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
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 - 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 - 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 - 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 - 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 - 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 - 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
inability to express oneself, is often
associated with damage to the frontal area. Receptive aphasia, the inability to
understand what someone
else is saying, is often associated with damage to the temporal lobe area.
7. What term is used to describe the fibrous connective tissue that hugs the brain
closely and extends into
every fold of the brains surface?
A) Dura mater
B) Arachnoid
C) Fascia
D) Pia mater - ANSWER D
Feedback:
The term meninges describes the fibrous connective tissue that covers the brain and
spinal cord. The
meninges have three layers, the dura mater, arachnoid, and pia mater. The pia
mater is the innermost
membrane that hugs the brain closely and extends into every fold of the brains
surface. The dura mater,
the outermost layer, covers the brain and spinal cord. The arachnoid, the middle
membrane, is
responsible for the production of cerebrospinal fluid.
8. The nurse is caring for a patient with an upper motor neuron lesion. What clinical
manifestations should
the nurse anticipate when planning the patients neurologic assessment?
A) Decreased muscle tone
B) Flaccid paralysis
C) Loss of voluntary control of movement
D) Slow reflexes - ANSWER C
Feedback:
, Upper motor neuron lesions do not cause muscle atrophy, flaccid paralysis, or slow
reflexes. However, upper motor neuron lesions normally cause loss of voluntary
control.
9. The nurse is admitting a patient to the unit who is diagnosed with a lower motor
neuron lesion. What
entry in the patients electronic record is most consistent with this diagnosis?
A) Patient exhibits increased muscle tone.
B) Patient demonstrates normal muscle structure with no evidence of atrophy.
C) Patient demonstrates hyperactive deep tendon reflexes.
D) Patient demonstrates an absence of deep tendon reflexes. - ANSWER D
Feedback:
Lower motor neuron lesions cause flaccid muscle paralysis, muscle atrophy,
decreased muscle tone, and
loss of voluntary control.
10. An elderly patient is being discharged home. The patient lives alone and has
atrophy of his olfactory
organs. The nurse tells the patients family that it is essential that the patient have
what installed in the
home?
A) Grab bars
B) Nonslip mats
C) Baseboard heaters
D) A smoke detector - ANSWER D
Feedback:
The sense of smell deteriorates with age. The olfactory organs are responsible for
smell. This may
present a safety hazard for the patient because he or she may not smell smoke or
gas leaks. Smoke
detectors are universally necessary, but especially for this patient.
11. The patient in the ED has just had a diagnostic lumbar puncture. To reduce the
incidence of a postlumbar puncture headache, what is the nurses most appropriate
action?
A) Position the patient prone.
B) Position the patient supine with the head of bed flat.
C) Position the patient left side-lying.
D) Administer acetaminophen as ordered. - ANSWER A
Feedback:
The lumbar puncture headache may be avoided if a small-gauge needle is used and
if the patient remains
prone after the procedure. Acetaminophen is not administered as a preventative
measure for post-lumbar
puncture headaches.
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
TEXTBOOK OF MEDICAL SURGICAL NURSING
15TH EDITION COMPLETE SET CH1-68 | REAL
EXAM QUESTIONS WITH CORRECT EXPERT
VERIFIED ANSWERS | LATEST UPDATE |
ALREADY PASSED
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 - 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 - 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 - 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 - 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 - 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 - 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
inability to express oneself, is often
associated with damage to the frontal area. Receptive aphasia, the inability to
understand what someone
else is saying, is often associated with damage to the temporal lobe area.
7. What term is used to describe the fibrous connective tissue that hugs the brain
closely and extends into
every fold of the brains surface?
A) Dura mater
B) Arachnoid
C) Fascia
D) Pia mater - ANSWER D
Feedback:
The term meninges describes the fibrous connective tissue that covers the brain and
spinal cord. The
meninges have three layers, the dura mater, arachnoid, and pia mater. The pia
mater is the innermost
membrane that hugs the brain closely and extends into every fold of the brains
surface. The dura mater,
the outermost layer, covers the brain and spinal cord. The arachnoid, the middle
membrane, is
responsible for the production of cerebrospinal fluid.
8. The nurse is caring for a patient with an upper motor neuron lesion. What clinical
manifestations should
the nurse anticipate when planning the patients neurologic assessment?
A) Decreased muscle tone
B) Flaccid paralysis
C) Loss of voluntary control of movement
D) Slow reflexes - ANSWER C
Feedback:
, Upper motor neuron lesions do not cause muscle atrophy, flaccid paralysis, or slow
reflexes. However, upper motor neuron lesions normally cause loss of voluntary
control.
9. The nurse is admitting a patient to the unit who is diagnosed with a lower motor
neuron lesion. What
entry in the patients electronic record is most consistent with this diagnosis?
A) Patient exhibits increased muscle tone.
B) Patient demonstrates normal muscle structure with no evidence of atrophy.
C) Patient demonstrates hyperactive deep tendon reflexes.
D) Patient demonstrates an absence of deep tendon reflexes. - ANSWER D
Feedback:
Lower motor neuron lesions cause flaccid muscle paralysis, muscle atrophy,
decreased muscle tone, and
loss of voluntary control.
10. An elderly patient is being discharged home. The patient lives alone and has
atrophy of his olfactory
organs. The nurse tells the patients family that it is essential that the patient have
what installed in the
home?
A) Grab bars
B) Nonslip mats
C) Baseboard heaters
D) A smoke detector - ANSWER D
Feedback:
The sense of smell deteriorates with age. The olfactory organs are responsible for
smell. This may
present a safety hazard for the patient because he or she may not smell smoke or
gas leaks. Smoke
detectors are universally necessary, but especially for this patient.
11. The patient in the ED has just had a diagnostic lumbar puncture. To reduce the
incidence of a postlumbar puncture headache, what is the nurses most appropriate
action?
A) Position the patient prone.
B) Position the patient supine with the head of bed flat.
C) Position the patient left side-lying.
D) Administer acetaminophen as ordered. - ANSWER A
Feedback:
The lumbar puncture headache may be avoided if a small-gauge needle is used and
if the patient remains
prone after the procedure. Acetaminophen is not administered as a preventative
measure for post-lumbar
puncture headaches.
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
