ATI LPN
Quizlet Adult Medical Surgical Head Injury Monitoring Neurological Status Questions
Question 1 of 5
Which of the following allows the visual apparatus to accurately determine the distance of an object from the eye (depth perception)?
Correct Answer: D
Rationale: Stereopsis (binocular parallax) enables depth perception using both eyes. TMP13 p. 644
Question 2 of 5
For a patient who had a right hemisphere stroke, the nurse anticipates planning interventions to manage
Correct Answer: B
Rationale: The patient with right-sided brain damage typically denies any deficits and has poor impulse control, leading to risk for injury when the patient attempts activities such as transferring from a bed to a chair. Right-sided brain damage causes left hemiplegia. Left-sided brain damage typically causes language deficits. Left-sided brain damage is associated with depression and distress about the disability.
Question 3 of 5
You are at Publix and see a woman collapsed with right-sided weakness and slurred speech. What should you do?
Correct Answer: B
Rationale: Right-sided weakness and slurred speech suggest a stroke. The priority is to call emergency services (e.g., 911) to ensure rapid professional assessment and treatment, such as thrombolysis if within the time window. Offering water risks aspiration, driving delays care, and carotid massage is irrelevant.
Question 4 of 5
A previously healthy 26-year-old male is brought to the emergency department due to muscle weakness. He reports mild weakness in his legs that has progressively worsened over a few days to the point that he can barely move his legs. He has some numbness in his legs and his arms feel weak. He has recently recovered from a respiratory infection. 1/5 muscle strength is noted throughout the lower extremities, as well as absent patellar and ankle reflexes. 3 to 4-/5 muscle strength is appreciated throughout his upper extremities. A lumbar puncture is performed, which shows the following: Cell count: 4 cells/mm3, Glucose: 67 mg/dL, Protein: 187 mg/dL Gram stain: no organisms Spirometry is performed, which shows a forced vital capacity of 0.85 L. Which of the following is the best next step in management?
Correct Answer: B
Rationale: Acute progressive weakness post-infection, areflexia, and albuminocytologic dissociation (elevated protein, normal cells) on CSF suggest Guillain-Barre syndrome. A forced vital capacity of 0.85 L indicates severe respiratory compromise, making intubation the priority to prevent respiratory failure.
Question 5 of 5
A 37-year-old female with migraine without aura presents with headaches of increased frequency that typically begin in the morning. She says that zolmitriptan and acetaminophen are no longer effective in treating her episodes. In a month, she experiences approximately 20 days of headaches, and in the past 3 months, she has used zolmitriptan 15 times per month, on average, and acetaminophen at least 20 days per month. Medical history is significant for migraine and asthma. Medications are zolmitriptan, over the counter acetaminophen, and an albuterol inhaler. Which of the following is the next best step in management?
Correct Answer: C
Rationale: Frequent headaches (20 days/month) and overuse of zolmitriptan and acetaminophen suggest medication-overuse headache complicating migraines. Prophylaxis (e.g., topiramate) and effective acute treatment are needed to break the cycle.