Question 1

Nursing management of a patient with a clipped cerebral aneurysm receiving hemodynamic augmentation includes which intervention?

Accepted Answer

A)  Administering osmotic diuretics and vasodilator agents 
B)  Providing the patient with a quiet environment 
C)  Maintaining the patient's systolic blood pressure at 150 to 160 mm Hg 
D)  Keeping the patient's central venous pressure at 5 to 8 mm Hg 
A)  Administering osmotic diuretics and vasodilator agents 
B)  Providing the patient with a quiet environment 
C)  Maintaining the patient's systolic blood pressure at 150 to 160 mm Hg 
D)  Keeping the patient's central venous pressure at 5 to 8 mm Hg C

Question 2

The incidence of rebleeding after a ruptured cerebral aneurysm is highest during which of the following time periods?

Accepted Answer

A)  First 24 hours 
B)  4 to 12 days 
C)  3 to 4 weeks 
D)  3 to 6 months 
A)  First 24 hours 
B)  4 to 12 days 
C)  3 to 4 weeks 
D)  3 to 6 months A

Question 3

A right-handed patient has been admitted with an intracerebral hemorrhage.A computed tomography (CT)scan of the patient's head reveals a large left parietal area bleed.Based on the type of stroke,which signs and symptoms might the patient exhibit?

Accepted Answer

A)  Right-sided hemiplegia and receptive aphasia 
B)  Left-sided hemiplegia and tactile agnosia 
C)  Decorticate posturing and unequal pupils 
D)  Unilateral neglect and dressing apraxia 
A)  Right-sided hemiplegia and receptive aphasia 
B)  Left-sided hemiplegia and tactile agnosia 
C)  Decorticate posturing and unequal pupils 
D)  Unilateral neglect and dressing apraxia A

Question 4

A ventriculoperitoneal shunt may be placed in a post-stroke patient to treat which complication?

Accepted Answer

A)  Hyponatremia 
B)  Intracerebral hemorrhage 
C)  Spontaneous intracerebral hemorrhage 
D)  Hydrocephalus 
A)  Hyponatremia 
B)  Intracerebral hemorrhage 
C)  Spontaneous intracerebral hemorrhage 
D)  Hydrocephalus

Question 5

What is a pathologic consequence of an unruptured cerebral aneurysm?

Accepted Answer

A)  It shunts blood away from the surrounding tissues. 
B)  It leaks blood into the subarachnoid space. 
C)  It causes damage the middle layer of the arterial wall. 
D)  It places pressure on the surrounding tissues. 
A)  It shunts blood away from the surrounding tissues. 
B)  It leaks blood into the subarachnoid space. 
C)  It causes damage the middle layer of the arterial wall. 
D)  It places pressure on the surrounding tissues.

Question 6

A male patient post right-sided stroke is experiencing hemiagnosia.This is evidenced by which finding?

Accepted Answer

A)  The patient only reads the right side of the newspaper. 
B)  The patient refuses to acknowledge the left side of his body. 
C)  The patient is hyperresponsive when approached on the right side. 
D)  The patient attempts to comb his hair with a toothbrush. 
A)  The patient only reads the right side of the newspaper. 
B)  The patient refuses to acknowledge the left side of his body. 
C)  The patient is hyperresponsive when approached on the right side. 
D)  The patient attempts to comb his hair with a toothbrush.

Question 7

A patient becomes flaccid with fixed and dilated pupils.The patient's intracranial pressure (ICP)falls from 65 to 12 mm Hg.What should the nurse suspect is happening?

Accepted Answer

A)  The patient is having a seizure. 
B)  The patient's brain has herniated. 
C)  The patient's cerebral edema is resolving. 
D)  The patient is excessively dehydrated from the mannitol. 
A)  The patient is having a seizure. 
B)  The patient's brain has herniated. 
C)  The patient's cerebral edema is resolving. 
D)  The patient is excessively dehydrated from the mannitol.

Question 8

A female right-handed patient has been admitted with an intracerebral hemorrhage.A computed tomography (CT)scan of the patient's head reveals a large left parietal area bleed.While assisting with personal care,the nurse notes that the patient is unable to comb her hair with her left hand.The nurse suspects the patient may be experiencing which complication?

Accepted Answer

A)  Agnosia 
B)  Apraxia 
C)  Broca aphasia 
D)  Wernicke aphasia 
A)  Agnosia 
B)  Apraxia 
C)  Broca aphasia 
D)  Wernicke aphasia

Question 9

Which statement is true regarding the occurrence of subarachnoid hemorrhages (SAHs)?

Accepted Answer

A)  Occurrence is greater in men than women younger than the age of 40 years old. 
B)  Occurrence is greater in men than women older than the age of 40 years old. 
C)  90% of SAHs are caused by traumatic injury. 
D)  Patients with SAHs have a better survival rate than patients with arteriovenous malformations. 
A)  Occurrence is greater in men than women younger than the age of 40 years old. 
B)  Occurrence is greater in men than women older than the age of 40 years old. 
C)  90% of SAHs are caused by traumatic injury. 
D)  Patients with SAHs have a better survival rate than patients with arteriovenous malformations.

Question 10

The patient has uncontrolled intracranial pressure and now is receiving high-dose barbiturate therapy.The nursing management plan for this patient should include monitoring the patient for what complication?

Accepted Answer

A)  Hypothermia 
B)  Hypotension 
C)  Myocardial depression 
D)  Dehydration 
A)  Hypothermia 
B)  Hypotension 
C)  Myocardial depression 
D)  Dehydration

Question 11

A patient has had an ischemic stroke and now having difficulty with speech.The nurse knows the patient is experiencing what problem?

Accepted Answer

A)  Expressive aphasia 
B)  Global aphasia 
C)  Receptive aphasia 
D)  Apraxia 
A)  Expressive aphasia 
B)  Global aphasia 
C)  Receptive aphasia 
D)  Apraxia

Question 12

A patient has been told he has a nonencapsulated tumor that has infiltrated the brain tissue.Why type of tumor does the nurse suspect the patient has?

Accepted Answer

A)  Angioma 
B)  Pituitary adenoma 
C)  Meningioma 
D)  Glioma 
A)  Angioma 
B)  Pituitary adenoma 
C)  Meningioma 
D)  Glioma

Question 13

A patient presents with aphasia,decreased level of consciousness,and right-sided weakness.The patient has a history of heart disease,hyperlipidemia,and transient ischemic attacks.Based on the history,the nurse suspects that the patient has sustained which type of stroke?

Accepted Answer

A)  Hemorrhagic stroke 
B)  Intracerebral hemorrhages 
C)  Subarachnoid hemorrhages 
D)  Ischemic stroke 
A)  Hemorrhagic stroke 
B)  Intracerebral hemorrhages 
C)  Subarachnoid hemorrhages 
D)  Ischemic stroke

Question 14

After neurosurgery,the patient is at risk of developing what problem?

Accepted Answer

A)  Aspiration 
B)  Diabetes mellitus 
C)  Seizures 
D)  Corneal abrasions 
A)  Aspiration 
B)  Diabetes mellitus 
C)  Seizures 
D)  Corneal abrasions

Question 15

Ideally fibrinolytic therapy should be administered within how many hours of the onset of stroke symptoms?

Accepted Answer

A)  1 
B)  3 
C)  6 
D)  10 
A)  1 
B)  3 
C)  6 
D)  10

Question 16

Which of the following statements regarding Guillain-Barré syndrome (GBS)supports the admission to a critical care unit?

Accepted Answer

A)  The demyelination process of the peripheral nerves is irreversible. 
B)  The demyelination process is limited to the peripheral nervous system only. 
C)  The paralysis associated with the syndrome occurs in a descending pattern. 
D)  The most common cause of death is respiratory arrest. 
A)  The demyelination process of the peripheral nerves is irreversible. 
B)  The demyelination process is limited to the peripheral nervous system only. 
C)  The paralysis associated with the syndrome occurs in a descending pattern. 
D)  The most common cause of death is respiratory arrest.

Question 17

Which medication is a fast-acting,short-duration agent used for breakthrough seizures?

Accepted Answer

A)  Lorazepam 
B)  Phenytoin 
C)  Phenobarbital 
D)  Midazolam 
A)  Lorazepam 
B)  Phenytoin 
C)  Phenobarbital 
D)  Midazolam

Question 18

Which patient position is optimal to prevent elevated intracranial (ICP)pressures?

Accepted Answer

A)  The head of the bed elevated 30 to 40 degrees 
B)  Supine with the patient's neck in a neutral alignment 
C)  Individualized head position to minimize ICP measurements 
D)  The head of the bed elevated with flexion of the hips 
A)  The head of the bed elevated 30 to 40 degrees 
B)  Supine with the patient's neck in a neutral alignment 
C)  Individualized head position to minimize ICP measurements 
D)  The head of the bed elevated with flexion of the hips

Question 19

When an object is placed in the hand of a patient with neurologic impairment during assessment,the patient is unable to recognize the placement.What is this complication called?

Accepted Answer

A)  Homonymous hemianopsia 
B)  Aphasia 
C)  Agnosia 
D)  Apraxia 
A)  Homonymous hemianopsia 
B)  Aphasia 
C)  Agnosia 
D)  Apraxia

Question 20

What is the target range for PaCO₂ in the patient with intracranial hypertension?

Accepted Answer

A)  25 to 30 mm Hg 
B)  25 to 35 mm Hg 
C)  35 to 40 mm Hg 
D)  33 to 37 mm Hg 
A)  25 to 30 mm Hg 
B)  25 to 35 mm Hg 
C)  35 to 40 mm Hg 
D)  33 to 37 mm Hg

Exam 23: Neurologic Disorders and Therapeutic Management

Nursing management of a patient with a clipped cerebral aneurysm receiving hemodynamic augmentation includes which intervention?

The incidence of rebleeding after a ruptured cerebral aneurysm is highest during which of the following time periods?

A right-handed patient has been admitted with an intracerebral hemorrhage.A computed tomography (CT)scan of the patient's head reveals a large left parietal area bleed.Based on the type of stroke,which signs and symptoms might the patient exhibit?

A ventriculoperitoneal shunt may be placed in a post-stroke patient to treat which complication?

What is a pathologic consequence of an unruptured cerebral aneurysm?

A male patient post right-sided stroke is experiencing hemiagnosia.This is evidenced by which finding?

A patient becomes flaccid with fixed and dilated pupils.The patient's intracranial pressure (ICP)falls from 65 to 12 mm Hg.What should the nurse suspect is happening?

Which statement is true regarding the occurrence of subarachnoid hemorrhages (SAHs)?

The patient has uncontrolled intracranial pressure and now is receiving high-dose barbiturate therapy.The nursing management plan for this patient should include monitoring the patient for what complication?

A patient has had an ischemic stroke and now having difficulty with speech.The nurse knows the patient is experiencing what problem?

A patient has been told he has a nonencapsulated tumor that has infiltrated the brain tissue.Why type of tumor does the nurse suspect the patient has?

A patient presents with aphasia,decreased level of consciousness,and right-sided weakness.The patient has a history of heart disease,hyperlipidemia,and transient ischemic attacks.Based on the history,the nurse suspects that the patient has sustained which type of stroke?

After neurosurgery,the patient is at risk of developing what problem?

Ideally fibrinolytic therapy should be administered within how many hours of the onset of stroke symptoms?

Which of the following statements regarding Guillain-Barré syndrome (GBS)supports the admission to a critical care unit?

Which medication is a fast-acting,short-duration agent used for breakthrough seizures?

Which patient position is optimal to prevent elevated intracranial (ICP)pressures?

When an object is placed in the hand of a patient with neurologic impairment during assessment,the patient is unable to recognize the placement.What is this complication called?

What is the target range for PaCO₂ in the patient with intracranial hypertension?

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