Question 1

The nurse is caring for a client whose intracranial pressure waveform appears as shown. What action by the nurse is best?

Accepted Answer

A)  Calculate the client's CPP. 
B)  Ensure the client's neck is midline. 
C)  Document the findings in the chart. 
D)  Call an RRT. 
A)  Calculate the client's CPP. 
B)  Ensure the client's neck is midline. 
C)  Document the findings in the chart. 
D)  Call an RRT.

Question 2

The nurse is performing a neurological exam on a client and observes the following: Pupils: equal, round, reactive to light and accommodation; eyes open to verbal command; uses inappropriate words to answer questions; obeys commands; hand grasps are weak but equal bilaterally. Calculate the client's Glasgow Coma Score.

Accepted Answer

A)  3 
B)  6 
C)  9 
D)  12 
A)  3 
B)  6 
C)  9 
D)  12

Question 3

The nurse reviews the client's daily laboratory results and the results of a lumbar puncture. The client's serum glucose was 136 mg/dL and the spinal glucose was 75 mg/dL. What action does the nurse take?

Accepted Answer

A)  Document the findings in the client's chart. 
B)  Assess the client for infection. 
C)  Anticipate a work up for diabetes. 
D)  Compare the serum and CSF protein levels. 
A)  Document the findings in the client's chart. 
B)  Assess the client for infection. 
C)  Anticipate a work up for diabetes. 
D)  Compare the serum and CSF protein levels.

Question 4

The nurse observing a client during a seizure reports which findings to the provider? (Select all that apply.)

Accepted Answer

A)  Presentation of the seizure 
B)  Duration of the seizure 
C)  MEND score 
D)  Mental status after the seizure 
E)  Client behavior prior to the seizure 
A)  Presentation of the seizure 
B)  Duration of the seizure 
C)  MEND score 
D)  Mental status after the seizure 
E)  Client behavior prior to the seizure

Question 5

A client has the following data: Blood pressure: 116/72, Pulse: 68 beats/min, Respirations: ventilator rate 18 breaths/min, Temperature: 37 $\degree$ C (98.6 $\degree$ F), ICP 56, oxygen saturation 97%. Calculate the client's cerebral perfusion pressure. Round to the nearest whole number.The client's cerebral perfusion pressure is:

Accepted Answer

A)  31 
B)  46 
C)  142 
D)  203 
A)  31 
B)  46 
C)  142 
D)  203

The nurse is caring for a client whose intracranial pressure waveform appears as shown. What action by the nurse is best?

The nurse reviews the client's daily laboratory results and the results of a lumbar puncture. The client's serum glucose was 136 mg/dL and the spinal glucose was 75 mg/dL. What action does the nurse take?

The nurse observing a client during a seizure reports which findings to the provider? (Select all that apply.)

Foundations of Safe Client Care

Personal Care and Hygiene

Vital Signs and Vital Measurements

Performing an Assessment

Nutrition and Gastrointestinal Tube Therapy

Supporting Mobility and Immobilization

Comfort Care

End-Of-Life Care

Airway and Breathing

Sterile Technique

Medication Administration

Venous Access

Central Venous Access

Bowel Management

Urinary Elimination

Wound Care

Perioperative Care

Advanced Respiratory Management

Advanced Cardiovascular Care

Filters

Exam 20: Advanced Neurologic Care

The nurse is caring for a client whose intracranial pressure waveform appears as shown. What action by the nurse is best?

The nurse reviews the client's daily laboratory results and the results of a lumbar puncture. The client's serum glucose was 136 mg/dL and the spinal glucose was 75 mg/dL. What action does the nurse take?

The nurse observing a client during a seizure reports which findings to the provider? (Select all that apply.)

Foundations of Safe Client Care

Personal Care and Hygiene

Vital Signs and Vital Measurements

Performing an Assessment

Nutrition and Gastrointestinal Tube Therapy

Supporting Mobility and Immobilization

Comfort Care

End-Of-Life Care

Airway and Breathing

Sterile Technique

Medication Administration

Venous Access

Central Venous Access

Bowel Management

Urinary Elimination

Wound Care

Perioperative Care

Advanced Respiratory Management

Advanced Cardiovascular Care

Filters