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Nursing Process Brain: Injury, Seizures, Migraines

Total questions: 26

Worksheet time: 14mins

Name
Class
Date
1.

Which definition relates to a myoclonic seizure?

a)

Loss of consciousness or blackout for 1-3 minutes

b)

Activity beginning in a part of one cerebral hemisphere

c)

Sudden loss of muscle tone followed by postictal confusion

d)

Brief jerking or stiffening of extremities lasting a few seconds

2.

Which substance is prevented from crossing the blood brain barrier?

a)

Alcohol

b)

Glucose

c)

Antibiotic

d)

Anesthesia

3.

Which patient condition is associated with a lower thoracic spinal cord injury?

a)

Paraplegia

b)

Tetraplegia

c)

Hemiplegia

d)

Quadriplegia

4.

Which goal would the nurse associate with abortive therapy for patients with migraine headaches?

a)

Identify triggers

b)

Prevent recurrence of migraines

c)

Alleviate pain during the aura phase

d)

Decrease pain during the second phase

5.

Which phrase describes traumatic brain injury (TBI)?

a)

Injury to the brain from a congenital condition

b)

Damage to the brain from an external mechanical force

c)

Impairment of the brain caused by neurodegeneration

d)

Diminishing functionality of the brain due to internal forces

6.

Which statement about Multiple Sclerosis (MS) is accurate?

a)

MS affects more men than women

b)

MS usually occurs in people over 50 years old

c)

MS is often seen in warmer climates

d)

MS occurs more frequently among whites than other races

7.

Which term describes a patient who experiences continuous seizures for more than 6 minutes per episode?

a)

Acute seizure

b)

Chronic seizure

c)

Status epilepticus

d)

Tonic-clonic seizure

8.

Which clinical manifestation would the nurse associate with an absence seizure? SATA

a)

Rigidity of the muscles

b)

Sudden loss of muscle tone

c)

Brief, blank staring episodes

d)

Involuntary picking at clothes

e)

Jerky movements of the extremities

9.

The Glasgow Coma Scale (GCS) assesses what areas of response to stimuli? Select all that apply:

a)

Auditory response

b)

Verbal response

c)

Tactile response

d)

Eye-opening response

e)

Motor response

10.

What Glasgow Coma Scale score usually requires intubation because the airway reflexes are affected?

a)

10 or less

b)

9 or greater

c)

8 or less

d)

10 or greater

11.

You’re assessing your patient load for the patients who are at MOST risk for seizures. Select all the patients below that are at risk:

a)

A 32-year-old with a blood glucose of 20 mg/dL.

b)

A 63-year-old whose CT scan shows an ischemic stroke.

c)

A 72-year-old who is post opt day 5 from open heart surgery.

d)

A 16-year-old with bacterial meningitis.

e)

A 58-year-old experiencing ETOH withdrawal.

12.

A patient with a history of epilepsy is taking Phenytoin. The patient’s morning labs are back, and the patient’s Phenytoin level is 7 mcg/mL. Based on this finding, the nurse will?

a)

Assess the patient for a rash

b)

Initiate seizure precautions

c)

Hold the next dose of Phenytoin

d)

Continue to monitor the patient

13.

True or False: A patient who is experiencing a tonic-clonic seizure is experiencing a focal (partial) seizure.

a)

TRUE

b)

FALSE

14.

Your patient has a history of epilepsy. While helping the patient to the restroom, the patient reports having this feeling of déjà vu and seeing spots in their visual field. Your next nursing action is to?

a)

Continue assisting the patient to the restroom and let them sit down.

b)

Initiate the emergency response system.

c)

Lay the patient down on their side with a pillow underneath the head.

d)

Assess the patient’s medication history.

15.

A patient is being treated for increased intracranial pressure. Which activities below should the patient avoid performing? SATA

a)

Coughing

b)

Sneezing

c)

Valsalva maneuver

d)

Vomiting

e)

Keeping the head of the bed between 30- 35 degrees

16.

A patient is experiencing hyperventilation and has a PaCO2 level of 52. The patient has an ICP of 20 mmHg. As the nurse you know that the PaCO2 level will?

a)

cause vasoconstriction and decrease the ICP

b)

promote diuresis and decrease the ICP

c)

cause vasodilation and increase the ICP

d)

cause vasodilation and decrease the ICP

17.

Which patient below is at MOST risk for increased intracranial pressure?

a)

A patient who is experiencing severe hypotension.

b)

A patient who is admitted with a traumatic brain injury.

c)

A patient who recently experienced a myocardial infarction.

d)

A patient post-op from eye surgery.

18.

A patient who experienced a cerebral hemorrhage is at risk for developing increased ICP. Which sign and symptom below is the EARLIEST indicator the patient is having this complication?

a)

Bradycardia

b)

Decerebrate posturing

c)

Restlessness

d)

Unequal pupil size

19.

During the assessment of a patient with increased ICP, you note that the patient’s arms are extended straight out and toes pointed downward. You will document this as:

a)

Decorticate posturing

b)

Decerebrate posturing

c)

Flaccid posturing

d)

Zombie pose

20.

You’re caring for a patient with Parkinson’s Disease that has tremors. Select the option that is INCORRECT about tremors experienced in this disease:

a)

The tremors are most likely to occur with purposeful movements.

b)

A common term used to describe the tremors in the hands and fingers is called “pill-rolling”.

c)

Tremors are one of the most common signs and symptoms in Parkinson’s Disease.

d)

Tremors in this disease can occur in the hands, fingers, arms, legs and even the lips and tongue.

21.

A patient with Parkinson’s Disease has slow movements that affects their swallowing, facial expressions, and ability to coordinate movements. As the nurse you will document the patient has:

a)

Akinesia

b)

“Freeze up” tremors

c)

Bradykinesia

d)

Pill-rolling

22.

A patient is prescribed to take Carbidopa/Levodopa (Sinemet). As the nurse you know that which statement is incorrect about this medication:

a)

It can take up to 3 weeks for the patient to notice a decrease in signs and symptoms when beginning treatment with this medication.

b)

Body fluids can turn a dark color and stain clothes.

c)

This medication is most commonly prescribed with a vitamin B6 supplement.

d)

Carbidopa helps to prevent Levodopa from being broken down in the blood before it enters the brain. Hence, levodopa is able to enter the brain.

23.

A patient is admitted with uncontrolled atrial fibrillation. The patient’s medication history includes vitamin D supplements and calcium. What type of stroke is this patient at MOST risk for?

a)

Ischemic thrombosis

b)

Ischemic embolism

c)

Hemorrhagic

d)

Ischemic stenosis

24.

Which patient below is at most risk for a hemorrhagic stroke?

a)

A 65 year old male patient with carotid stenosis.

b)

A 89 year old female with atherosclerosis.

c)

A 88 year old male with uncontrolled hypertension and a history of brain aneurysm repair 2 years ago.

d)

A 55 year old female with atrial flutter.

25.

Your patient who had a stroke has issues with understanding speech. What type of aphasia is this patient experiencing and what area of the brain is affected?

a)

Expressive; Wernicke’s area

b)

Receptive, Broca’s area

c)

Expressive; hippocampus

d)

Receptive; Wernicke’s area

26.

A patient has experienced right side brain damage. You note the patient is experiencing neglect syndrome. What nursing intervention will you include in the patient’s plan of care?

a)

Remind the patient to use and touch both sides of the body daily.

b)

Offer the patient a soft mechanical diet with honey thick liquids.

c)

Ask direct questions that require one word responses.

d)

Offer the bedpan and bedside commode every 2 hours.