ATI LPN
Neurological Disorders in Medical Surgical Nursing Questions
Question 1 of 5
A patient has had a cerebral hemorrhage and is unconscious. Which of the following is the priority intervention?
Correct Answer: C
Rationale: In an unconscious patient with cerebral hemorrhage, airway protection is the priority. Suctioning saliva prevents aspiration, which could worsen the condition. Passive ROM, electrolyte monitoring, and documentation are secondary to maintaining a patent airway.
Question 2 of 5
A 69-year-old male presents with abnormal speech and right-sided weakness. While eating lunch with his wife, he suddenly could not move his right arm or leg, and was unable to speak. They arrived to the emergency department within minutes. His wife currently reports improvement from when the symptoms first began, and he is almost back to normal when examined 1 hour later. Past medical history is significant for hypertension and type 2 diabetes mellitus. He has smoked 1 pack of cigarettes daily for 45 years. Non-contrast head CT is shown. Diffusion-weighted image MRI shows no sign of infarction. CT angiogram of the neck shows 72% stenosis of the left internal carotid artery. Which of the following is most likely etiology of his transient ischemic attack?
Correct Answer: A
Rationale: Transient symptoms resolving within 1 hour with significant carotid stenosis (72%) suggest TIA from artery-to-artery embolization. Cardioembolism requires atrial fibrillation, small vessel disease causes lacunar syndromes, and hypoperfusion lacks focal deficits.
Question 3 of 5
A 65-year-old male presents with constant falls and fatigue. His symptoms have progressively worsened throughout the years. He reports feeling unstable when standing, and has fallen 4 times in the past year. It takes him longer to perform certain activities of daily living, and describes himself as feeling weak. The patient denies any illicit drug or alcohol use. He smokes 2 packs of cigarettes daily for the past 25 years. He denies night sweats, or fever, but has lost 5 pounds over the course of 8 months. Medical history is significant for type 2 diabetes mellitus, hypertension, and recently diagnosed depression. The patient appears apathetic, with mild patchy scaling on the eyebrows. A mild right hand tremor is present at rest and tempered with voluntary movement. On gait testing, the patient has a stooped posture, and takes shorter steps as he moves forward. When firmly pulling the patient by the shoulders, he falls back. Which of following best explains this patient's clinical presentation?
Correct Answer: B
Rationale: Rest tremor, bradykinesia, stooped posture, and postural instability (retropulsion) suggest Parkinson’s disease, caused by alpha-synuclein deposition in nigrostriatal neurons. Cerebellar atrophy causes ataxia, not rest tremor.
Question 4 of 5
A 66-year-old man presents with progressively worsening headache that is most severe with sneezing and picking up heavy objects. The headache began approximately 3 months ago, is diffuse, non-pulsating, and associated with nausea and 2 episodes of vomiting. Medical history is unremarkable. A gadolinium-enhanced magnetic resonance imaging (MRI) of the brain shows a hyperintense serpentine irregularity of the margins. Pathology shows a hypercellular gliotic tumor with necrosis and high mitotic count. Preparations are made for radiation therapy with adjuvant chemotherapy. Which of the following is most likely the adjuvant chemotherapeutic agent used?
Correct Answer: B
Rationale: High-grade glioma (e.g., glioblastoma) with necrosis and mitotic activity is treated with radiation and temozolomide, an alkylating agent improving survival. Bevacizumab is for recurrence.
Question 5 of 5
The part of the brain responsible for coordinating all your movements is the:
Correct Answer: B
Rationale: The cerebellum coordinates voluntary movements, balance, and posture, fine-tuning motor actions.