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Question 1:

A nurse is teaching a client about the functions of the central nervous system (CNS). Which of the following statements by the client indicates a need for further teaching?

A. The CNS processes sensory information from the body. B. The CNS generates motor commands to control movement. C. The CNS regulates cognitive and emotional functions. D. The CNS connects the brain and spinal cord to the rest of the body.

Answer and Explanation

Choice A:

This is a correct statement, as the CNS receives sensory information from various receptors in the body and interprets it.

Choice B:

This is a correct statement, as the CNS initiates and coordinates motor commands to control voluntary and involuntary movements.

Choice C:

This is a correct statement, as the CNS is involved in higher cognitive functions such as memory, learning, reasoning, and emotions.

Choice D:

This is an incorrect statement, as this is the function of the PNS. The PNS consists of cranial and spinal nerves that connect the CNS to the rest of the body and transmit sensory and motor signals.

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Question 2:

A nurse is assessing a client who has a spinal cord injury at the level of T6. Which of the following functions are likely to be affected by this injury? (Select all that apply.)

A. Bladder control B. Respiratory rate C. Heart rate D. Arm movement E. Leg movement

Answer and Explanation

Choice A:

This is a correct answer, as bladder control is regulated by nerves that originate from the sacral region of the spinal cord, which is below T6.

Choice B:

This is an incorrect answer, as respiratory rate is regulated by nerves that originate from the cervical and thoracic regions of the spinal cord, which are above T6.

Choice C:

This is a correct answer, as heart rate is regulated by nerves that originate from the thoracic and lumbar regions of the spinal cord, which are below T6.

Choice D:

This is an incorrect answer, as arm movement is regulated by nerves that originate from the cervical region of the spinal cord, which is above T6.

Choice E:

This is a correct answer, as leg movement is regulated by nerves that originate from the lumbar and sacral regions of the spinal cord, which are below T6.

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Question 3:

A nurse is caring for a client who has a seizure disorder. The client asks the nurse how seizures occur. Which of the following responses by the nurse is appropriate?

A. "Seizures occur when there is too much stimulation in your brain cells." B. "Seizures occur when there is an imbalance in your brain chemicals." C. "Seizures occur when there is a lack of oxygen in your brain tissue." D. "Seizures occur when there is an infection in your brain tissue."

Answer and Explanation

Choice A:

This is an incorrect answer, as seizures do not occur due to too much stimulation in brain cells, but rather due to abnormal electrical activity caused by neurotransmitter imbalance.

Choice B:

This is a correct answer, as seizures occur due to neurotransmitter imbalance, which disrupts communication between neurons and causes abnormal electrical activity in the brain.

Choice C:

This is an incorrect answer, as seizures do not occur due to lack of oxygen in brain tissue, but rather due to abnormal electrical activity caused by neurotransmitter imbalance.

Choice D:

This is an incorrect answer, as seizures do not occur due to infection in brain tissue, but rather due to abnormal electrical activity caused by neurotransmitter imbalance.

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Question 4:

A nurse is administering medication to a client who has Parkinson's disease. The client asks the nurse how the medication works. Which of the following responses by the nurse is appropriate?

A. "The medication increases dopamine levels in your brain." B. "The medication decreases acetylcholine levels in your brain." C. "The medication increases serotonin levels in your brain." D. "The medication decreases glutamate levels in your brain."

Answer and Explanation

Choice A:

This is a correct answer, as the medication increases dopamine levels in the brain, which helps to improve the symptoms of Parkinson's disease, such as tremors, rigidity, and bradykinesia.

Choice B:

This is an incorrect answer, as the medication does not decrease acetylcholine levels in the brain, but rather increases dopamine levels. Acetylcholine is another neurotransmitter that controls muscle contraction, learning, and memory.

Choice C:

This is an incorrect answer, as the medication does not increase serotonin levels in the brain, but rather increases dopamine levels. Serotonin is another neurotransmitter that controls mood, sleep, and appetite.

Choice D:

This is an incorrect answer, as the medication does not decrease glutamate levels in the brain, but rather increases dopamine levels. Glutamate is another neurotransmitter that controls excitatory signals in the brain.

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Question 5:

A nurse is reviewing the anatomy of the peripheral nervous system (PNS) with a group of nursing students. Which of the following statements by a student indicates a need for further teaching?

A. The PNS consists of cranial and spinal nerves that connect the CNS to the rest of the body. B. The PNS is divided into two subdivisions: the somatic nervous system and the autonomic nervous system. C. The PNS controls voluntary movements of skeletal muscles and provides sensory feedback from the skin, joints, and muscles. D. The PNS regulates involuntary functions of smooth muscles, cardiac muscles, and glands.

Answer and Explanation

Choice A:

This is a correct statement, as the PNS consists of cranial and spinal nerves that connect the CNS to the rest of the body and transmit sensory and motor signals.

Choice B:

This is a correct statement, as the PNS is divided into two subdivisions: the somatic nervous system (SNS) and the autonomic nervous system (ANS).

Choice C:

This is a correct statement, as the PNS controls voluntary movements of skeletal muscles and provides sensory feedback from the skin, joints, and muscles through the SNS.

Choice D:

This is an incorrect statement, as this is the function of the ANS, which is a subdivision of the PNS. The ANS regulates involuntary functions of smooth muscles, cardiac muscles, and glands through its two branches: the sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS).

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Question 6:

A nurse is caring for a client who has multiple sclerosis (MS). Which of the following statements by the client indicates an understanding of this condition?

A. "MS is caused by an autoimmune attack on my nerve cells." B. "MS is caused by a degeneration of my nerve fibers." C. "MS is caused by an inflammation of my nerve coverings." D. "MS is caused by a compression of my nerve roots."

Answer and Explanation

Choice A:

This is an incorrect answer, as MS is not caused by an autoimmune attack on nerve cells, but rather on nerve coverings called myelin sheaths.

Choice B:

This is an incorrect answer, as MS is not caused by a degeneration of nerve fibers, but rather by an inflammation of nerve coverings called myelin sheaths.

Choice C:

This is a correct answer, as MS is caused by an inflammation of nerve coverings called myelin sheaths, which impair transmission of nerve impulses.

Choice D:

This is an incorrect answer, as MS is not caused by a compression of nerve roots, but rather by an inflammation of nerve coverings called myelin sheaths.

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Question 7:

A nurse is assessing a client who has peripheral neuropathy due to diabetes mellitus. Which of the following findings should the nurse expect?

A. Decreased sensation in the feet and lower legs. B. Increased muscle tone and reflexes in the upper limbs. C. Decreased pain perception in the hands and fingers. D. Increased sweating and flushing in the face and neck.

Answer and Explanation

Choice A:

This is the correct answer because peripheral neuropathy affects the sensory nerves, which can cause loss of sensation, especially in the distal parts of the body. Diabetes mellitus is a common cause of peripheral neuropathy.

Choice B:

This is incorrect because peripheral neuropathy does not affect the motor nerves, which control muscle tone and reflexes. Increased muscle tone and reflexes in the upper limbs are more likely to indicate a central nervous system disorder, such as a stroke or spinal cord injury.

Choice C:

This is incorrect because peripheral neuropathy can cause decreased pain perception in any part of the body, not just the hands and fingers. However, this is not a specific finding for peripheral neuropathy, as other conditions can also impair pain perception, such as spinal cord injury or opioid use.

Choice D:

This is incorrect because peripheral neuropathy does not affect the autonomic nerves, which control sweating and flushing. Increased sweating and flushing in the face and neck are more likely to indicate a sympathetic nervous system disorder, such as pheochromocytoma or carcinoid syndrome.

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Question 8:

A client has been diagnosed with radiculopathy due to a herniated disc in the lumbar spine. The nurse should instruct the client to avoid which of the following activities? (Select all that apply.)

A. Bending forward at the waist. B. Lifting heavy objects. C. Sitting for prolonged periods. D. Swimming or water aerobics. E. Walking or jogging.

Answer and Explanation

Choice A:

This is correct because bending forward at the waist can increase the pressure on the spinal discs and nerve roots, which can worsen radiculopathy symptoms.

Choice B:

This is correct because lifting heavy objects can also increase the pressure on the spinal discs and nerve roots, as well as strain the back muscles and ligaments, which can worsen radiculopathy symptoms.

Choice C:

This is correct because sitting for prolonged periods can reduce blood flow to the spinal discs and nerve roots, which can impair healing and worsen radiculopathy symptoms.

Choice D:

This is incorrect because swimming or water aerobics can be beneficial for clients with radiculopathy, as they can reduce stress on the spine, improve flexibility and strength, and relieve pain.

Choice E:

This is incorrect because walking or jogging can also be beneficial for clients with radiculopathy, as they can improve blood flow to the spine, enhance mood and well-being, and prevent deconditioning.

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Question 9:

A nurse is performing a physical examination on a client who has cervical radiculopathy due to spondylosis. The nurse asks the client to tilt their head toward their affected shoulder and apply slight pressure. The client reports increased pain radiating from their neck to their arm. The nurse recognizes this as a positive result of which of the following tests?

A. Spurling's test. B. Straight leg raise test. C. Tinel's sign. D. Phalen's test.

Answer and Explanation

Choice A:

This is the correct answer because Spurling's test is used to diagnose cervical radiculopathy by reproducing radicular pain with neck extension, lateral flexion, and compression. A positive result indicates nerve root compression by a herniated disc, osteophyte, or other lesion.

Choice B:

This is incorrect because straight leg raise test is used to diagnose lumbar radiculopathy by reproducing radicular pain with hip flexion and knee extension. A positive result indicates nerve root compression by a herniated disc or other lesion in the lower back.

Choice C:

This is incorrect because Tinel's sign is used to diagnose peripheral neuropathy by reproducing tingling or paresthesia with tapping over a damaged nerve. A positive result indicates nerve regeneration or irritation by a scar, tumor, or other lesion.

Choice D:

This is incorrect because Phalen's test is used to diagnose carpal tunnel syndrome by reproducing numbness or tingling in the median nerve distribution with wrist flexion for 60 seconds. A positive result indicates median nerve compression by a thickened flexor retinaculum or other lesion in the wrist.

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Question 10:

A client who has lumbar radiculopathy due to spinal stenosis is scheduled for an interventional procedure to relieve their symptoms. The nurse explains to the client that they will receive an injection of a steroid and a local anesthetic into the epidural space of their spine. The client asks the nurse, "How will this help me?" Which of the following responses should the nurse give?

A. "The steroid will reduce the inflammation and swelling of the nerve root, which will decrease your pain and improve your function." B. "The local anesthetic will block the transmission of pain signals from the nerve root to your brain, which will provide you with temporary relief." C. "The combination of steroid and local anesthetic will shrink the size of the disc or bone spur that is compressing the nerve root, which will restore your mobility and sensation." D. "The injection will deliver medication directly to the affected area of your spine, which will have fewer side effects than oral or intravenous medications."

Answer and Explanation

Choice A:

This is the correct answer because epidural steroid injections are used to treat radiculopathy by reducing inflammation and edema of the nerve root, which can relieve radicular pain and improve neurological function.

Choice B:

This is incorrect because local anesthetic alone can provide temporary pain relief by blocking nerve conduction, but it does not address the underlying cause of radiculopathy, which is nerve root compression.

Choice C:

This is incorrect because steroid and local anesthetic do not have any effect on the size or shape of the disc or bone spur that is compressing the nerve root. They only reduce inflammation and pain.

Choice D:

This is incorrect because although epidural injections may have fewer systemic side effects than oral or intravenous medications, they still have some risks and complications, such as infection, bleeding, nerve damage, or spinal headache.

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Question 11:

A nurse is providing education to a client who has peripheral neuropathy due to chemotherapy. The nurse should include which of the following instructions in the teaching plan?

A. Wear tight-fitting shoes to prevent foot injuries. B. Use a heating pad to relieve pain in the affected areas. C. Inspect your skin daily for cuts, blisters, or ulcers. D. Avoid taking vitamin B supplements to prevent toxicity.

Answer and Explanation

Choice A:

This is incorrect because wearing tight-fitting shoes can cause pressure ulcers, blisters, or infections in clients with peripheral neuropathy, who have reduced sensation and blood flow in their feet. The nurse should advise the client to wear well-fitting shoes with cushioned socks and avoid walking barefoot.

Choice B:

This is incorrect because using a heating pad can cause burns or skin damage in clients with peripheral neuropathy, who have impaired temperature perception and pain sensation in their affected areas. The nurse should advise the client to avoid exposure to extreme heat or cold and use other methods to relieve pain, such as medications, massage, or acupuncture.

Choice C:

This is the correct answer because inspecting the skin daily for cuts, blisters, or ulcers can help prevent infection and complications in clients with peripheral neuropathy, who have reduced sensation and healing ability in their affected areas. The nurse should advise the client to wash their skin with mild soap and water, apply moisturizer, and report any signs of infection to their provider.

Choice D:

This is incorrect because taking vitamin B supplements can help prevent or treat peripheral neuropathy caused by vitamin B deficiency, which can occur in clients who receive chemotherapy. The nurse should advise the client to consult with their provider before taking any supplements and follow a balanced diet that includes foods rich in vitamin B, such as meat, eggs, dairy products, and fortified cereals.

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Question 12:

A nurse is caring for a client who has cervical radiculopathy due to a herniated disc at C6-C7 level. Which of the following muscles should the nurse assess for weakness?

A. Biceps brachii. B. Triceps brachii. C. Deltoid. D. Trapezius.

Answer and Explanation

Choice A:

This is incorrect because biceps brachii is innervated by C5-C6 nerve roots, which are not affected by a herniated disc at C6-C7 level.

Choice B:

This is the correct answer because triceps brachii is innervated by C6-C8 nerve roots, which are affected by a herniated disc at C6-C7 level.

Choice C:

This is incorrect because deltoid is innervated by C5-C6 nerve roots, which are not affected by a herniated disc at C6-C7 level.

Choice D:

This is incorrect because trapezius is innervated by cranial nerve XI (spinal accessory nerve), which is not affected by a herniated disc at C6-C7 level.

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Question 13:

A nurse is teaching a client who has peripheral neuropathy about foot care. Which of the following statements by the client indicates an understanding of the teaching?

A. "I should trim my toenails straight across and file the edges." B. "I should soak my feet in warm water for 15 minutes every day." C. "I should wear cotton socks and change them when they are damp." D. "I should apply lotion between my toes to prevent dryness."

Answer and Explanation

Choice A:

This is the correct answer because trimming the toenails straight across and filing the edges can prevent ingrown toenails, which can cause infection and complications in clients with peripheral neuropathy.

Choice B:

This is incorrect because soaking the feet in warm water for 15 minutes every day can cause maceration, which can increase the risk of skin breakdown and infection in clients with peripheral neuropathy.

Choice C:

This is incorrect because wearing cotton socks and changing them when they are damp can cause friction and moisture, which can also increase the risk of skin breakdown and infection in clients with peripheral neuropathy.

Choice D:

This is incorrect because applying lotion between the toes can cause fungal growth, which can lead to athlete's foot or other infections in clients with peripheral neuropathy.

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Question 14:

A nurse is reviewing the medical history of a client who has ischemic stroke. Which of the following conditions is the most common cause of ischemic stroke?

A. Atherosclerosis B. Atrial fibrillation C. Cerebral aneurysm D. Arteriovenous malformation

Answer and Explanation

Choice A:

This is the correct answer because atherosclerosis is the main cause of ischemic stroke, as it leads to the formation of plaques that narrow the cerebral arteries and reduce blood flow to the brain.

Choice B:

This is incorrect because atrial fibrillation is a risk factor for ischemic stroke, but not the most common cause. Atrial fibrillation can cause embolic stroke, which occurs when a blood clot from the heart travels to the brain and blocks a cerebral artery.

Choice C:

This is incorrect because cerebral aneurysm is a cause of hemorrhagic stroke, not ischemic stroke. Cerebral aneurysm is a weak spot in a cerebral artery that can rupture and bleed into the brain.

Choice D:

This is incorrect because arteriovenous malformation is also a cause of hemorrhagic stroke, not ischemic stroke. Arteriovenous malformation is a congenital abnormality of the blood vessels in the brain that can leak or burst and cause bleeding.

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Question 15:

A nurse is caring for a client who has ischemic stroke and is receiving thrombolytic therapy with recombinant tissue plasminogen activator (rtPA). Which of the following actions should the nurse take? (Select all that apply.)

A. Monitor the client's vital signs and neurological status frequently. B. Administer rtPA within 4.5 hours of symptom onset. C. Maintain the client's systolic blood pressure below 180 mm Hg. D. Give aspirin or other antiplatelet agents along with rtPA. E. Assess the client for signs of bleeding or hemorrhagic transformation.

Answer and Explanation

Choice A:

This is correct because monitoring the client's vital signs and neurological status frequently can help detect any changes in the client's condition, such as improvement or deterioration of symptoms, or complications such as bleeding or increased intracranial pressure.

Choice B:

This is correct because administering rtPA within 4.5 hours of symptom onset can increase the chances of restoring blood flow to the ischemic brain tissue and reducing neurological damage. The effectiveness and safety of rtPA decrease after this time window.

Choice C:

This is correct because maintaining the client's systolic blood pressure below 180 mm Hg can prevent further ischemia or hemorrhage in the brain. High blood pressure can increase the risk of bleeding or reperfusion injury after thrombolytic therapy.

Choice D:

This is incorrect because giving aspirin or other antiplatelet agents along with rtPA can increase the risk of bleeding or hemorrhagic transformation. Antiplatelet agents should be avoided for at least 24 hours after thrombolytic therapy.

Choice E:

This is correct because assessing the client for signs of bleeding or hemorrhagic transformation can help identify any adverse effects of thrombolytic therapy. Bleeding or hemorrhagic transformation can manifest as hematuria, hematemesis, melena, petechiae, ecchymosis, epistaxis, gingival bleeding, headache, altered mental status, or worsening neurological deficits.

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Question 16:

A nurse is performing a neurological assessment on a client who has ischemic stroke affecting the left cerebral hemisphere. The nurse asks the client to name an object that the nurse points to, but the client does not respond verbally. The nurse interprets this as a sign of which of the following types of aphasia?

A. Expressive aphasia B. Receptive aphasia C. Global aphasia D. Anomic aphasia

Answer and Explanation

Choice A:

This is incorrect because expressive aphasia is a type of aphasia that affects the ability to produce speech, but not to comprehend it. A client with expressive aphasia would be able to respond verbally, but with difficulty or errors.

Choice B:

This is the correct answer because receptive aphasia is a type of aphasia that affects the ability to comprehend speech, but not to produce it. A client with receptive aphasia would not be able to respond verbally, as they do not understand what is being asked.

Choice C:

This is incorrect because global aphasia is a type of aphasia that affects both the ability to produce and comprehend speech. A client with global aphasia would not be able to respond verbally or nonverbally, as they have no language function.

Choice D:

This is incorrect because anomic aphasia is a type of aphasia that affects the ability to recall specific words or names, but not the general ability to produce or comprehend speech. A client with anomic aphasia would be able to respond verbally, but with pauses or substitutions.

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Question 17:

A nurse is planning care for a client who has ischemic stroke and is at risk for cerebral edema. Which of the following interventions should the nurse include in the plan?

A. Elevate the head of the bed to 30 degrees. B. Administer mannitol as prescribed. C. Monitor the client's intracranial pressure. D. All of the above.

Answer and Explanation

Choice A:

This is correct because elevating the head of the bed to 30 degrees can help reduce intracranial pressure by facilitating venous drainage and decreasing cerebral blood volume.

Choice B:

This is correct because administering mannitol as prescribed can help reduce intracranial pressure by creating an osmotic gradient that draws fluid out of the brain tissue and into the bloodstream.

Choice C:

This is correct because monitoring the client's intracranial pressure can help detect any signs of increased intracranial pressure or cerebral herniation, which can be life-threatening complications of cerebral edema.

Choice D:

This is correct because all of the above interventions are appropriate for a client who has ischemic stroke and is at risk for cerebral edema.

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Question 18:

A nurse is evaluating the outcomes of a client who has ischemic stroke and has received rehabilitation. Which of the following statements by the client indicates an improvement in functional recovery?

A. "I can move my arm and leg on the affected side better than before." B. "I can speak more clearly and understand what others are saying." C. "I can swallow without choking or coughing." D. All of the above.

Answer and Explanation

Choice A:

This is correct because improved movement of the arm and leg on the affected side indicates an improvement in motor function, which can be impaired by ischemic stroke.

Choice B:

This is correct because improved speech and comprehension indicate an improvement in language function, which can be impaired by ischemic stroke, especially if it affects the dominant hemisphere.

Choice C:

This is correct because improved swallowing indicates an improvement in cranial nerve function, which can be impaired by ischemic stroke, especially if it affects the brainstem.

Choice D:

This is correct because all of the above statements indicate an improvement in functional recovery, which is the goal of rehabilitation for clients who have ischemic stroke.

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Question 19:

A nurse is educating a client who has a history of ischemic stroke about modifiable risk factors. Which of the following risk factors should the nurse include in the teaching? (Select all that apply.)

A. Hypertension B. Smoking C. Diabetes mellitus D. Age E. Family history

Answer and Explanation

Choice A:

This is correct because hypertension is a modifiable risk factor for ischemic stroke, as it increases the stress on the arterial walls and accelerates atherosclerosis, which can lead to plaque formation and reduced blood flow to the brain.

Choice B:

This is correct because smoking is a modifiable risk factor for ischemic stroke, as it damages the endothelial lining of the arteries and promotes thrombosis, which can lead to clot formation and blockage of blood flow to the brain.

Choice C:

This is correct because diabetes mellitus is a modifiable risk factor for ischemic stroke, as it causes hyperglycemia and dyslipidemia, which can damage the blood vessels and increase the risk of atherosclerosis and thrombosis.

Choice D:

This is incorrect because age is a non-modifiable risk factor for ischemic stroke, as it cannot be changed or controlled by the client. The risk of ischemic stroke increases with age due to physiological changes in the blood vessels and other organs.

Choice E:

This is incorrect because family history is also a non-modifiable risk factor for ischemic stroke, as it cannot be changed or controlled by the client. The risk of ischemic stroke may be higher in clients who have relatives who had a stroke due to genetic or environmental factors.

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