Deck 27: Disorders of Circulation Within the Cns

Question 1

Which information should the nurse include in a teaching care plan for a patient with moyamoya disease?

A) It may be an inherited genetic disorder.
B) It is caused by an arteriovenous fistula.
C) It is caused by the inflammatory process.
D) It is caused by a narrowing of the cerebral arteries.

Answer 1

It may be an inherited genetic disorder.

Question 2

When performing an assessment of the central nervous system, which concept should the nurse keep in mind?

A) White matter uses 94% of the cerebral oxygen.
B) Gray matter uses only 6% of cerebral oxygen.
C) The brain receives about 15% of the cardiac output.
D) The brain weighs 25% of total body mass.

Answer 2

The brain receives about 15% of the cardiac output.

Question 3

Which statement by the mother of a baby with hydrocephalus indicates that the mother understands this condition?

A) "My baby had a stroke."
B) "My baby has too much fluid in his brain."
C) "My baby has a collection of blood around his brain."
D) "My baby has swelling of the brain."

Answer 3

"My baby has too much fluid in his brain."

Question 4

When administering medications, which concept pertaining to the blood-brain barrier must the nurse understand?

A) Highly lipophilic medications cross the blood-brain barrier directly.
B) Highly lipophilic medications cannot cross the blood-brain barrier.
C) Highly lipophilic medications cross the blood-brain barrier by simple diffusion.
D) Highly lipophilic medications cross into the brain where there is no blood-brain barrier.

Question 5

A history and assessment of a patient with normal pressure hydrocephalus will most likely reveal:

A) no change in mental status.
B) acute dementia.
C) bowel incontinence.
D) an older adult.

Question 6

The nurse instructs a patient who had a TIA to take which action if he experiences symptoms of a TIA in the future?

A) No action is needed if the symptoms resolve immediately.
B) Wait 24 hours to see if symptoms resolve before seeking medical care.
C) Seek urgent medical care.
D) Make an appointment with healthcare provider if symptoms recur.

Question 7

When caring for a patient with increased intracranial pressure, which laboratory value trend requires immediate action by the nurse?

A) A falling PaCO₂ level
B) A rising PaCO₂ level
C) A falling PaO₂ level
D) A rising PaO₂ level

Question 8

When assessing a patient with traumatic brain injury, which cerebral blood flow would the nurse consider normal?

A) 750 milliliters of blood/minute
B) 1000 milliliters of blood/minute
C) 1500 milliliters of blood/minute
D) 2000 milliliters of blood/minute

Question 9

The nurse is developing a community program about stroke risk factor reduction. Which would the nurse explain is a non-modifiable risk factor?

A) Poor nutrition
B) Prior stroke or TIA
C) Diabetes
D) High levels of homocysteine

Question 10

The nurse should expect to assess which findings in a patient with a right anterior cerebral artery stroke?

A) Diplopia, dysarthria, and nystagmus
B) Right cerebellar ataxia and Horner syndrome
C) Aphasia and neglect
D) Paresis and sensory loss of the left leg and foot

Question 11

A patient with an ischemic stroke has a blood pressure of 200/110 mmHg. Which action should the nurse anticipate?

A) Administering antihypertensives to lower the blood pressure as quickly as possible.
B) Administering antihypertensives if the blood pressure exceeds 220/120 mmHg.
C) Administering antihypertensives to lower blood pressure by 25% over 24 hours.
D) Administering antihypertensives to lower the blood pressure to less than 140/80 mmHg.

Question 12

When checking the orders for a patient with hemorrhagic stroke, which order would be a cause for concern for the nurse?

A) Monitoring blood pressure
B) Monitoring blood glucose levels
C) Administering an osmotic diuretic
D) Administering aspirin

Question 13

A patient on warfarin fell and hit his head on an icy sidewalk and has been diagnosed with a subdural hematoma. Which intervention should be included in the nursing plan of care this patient?

A) Administer aspirin
B) Administer protamine
C) Administer vitamin K
D) Administer thrombolytic therapy

Question 14

Which finding would the nurse expect when assessing a patient with a spinal subarachnoid hemorrhage?

A) Neck stiffness and photosensitivity
B) Quadriparesis
C) Loss of sphincter control
D) Sensory loss below the lesion

Question 15

A baby has been brought to the emergency department unresponsive. The parent reports that the baby was in a motor vehicle accident, but the nurse notes no physical signs of trauma. A physical examination reveals retinal hemorrhages. Which diagnosis does the nurse suspect?

A) Ischemic stroke
B) Hemorrhagic stroke
C) Spinal cord hemorrhage
D) Shaken baby syndrome

Question 16

Which cardiac arrhythmia is the nurse most likely to assess in a patient with an embolic stroke?

A) Sinus tachycardia
B) Atrial fibrillation
C) First degree heart block
D) Ventricular tachycardia

Question 17

When assessing a patient with manifestations of a stroke, the nurse keeps in mind that embolic strokes most commonly occur in which artery?

A) Vertebral artery
B) Basilar artery
C) Middle cerebral artery
D) Posterior cerebral artery

Question 18

When a patient is suspected of having a brain arteriovenous malformation (AVM), which of the following may be auscultated?

A) A cerebral bruit
B) A carotid bruit
C) An aortic arch bruit
D) An abdominal aortic bruit

Question 19

The nurse would expect to assess third nerve palsy in patient with an ischemic stroke involving which artery?

A) Anterior cerebral artery
B) Basilar artery
C) Proximal posterior cerebral artery
D) Distal posterior cerebral artery

Question 20

When assessing a patient following an aneurysmal subarachnoid hemorrhage, the nurse should be alert for delayed cerebral ischemia during which time period?

A) In the first 2 hours
B) In 3 to 5 days
C) In 3 to 14 days
D) After 6 weeks