ATI LPN
Medical Surgical Nursing Neurological Disorders Questions
Question 1 of 5
Which information about the patient who has had a subarachnoid hemorrhage is most important to communicate to the health care provider?
Correct Answer: B
Rationale: To prevent cerebral vasospasm and maintain cerebral perfusion, BP needs to be maintained at a level higher than $90 \mathrm{~mm} \mathrm{Hg}$ systolic after a subarachnoid hemorrhage. A low BP or drop in BP indicates a need to administer fluids and/or vasopressors to increase the BP. An ongoing headache, RBCs in the CSF, and a stiff neck are all typical clinical manifestations of a subarachnoid hemorrhage and do not need to be rapidly communicated to the health care provider.
Question 2 of 5
A 72-year-old male presents with abnormal speech and right-sided weakness. He was last seen normal approximately 1 hour ago. Past medical history is significant for hypertension, hypercholesterolemia, and type 2 diabetes mellitus. Five years ago, he underwent coronary artery bypass grafting for the management of a myocardial infarction. On exam, his speech is non-fluent and sparse, with impaired repetition. He has difficulty naming even common objects. Comprehension is relatively intact. There is a right-sided mouth droop, with sparing of the forehead. Strength is 3/5 throughout the right upper extremity, and 4+/5 in the right lower extremity. Sensation appears intact. Which of the following is the best next step in management?
Correct Answer: D
Rationale: Acute stroke symptoms (Broca’s aphasia, right-sided weakness) within 1 hour require a head CT first to rule out hemorrhage before considering thrombolysis (alteplase) or thrombectomy, both viable within the time window. Aspirin is for secondary prevention.
Question 3 of 5
A 14-year-old male presents with a witnessed generalized tonic-clonic seizure. Prior to the seizure event, he felt anxious, confused, and diaphoretic. Medical history is significant for recently diagnosed type I diabetes mellitus, and he has been struggling to control his blood glucose levels. His only medication is an insulin regimen administered via needle and syringe injections. He denies any alcohol or drug use. Laboratory tests were obtained. Which of the following is the best next step in management?
Correct Answer: A
Rationale: A single seizure with hypoglycemia risk (diabetes, poor glucose control) and prodrome (anxiety, diaphoresis) suggests a provoked event. Education on glucose management prevents recurrence; AEDs are for epilepsy, not single provoked seizures.
Question 4 of 5
A 29-year-old African American woman presents with bilateral facial weakness. This symptom developed over the course of a few hours and has never happened before. Upon further questioning, the patient reports seeing her pulmonologist every 6 months to follow her lung function and seeing her ophthalmologist annually for an eye exam. Neurological exam is significant for the patient being unable to smile, or raise her eyebrows. There is also an erythematous and tender nodule affecting the pretibial surfaces of both legs. Magnetic resonance imaging (MRI) of the brain shows leptomeningeal enhancement. Which of the following is most likely the diagnosis in this patient?
Correct Answer: A
Rationale: Bilateral facial weakness, erythema nodosum (pretibial nodules), and leptomeningeal enhancement with systemic involvement (lung monitoring) suggest neurosarcoidosis, a granulomatous disease.
Question 5 of 5
The chemical messenger between neurons or a neuron and its target muscle is:
Correct Answer: C
Rationale: Neurotransmitters are chemicals released into the synapse to transmit signals from one neuron to another or to a target muscle.