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Boone's Exam 2

Total questions: 100

Worksheet time: 2hrs 40mins

Name
Class
Date
1.

A nurse is caring for a patient with an increase in ICP after a MVC. The nurse keeps the head of the bed elevated, keeps the lighting in the room low, keeps the door to the room shut, and turns the TV off in the room. The nurse understands that the reasoning behind this would be what?

a)

Keep the electric bill of the hospital down.

b)

Provide a safe environment for the patient.

c)

Decrease stimulation for the patient.

d)

This clusters care for the patient.

2.

Neurologic assessment using a standardized numeric scale

a)

MRI

b)

Glascow Coma Scale

c)

SAD PERSONS Scale

d)

Electroencephalogram

3.

Which Pharmacotherapy would be most appropriate for a patient with cerebral edema

a)

insulin

b)

MAO inhibitors

c)

antianxlytic

d)

osmotic diuretic

4.

what would you suspect would be the problem with a patient who has sudden vomiting without nausea

a)

epilepsy

b)

increased cranial pressure

c)

hypertension

d)

cardiovascular ischemia

5.

which is not a sign included in cushing's triad

a)

tachycardia

b)

changes in respiratory pattern

c)

bradycardia

d)

hypertension

6.

which position is recommened for a patient with ICP

a)

trendelenburgs

b)

reverse trendelenburgs

c)

head of bed at 30 degrees

d)

prone

7.

What should you teach the patient when it comes to bowel management to lower ICP?

a)

Tell them to push hard

b)

Tell them to stay constipated

c)

Do not strain if become constipated

8.

disease that results from the healthy liver tissue tissue being replaced with scar tissue

a)

athrosclerosis

b)

asthma

c)

cirrhosis

d)

psoriasis

9.

A client being take care of in the ICU after a subdural hematoma has a blood pressure: 190/110, HR: 70, RR: 20 on a vent, and O2 sat.: 99% at 1000. During the 1100 assessment the vitals read at a blood pressure 200/100, HR: 58, RR: 20 on a vent, and O2 sat.: 99%. The nurse recognizes that this is a sign of what?

a)

A decrease in ICP.

b)

The patient is having a stroke.

c)

The brain is compensating for an increase in ICP.

d)

Imminent Death

10.

Which of the following is a possible indication of head injury?

a)

difficulty staying awake

b)

loss of sensation in the hands

c)

paralysis in some part of the body

11.

Which trauma injury can cause spinal injury?

a)

falls from height

b)

arthritis

c)

cancer

12.

A clear fluid coming from the ears or nose is a sign of head injury.

a)

True

b)

False

13.

The calculation for determining Cerebral Perfusion Pressure is which of the following?

a)

MAP-ICP

b)

ICP-BP

c)

ICP-MAP

d)

Systolic BP-Diastolic BP

14.

A PaCO2 of greater than 40-45 would be considered which of the following?

a)

Hypocapnia

b)

Normal

c)

Respiratory Acidosis

d)

Hypercapnia

15.

Which of the following would be considered a normal ICP?

a)

0-10 mmHg

b)

0-15 mmHg

c)

10-25 mmHg

d)

5-20 mmHg

16.

Which of the following would be considered a normal CPP?

a)

0-15 mmHg

b)

75-95 mmHg

c)

70-100mmHg

d)

50-80mmHg

17.

A client what has a CPP of less than 50 would be considered to have which of the following?

a)

Irreversible brain damage

b)

This is normal.

c)

An improvement in their condition.

d)

Herniation

18.

The family of a client with a traumatic brain injury due to an ATV accident are asking what medications are being given to their family member. The RN knows which of the following medications would be given

a)

Solumedrol

b)

Mannitol

c)

Furosemide

d)

Normal Saline

19.

The major concern with giving a diuretic to a client with a TBI would be?

a)

Hypovolemic shock

b)

Hypotension

c)

increased urination

d)

Electrolyte imbalance.

20.

Signs of possible stroke include (Select all that apply)

a)

Face Drooping

b)

Arm Weakness

c)

Speech Difficulty

d)

Shuffling gait

21.

Assessment/Diagnostics used for stroke patients include (Select all that apply)

a)

EMG (Electromyography)

b)

GCS (Glasgow Coma Scale)

c)

NIHSS (National Institutes of Health Stroke Scale)

d)

MEND (Miami Emergency Neurologic Deficit)

e)

Evoked Potential Test

22.

Which of the below is the most in-depth assessment tool for a stroke patient?

a)

GCS (Glasgow Coma Scale)

b)

NIHSS (National Institutes of Health Stroke Scale)

c)

MEND (Miami Emergency Neurologic Deficit)

23.

The most important modifiable risk factor for stroke is

a)

Diabetes

b)

Hypertension

c)

Obesity

d)

Poor diet

24.

Which of the following are accurate statements about TIAs (Select all that apply)

a)

1/3 do not experience another event

b)

1/3 will have additional TIAs

c)

1/3 will have a stroke

d)

The symptoms of a TIA are different from a stroke

25.

If you suspect a patient is having a TIA, monitor to see if symptoms disappear in a couple hours

a)

True

b)

False

26.

Stroke due to occlusion of an artery where an infarction occurs is:

a)

a hemorrhagic stoke

b)

an ischemic stroke

c)

a transient ischemic attack

27.

The most common type of stroke is:

a)

Embolic ischemic stroke

b)

Intracerebral hemorrhagic stroke

c)

Subarachnoid hemorrhagic stroke

d)

Thrombotic ischemic stroke

28.

You can easily tell by the symptoms whether the patient had an ischemic or hemorrhagic stroke

a)

True

b)

False

29.

Motor deficits are on the opposite side of the body as to where the brain damage occurred

a)

True

b)

False

30.

A form of aphasia where small words are omitted and short phrases take effort but make sense:

a)

Expressive aphasia

b)

Global aphasia

c)

Receptive aphasia

31.

Which of the following is true of dysarthria?

a)

It affects the muscles that control speech

b)

It occurs with receptive aphasia

c)

It occurs with global aphasia

32.

Which of the following is not an appropriate intervention for a patient with a hemorrhagic stroke?

a)

Antiepileptics

b)

Anticoagulants

c)

Clipping

d)

Coiling

33.

Considerations for a pt with dysphagia following a stoke include which of the following (Select all that apply):

a)

Assess LOC, gag reflex and swallowing ability

b)

Avoid liquids or use thickeners

c)

Perform mouth care before feeding

d)

Place food on affected side of mouth

34.

The term used for not seeing items on half of the visual field:

a)

Diplopia

b)

Homonymous hemianopsia

c)

Myopia

d)

Ptosis

35.

Treat bladder control issues with which of the following (Select all that apply):

a)

Ensure adequate fluid intake (mostly between 7 am and 7 pm)

b)

Insert indwelling Foley catheter

c)

Palpate for bladder distention

d)

Toileting every 2 hours

36.

What is a symptom of a stroke?

a)

Hemiplegia of one body part

b)

Aphasia of the face

c)

Numbness of the hand

d)

All of the above

37.

What acronym can help you identify a stroke?

a)

SLOW

b)

FAST

c)

STROKE

d)

SLEEP

38.

What are some common symptoms of a stroke?

a)

Paralysis of one side of body, slurring speech, facial droop

b)

Headache

c)

Chest pain

d)

Shortness of breath

39.

What is a stroke?

a)

Blocked blood vessel

b)

Bleeding in the brain from a blood vessel

c)

Loss of oxygen to part of the brain

d)

All of the above

40.

The letter F refer to Face in FAST acronym?

a)

True

b)

False

41.

The letter A refer to Arm in FAST acronym

a)

True

b)

False

42.

The letter S refer to speed in FAST acronym

a)

true

b)

false

43.

The letter T refer to Time in FAST acronym

a)

True

b)

false

44.
Slurred speech is a potential stroke indication
a)
True
b)
False
45.

This patient would have a Stroke

a)

True

b)

False

46.

Which of these are risk factors for stroke?

a)

High blood pressure

b)

Age > 55 years

c)

Low cholesterol

d)

Family history of stroke

e)

All of the above

47.

A stroke happens when

a)

when there is enough oxygen getting to the brain.

b)

when there is a lack of oxygen getting to the brain.

c)

Both of them

48.

Placing the object on the non-affected side of a TBI - stroke client would be helpful for a client who is experiencing which of the following?

a)

Aphasia

b)

Homonymous Hemianopsia

c)

Apraxia

d)

Diplopia

49.

What are the three components of the Glasgow Coma Scale?

a)

Eyes

b)

Pain

c)

Verbal

d)

Motor

50.

What is the lowest score a client can receive on the GCS?

a)

0

b)

3

c)

2

d)

1

51.

You are assessing the GCS score in a 90-year-old trauma patient. Your patient's eyes open in response to speech, but is nonverbal and only appears to make localizing, purposeful movement towards painful stimuli. What's your best estimate of this patient's GCS score?

a)

12

b)

9

c)

5

d)

3

52.

Your 72-year-old patient opens his eyes spontaneously, responds but is confused about time and place, and can follow physical commands correctly. What would you determine his GCS score to be?

a)

14

b)

8

c)

3

d)

10

53.

Which of the following medications would the nurse consider a client with a RBC count of 3.0 to be taking?

a)

Mannitol

b)

Hydrochloroquine

c)

Baclofen

d)

Methotrexate

54.

What is Rheumatoid Arthritis?

a)

inflammation of the joints

b)

inflammation of the muscles

c)

inflammation of the skin

d)

inflammation of the ankles

55.

Rheumatoid Arthritis is curable.

a)

true

b)

false

56.

What are synovial joints?

a)

least common joints

b)

most common joints

57.

Weight loss is a sign and symptoms of RA.

a)

true

b)

false

58.

Cracking our knuckles causes Rheumatoid Arthritis.

a)

true

b)

false

59.

What side of the body does RA occur at?

a)

both sides

b)

one side

60.

Where is RA most common?

a)

in our hands

b)

in our feet

c)

in our elbows

d)

in our knees

61.

Arthritis caused by an autoimmune disorder.

a)

osteoarthritis

b)

rheumatoid arthritis

c)

gout

d)

bursitis

62.

A client experiencing bilateral hand pain, nodules, weight loss, and a temperature of 100.4 F would be considered to have which disease?

a)

Osteoarthritis

b)

Sjogren Syndrome

c)

Lupus

d)

Rheumatoid Arthritis

63.

A client diagnosed with RA complains to the nurse about the inflammation and pain. Which of the following actions would the nurse advise the client on? SATA

a)

Warmth for inflammation

b)

Cool for inflammation

c)

Warmth for morning stiffness

d)

Cool for morning stiffness

64.

The client with RA asks the nurse for helpful ideas to assist with ADL's. Which of the following would be the best response by the nurse

a)

Purchase styrofoam cups and plates.

b)

Plan your day with rest periods.

c)

Force yourself to perform tasks in a normal way.

d)

Stay up later at night so you sleep later in the morning.

65.
Sickle red blood cells have a decreased ability to carry 
a)
nutrients
b)
wastes
c)
oxygen
d)
proteins
66.
Which is NOT a symptom of sickle cell disease?
a)
shortness of breath
b)
pain and tissue damage
c)
increased infections
d)
enlarged blood vessels
67.

Symptoms of sickle cell include

a)

Low red blood cell count

b)

High red blood cell count

c)

Recurrent infections

d)

Periodic pain episodes

e)

Nausea

68.

Symptoms of Sickle Cell Anemia are caused by

a)

premature break down of RBCs

b)

stiff and inflexible RBCs get stuck in small blood vessels

c)

oxygen deprivation (lack of) to organs

d)

high blood pressure

69.

A condition in which the blood doesn't have enough healthy red blood cells.

a)

Anemia

b)

Sickle Cell Anemia

c)

Sickle Cell Trait

d)

Episodes of Pain

e)

Red Blood Cells

70.

The sickle-shaped cells can also stick to vessel walls, causing a blockage that slows or stops the flow of blood. When this happens, oxygen can't reach nearby tissues. The lack of oxygen can cause ______.

a)

Anemia

b)

Sickle Cell Anemia

c)

Sickle Cell Trait

d)

Episodes of Pain

e)

Red Blood Cells

71.

Sickled cells live ___ days and healthy read blood cells live ___ days.

a)

90 to 120 day; 10 to 20 days

b)

10 to 20 days; 90 to 120 days

c)

50 to 60 days; 200 to 500 days

d)

200 to 500 days; 50 to 60 days

72.

The lack of _____ can cause attacks of sudden, severe pain, called pain crises.

a)

circulation

b)

oxygen

c)

carbon dioxide

d)

red blood cells

e)

blood

73.

How can the symptoms of SCD be relieved? Select all that apply.

a)

Pain Relivers

b)

Antibiotics

c)

There is no way to relieve symptoms.

d)

Blood Transfusions

e)

Immunizations (Shots)

74.

Bone marrow suppression, production of fetal hemoglobin, risk for birth defects, and leukemia are the side effects of which of the following medications?

a)

Prednisone

b)

Methotraxate

c)

Hydroxyurea

d)

Ferumoxytol

75.

The priority treatment for a patient who has sickle-cell disease is which of the following?

a)

Oxygen administration

b)

Prevent crisis

c)

Blood transfusions

d)

Pain management

76.

When would the nurse notify the neurosurgeon immediately?

a)

Client has a GCS of 11, from a 10.

b)

Pin on a Halo device is detached.

c)

Client states itching under the jacket.

d)

Client has skin breakdown where the jacket is touching the skin.

77.

Which of the following would be complications of a spinal cord injury?

a)

Orthostatic Hypotension

b)

Constipation

c)

Aspiration

d)

Anorexia

78.

A graduate RN is educating a patient newly diagnosed with SLE. Which of the following should the RN include in her teaching plan?

a)

Don't use make up to cover rash.

b)

Apply powder to my rash.

c)

Wash with mild soap.

d)

Wear sunscreen outdoors

79.

When treating a client with SLE, which of the following should be included in the treatment plan? SATA

a)

Identify stressors

b)

Monitor lab values

c)

Avoid physical exercise.

d)

Stop corticosteroids immediately if swelling occurs.

80.

Vasopressin, Octreotide, Propanolol, IV Fluids and Blood Products would be expected treatments for what disease process?

a)

Hepatic Encephalopathy

b)

Ascites

c)

Portal Hypertension

d)

Esophogeal Varices

81.

One of the main concerns with a patient diagnosed with cirrhosis would be which of the following?

a)

Heart Failure

b)

Bleeding

c)

Kidney failure

d)

Electrolyte imbalance

82.

Which of the following would be an indication to perform a neuro assessment on a client?

a)

Vomiting

b)

Hypotension

c)

Headache

d)

Leg cramping

83.

Interpret this EKG strip

a)

Sinus Rhythm, Hr.70

b)

Sinus Rhythm, Hr.90

c)

Sinus Bradycardia, Hr.50

d)

Sinus Tachycardia, Hr. 110

84.

Interpret this Rhythm:

a)

Normal sinus rhythm

b)

Ventricular fibrillation

c)

Sinus Brady with PAC's

d)

Sinus Bradycardia

85.

Which best describes this rhythm?

a)

Atrial Fibrillation

b)

Atrial Flutter

c)

Asystole

d)

PEA

86.

Which best describes this rhythm?

a)

Asystole

b)

PEA

c)

Pulseless Ventricular Tachycardia

d)

Ventricular Fibrillation

87.

Which best describes this rhythm?

a)

Asystole

b)

PEA

c)

Ventricular Tachycardia

d)

Ventricular fibrillation

88.

Which best describes this rhythm?

a)

Asystole

b)

PEA

c)

Ventricular Tachycardia

d)

Ventricular fibrillation

89.

Identify the waveform after the second heartbeat?

a)

NSR with PAC

b)

Sinus Tachycardia

c)

NSR with PVC

d)

Asystole

90.

Identify the cardiac rhythm strip pictured above

a)

Ventricular Tachycardia

b)

Normal Sinus Rhythm

c)

Atrial Fibrillation

d)

Sinus Tachycardia

91.

Benzodiazepines and Skeletal Muscle Relaxants are used for the treatment of which of the following? SATA

a)

Cerebral Palsy

b)

Seizures

c)

Muscle Spasticity

d)

Diabetes

92.

A client who is receiving TPA begins to bleed from their rectum. Which order would the nurse follow for this problem?

a)

Obtain, Assess, Draw, Contact

b)

Contact, Obtain, Assess, Draw

c)

Assess, Obtain, Contact, Draw

d)

Draw, Assess, Obtain, Contact

93.

The family of a client with Cerebral Palsy is concerned about what they should watch for with their family member. The biggest risk factor for CP is which of the following?

a)

Aspiration

b)

Safety

c)

Mobility

d)

Bleeding

94.

A client diagnosed with hepatic encephalopathy should have which of the following included in their care plan?

a)

Avoid medications that can alter the LOC.

b)

Independence

c)

Orthostatic Hypotension

d)

Atelectasis

95.
Cerebral Palsy is a death sentence.  
a)
True
b)
False
96.

what is spastic cerebral palsy

a)

the muscles are stiff and tight making it difficult to move and reducing the range of movement that's possible

b)

when a person has balance and co-ordination problems, resulting in shaky or clumsy movements and sometimes tremors

c)

or none of the above

97.

What is the most common type of Cerebral Palsy?

(a)  

98.

What are some symptoms of cerebral palsy?

a)

Baby doesn't roll over in either direction

b)

Baby cannot bring her hands together

c)

Baby has difficulty bringing her hands to mouth

d)

All of the above

99.

Some kids with cerebral palsy will have trouble with motor skills. Which of the following is an example of a motor skill?

a)

Learning how to read

b)

Lifting a fork to one's mouth

c)

Staying quiet in class

d)

Learning how to run

100.

For kids with cerebral palsy, physical therapy:

a)

Can permanently cure their condition

b)

Isn't much help at all

c)

Prevents their symptoms from spreading

d)

Can help manage their symptoms