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Worksheets217 Neuro/Integumentary
Total questions: 64
Worksheet time: 2hrs 11mins
Name
Class
Date
1.
A client is recovering from an injury to the frontal lobe of the brain. The nurse realizes that which of the following will be affected by this injury?
a)
Higher intellectual functioning
b)
Visual perception
c)
Coordination
d)
Respiratory rate
2.
A client is recovering from a cerebral bleed which is placing pressure on the hypothalamus. Which of the following will the nurse most likely assess in this client?
a)
Variations in body temperature
b)
Blindness
c)
Alteration in speech
d)
Uncoordinated body movements
3.
A client recovering from a cerebral vascular accident is having difficulty remembering how to chew food. The nurse realizes that which of the following cranial nerves could be affected in this client?
a)
IX
b)
X
c)
XI
d)
V
4.
A client is scheduled for a diagnostic test to assess the amount of electrical activity within each of the cerebral hemispheres. The nurse realizes that the diagnostic test this client will be having is a(n):
a)
myelogram.
b)
electroencephalogram.
c)
transcranial Doppler sonogram.
d)
electromyogram.
5.
For the client who is at risk for stroke, the most important guideline the nurse should teach is to:
a)
increase drinks with caffeine.
b)
monitor blood pressure.
c)
increase amounts of sodium in the diet.
d)
monitor weight and activity.
6.
The nurse is planning care for a client diagnosed with increased intracranial pressure after a head injury. Which of the following interventions can be used to reduce increased intracranial pressure?
a)
Administer antibiotics as prescribed.
b)
Keep the head of the bed in the flat position.
c)
Administer corticosteroids and osmotic diuretics as prescribed.
d)
Perform range-of-motion exercises every hour.
7.
Which of the following should be avoided when caring for a client diagnosed with increased intracranial pressure?
a)
Starting an intravenous access line
b)
Administering oxygen
c)
Placing the bed in Trendelenburg
d)
Placing the client on bed rest
8.
A client being treated for a spinal cord injury needs immediate ventilatory support. The nurse realizes that this client’s level of injury is most likely:
a)
C3
b)
C6
c)
T3
d)
L3
9.
A client receiving care for a spinal cord injury complains of a pounding headache, blurred vision, and has a blood pressure of 200/100 mmHg. What is the first action the nurse should take?
a)
Administer pain medication.
b)
Position the client on the left side.
c)
Turn off the lights and decrease the noise in the room.
d)
Check the bladder for distension.
10.
A client is diagnosed with Guillain-Barré syndrome. The nurse would assess that signs and symptoms of the disorder would appear in which of the following order?
a)
In the hands and arms, progressing to the shoulders and head
b)
At the top of the spine, progressing to the brain
c)
In the legs, progressing up the body
d)
In the face, spreading over the entire facial muscles
11.
Which of the following should the nurse instruct a client diagnosed with trigeminal neuralgia to help control symptoms?
a)
Perform active range-of-motion exercises to all extremities.
b)
Avoid extreme temperature variances in food and drink.
c)
Stay in bed with little movement.
d)
Drink eight glasses of water a day.
12.
A client diagnosed with Bell’s palsy asks the nurse why eye drops have been prescribed. Which of the following should the nurse respond to this client?
a)
“Eyes tend to dry out because the eyelids do not close.”
b)
“Eyes become irritated because the eye does not make tears.”
c)
“Eyes trap dust because the eyelid does not open and the eye needs to be flushed.”
d)
“The eye drops should not be prescribed and the physician should be notified.”
13.
A client is experiencing a grand mal seizure. Which of the following should the nurse do during this seizure?
a)
Protect the client’s head.
b)
Leave the client alone.
c)
Give water to the client to avoid dehydration.
d)
Place a finger in the client’s mouth to avoid swallowing the tongue.
14.
One of the most important things a nurse can teach a client about seizure control is to:
a)
take the medication every day as prescribed by the doctor.
b)
eat a balanced diet.
c)
get lots of exercise.
d)
take naps during the day.
15.
The nurse is instructing a client newly diagnosed with multiple sclerosis (MS). To determine the effectiveness of his teaching, the nurse would expect the client to state:
a)
“It is best for me to be in a cold environment.”
b)
“I should avoid taking a hot bath.”
c)
“I should eat foods low in salt.”
d)
“I should be better in a week.”
16.
An adult female in her 30s complains of numbness and tingling in the hands, fatigue, loss of coordination, incontinence, nystagmus, and ataxia. Which of the following health problems do these symptoms suggest to the nurse?
a)
Brain tumor
b)
Myasthenia gravis
c)
Multiple sclerosis
d)
Diabetes
17.
For a client diagnosed with Parkinson’s disease, which of the following might be contraindicated?
a)
Performing range-of-motion exercises
b)
Drinking bottled water
c)
Instituting fall precautions
d)
Taking naps
18.
A client presents complaining of abnormal muscle weakness and fatigability. The physician suspects myasthenia gravis. Which drug can be used to test for this disease?
a)
Pyridostigmine (Mestinon)
b)
Neostigmine (Prostigmin)
c)
Ambenonium (Mytelase)
d)
Edrophonium (Tensilon)
19.
A client has a yellow tone to the skin. The nurse realizes that which of the following cells are responsible for the yellow tone of the skin?
a)
Carotenoids
b)
Langerhans’ cells
c)
Melanocytes
d)
Merkel cells
20.
The nurse is assessing the skin of an elderly client. Which of the following would not be assessed in this client?
a)
Decreased elasticity
b)
Increased skin hydration
c)
Slow wound healing
d)
Thinning skin
21.
A client is experiencing elevated fluid-filled lesions on the skin. The nurse would document these lesions as being:
a)
macules
b)
nodules
c)
vesicles
d)
wheals
22.
A client has a nonpalpable skin lesion that is causing a change in skin color greater than 1 cm in diameter. The nurse would document this finding as being a(n):
a)
patch
b)
macule
c)
wheal
d)
vesicle
23.
A client has an enlarged scar as a result of abdominal surgery. The nurse realizes this scar would be considered a(n):
a)
erosion
b)
fissure
c)
excoriation
d)
keloid
24.
A client’s wound is being debrided by letting a wet-to-dry dressing that is packed into the wound dry. This type of debridement is called:
a)
autolytic debridement.
b)
enzymatic debridement.
c)
mechanical debridement.
d)
sharp debridement.
25.
A school-age child is experiencing pruritic vesicles around the mouth. The lesions have a honey-colored crust. The nurse realizes that the child is most likely experiencing:
a)
candidiasis.
b)
herpes simplex.
c)
impetigo
d)
tinea corporis
26.
A client is being treated for lice. Which of the following medications would the nurse expect to see prescribed for this client?
a)
Acyclovir
b)
Diphenhydramine
c)
Mupirocin
d)
Permethrin
27.
A middle-aged construction worker has a raised lesion with a pearly border on his arm that bleeds easily. The nurse realizes that this client most likely is experiencing a(n):
a)
actinic keratosis.
b)
basal cell carcinoma.
c)
malignant melanoma.
d)
melanoma in situ.
28.
The nurse is at the scene of a fire caring for a patient with a thermal burn on the face, chest, and abdomen. What action should the nurse perform first?
a)
Ensure an open airway.
b)
Cover the burns with sterile dressings.
c)
Wash the burn gently with dilute antiseptic.
d)
Pour cool, clean water over the burned areas.
29.
The nurse is caring for a patient with burns covering the entire surface of both arms and the anterior trunk. Approximately what percentage of the patient’s body surface area has been affected?
a)
18%
b)
27%
c)
36%
d)
45%
30.
The nurse is caring for a patient in the initial phase of treatment for a partial-thickness burn. The patient has been stabilized, with blood pressure 140/88 mm Hg, pulse 78 beats/min, respirations 22 breaths/min, and temperature 97.4°F (36.3°C). Which new assessment finding should be immediately communicated to the health care provider (HCP)?
a)
Report of increasing pain
b)
Temperature 99°F (37.2°C)
c)
Serum-filled blister formation
d)
Blood pressure 122/74 mm Hg
31.
The nurse is caring for a patient who is 2 days post-inhalation burn injury from a house fire. Which outcome best indicates that nursing interventions for impaired gas exchange have been effective?
a)
The patient is afebrile.
b)
The patient is alert and oriented.
c)
Peripheral pulses are present and strong.
d)
PaCO2 is 56 mm Hg.
32.
A patient is having a surgical procedure done to promote peripheral tissue perfusion in an extremity with full-thickness circumferential burns. What term should the nurse use to document this procedure?
a)
excision
b)
skin graft
c)
debridement
d)
escharotomy
33.
The nurse notes that a patient with full thickness burns has an increase in hematocrit level. What should the nurse realize is causing this change in laboratory value?
a)
Loss of intravascular fluid
b)
Destruction of blood vessels
c)
Increased function of platelets
d)
Migration of white blood cells
34.
The nurse is explaining the transmission of nerve impulses to a patient with a spinal cord injury. What should the nurse explain as the structure that carries nerve impulses at synapses?
a)
Cell membrane
b)
Depolarizations
c)
Schwann’s cells
d)
Neurotransmitters
35.
The nurse is assessing a patient’s pupils for reactivity to light. Which cranial nerve (CN) is being tested?
a)
III
b)
IV
c)
VI
d)
XII
36.
The nurse is caring for a patient who has impaired functioning of the left glossopharyngeal (IX) nerve and the vagus (X) nerve. What intervention should the nurse plan to maintain the patient’s safety while diagnostic testing is being completed?
a)
Insert an oral airway.
b)
Withhold oral fluid or foods.
c)
Obtain a picture board and a Magic Slate.
d)
Apply eye patches to keep the eyes closed.
37.
The nurse is providing post-procedure care for a patient recovering from a lumbar puncture. Which order should the nurse anticipate for this patient?
a)
Keep the patient NPO for 4 hours.
b)
Have the patient lie flat for 6 hours.
c)
Monitor the patient’s pedal pulses every 4 hours.
d)
Keep the head of the bed elevated 30 degrees for 8 hours.
38.
A patient becomes startled when the alarm rings for a fire drill. After reassuring the patient that there is no danger, an assessment is completed. Which finding may be related to a sympathetic response?
a)
wheezing
b)
confusion
c)
incontinence
d)
diminished bowel sounds
39.
A patient who is severely brain damaged has decerebrate posturing with extended extremities. In which area of the brain should the nurse suspect the patient has sustained damage?
a)
cerebrum
b)
brain stem
c)
cerebellum
d)
hypothalamus
40.
The nurse is caring for a patient who has had a stroke (brain attack). The patient is unable to understand what the nurse is saying and appears frustrated. What term should the nurse use to document this finding?
a)
dysphagia
b)
confusion
c)
receptive aphasia
d)
expressive aphasia
41.
The nurse is providing care for an 87-year-old woman who is recovering from a cerebral vascular accident. Which precaution should the nurse take after noting the patient has a positive Romberg test?
a)
Institute fall-risk precautions.
b)
Provide small, frequent meals.
c)
Request a footboard and splints.
d)
Darken the room and reduce stimuli.
42.
A patient opens the eyes to painful stimuli, makes incomprehensible sounds, and withdraws from pain. What should the nurse calculate this patient’s Glasgow Coma Scale score to be?
a)
2
b)
4
c)
6
d)
8
43.
While collecting data the nurse learns that a patient with a neurological illness has not had a sense of smell for several decades. Which part of the central nervous system should the nurse question as being damaged in this patient?
a)
Brainstem
b)
Occipital Lobe
c)
Hypothalamus
d)
Temporal lobe
44.
The nurse is caring for a patient brought to the emergency department after an automobile accident. The patient is fully conscious. For what early signs of increased intracranial pressure (ICP) should the nurse be alert?
a)
bradycardia
b)
hypothermia
c)
pinpoint pupils
d)
decreased level of consciousness
45.
A patient is incontinent during a seizure and sleeps for several hours afterward. What type of seizure did the patient most likely experience?
a)
absence
b)
tonic-clonic
c)
simple partial
d)
status epilepticus
46.
A patient in the post-ictal period after a seizure remembers smelling something like dead fish prior to the seizure. Which response by the nurse is best?
a)
“Today is Friday; the hospital always cooks fish on Fridays.”
b)
“You were probably hallucinating; I will ask for an order for an anti-hallucinatory agent.”
c)
“The smell of dead fish might be your aura; you should call for help immediately if you smell it again.”
d)
“Most people see a flash of light before a seizure; if this occurs, you should get to safety immediately.”
47.
The nurse is caring for a patient with a traumatic brain injury. Which assessment finding alerts the nurse to possible diabetes insipidus?
a)
headache
b)
confusion
c)
frequent urination
d)
elevated blood glucose
48.
The physician prescribes intravenous mannitol for a patient who has a head injury and increased intracranial pressure (ICP). Which assessment finding indicates to the nurse that the patient is having a therapeutic response to the mannitol?
a)
Return of the gag reflex
b)
Increased blood glucose
c)
Increased urinary output
d)
Decreased Glasgow Coma Scale (GCS) score
49.
A teen is experiencing a headache and dizziness after falling of a bicycle and hitting the head. The physician diagnoses a concussion. What explanation should the nurse provide to the patient’s mother?
a)
The patient may lose consciousness before beginning to recover.
b)
The patient has had some intracranial bleeding but should recover in time.
c)
The patient has had a minor head trauma and should recover spontaneously.
d)
The patient may need to have surgery to relieve increased intracranial pressure.
50.
The nurse notes that a patient with a head injury has a widening pulse pressure. Which action should the nurse take at this time?
a)
Give an extra dose of diuretic.
b)
Lay the bed flat and check pupil response.
c)
Raise the head of the bed to 30 degrees
d)
None; this is an expected finding after a head injury.
51.
A patient is unable to move the extremities after experiencing a spinal cord injury. What term should the nurse use to document paralysis of all four extremities?
a)
paraplegia
b)
hemiparesis
c)
quadriplegia
d)
quadriparesis
52.
A patient newly diagnosed with Parkinson’s disease is prescribed carbidopa/levodopa (Sinemet). Which patient statement indicates teaching about the medication has been effective?
a)
“The medication causes urinary retention and a dry mouth.”
b)
“Sinemet reduces inflammation in the central nervous system.”
c)
“I should take this medication when my hand tremors bother me.”
d)
“This medication converts to dopamine in the brain so my symptoms should improve.”
53.
The nurse caring for patients with dementia. Which intervention would be least helpful when coordinating care for patients who are experiencing confusion?
a)
Providing finger foods
b)
Monitoring cognitive functioning
c)
Using soft restraints when the patient is left alone
d)
Providing structured rest periods to prevent fatigue
54.
The nurse is notes that a patient recovering from a craniotomy has a pink spot with a yellow ring around it on the pillow. What should the nurse do?
a)
Change the patient’s pillowcase.
b)
Do a basic neurological assessment.
c)
Notify the charge nurse immediately.
d)
Change the patient’s cranial dressing.
55.
A patient with a cerebrovascular accident (stroke) has left-sided flaccidity and is unable to speak but seems to understand everything the nurse says. Which term should the nurse use to document the patient’s communication impairment?
a)
Sensory aphasia
b)
Motor dysphagia
c)
Expressive aphasia
d)
Receptive dysphagia
56.
A patient began experiencing manifestations of a stroke at 0800 hours. By which time should thrombolytic medications be provided to reverse stroke symptoms?
a)
0900 hours
b)
1100 hours
c)
1400 hours
d)
1600 hours
57.
The nurse is caring for a patient experiencing an acute exacerbation of multiple sclerosis (MS). Which pathophysiological change should the nurse recognize as causing the manifestations of MS?
a)
Myelin buildup in the central nervous system
b)
Demyelination and destruction of nerve fibers
c)
Gamma aminobutyric acid (GABA) deficiency
d)
Reduced acetylcholine receptors with impaired nerve impulse transmission
58.
A patient diagnosed with Guillain-Barré syndrome (GBS) asks how the disease developed since the patient rarely has an illness. What nursing response is the most accurate?
a)
“No one knows what causes it.”
b)
“It may be an autoimmune reaction to a virus.”
c)
“It most often occurs as a result of a bacterial infection.”
d)
“It is usually hereditary. Does anyone in your family have it?”
59.
When assessing a patient who spilled hot oil on the right leg and foot, the nurse notes that the skin is red, swollen, and covered with large blisters. The patient states that they are very painful. The nurse will document the injury as
a)
full-thickness skin destruction.
b)
deep full-thickness skin destruction.
c)
deep partial-thickness skin destruction.
d)
superficial partial-thickness skin destruction.
60.
A patient with severe burns has crystalloid fluid replacement ordered using the Parkland formula. The initial volume of fluid to be administered in the first 24 hours is 30,000 mL. The initial rate of administration is 1875 mL/hr. After the first 8 hours, the nurse will decrease the fluid infusion rate to
a)
350 mL/hour.
b)
523 mL/hour.
c)
938 mL/hour.
d)
1250 mL/hour.
61.
During the emergent phase of burn care, which nursing action will be most useful in determining whether the patient is receiving adequate fluid infusion?
a)
Check skin turgor.
b)
Monitor daily weight.
c)
Assess mucous membranes.
d)
Measure hourly urine output.
62.
The nurse caring for a patient admitted with burns over 30% of the body surface will recognize that the patient has moved from the emergent to the acute phase of the burn injury when
a)
white blood cell levels decrease.
b)
blisters and edema have subsided.
c)
the patient has large quantities of pale urine.
d)
the patient has been hospitalized for 48 hours.
63.
A patient in the dermatology clinic has a small, slow-growing papule with ulceration and a depression in the center of the lesion on the right cheek. The nurse will anticipate the need to
a)
prepare the patient for a biopsy.
b)
teach about the use of corticosteroid creams.
c)
educate the patient about use of tretinoin (Retin-A).
d)
discuss the need for topical application of antibiotics.
64.
When examining a patient’s scalp, the nurse suspects the presence of pediculosis on finding
a)
ringlike rashes with red, scaly borders over the entire scalp.
b)
papular, wheal-like lesions with white deposits on the hair shaft.
c)
patchy areas of alopecia with small vesicles and excoriated areas.
d)
red, hivelike papules and plaques with sharply circumscribed borders.
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