ATI LPN
Medical Surgical Nursing Neurological Disorders Quizlet Questions
Question 1 of 5
After receiving change-of-shift report on the following four patients, which patient should the nurse see first?
Correct Answer: A
Rationale: tPA needs to be infused within the first few hours after stroke symptoms start in order to be effective in minimizing brain injury. The other medications should also be given as quickly as possible, but timing of the medications is not as critical.
Question 2 of 5
A 62-year-old male presents with left-sided weakness. He was last seen normal approximately 5 hours ago. Past medical history is significant for coronary artery disease and hypertension. On exam, there is 4+/5 strength in the left upper extremity, and 3/5 strength in the left lower extremity. He is unable to walk. Non-contrast head CT is negative for blood and a large territory infarct, and CT angiography shows an occlusion in the proximal portion of the anterior cerebral artery. Which of the following is the best next step in management?
Correct Answer: B
Rationale: Left-sided weakness with ACA occlusion 5 hours post-onset exceeds the tPA window (4.5 hours) but is within the 24-hour window for thrombectomy if large vessel occlusion is confirmed, offering the best chance for recovery.
Question 3 of 5
A 15-year-old female presents to the emergency department with a seizure. While she was eating her breakfast in the morning, her mother witnessed myoclonic jerks involving the upper extremities. Over a half-hour, the myoclonus became more dramatic, finally evolving into a generalized-tonic clonic seizure lasting 1-2 minutes. The patient reports sleeping 4-5 hours per night for the last few days due to upcoming midterm examinations. She denies alcohol or drug use. She is currently sexually active with her boyfriend and uses condoms as her only form of contraception. On physical exam, there is evidence of recent tongue biting, no focal neurological deficits, and normal intelligence. A sleep-deprived EEG is performed with interictal findings showing generalized 4-5-Hz polyspike and slow-wave discharges, with activation during photic stimulation (photoparoxysmal response). MRI of the brain is normal. Which of the following is the best treatment option for this patient?
Correct Answer: C
Rationale: Myoclonic jerks progressing to tonic-clonic seizures with photoparoxysmal EEG findings suggest juvenile myoclonic epilepsy (JME). Levetiracetam is effective and safe in women of childbearing age, unlike valproic acid (teratogenic).
Question 4 of 5
A 28-year-old woman presents to her primary care physician with diplopia on horizontal gaze, and dizziness. She reports that these symptoms began approximately 2 weeks ago, and has never happened before. Her double vision is only elicited when looking towards the left, but is absent with primary gaze. She states that approximately 4 months ago, she had right lower extremity weakness and numbness that lasted one week before being completely resolved. Medical history is significant for migraine headache with aura that is adequately treated with ibuprofen. On physical examination, there is impaired adduction of the right eye, with contralateral disassociated horizontal nystagmus of the abducting eye. There is normal convergence and diminished vertical gaze holding. A postural tremor is also noted on examination. Laboratory tests are significant for a normal B12 and thyroid-stimulating hormone (TSH) level, and normal white cell count. MRI of the brain is shown. What additional information is needed to make a diagnosis of multiple sclerosis?
Correct Answer: C
Rationale: Internuclear ophthalmoplegia and prior neurological episode suggest MS, but diagnosis requires dissemination in time and space. An additional attack with a new lesion on MRI confirms this.
Question 5 of 5
The Peripheral Nervous System is made up of the:
Correct Answer: C
Rationale: The peripheral nervous system (PNS) includes spinal nerves and cranial nerves (excluding cranial nerve II and the retina, which are CNS), but not the brain or spinal cord.