1. The nurse concludes that a patient’s

1. The nurse concludes that a patient’s meningitis is improving when the patient can perform which of the following activities? Maintain a side-lying position in bed Sit up and drink water Touch the chin to the chest Dorsiflex both feet 2. When Ann came to have her INR checked, she had an critical high level and needed to be admitted. Name one antidote and 1 possible treatment for elevated INR due to Coumadin dosages. 3. A nurse is checking for the presence of Brudzinski’s sign in a patient who has suspected meningitis. Which of the following actions should the nurse take when performing this techniques? (Select all that apply) Place the patient in supine position Assist the patient to flex their knee Place your(The nurse’s) hand behind the patient’s neck Bend the patient’s head toward the chest Straighten the patients flexed leg at the knee 4. A patient is experiencing hyperventilation in attempts to compensate for the increased intracranial pressure the patient is experiencing. As you assess this, you realize that the hyperventilation will do which of the following? Cause vasoconstriction and decrease the ICP Promote diuresis and decrease the ICP Cause vasodilation and increase the ICP Cause vasodilation and decrease the ICP 5. A nurse is caring for a client that has absence seizures. Which of the following findings are indicative of absence seizures? (Select all that apply). A shill cry Appearing to day dream or not pay attention Dropping a toy they are playing with Falling to the floor with jerking motions Tonic clonic positions More commonly found in elderly clients They begin and end abruptly and usually a few seconds 6. In addition, you will need to give your patient health care information on Coumadin. List important items in your discharge teaching in regards to Coumadin and dietary nutrition/considerations. 7. The nurse is caring for an adult patient with a history of seizures. In the event of a seizure, the nurse should document which information in their focus note? (Select all that apply.) Duration of the seizure Description of movements Location of family members during seizure Presence of incontinence How much was eaten during last meal 8. Which conditions may cause seizures? (Select all that apply.) Stroke Cerebral tumor A state of being afebrile Epilepsy Renal failure 9. A patient is admitted to the hospital with a severe headache and photophobia. A lumbar puncture confirms a bleeding cerebral aneurysm. What nursing interventions should the nurse anticipate assisting with to prevent increased intracranial pressure (ICP) during the acute phase of illness? Quiet room, head of bed up 30 degrees, and stool softeners Morphine, dark glasses, and expectorants Range of motion exercises, bedside commode, and suctioning as needed Coughing and deep breathing exercises and tranquilizers 10. The nurse is caring for a patient with a cerebral injury with increased intracranial pressure. Which intervention can help prevent any further increasing intracranial pressure? Provide as much nursing care at one time as possible to allow the patient to rest. Space nursing care at intervals so that necessary care is distributed evenly throughout a shift. Provide stimulation such as radio and television for 12 hours each day. Avoid touching the patient as much as possible. 11. You are completing a neuro exam on your patient and are testing for Romberg’s sign. Which of the following should you take to perform this test? Stroke the patient’s sole of the foot in an upside down “J” formation and observe toe movement. Observe the patient while ambulating for a steady or non-steady gait Have the patient stand with their eyes closed while you stand by them and observe for swaying. Have the patient bring their arms out to the side and touch their nose with the right and then left pointer finger and observe for accuracy. 12. The nursing assistant is attempting to put an oral airway in the mouth of a client having a tonic-clonic seizure. Which action should the nurse take? Assist with the insertion of the oral airway into the mouth Tell the assistant to stop trying to insert the airway Take no action because the assistant is handling the situation as he/she would Notify the charge nurse of the situation 13. Your patient will be coming into the clinic to have his lab drawn while on Coumadin (Warfarin). If the control for ProTime is 12, what range would the physician want his Protime level to be in order to be therapeutic? What does the physician want her INR to be, so that she is therapeutic? 14. The nurse is assisting with a community education program related to cerebral vascular accidents. Which of the following would be included in a list of symptoms that should prompt immediate medical attention in regards to CVA’s? (Select all that apply.) Blood in the stool Impaired hearing Sudden numbness or weakness of face, arm, or leg, especially on one side of the body Sudden confusion, trouble speaking, or understanding Sudden trouble walking, dizziness, or loss of balance or coordination 15. The nurse is walking a patient to the bathroom when the patient begins a generalized tonic-clonic seizure. Of the following interventions listed below, which should the nurse do first? Perform a brief neurological assessment. Suction airway immediately. Reduce external stimuli. Check the patient’s airway 16. How many days does it take before Coumadin is at therapeutic levels? 17. Which of the following are interventions used to prevent increased intracranial pressure in a patient who has had an acute brain injury? (Select all that apply.) Administer Digoxin for arrhythmia’s. Encourage activity Keep head of bed elevated 30 degrees. Administer stool softeners. Encourage coughing. 18. A patient is placed on dexamethasone (Decadron) for treatment of his brain tumor. Which of the following is true regarding steroid therapy? Hyperglycemia is an expected adverse effect. Hypoglycemia is an expected adverse effect 19. Your patient has recently suffered a ischemic stroke. He is placed on Warfarin 2.5mg daily. There are side effects you will need to assess for and teach your patient about. Please list 3. SCIENCE HEALTH SCIENCE NURSING NURSING 1254

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