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MS2|! Quiz |! 8 |! exam|! with|! precise |!
detailed |! solutions
To |! what |! does |! the |! neural |! synapse |! refer? a. |! Length |! of |! time |! it |! takes |! for |! afferent |! neurons |! to |! carry |! impulses |! to |! the |! central |! nervous |! system |! (CNS) b. |! Length |! of |! time |! it |! takes |! for |! efferent |! neurons |! to |! carry |! impulses |! to |! the |! motor |! neurons c. |! Space |! between |! the |! axons |! and |! the |! dendrites |! of |! a |! neuron d. |! Space |! between |! the |! axons |! of |! one |! neuron |! and |! the |! dendrites |! of |! the |! next |! - |! Correct |! answer |! ✔d. |! Space |! between |! the |! axons |! of |! one |! neuron |! and |! the |! dendrites |! of |! the |! next Smooth, |! coordinated |! transmission |! must |! travel |! from |! one |! neuron |! to |! another |! across |! the |! neural |! synapse. An |! older |! adult |! patient |! is |! experiencing |! extreme |! stress |! related |! to |! an |! admission |! to |! the |! hospital. |! What |! should |! the |! nurse |! expect |! the |! patient |! to |! demonstrate? a. |! Decreased |! heart |! rate b. |! Decreased |! blood |! pressure |! (BP)
c. |! Irregular |! respiration d. |! Dilation |! of |! the |! pupils |! - |! Correct |! answer |! ✔d. |! Dilation |! of |! the |! pupils Stress |! stimulates |! the |! fight-or-flight |! reaction |! with |! the |! release |! of |! epinephrine |! and |! norepinephrine, |! which |! causes |! increased |! heart |! rate |! and |! BP, |! reduced |! peristalsis, |! and |! pupil |! dilation. Which |! neurologic |! finding |! would |! be |! considered |! abnormal |! in |! an |! 88-year-old |! patient? a. |! Slow |! papillary |! response |! to |! light b. |! Jerky |! eye |! movements c. |! Dizziness |! and |! problems |! with |! balance d. |! Absence |! of |! the |! Achilles |! tendon |! jerk |! - |! Correct |! answer |! ✔c. |! Dizziness |! and |! problems |! with |! balance Dizziness |! and |! vertigo, |! although |! common, |! are |! considered |! abnormal. What |! is |! the |! most |! reliable |! indicator |! of |! neurologic |! status? a. |! Blood |! pressure b. |! Pulse |! rate c. |! Temperature d. |! Level |! of |! consciousness |! - |! Correct |! answer |! ✔d. |! Level |! of |! consciousness
What |! should |! the |! nurse |! assess |! when |! a |! patient |! is |! scheduled |! for |! an |! angiogram? a. |! Dizziness b. |! Allergy |! to |! shrimp c. |! Increased |! BP d. |! Irregular |! heartbeat |! - |! Correct |! answer |! ✔b. |! Allergy |! to |! shrimp Allergy |! to |! shrimp |! and |! other |! shellfish |! also |! indicates |! a |! probable |! allergy |! to |! contrast |! medium. What |! diagnostic |! test |! might |! be |! contraindicated |! for |! a |! patient |! who |! has |! a |! pacemaker? a. |! Computed |! tomography |! (CT) b. |! Electromyography |! (EMG) c. |! Magnetic |! resonance |! imaging |! (MRI) d. |! Electroencephalography |! (EEG) |! - |! Correct |! answer |! ✔c. |! Magnetic |! resonance |! imaging |! (MRI) Metal |! appliances |! may |! be |! affected |! by |! the |! magnetic |! field |! during |! MRI. A |! patient |! with |! a |! severe |! head |! injury |! begins |! to |! assume |! a |! posture |! of |! flexed |! upper |! extremities, |! with |! plantarflexed |! lower |! extremities. |! What |! do |! these |! assessments |! indicate?
a. |! Increasing |! intracranial |! pressure |! (ICP) |! with |! decorticate |! posturing b. |! Decreasing |! ICP |! with |! decerebrate |! posturing c. |! Decreasing |! ICP |! with |! decorticate |! posturing d. |! Increasing |! ICP |! with |! decerebrate |! posturing |! - |! Correct |! answer |! ✔a. |! Increasing |! intracranial |! pressure |! (ICP) |! with |! decorticate |! posturing Increasing |! pressure |! on |! the |! tissue |! above |! the |! midbrain |! results |! in |! abnormal |! flexion |! (decorticate |! posturing). What |! should |! be |! immediately |! reported |! by |! the |! nurse |! caring |! for |! a |! 90-year-old |! patient |! with |! a |! closed |! head |! injury? a. |! Blood |! pressure |! change |! from |! 147/72 |! to |! 176/70-mm |! Hg b. |! Respiration |! rate |! increase |! from |! 14 |! to |! 18 |! breaths/min c. |! Slow |! pupillary |! reaction |! bilaterally d. |! Temperature |! decrease |! from |! 100.2q |! F |! to |! 97.6q |! F |! - |! Correct |! answer |! ✔a. |! Blood |! pressure |! change |! from |! 147/72 |! to |! 176/70-mm |! Hg The |! widening |! pulse |! pressure |! is |! an |! indicator |! of |! increased |! ICP. |! Respirations |! and |! temperature |! are |! returning |! to |! more |! normal |! levels. |! Older |! adults |! have |! a |! slowed |! pupillary |! response |! as |! they |! age. Which |! assessment |! on |! a |! patient |! on |! mannitol |! therapy |! for |! cerebral |! edema |! indicates |! the |! medication |! is |! effective |! in |! decreasing |! ICP?
c. |! Widening |! pulse |! pressure, |! headache, |! and |! seizure d. |! Bradycardia, |! hypertension, |! and |! widening |! pulse |! pressure |! - |! Correct |! answer |! ✔d. |! Bradycardia, |! hypertension, |! and |! widening |! pulse |! pressure How |! can |! the |! nurse |! help |! reduce |! ICP |! in |! caring |! for |! the |! patient |! after |! a |! craniotomy? a. |! Keeping |! the |! patient |! flat |! in |! bed b. |! Elevating |! the |! head |! of |! the |! bed |! 30 |! degrees c. |! Closely |! monitoring |! the |! IV |! rate d. |! Turning |! the |! patient |! to |! the |! right |! side |! - |! Correct |! answer |! ✔b. |! Elevating |! the |! head |! of |! the |! bed |! 30 |! degrees Which |! neurotransmitters |! support |! smooth |! neural |! transmission? |! (Select |! all |! that |! apply.) a. |! Acetylcholine b. |! CSF c. |! Dopamine d. |! Dendrite e. |! Epinephrine |! - |! Correct |! answer |! ✔A, |! C, |! E Acetylcholine, |! dopamine, |! and |! epinephrine |! are |! neurotransmitters. |! CSF |! bathes |! the |! brain |! and |! spinal |! cord |! but |! has |! no |! transmission |! activity; |! the |! dendrite |! is |! the |! locus |! of |! the |! synapse.
Which |! are |! normal |! brain |! alterations |! associated |! with |! age? |! (Select |! all |! that |! apply.) a. |! Decrease |! in |! brain |! weight b. |! Pigmentation |! of |! brain |! with |! lipofuscin c. |! Present |! of |! amyloid d. |! Tiny |! clot |! formation e. |! Tangled |! nerve |! fibers |! - |! Correct |! answer |! ✔A, |! B, |! C, |! E All |! brain |! alterations |! listed |! are |! expected |! changes |! that |! affect |! the |! older |! adult's |! neurologic |! function |! except |! for |! tiny |! clot |! formations, |! which |! are |! a |! pathologic |! change. The |! nurse |! assessing |! the |! level |! of |! consciousness |! in |! a |! patient |! will |! perform |! the |! following: |! (Arrange |! in |! order |! from |! the |! simplest |! to |! the |! most |! complex. |! Do |! not |! separate |! answers |! with |! a |! space |! or |! punctuation. |! Example: |! ABCD.) |! a. |! Apply |! pressure |! to |! the |! nail |! bed. b. |! Shake |! the |! patient. c. |! Touch |! the |! patient. d. |! Call |! the |! patient's |! name. e. |! Approach |! the |! patient. |! - |! Correct |! answer |! ✔EDCBA
b. |! Brush |! teeth |! vigorously |! to |! encourage |! gingival |! growth. c. |! Limit |! fluids |! and |! eats |! foods |! that |! reduce |! diarrhea. d. |! Reduce |! stimuli |! and |! take |! warm |! baths |! to |! induce |! drowsiness. |! - |! Correct |! answer |! ✔a. |! Take |! medication |! with |! food. Dilantin |! is |! irritating |! to |! GI |! tissues. |! Dilantin |! causes |! gingival |! hyperplasia, |! constipation, |! and |! drowsiness. A |! nurse |! is |! caring |! for |! a |! patient |! with |! meningitis |! who |! has |! a |! positive |! Brudzinski |! sign. |! Which |! assessment |! led |! to |! this |! conclusion? a. |! Flexed |! hips |! when |! the |! neck |! is |! flexed |! by |! the |! nurse b. |! Inability |! to |! extend |! the |! flexed |! leg |! fully |! because |! of |! hamstring |! pain c. |! Resisting |! efforts |! of |! the |! nurse |! to |! flex |! his |! or |! her |! neck d. |! Flexing |! the |! big |! toe |! upward |! and |! fan |! out |! the |! other |! toes |! - |! Correct |! answer |! ✔a. |! Flexed |! hips |! when |! the |! neck |! is |! flexed |! by |! the |! nurse Inflamed |! meninges |! will |! stimulate |! hip |! flexion |! to |! reduce |! meningeal |! discomfort. A |! nurse |! is |! evaluating |! the |! effectiveness |! of |! teaching |! for |! a |! patient |! with |! multiple |! sclerosis |! (MS). |! Which |! statement |! by |! the |! patient |! indicates |! that |! accurate |! patient |! learning |! has |! taken |! place? a. |! "Now |! that |! I |! am |! taking |! steroids, |! I |! will |! be |! able |! to |! work |! like |! I |! used |! to."
b. |! "I'm |! making |! a |! list |! of |! things |! that |! are |! important |! and |! things |! I |! will |! simply |! have |! to |! let |! go." c. |! "I |! will |! make |! a |! plan |! to |! allow |! for |! long |! rest |! periods |! at |! least |! four |! times |! a |! day." d. |! "I |! am |! working |! on |! balancing |! time |! among |! rest, |! work, |! and |! family |! time." |! - |! Correct |! answer |! ✔d. |! "I |! am |! working |! on |! balancing |! time |! among |! rest, |! work, |! and |! family |! time." Balancing |! time |! between |! various |! activities |! indicates |! that |! the |! patient |! with |! MS |! understands |! the |! need |! to |! conserve |! energy, |! not |! just |! to |! give |! up |! things |! or |! attempt |! to |! perform |! at |! a |! preillness |! level. A |! patient |! in |! the |! emergency |! department |! states |! that |! she |! fell |! and |! hit |! her |! head |! and |! blacked |! out |! for |! a |! while |! but |! became |! alert |! again. |! The |! nurse |! suspects |! an |! epidural |! hematoma. |! For |! what |! should |! the |! nurse |! be |! diligent |! to |! assess? a. |! Headache b. |! Drowsiness c. |! Increasing |! respiration |! rate d. |! Vomiting |! - |! Correct |! answer |! ✔b. |! Drowsiness Increasing |! BP, |! drowsiness, |! and |! a |! widening |! pulse |! pressure |! are |! indicators |! of |! increased |! ICP. Which |! intervention |! supports |! nutritional |! intake |! in |! a |! patient |! with |! Parkinson |! disease?
A |! patient |! with |! Parkinson |! disease |! is |! considering |! taking |! St. |! John's |! wort, |! an |! herbal |! remedy |! for |! depression, |! in |! addition |! to |! Sinemet |! and |! L-dopa. |! What |! is |! the |! most |! appropriate |! nursing |! response? a. |! Depression |! is |! reduced |! by |! the |! use |! of |! herbal |! remedies |! such |! as |! St. |! John's |! wort. b. |! Doses |! of |! St. |! John's |! wort |! and |! parkinsonian |! drugs |! should |! be |! taken |! on |! alternate |! days. c. |! St. |! John's |! wort |! must |! be |! taken |! in |! large |! doses |! to |! reduce |! depression. d. |! Herbal |! remedies |! can |! interfere |! with |! the |! effectiveness |! of |! the |! parkinsonian |! drugs. |! - |! Correct |! answer |! ✔d. |! Herbal |! remedies |! can |! interfere |! with |! the |! effectiveness |! of |! the |! parkinsonian |! drugs. Which |! nursing |! assessment |! would |! indicate |! a |! need |! for |! suctioning |! a |! patient |! with |! Guillain-Barré |! who |! is |! experiencing |! impaired |! breathing |! patterns |! because |! of |! neuromuscular |! failure? a. |! Decreased |! pulse |! rate |! and |! respiration |! of |! 20 |! breaths/min b. |! Increased |! pulse |! rate |! and |! adventitious |! breath |! sounds c. |! Increased |! pulse |! rate |! and |! respiration |! of |! 16 |! breaths/min d. |! Decreased |! pulse |! and |! abdominal |! breathing |! - |! Correct |! answer |! ✔b. |! Increased |! pulse |! rate |! and |! adventitious |! breath |! sounds Increased |! pulse |! rate, |! adventitious |! breath |! sounds, |! and |! abdominal |! breathing |! indicate |! an |! impaired |! breathing |! pattern.
A |! family |! member |! asks |! the |! nurse |! what |! would |! be |! an |! appropriate |! gift |! for |! a |! patient |! with |! Parkinson |! disease. |! What |! is |! the |! most |! useful |! suggestion? a. |! Soft-soled |! house |! shoes b. |! Jigsaw |! puzzle c. |! Set |! of |! card |! games d. |! Satin |! sheets |! - |! Correct |! answer |! ✔d. |! Satin |! sheets Satin |! sheets |! make |! moving |! in |! bed |! easier. |! Card |! games |! and |! jigsaw |! puzzles |! are |! frustrating |! because |! of |! the |! palsy. |! Hard-soled |! shoes |! provide |! better |! support |! than |! soft-soled |! shoes. What |! action |! should |! the |! nurse |! implement |! when |! a |! patient |! falls |! to |! the |! floor |! in |! a |! generalized |! seizure? a. |! Cradle |! the |! head |! to |! prevent |! injury. b. |! Insert |! an |! object |! between |! the |! teeth |! to |! prevent |! the |! patient |! from |! biting |! the |! tongue. c. |! Manually |! restrain |! the |! limbs. d. |! Keep |! the |! patient |! on |! his |! or |! her |! back |! to |! prevent |! aspiration. |! - |! Correct |! answer |! ✔a. |! Cradle |! the |! head |! to |! prevent |! injury. Cradling |! the |! head |! and |! turning |! it |! to |! the |! side |! prevents |! injury |! and |! aspiration; |! restraint |! of |! limbs |! and |! insertion |! of |! an |! object |! into |! a |! patient's |! mouth |! often |! result |! in |! injury.
What |! should |! the |! nurse |! implement |! before |! giving |! an |! enteral |! feeding |! to |! a |! patient? a. |! Palpate |! the |! abdomen |! to |! check |! for |! residual |! feeding. b. |! Warm |! the |! feeding. c. |! Elevate |! the |! head |! of |! the |! bed |! 30 |! degrees. d. |! Ask |! the |! patient |! to |! tip |! his |! head |! forward. |! - |! Correct |! answer |! ✔c. |! Elevate |! the |! head |! of |! the |! bed |! 30 |! degrees. A |! nurse |! caring |! for |! an |! immobilized |! patient |! with |! a |! brain |! tumor |! stimulates |! the |! patient |! several |! times |! a |! day |! with |! range-of-motion |! exercises |! and |! changes |! his |! position |! every |! 2 |! hours |! to |! try |! to |! prevent |! a |! disuse |! syndrome. |! What |! signs |! and |! symptoms |! does |! disuse |! syndrome |! include? |! (Select |! all |! that |! apply.) a. |! Pooling |! of |! pulmonary |! secretions b. |! Paralysis c. |! Muscle |! tremor d. |! Pressure |! ulcers e. |! Altered |! visual |! perceptions |! - |! Correct |! answer |! ✔A, |! D A |! disuse |! syndrome |! includes |! pooling |! of |! pulmonary |! secretions, |! pressure |! ulcers, |! weakness, |! and |! stiff |! joints. The |! nurse |! is |! caring |! for |! a |! patient |! with |! symptoms |! of |! a |! migraine |! headache. |! What |! assessment |! information |! supports |! this |! diagnosis? |! (Select |! all |! that |! apply.)
a. |! Bilateral |! pain |! in |! temples b. |! Nausea c. |! Photosensitivity d. |! Elevated |! WBC |! count e. |! Tearing |! - |! Correct |! answer |! ✔B, |! C, |! E Migraine |! pain |! is |! usually |! unilateral, |! often |! begins |! in |! the |! temple |! or |! eye |! area, |! and |! is |! often |! very |! intense. |! Tearing |! and |! nausea |! and |! vomiting |! may |! occur. |! The |! patient |! is |! hypersensitive |! to |! light |! and |! sound |! and |! prefers |! a |! dark, |! quiet |! environment. |! WBC |! count |! is |! not |! expected |! to |! be |! elevated. The |! ______ |! of |! the |! seizure |! is |! characterized |! by |! stiffening |! of |! the |! muscles |! or |! extremities |! with |! loss |! of |! consciousness. |! - |! Correct |! answer |! ✔tonic |! phase A(n) |! ______ |! hematoma |! forms |! in |! the |! space |! between |! the |! inner |! surface |! of |! the |! skull |! and |! the |! outermost |! meningeal |! covering |! of |! the |! brain. |! - |! Correct |! answer |! ✔epidural Which |! condition |! would |! alert |! the |! nurse |! of |! the |! need |! to |! use |! beta-adrenergic |! blockers |! cautiously? a. |! Hypertension b. |! Raynaud's |! phenomenon c. |! Emphysema
What |! is |! the |! primary |! response |! to |! alpha-1-receptor |! stimulation? a. |! Bronchodilation b. |! Tachycardia c. |! Vasoconstriction d. |! Uterine |! relaxation |! - |! Correct |! answer |! ✔c. |! Vasoconstriction Stimulation |! of |! the |! alpha-1 |! receptors |! causes |! vasoconstriction |! of |! all |! blood |! vessels |! throughout the |! body. |! Alpha-1-receptor |! stimulation |! causes |! bronchoconstriction. |! Alpha- 1-receptor |! stimulation |! does |! not |! cause |! tachycardia. |! Beta-2-receptor |! stimulation |! produces |! relaxation |! of |! smooth |! muscle |! tissue, |! such |! as |! the |! uterus. Which |! category |! of |! medications |! is |! used |! for |! peripheral |! vascular |! diseases |! characterized |! by |! excessive |! vasoconstriction, |! such |! as |! Raynaud's |! disease? a. |! Adrenergic |! agents b. |! Alpha-adrenergic |! blocking |! agents c. |! Beta-adrenergic |! blocking |! agents d. |! Cholinergic |! agents |! - |! Correct |! answer |! ✔b. |! Alpha-adrenergic |! blocking |! agents Alpha-adrenergic |! blocking |! agents |! interfere |! with |! the |! stimulation |! of |! alpha-1 |! and |! alpha-2 |! receptors. |! Because |! the |! primary |! action |! of |! alpha-receptor |!
stimulation |! is |! vasoconstriction, |! alpha-adrenergic |! blocking |! agents |! are |! indicated |! for |! patients |! with |! diseases |! associated |! with vasoconstriction. |! Adrenergic |! drugs |! cause |! vasoconstriction. |! Beta-adrenergic |! blocking |! agents are |! used |! to |! treat |! hypertension |! and |! dysrhythmias. |! Cholinergic |! drugs |! are |! used |! to |! treat |! ocular |! diseases |! such |! as |! glaucoma, |! respiratory |! tract |! disease, |! and |! urinary |! system |! diseases. Why |! are |! beta |! blockers |! used |! cautiously |! in |! patients |! with |! respiratory |! conditions? a. |! They |! mask |! the |! signs |! and |! symptoms |! of |! acute |! hypoglycemia. b. |! They |! cause |! extensive |! vasodilation |! and |! cardiac |! overload. c. |! They |! may |! produce |! severe |! bronchoconstriction. d. |! They |! increase |! hypertensive |! episodes. |! - |! Correct |! answer |! ✔c. |! They |! may |! produce |! severe |! bronchoconstriction. Nonselective |! beta |! blockers, |! such |! as |! Inderal, |! and |! larger |! doses |! of |! selective |! beta |! antagonists |! will |! readily |! affect |! the |! beta-2 |! receptors |! of |! the |! bronchi, |! causing |! bronchoconstriction. |! Therefore, |! beta |! blockers |! must |! be |! used |! with |! extreme |! caution |! in |! patients |! with |! respiratory |! conditions |! such |! as |! bronchitis, |! emphysema, |! asthma, |! or |! allergic |! rhinitis. |! Beta |! blockers |! affect |! blood |! glucose |! by inducing |! the |! hypoglycemic |! effects |! of |! insulin. |! Vasodilation |! relieves |! cardiac |! overload. |! Beta |! blockers |! induce |! hypotensive |! effects.
