ATI LPN
Brunner & Suddarth's Textbook of Medical-Surgical Nursing 14e (Hinkle 2017)
Chapter 66 : Management of Patients with Neurologic Dysfunction Questions
Question 1 of 5
The neurologic ICU nurse is admitting a patient following a craniotomy using the supratentorial approach. How should the nurse best position the patient?
Correct Answer: B
Rationale: HOB elevation at 30-45 degrees reduces ICP in supratentorial craniotomy patients. Supine, prone, or Trendelenberg positions increase ICP risk.
Question 2 of 5
A clinic nurse is caring for a patient diagnosed with migraine headaches. During the patient teaching session, the patient questions the nurse regarding alcohol consumption. What would the nurse be correct in telling the patient about the effects of alcohol?
Correct Answer: B
Rationale: Alcohol's vasodilatory effect can worsen migraines. It depresses the CNS, does not affect hormones significantly, and does not reduce endorphins in this context.
Question 3 of 5
A patient has developed diabetes insipidus after having increased ICP following head trauma. What nursing assessment best addresses this complication?
Correct Answer: A
Rationale: Diabetes insipidus causes extreme polyuria, requiring close fluid balance monitoring. BP, ABGs, and airway monitoring are less directly related.
Question 4 of 5
What should the nurse suspect when hourly assessment of urine output on a patient postcraniotomy exhibits a urine output from a catheter of 1,500 mL for two consecutive hours?
Correct Answer: D
Rationale: High urine output post-craniotomy suggests diabetes insipidus, common after brain surgery. Cushing syndrome and SIADH cause fluid retention, and adrenal crisis causes hypovolemia.
Question 5 of 5
During the examination of an unconscious patient, the nurse observes that the patients pupils are fixed and dilated. What is the most plausible clinical significance of the nurses finding?
Correct Answer: D
Rationale: Fixed, dilated pupils suggest midbrain injury, often from increased ICP. Metabolic issues, unilateral paralysis, or CN X damage do not typically cause this finding.