Handbook 3rd Edition by Karen G. Complete Guide 2025
1. A patient is brought to the ER following a motor vehicle accident in which he
sustained head trauma. Preliminary assessment reveals a vision deficit in the patients
left eye. The nurse should associate this
abnormal finding with trauma to which of the following cerebral lobes?
A) Temporal
B) Occipital
C) Parietal
D) Frontal - CORRECT ANSWER>> B
Feedback:
The posterior lobe of the cerebral hemisphere is responsible for visual interpretation.
The temporal lobe
contains the auditory receptive areas. The parietal lobe contains the primary sensory
cortex, and is
essential to an individuals awareness of the body in space, as well as orientation in
space and spatial
relations. The frontal lobe functions in concentration, abstract thought, information
storage or memory, and motor function.
2. A patient scheduled for magnetic resonance imaging (MRI) has arrived at the
radiology department. The
nurse who prepares the patient for the MRI should prioritize which of the following
actions?
A) Withholding stimulants 24 to 48 hours prior to exam
B) Removing all metal-containing objects
,C) Instructing the patient to void prior to the MRI
D) Initiating an IV line for administration of contrast - CORRECT ANSWER>> B
Feedback:
Patient preparation for an MRI consists of removing all metal-containing objects prior to
the
examination. Withholding stimulants would not affect an MRI; this relates to an
electroencephalography
(EEG). Instructing the patient to void is patient preparation for a lumbar puncture.
Initiating an IV line
for administration of contrast would be done if the patient was having a CT scan with
contrast.
3. A gerontologic nurse planning the neurologic assessment of an older adult is
considering normal, age related changes. Of what phenomenon should the nurse be
aware?
A) Hyperactive deep tendon reflexes
B) Reduction in cerebral blood flow
C) Increased cerebral metabolism
D) Hypersensitivity to painful stimuli - CORRECT ANSWER>> B
Feedback:
Reduction in cerebral blood flow (CBF) is a change that occurs in the normal aging
process. Deep
tendon reflexes can be decreased or, in some cases, absent. Cerebral metabolism
decreases as the patient
advances in age. Reaction to painful stimuli may be decreased with age. Because pain
is an important
warning signal, caution must be used when hot or cold packs are used.
,4. The nurse has admitted a new patient to the unit. One of the patients admitting
orders
is for an
adrenergic medication. The nurse knows that this medication will have what effect on
the circulatory
system?
A) Thin, watery saliva
B) Increased heart rate
C) Decreased BP
D) Constricted bronchioles - CORRECT ANSWER>> B
Feedback:
The term adrenergic refers to the sympathetic nervous system. Sympathetic effects
include an increased
rate and force of the heartbeat. Cholinergic effects, which correspond to the
parasympathetic division of
the autonomic nervous system, include thin, watery saliva, decreased rate and force of
heartbeat, and
decreased BP.
5. A nurse is assessing reflexes in a patient with hyperactive reflexes. When the
patients foot is abruptly
dorsiflexed, it continues to beat two to three times before settling into a resting
position.
How would the
nurse document this finding?
A) Rigidity
B) Flaccidity
, C) Clonus
D) Ataxia - CORRECT ANSWER>> C
Feedback:
When reflexes are very hyperactive, a phenomenon called clonus may be elicited. If the
foot is abruptly
dorsiflexed, it may continue to beat two to three times before it settles into a position
of
rest. Rigidity is
an increase in muscle tone at rest characterized by increased resistance to passive
stretch. Flaccidity is
lack of muscle tone. Ataxia is the inability to coordinate muscle movements, resulting in
difficulty
walking, talking, and performing self-care activities.
6. The nurse is doing an initial assessment on a patient newly admitted to the unit with a
diagnosis of
cerebrovascular accident (CVA). The patient has difficulty copying a figure that the
nurse has drawn and
is diagnosed with visual-receptive aphasia. What brain region is primarily involved in
this deficit?
A) Temporal lobe
B) Parietal-occipital area
C) Inferior posterior frontal areas
D) Posterior frontal area - CORRECT ANSWER>> B
Feedback:
Difficulty copying a figure that the nurse has drawn would be considered
visual receptive aphasia, which involves the parietal-occipital area. Expressive aphasia,
the