Neuro Sample Exam with Answers: Traumatic Brain Injury and Related Neurological Conditions, Exams of Nursing

Download Neuro Sample Exam with Answers: Traumatic Brain Injury and Related Neurological Conditions and more Exams Nursing in PDF only on Docsity! NR 265: NEURO SAMPLE EXAM WITH ANSWER S . Download to score 1) A nurse cares for older clients who have traumatic brain injury. What should the nurse understand about this population? (Select all that apply.) A. Admission can overwhelm the coping mechanisms for older clients. B. Alcohol is typically involved in most traumatic brain injuries for this age group. C. These clients are more susceptible to systemic and wound infections. D. Other medical conditions can complicate treatment for these clients. E. Very few traumatic brain injuries occur in this age group. 2) A client has meningitis following brain surgery. What comfort measures may the nurse delegate to the unlicensed assistive personnel (UAP)? (Select all that apply.) A. Applying a cool washcloth to the head B. Assisting the client to a position of comfort C. Keeping voices sof t and soothing D. Maintaining low lighting in the room E. Providing antipyretics for fever NR 265: NEURO SAMPLE EXAM WITH ANSWER S . Download to score 3) A client has a small-bore feeding tube (Dobhoff tube) inserted for continuous enteral feedings while recovering from a traumatic brain injury. What actions should the nurse include in the client’s care? (Select all that apply.) A. Assess tube placement per agency policy. B. Keep the head of the bed elevated at least 30 degrees. C. Listen to lung sounds at least every 4 hours D. Run continuous feedings on a feeding pump. E. Use blue dye to determine proper placement. 4) A nurse is dismissing a client from the emergency department who has a mild traumatic brain injury. What information obtained from the client represents a possible barrier to self- management? (Select all that apply.) A. Does not want to purchase a thermometer B. Is allergic to acetaminophen (Tylenol) Correct C. Laughing, says “Strenuous? What’s that?” D. Lives alone and is new in town with no friends Correct E. Plans to have a beer and go to bed once home Correct 5) The nurse is evaluating the collaborative care of a client with traumatic brain injury (TBI). What is the most important goal for this client? A. Achieving the highest level of functioning NR 265: NEURO SAMPLE EXAM WITH ANSWER S . Download to score 10) The nurse is monitoring a postoperative craniotomy client with increased intracranial pressure (ICP). Which pharmacologic agent does the nurse expect to be requested to maintain the ICP within a specified range? A. Dexamethasone (Decadron) B. Hydrochlorothiazide (HydroDIURIL) C. Mannitol (Osmitrol) D. Phenytoin (Dilantin) 11) A client is admitted with a brain abscess. Which diagnostic assessment intervention does the nurse question as nonspecific to the diagnosis? A. Bone scan B. Electroencephalogram (EEG) C. Throat culture D. Sinus x-rays 12) A nurse prepares to provide perineal care to a client with meningococcal meningitis. Which personal protective equipment should the nurse wear? (Select all that apply.) A. Particulate respirator B. Isolation gown C. Shoe covers D. Surgical mask Correct E. Gloves Correct NR 265: NEURO SAMPLE EXAM WITH ANSWER S . Download to score 13) A nurse is caring for a client with meningitis. Which laboratory values should the nurse monitor to identify potential complications of this disorder? (Select all that apply.) A. Sodium level B. Liver enzymes C. Clotting factors D. Cardiac enzymes E. Creatinine level 14) A nurse assesses a client who has encephalitis. Which manifestations should the nurse recognize as signs of increased intracranial pressure (ICP), a complication of encephalitis? (Select all that apply.) A. Photophobia B. Dilated pupils Correct C. Headache D. Widened pulse pressure Correct E. Bradycardia Correct 15) A nurse evaluates the results of diagnostic tests on a client’s cerebrospinal fluid (CSF). Which fluid results alerts the nurse to possible viral meningitis? (Select all that apply.) A. Clear Correct B. Cloudy NR 265: NEURO SAMPLE EXAM WITH ANSWER S . Download to score C. Increased protein level Correct NR 265: NEURO SAMPLE EXAM WITH ANSWER S . Download to score C. “Implement digital anal stimulation when your bladder is full.” D. “Tighten your abdominal muscles to stimulate urine flow.” 20) A nurse is caring for a client with paraplegia who is scheduled to participate in a rehabilitation program. The client states, “I do not understand the need for rehabilitation; the paralysis will not go away and it will not get better.” How should the nurse respond? A. “If you don’t want to participate in the rehabilitation program, I’ll let the provider know.” B. “Rehabilitation programs have helped many clients with your injury. You should give it a chance.” C. “The rehabilitation program will teach you how to maintain the functional ability you have and prevent further disability.” Correct D. “When new discoveries are made regarding paraplegia, people in rehabilitation programs will benefit first.” 21) A nurse assesses a client with a neurologic disorder. Which assessment finding should the nurse identify as a late manifestation of amyotrophic lateral sclerosis (ALS)? A. Dysarthria B. Dysphagia C. Muscle weakness D. Impairment of respiratory muscles 22) A nurse cares for a client with a spinal cord injury. With which interdisciplinary team member should the nurse consult to assist the client with activities of daily living? NR 265: NEURO SAMPLE EXAM WITH ANSWER S . Download to score A. Social worker B. Physical therapist C. Occupational therapist D. Case manager 23) A nurse cares for a client with amyotrophic lateral sclerosis (ALS). The client states, “I do not want to be placed on a mechanical ventilator.” How should the nurse respond? A. “You should discuss this with your family and health care provider.” B. “Why are you afraid of being placed on a breathing machine?” C. “Using the incentive spirometer each hour will delay the need for a ventilator.” NR 265: NEURO SAMPLE EXAM WITH ANSWER S . Download to score D. “What would you like to be done if you begin to have difficulty breathing?” 24) A nurse assesses a client who recently experienced a traumatic spinal cord injury. Which assessment data should the nurse obtain to assess the client’s coping strategies? (Select all that apply.) A. Spiritual beliefs B. Level of pain C. Family support D. Level of independence E. Annual income F.Previous coping strategies 25) After teaching a male client with a spinal cord injury at the T4 level, the nurse assesses the client’s understanding. Which client statements indicate a correct understanding of the teaching related to sexual effects of this injury? (Select all that apply.) A. “I will explore other ways besides intercourse to please my partner.” B. “I will not be able to have an erection because of my injury.” C. “Ejaculation may not be as predictable as before.” D. “I may urinate with ejaculation but this will not cause infection.” E. “I should be able to have an erection with stimulation.” 26) A nurse assesses a client with paraplegia from a spinal cord injury and notes reddened areas over the client’s hips and sacrum. Which actions should the nurse take? (Select all that apply.) A. Apply a barrier cream to protect the skin from excoriation. NR 265: NEURO SAMPLE EXAM WITH ANSWER S . Download to score A. Delayed afferent nerve impulses B. Paralysis of affected muscles C. Paresthesia in upper extremities D. Slowed nerve impulse transmission 31) A client with Guillain-Barré syndrome is admitted to the hospital. The nurse plans caregiving priority to interventions that address which priority client problem? A. Anxiety B. Low fluid volume NR 265: NEURO SAMPLE EXAM WITH ANSWER S . Download to score C. Inadequate airway D. Potential for skin breakdown 32) The nurse is preparing a client for a Tensilon (edrophonium chloride) test. What action by the nurse is most important? A. Administering anxiolytics B. Having a ventilator nearby C. Obtaining atropine sulfate D. Sedating the client 33) A client is taking long-term corticosteroids for myasthenia gravis. What teaching is most important? A. Avoid large crowds and people who are ill. B. Check blood sugars four times a day. C. Use two forms of contraception. D. Wear properly fitting socks and shoes. 34) A client with myasthenia gravis has the priority client problem of inadequate nutrition. What assessment finding indicates that the priority goal for this client problem has been met? A. Ability to chew and swallow without aspiration B. Eating 75% of meals and between-meal snacks NR 265: NEURO SAMPLE EXAM WITH ANSWER S . Download to score C. Intake greater than output 3 days in a row D. Weight gain of 3 pounds in 1 month 35) A client has trigeminal neuralgia and has begun skipping meals and not brushing his teeth, and his family believes he has become depressed. What action by the nurse is best? A.Ask the client to explain his feelings related to this disorder. B. Explain how dental hygiene is related to overall health. C. Refer the client to a medical social worker for assessment. D. Tell the client that he will become malnourished in time NR 265: NEURO SAMPLE EXAM WITH ANSWER S . Download to score A. Acyclovir (Zovirax) B. Carbamazepine (Tegretol) C. Famciclovir (Famvir) D. Prednisone (Deltasone) E. Valacyclovir (Valtrex) 41) A client with myasthenia gravis is malnourished. What actions to improve nutrition may the nurse delegate to the unlicensed assistive personnel (UAP)? (Select all that apply.) A. Assessing the client’s gag reflex B. Cutting foods up into small bites C. Monitoring prealbumin levels D. Thickening liquids prior to drinking E. Weighing the client daily 42) An older adult client is hospitalized with Guillain-Barré syndrome. The client is given amitriptyline (Elavil). After receiving the hand-off report, what actions by the nurse are most important? (Select all that apply.) A. Administering the medication as ordered B. Advising the client to have help getting up C. Consulting the provider about the drug D. Cutting the dose of the drug in half E. Placing the client on safety precautions NR 265: NEURO SAMPLE EXAM WITH ANSWER S . Download to score 43) The nurse caring for a client with Guillain-Barré syndrome has identified the priority client problem of decreased mobility for the client. What actions by the nurse are best? (Select all that apply.) A. Ask occupational therapy to help the client with activities of daily living. B. Consult with the provider about a physical therapy consult. C. Provide the client with information on support groups. D. Refer the client to a medical social worker or chaplain. E. Work with speech therapy to design a high-protein diet. NR 265: NEURO SAMPLE EXAM WITH ANSWER S . Download to score 44) A client’s mean arterial pressure is 60 mm Hg and intracranial pressure is 20 mm Hg. Based on the client’s cerebral perfusion pressure, what should the nurse anticipate for this client? A. Impending brain herniation B. Poor prognosis and cognitive function C. Probable complete recovery D. Unable to tell from this information 45) A client has a traumatic brain injury. The nurse assesses the following: pulse change from 82 to 60 beats/min, pulse pressure increase from 26 to 40 mm Hg, and respiratory irregularities. What action by the nurse takes priority? A. Call the provider or Rapid Response Team. B. Increase the rate of the IV fluid administration. C. Notify respiratory therapy for a breathing treatment. D. Prepare to give IV pain medication. 46) A nurse is caring for four clients in the neurologic intensive care unit. After receiving the hand-off report, which client should the nurse see first? A. Client with a Glasgow Coma Scale score that was 10 and is now is 8 Correct B. Client with a Glasgow Coma Scale score that was 9 and is now is 12 C. Client with a moderate brain injury who is amnesic for the event D. Client who is requesting pain medication for a headache NR 265: NEURO SAMPLE EXAM WITH ANSWER S . Download to score 51) A client who had a severe traumatic brain injury is being discharged home, where the spouse will be a full-time caregiver. What statement by the spouse would lead the nurse to provide further education on home care? A. “I know I can take care of all these needs by myself.” B. “I need to seek counseling because I am very angry.” C. “Hopefully things will improve gradually over time.” D. “With respite care and support, I think I can do this.” NR 265: NEURO SAMPLE EXAM WITH ANSWER S . Download to score 52) A client in the intensive care unit is scheduled for a lumbar puncture (LP) today. On assessment, the nurse finds the client breathing irregularly with one pupil fixed and dilated. What action by the nurse is best? A. Ensure that informed consent is on the chart. B. Document these findings in the client’s record. C. Give the prescribed pre procedure sedation. D. Notify the provider of the findings immediately. 53) After a craniotomy, the nurse assesses the client and finds dry, sticky mucous membranes and restlessness. The client has IV fluids running at 75 mL/hr. What action by the nurse is best? A. Assess the client’s magnesium level. B. Assess the client’s sodium level. C. Increase the rate of the IV infusion. D. Provide oral care every hour. 54) A nurse assesses a client with the National Institutes of Health (NIH) Stroke Scale and determines the client’s score to be 36. How should the nurse plan care for this client? A. The client will need near-total care. B. The client will need cuing only. C. The client will need safety precautions. D. The client will be discharged home. NR 265: NEURO SAMPLE EXAM WITH ANSWER S . Download to score 55) A client has a brain abscess and is receiving phenytoin (Dilantin). The spouse questions the use of the drug, saying the client does not have a seizure disorder. What response by the nurse is best? A. “Increased pressure from the abscess can cause seizures.” B. “Preventing febrile seizures with an abscess is important.” C. “Seizures always occur in clients with brain abscesses.” D. “This drug is used to sedate the client with an abscess.”