TEST BANK FOR BRUNNER AND SUDDARTH’S
TEXTBOOK OF MEDICAL SURGICAL NURSING
15TH EDITION COMPLETE SET CH1-68 | REAL
EXAM QUESTIONS WITH CORRECT EXPERT
VERIFIED ANSWERS | LATEST UPDATE |
ALREADY PASSED
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 - 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.
12. The nurse is conducting a focused neurologic assessment. When assessing the
patients cranial nerve
function, the nurse would include which of the following assessments?
A) Assessment of hand grip
B) Assessment of orientation to person, time, and place
C) Assessment of arm drift
D) Assessment of gag reflex - ANSWER D
Feedback:
The gag reflex is governed by the glossopharyngeal nerve, one of the cranial nerves.
Hand grip and arm
drifting are part of motor function assessment. Orientation is an assessment
parameter related to a mental
status examination.
14. A patient exhibiting an uncoordinated gait has presented at the clinic. Which of
the following is the most
plausible cause of this patients health problem?
A) Cerebellar dysfunction
B) A lesion in the pons
C) Dysfunction of the medulla
,D) A hemorrhage in the midbrain - ANSWER A
Feedback:
The cerebellum controls fine movement, balance, position sense, and integration of
sensory input. Portions of the pons control the heart, respiration, and blood pressure.
Cranial nerves IX through XII
connect to the brain in the medulla. Cranial nerves III and IV originate in the
midbrain.
21. The nurse is planning the care of a patient with Parkinsons disease. The nurse
should be aware that
treatment will focus on what pathophysiological phenomenon?
A) Premature degradation of acetylcholine
B) Decreased availability of dopamine
C) Insufficient synthesis of epinephrine
D) Delayed reuptake of serotonin - ANSWER B
Feedback:
Parkinsons disease develops from decreased availability of dopamine, not
acetylcholine, epinephrine, or
serotonin.
22. A patient is admitted to the medical unit with an exacerbation of multiple
sclerosis. When assessing this
patient, the nurse has the patient stick out her tongue and move it back and forth.
What is the nurse
assessing?
A) Function of the hypoglossal nerve
B) Function of the vagus nerve
C) Function of the spinal nerve
D) Function of the trochlear nerve - ANSWER A
Feedback:
The hypoglossal nerve is the 12th cranial nerve. It is responsible for movement of
the tongue. None of
the other listed nerves affects motor function in the tongue.
28. A 72-year-old man has been brought to his primary care provider by his
daughter, who claims that he
has been experiencing uncharacteristic lapses in memory. What principle should
underlie the nurses
assessment and management of this patient?
A) Loss of short-term memory is normal in older adults, but loss of long-term memory
is pathologic.
B) Lapses in memory in older adults are considered benign unless they have
negative consequences.
C) Gradual increases in confusion accompany the aging pr - ANSWER D
Feedback:
Although mental processing time decreases with age, memory, language, and
judgment capacities
remain intact. Change in mental status should never be assumed to be a normal part
of aging.
,29. A gerontologic nurse educator is providing practice guidelines to unlicensed care
providers. Because
reaction to painful stimuli is sometimes blunted in older adults, what must be used
with caution?
A) Hot or cold packs
B) Analgesics
C) Anti-inflammatory medications
D) Whirlpool baths - ANSWER A
Feedback:
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. The older
patient may be burned or suffer
frostbite before being aware of any discomfort. Any medication is used with caution
in the elderly, but
not because of the decreased sense of heat or cold. Whirlpool baths are generally
not a routine treatment
ordered for the elderly.
30. A trauma patient in the ICU has been declared brain dead. What diagnostic test
is used in making the
determination of brain death?
A) Magnetic resonance imaging (MRI)
B) Electroencephalography (EEG)
C) Electromyelography (EMG)
D) Computed tomography (CT) - ANSWER B
Feedback:
The EEG can be used in determining brain death. MRI, CT, and EMG are not
normally used in
determining brain death.
39. The neurologic nurse is testing the function of a patients cerebellum and basal
ganglia. What action will
most accurately test these structures?
A) Have the patient identify the location of a cotton swab on his or her skin with the
eyes closed.
B) Elicit the patients response to a hypothetical problem.
C) Ask the patient to close his or her eyes and discern between hot and cold stimuli.
D) Guide the patient through the performance of rapid, alternating movements. -
ANSWER D
Feedback:
Cerebellar and basal ganglia influence on the motor system is reflected in balance
control and
coordination. Coordination in the hands and upper extremities is tested by having the
patient perform
rapid, alternating movements and point-to-point testing. The cerebellum and basal
ganglia do not
mediate cutaneous sensation or judgment.
1. A patient is being admitted to the neurologic ICU following an acute head injury
that has resulted in
, cerebral edema. When planning this patients care, the nurse would expect to
administer what priority
medication?
A) Hydrochlorothiazide (HydroDIURIL)
B) Furosemide (Lasix)
C) Mannitol (Osmitrol)
D) Spirolactone (Aldactone) - ANSWER C
Feedback:
The osmotic diuretic mannitol is given to dehydrate the brain tissue and reduce
cerebral edema. This
drug acts by reducing the volume of brain and extracellular fluid. Spirolactone,
furosemide, and
hydrochlorothiazide are diuretics that are not typically used in the treatment of
increased ICP resulting
from cerebral edema.
2. The nurse is providing care for a patient who is unconscious. What nursing
intervention takes highest
priority?
A) Maintaining accurate records of intake and output
B) Maintaining a patent airway
C) Inserting a nasogastric (NG) tube as ordered
D) Providing appropriate pain control - ANSWER B
Feedback:
Maintaining a patent airway always takes top priority, even though each of the other
listed actions is
necessary and appropriate.
3. The nurse is caring for a patient in the ICU who has a brain stem herniation and
who is exhibiting an
altered level of consciousness. Monitoring reveals that the patients mean arterial
pressure (MAP) is 60
mm Hg with an intracranial pressure (ICP) reading of 5 mm Hg. What is the nurses
most appropriate
action?
A) Position the patient in the high Fowlers position as tolerated.
B) Administer osmotic diuretics as ordered.
C) Participate in interventions to increase cerebral perfusion pressure.
D - ANSWER C
Feedback:
The cerebral perfusion pressure (CPP) is 55 mm Hg, which is considered low. The
normal CPP is 70 to
100 mm Hg. Patients with a CPP of less than 50 mm Hg experience irreversible
neurologic damage. As
a result, interventions are necessary. A craniotomy is not directly indicated. Diuretics
and increased
height of bed would exacerbate the patients condition.
8. The nurse is caring for a patient with increased intracranial pressure (ICP). The
patient has a nursing
TEXTBOOK OF MEDICAL SURGICAL NURSING
15TH EDITION COMPLETE SET CH1-68 | REAL
EXAM QUESTIONS WITH CORRECT EXPERT
VERIFIED ANSWERS | LATEST UPDATE |
ALREADY PASSED
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 - 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.
12. The nurse is conducting a focused neurologic assessment. When assessing the
patients cranial nerve
function, the nurse would include which of the following assessments?
A) Assessment of hand grip
B) Assessment of orientation to person, time, and place
C) Assessment of arm drift
D) Assessment of gag reflex - ANSWER D
Feedback:
The gag reflex is governed by the glossopharyngeal nerve, one of the cranial nerves.
Hand grip and arm
drifting are part of motor function assessment. Orientation is an assessment
parameter related to a mental
status examination.
14. A patient exhibiting an uncoordinated gait has presented at the clinic. Which of
the following is the most
plausible cause of this patients health problem?
A) Cerebellar dysfunction
B) A lesion in the pons
C) Dysfunction of the medulla
,D) A hemorrhage in the midbrain - ANSWER A
Feedback:
The cerebellum controls fine movement, balance, position sense, and integration of
sensory input. Portions of the pons control the heart, respiration, and blood pressure.
Cranial nerves IX through XII
connect to the brain in the medulla. Cranial nerves III and IV originate in the
midbrain.
21. The nurse is planning the care of a patient with Parkinsons disease. The nurse
should be aware that
treatment will focus on what pathophysiological phenomenon?
A) Premature degradation of acetylcholine
B) Decreased availability of dopamine
C) Insufficient synthesis of epinephrine
D) Delayed reuptake of serotonin - ANSWER B
Feedback:
Parkinsons disease develops from decreased availability of dopamine, not
acetylcholine, epinephrine, or
serotonin.
22. A patient is admitted to the medical unit with an exacerbation of multiple
sclerosis. When assessing this
patient, the nurse has the patient stick out her tongue and move it back and forth.
What is the nurse
assessing?
A) Function of the hypoglossal nerve
B) Function of the vagus nerve
C) Function of the spinal nerve
D) Function of the trochlear nerve - ANSWER A
Feedback:
The hypoglossal nerve is the 12th cranial nerve. It is responsible for movement of
the tongue. None of
the other listed nerves affects motor function in the tongue.
28. A 72-year-old man has been brought to his primary care provider by his
daughter, who claims that he
has been experiencing uncharacteristic lapses in memory. What principle should
underlie the nurses
assessment and management of this patient?
A) Loss of short-term memory is normal in older adults, but loss of long-term memory
is pathologic.
B) Lapses in memory in older adults are considered benign unless they have
negative consequences.
C) Gradual increases in confusion accompany the aging pr - ANSWER D
Feedback:
Although mental processing time decreases with age, memory, language, and
judgment capacities
remain intact. Change in mental status should never be assumed to be a normal part
of aging.
,29. A gerontologic nurse educator is providing practice guidelines to unlicensed care
providers. Because
reaction to painful stimuli is sometimes blunted in older adults, what must be used
with caution?
A) Hot or cold packs
B) Analgesics
C) Anti-inflammatory medications
D) Whirlpool baths - ANSWER A
Feedback:
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. The older
patient may be burned or suffer
frostbite before being aware of any discomfort. Any medication is used with caution
in the elderly, but
not because of the decreased sense of heat or cold. Whirlpool baths are generally
not a routine treatment
ordered for the elderly.
30. A trauma patient in the ICU has been declared brain dead. What diagnostic test
is used in making the
determination of brain death?
A) Magnetic resonance imaging (MRI)
B) Electroencephalography (EEG)
C) Electromyelography (EMG)
D) Computed tomography (CT) - ANSWER B
Feedback:
The EEG can be used in determining brain death. MRI, CT, and EMG are not
normally used in
determining brain death.
39. The neurologic nurse is testing the function of a patients cerebellum and basal
ganglia. What action will
most accurately test these structures?
A) Have the patient identify the location of a cotton swab on his or her skin with the
eyes closed.
B) Elicit the patients response to a hypothetical problem.
C) Ask the patient to close his or her eyes and discern between hot and cold stimuli.
D) Guide the patient through the performance of rapid, alternating movements. -
ANSWER D
Feedback:
Cerebellar and basal ganglia influence on the motor system is reflected in balance
control and
coordination. Coordination in the hands and upper extremities is tested by having the
patient perform
rapid, alternating movements and point-to-point testing. The cerebellum and basal
ganglia do not
mediate cutaneous sensation or judgment.
1. A patient is being admitted to the neurologic ICU following an acute head injury
that has resulted in
, cerebral edema. When planning this patients care, the nurse would expect to
administer what priority
medication?
A) Hydrochlorothiazide (HydroDIURIL)
B) Furosemide (Lasix)
C) Mannitol (Osmitrol)
D) Spirolactone (Aldactone) - ANSWER C
Feedback:
The osmotic diuretic mannitol is given to dehydrate the brain tissue and reduce
cerebral edema. This
drug acts by reducing the volume of brain and extracellular fluid. Spirolactone,
furosemide, and
hydrochlorothiazide are diuretics that are not typically used in the treatment of
increased ICP resulting
from cerebral edema.
2. The nurse is providing care for a patient who is unconscious. What nursing
intervention takes highest
priority?
A) Maintaining accurate records of intake and output
B) Maintaining a patent airway
C) Inserting a nasogastric (NG) tube as ordered
D) Providing appropriate pain control - ANSWER B
Feedback:
Maintaining a patent airway always takes top priority, even though each of the other
listed actions is
necessary and appropriate.
3. The nurse is caring for a patient in the ICU who has a brain stem herniation and
who is exhibiting an
altered level of consciousness. Monitoring reveals that the patients mean arterial
pressure (MAP) is 60
mm Hg with an intracranial pressure (ICP) reading of 5 mm Hg. What is the nurses
most appropriate
action?
A) Position the patient in the high Fowlers position as tolerated.
B) Administer osmotic diuretics as ordered.
C) Participate in interventions to increase cerebral perfusion pressure.
D - ANSWER C
Feedback:
The cerebral perfusion pressure (CPP) is 55 mm Hg, which is considered low. The
normal CPP is 70 to
100 mm Hg. Patients with a CPP of less than 50 mm Hg experience irreversible
neurologic damage. As
a result, interventions are necessary. A craniotomy is not directly indicated. Diuretics
and increased
height of bed would exacerbate the patients condition.
8. The nurse is caring for a patient with increased intracranial pressure (ICP). The
patient has a nursing
