ATI RN
Questions to Ask About Neurological System Questions
Question 1 of 5
While the nurse performs formal patient assessment, assistive personnel often observe changes when obtaining vital signs or assisting patients with ADL's. When discussing care for a patient with back pain, the nurse should particularly alert the assistant to watch for:
Correct Answer: B
Rationale: Bowel and bladder incontinence in a patient with back pain may indicate cauda equina syndrome, a medical emergency caused by compression of the nerve roots in the lower spine. Dizziness, difficulty swallowing, and arm weakness are not typically associated with cauda equina syndrome.
Question 2 of 5
The nurse is caring for the client with increased intracranial pressure. The nurse would note which of the following trends in vital signs if the ICP is rising?
Correct Answer: B
Rationale: In increased ICP, Cushing's triad may occur, which includes bradycardia (decreasing pulse), irregular respirations (decreasing respirations), and widening pulse pressure (increasing blood pressure). These signs indicate severe brainstem compression and are late signs of increased ICP, requiring immediate intervention.
Question 3 of 5
When comparing a CVA and TIA, the nurse knows this is unique about TIAs:
Correct Answer: B
Rationale: Transient ischemic attacks (TIAs) are characterized by temporary neurological deficits that resolve spontaneously within 24 hours. Unlike strokes, TIAs do not cause permanent damage but are warning signs of an increased risk for future strokes. Immediate evaluation and intervention are necessary to prevent a full-blown stroke.
Question 4 of 5
A patient learns that abdominal pain is originating from the liver. The nurse should explain to the patient that the impulses from receptors in the internal organs to the central nervous system are transmitted from which type of neurons?
Correct Answer: D
Rationale: Visceral sensory neurons transmit impulses from internal organs, such as the liver, to the central nervous system. Somatic sensory neurons transmit impulses from the skin and skeletal muscles, while efferent neurons carry motor impulses. Interneurons are found entirely within the central nervous system. This distinction is important for understanding pain pathways.
Question 5 of 5
The nurse is assisting a neurologist with assessment of a patient with facial muscle weakness. When the neurologist asks the patient to identify different odors, which nerve is being tested?
Correct Answer: C
Rationale: Cranial nerve I (olfactory) is responsible for the sense of smell and is tested when a patient is asked to identify odors. Cranial nerves II, VIII, and X are involved in vision, hearing, and autonomic functions, respectively. Assessing the olfactory nerve is important for evaluating cranial nerve function.