ATI LPN
Medical Surgical Nursing Neurological Disorders Quizlet Questions
Question 1 of 5
The function of the round window can best be described by which statement?
Correct Answer: D
Rationale: The round window relieves pressure from stapes movement at the oval window. TMP13 p. 675
Question 2 of 5
A patient admitted with possible stroke has been aphasic for 3 hours, and his current blood pressure (BP) is 174/94 mm Hg. Which order by the health care provider should the nurse question?
Correct Answer: C
Rationale: Because elevated BP may be a protective response to maintain cerebral perfusion, antihypertensive therapy is recommended only if mean arterial pressure (MAP) is greater than $130 mm Hg or systolic pressure is greater than $220 mm Hg. Fluid intake should be 1500 to $2000 mL/day to maintain cerebral blood flow. The head of the bed should be elevated to at least 30 degrees unless the patient has symptoms of poor tissue perfusion. tPA may be administered if the patient meets the other criteria for tPA use.
Question 3 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 4 of 5
A 58-year-old female, accompanied by her husband, presents with trouble walking. She describes her legs as being heavy and stiff, and at times experiences muscle spasms in her lower extremities. Her husband notices that she has been having trouble writing, and buttoning her shirt. These symptoms have progressively worsened over that past 4-5 months. Neurologic exam is significant for intrinsic hand weakness, and arm fasciculations. The lower extremity is hypertonic, with increased patellar reflexes. On gait testing, the patient has poor balance, moves slowly, and has issues with turning. Which of the following is the best treatment to prolong life?
Correct Answer: D
Rationale: The presentation of upper (hypertonia, hyperreflexia) and lower (weakness, fasciculations) motor neuron signs suggests ALS. Riluzole is the only FDA-approved treatment to slow ALS progression and prolong life by reducing glutamate excitotoxicity. Pyridostigmine treats myasthenia gravis, botulinum toxin manages spasticity symptomatically, prednisone is for inflammatory conditions, and IVIG is for Guillain-Barre.
Question 5 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.