplopia are present. Myasthenia gravis is a
neuromuscular disease with altered neuromuscular junction and
receptors, not central nervous system symptoms (problems with
cognition). Intention tremors of the hands are associated with
, multiple sclerosis. Nonintention tremors of the extremities are
associated with Parkinson disease.
The nurse is caring for a client who underwent surgery for a brain
tumor. On assessment, the nurse suspects meningitis in the client.
Which finding would help confirm the nurse's suspicion?
1. Positive Kernig's sign
2. Glasgow coma scale: 10
3. Absence of nuchal rigidity
4. Negative Brudzinski sign - ANSWER-1. Positive Kernig's sign
Meningitis may occur secondary to surgical procedures on the brain.
It is highly probable when Kernig sign is positive. The Glasgow coma
scale is used as a reliable way of recording the conscious state of the
client, but it is not used to diagnose meningitis. A meningitis
diagnosis is highly probable with a positive Brudzinski sign and the
presence of nuchal rigidity (e.g., stiff neck).
A client comes into the emergency room (ER) after hitting his head
while playing basketball. He is alert and oriented. Which is a priority
nursing intervention?
1. Assess full range of motion (ROM) to determine extent of injuries.
2. Call for an immediate head computed tomography (CT).
3. Immobilize the client's head and neck.
4. Open the airway with the head-tilt chin-lift maneuver. - ANSWER-3.
Immobilize the client's head and neck.
