TEST BANK For Keltners Psychiatric Nursing, 9th Edition B
s s s s s s s s
y Debbie Steele
s s
1.sAspatientsissbroughtstosthesERsfollowingsasmotorsvehiclesaccidentsinswhichshessustain
edsheadstrauma.sPreliminarysassessmentsrevealssasvisionsdeficitsinsthespatientssleftseye.
sThesnursesshouldsassociatesthis
abnormalsfindingswithstraumastoswhichsofsthesfollowingscerebralslobes?
A)sTemporal
B)sOccipital
C)sParietal
D)sFrontals-sANSWER:B
Feedback:
Thesposteriorslobesofsthescerebralshemispheresissresponsiblesforsvisualsinterpretation.s
Thestemporalslobe
containssthesauditorysreceptivesareas.sThesparietalslobescontainssthesprimaryssensorysc
ortex,sandsis
essentialstosansindividualssawarenesssofsthesbodysinsspace,sasswellsassorientationsinsspa
cesandsspatial
relations.sThesfrontalslobesfunctionssinsconcentration,sabstractsthought,sinformationsst
oragesorsmemory,sandsmotorsfunction.
2.sAspatientsscheduledsforsmagneticsresonancesimagings(MRI)shassarrivedsatsthesradiolo
gysdepartment.sThe
nurseswhospreparessthespatientsforsthesMRIsshouldsprioritizeswhichsofsthesfollowingsact
ions?
A)sWithholdingsstimulantss24stos48shoursspriorstosexam
B)sRemovingsallsmetal-containingsobjects
C)sInstructingsthespatientstosvoidspriorstosthesMRI
D)sInitiatingsansIVslinesforsadministrationsofscontrasts-sANSWER:B
Feedback:
PatientspreparationsforsansMRIsconsistssofsremovingsallsmetal-
containingsobjectsspriorstosthe
examination.sWithholdingsstimulantsswouldsnotsaffectsansMRI;sthissrelatesstosanselectr
oencephalography
(EEG).sInstructingsthespatientstosvoidsisspatientspreparationsforsaslumbarspuncture.sIniti
atingsansIVsline
forsadministrationsofscontrastswouldsbesdonesifsthespatientswasshavingsasCTsscanswithsc
ontrast.
3.sAsgerontologicsnursesplanningsthesneurologicsassessmentsofsansoldersadultsissconside
ringsnormal,sagesrelatedschanges.sOfswhatsphenomenonsshouldsthesnursesbesaware?
A)sHyperactivesdeepstendonsreflexes
B)sReductionsinscerebralsbloodsflow
C)sIncreasedscerebralsmetabolism
D)sHypersensitivitystospainfulsstimulis-sANSWER:B
Feedback:
,Reductionsinscerebralsbloodsflows(CBF)sissaschangesthatsoccurssinsthesnormalsagingsproc
ess.sDeep
tendonsreflexesscansbesdecreasedsor,sinssomescases,sabsent.sCerebralsmetabolismsdecr
easessassthespatient
advancessinsage.sReactionstospainfulsstimulismaysbesdecreasedswithsage.sBecausespainsi
ssansimportant
warningssignal,scautionsmustsbesusedswhenshotsorscoldspackssaresused.
4.sThesnurseshassadmittedsasnewspatientstosthesunit.sOnesofsthespatientssadmittingsorde
rssissforsan
adrenergicsmedication.sThesnursesknowssthatsthissmedicationswillshaveswhatseffectsonst
hescirculatory
system?
A)sThin,swateryssaliva
B)sIncreasedsheartsrate
C)sDecreasedsBP
D)sConstrictedsbronchioless-sANSWER:B
Feedback:
Thestermsadrenergicsrefersstosthessympatheticsnervousssystem.sSympatheticseffectssin
cludesansincreased
ratesandsforcesofsthesheartbeat.sCholinergicseffects,swhichscorrespondstosthesparasymp
atheticsdivisionsof
thesautonomicsnervousssystem,sincludesthin,swateryssaliva,sdecreasedsratesandsforcesof
sheartbeat,sand
decreasedsBP.
5.sAsnursesissassessingsreflexessinsaspatientswithshyperactivesreflexes.sWhensthespatient
ssfootsissabruptly
dorsiflexed,sitscontinuesstosbeatstwostosthreestimessbeforessettlingsintosasrestingspositio
n.sHowswouldsthe
nursesdocumentsthissfinding?
A)sRigidity
B)sFlaccidity
C)sClonus
D)sAtaxias-sANSWER:C
Feedback:
Whensreflexessaresveryshyperactive,sasphenomenonscalledsclonussmaysbeselicited.sIfsth
esfootsissabruptly
dorsiflexed,sitsmayscontinuestosbeatstwostosthreestimessbeforesitssettlessintosaspositions
ofsrest.sRigiditysis
ansincreasesinsmusclestonesatsrestscharacterizedsbysincreasedsresistancestospassivesstre
tch.sFlacciditysis
lacksofsmusclestone.sAtaxiasissthesinabilitystoscoordinatesmusclesmovements,sresultingsi
nsdifficulty
walking,stalking,sandsperformingsself-caresactivities.
,6.sThesnursesissdoingsansinitialsassessmentsonsaspatientsnewlysadmittedstosthesunitswiths
asdiagnosissof
cerebrovascularsaccidents(CVA).sThespatientshassdifficultyscopyingsasfiguresthatsthesnur
seshassdrawnsand
issdiagnosedswithsvisual-
receptivesaphasia.sWhatsbrainsregionsissprimarilysinvolvedsinsthissdeficit?
A)sTemporalslobe
B)sParietal-occipitalsarea
C)sInferiorsposteriorsfrontalsareas
D)sPosteriorsfrontalsareas-sANSWER:B
Feedback:
Difficultyscopyingsasfiguresthatsthesnurseshassdrawnswouldsbesconsideredsvisual-
receptivesaphasia,swhichsinvolvessthesparietal-
occipitalsarea.sExpressivesaphasia,sthesinabilitystosexpresssoneself,sissoften
associatedswithsdamagestosthesfrontalsarea.sReceptivesaphasia,sthesinabilitystosunderst
andswhatssomeone
elsesisssaying,sissoftensassociatedswithsdamagestosthestemporalslobesarea.
7.sWhatstermsissusedstosdescribesthesfibroussconnectivestissuesthatshugssthesbrainsclose
lysandsextendssinto
everysfoldsofsthesbrainsssurface?
A)sDurasmater
B)sArachnoid
C)sFascia
D)sPiasmaters-sANSWER:D
Feedback:
Thestermsmeningessdescribessthesfibroussconnectivestissuesthatscoverssthesbrainsandss
pinalscord.sThe
meningesshavesthreeslayers,sthesdurasmater,sarachnoid,sandspiasmater.sThespiasmatersis
sthesinnermost
membranesthatshugssthesbrainscloselysandsextendssintoseverysfoldsofsthesbrainsssurface
.sThesdurasmater,
thesoutermostslayer,scoverssthesbrainsandsspinalscord.sThesarachnoid,sthesmiddlesmem
brane,sis
responsiblesforsthesproductionsofscerebrospinalsfluid.
8.sThesnursesisscaringsforsaspatientswithsansuppersmotorsneuronslesion.sWhatsclinicalsma
nifestationssshould
thesnursesanticipateswhensplanningsthespatientssneurologicsassessment?
A)sDecreasedsmusclestone
B)sFlaccidsparalysis
C)sLosssofsvoluntaryscontrolsofsmovement
D)sSlowsreflexess-sANSWER:C
Feedback:
Uppersmotorsneuronslesionssdosnotscausesmusclesatrophy,sflaccidsparalysis,sorsslowsrefl
exes.sHowever,suppersmotorsneuronslesionssnormallyscauseslosssofsvoluntaryscontrol.
, 9.sThesnursesissadmittingsaspatientstosthesunitswhosissdiagnosedswithsaslowersmotorsneu
ronslesion.sWhat
entrysinsthespatientsselectronicsrecordsissmostsconsistentswithsthissdiagnosis?
A)sPatientsexhibitssincreasedsmusclestone.
B)sPatientsdemonstratessnormalsmusclesstructureswithsnosevidencesofsatrophy.
C)sPatientsdemonstratesshyperactivesdeepstendonsreflexes.
D)sPatientsdemonstratessansabsencesofsdeepstendonsreflexes.s-sANSWER:D
Feedback:
Lowersmotorsneuronslesionsscausesflaccidsmusclesparalysis,smusclesatrophy,sdecreased
smusclestone,sand
losssofsvoluntaryscontrol.
10.sAnselderlyspatientsissbeingsdischargedshome.sThespatientslivessalonesandshassatroph
ysofshissolfactory
organs.sThesnursestellssthespatientssfamilysthatsitsissessentialsthatsthespatientshaveswhat
sinstalledsinsthe
home?
A)sGrabsbars
B)sNonslipsmats
C)sBaseboardsheaters
D)sAssmokesdetectors-sANSWER:D
Feedback:
Thessensesofssmellsdeterioratesswithsage.sThesolfactorysorganssaresresponsiblesforssmel
l.sThissmay
presentsassafetyshazardsforsthespatientsbecauseshesorsshesmaysnotssmellssmokesorsgassle
aks.sSmoke
detectorssaresuniversallysnecessary,sbutsespeciallysforsthisspatient.
11.sThespatientsinsthesEDshassjustshadsasdiagnosticslumbarspuncture.sTosreducesthesincid
encesofsaspostlumbarspuncturesheadache,swhatsissthesnursessmostsappropriatesaction?
A)sPositionsthespatientsprone.
B)sPositionsthespatientssupineswithsthesheadsofsbedsflat.
C)sPositionsthespatientsleftsside-lying.
D)sAdministersacetaminophensassordered.s-sANSWER:A
Feedback:
Theslumbarspuncturesheadachesmaysbesavoidedsifsassmall-
gaugesneedlesissusedsandsifsthespatientsremains
pronesaftersthesprocedure.sAcetaminophensissnotsadministeredsassaspreventativesmeas
uresforspost-lumbar
puncturesheadaches.
12.sThesnursesissconductingsasfocusedsneurologicsassessment.sWhensassessingsthespati
entsscranialsnerve
function,sthesnurseswouldsincludeswhichsofsthesfollowingsassessments?
A)sAssessmentsofshandsgrip
B)sAssessmentsofsorientationstosperson,stime,sandsplace
C)sAssessmentsofsarmsdrift
s s s s s s s s
y Debbie Steele
s s
1.sAspatientsissbroughtstosthesERsfollowingsasmotorsvehiclesaccidentsinswhichshessustain
edsheadstrauma.sPreliminarysassessmentsrevealssasvisionsdeficitsinsthespatientssleftseye.
sThesnursesshouldsassociatesthis
abnormalsfindingswithstraumastoswhichsofsthesfollowingscerebralslobes?
A)sTemporal
B)sOccipital
C)sParietal
D)sFrontals-sANSWER:B
Feedback:
Thesposteriorslobesofsthescerebralshemispheresissresponsiblesforsvisualsinterpretation.s
Thestemporalslobe
containssthesauditorysreceptivesareas.sThesparietalslobescontainssthesprimaryssensorysc
ortex,sandsis
essentialstosansindividualssawarenesssofsthesbodysinsspace,sasswellsassorientationsinsspa
cesandsspatial
relations.sThesfrontalslobesfunctionssinsconcentration,sabstractsthought,sinformationsst
oragesorsmemory,sandsmotorsfunction.
2.sAspatientsscheduledsforsmagneticsresonancesimagings(MRI)shassarrivedsatsthesradiolo
gysdepartment.sThe
nurseswhospreparessthespatientsforsthesMRIsshouldsprioritizeswhichsofsthesfollowingsact
ions?
A)sWithholdingsstimulantss24stos48shoursspriorstosexam
B)sRemovingsallsmetal-containingsobjects
C)sInstructingsthespatientstosvoidspriorstosthesMRI
D)sInitiatingsansIVslinesforsadministrationsofscontrasts-sANSWER:B
Feedback:
PatientspreparationsforsansMRIsconsistssofsremovingsallsmetal-
containingsobjectsspriorstosthe
examination.sWithholdingsstimulantsswouldsnotsaffectsansMRI;sthissrelatesstosanselectr
oencephalography
(EEG).sInstructingsthespatientstosvoidsisspatientspreparationsforsaslumbarspuncture.sIniti
atingsansIVsline
forsadministrationsofscontrastswouldsbesdonesifsthespatientswasshavingsasCTsscanswithsc
ontrast.
3.sAsgerontologicsnursesplanningsthesneurologicsassessmentsofsansoldersadultsissconside
ringsnormal,sagesrelatedschanges.sOfswhatsphenomenonsshouldsthesnursesbesaware?
A)sHyperactivesdeepstendonsreflexes
B)sReductionsinscerebralsbloodsflow
C)sIncreasedscerebralsmetabolism
D)sHypersensitivitystospainfulsstimulis-sANSWER:B
Feedback:
,Reductionsinscerebralsbloodsflows(CBF)sissaschangesthatsoccurssinsthesnormalsagingsproc
ess.sDeep
tendonsreflexesscansbesdecreasedsor,sinssomescases,sabsent.sCerebralsmetabolismsdecr
easessassthespatient
advancessinsage.sReactionstospainfulsstimulismaysbesdecreasedswithsage.sBecausespainsi
ssansimportant
warningssignal,scautionsmustsbesusedswhenshotsorscoldspackssaresused.
4.sThesnurseshassadmittedsasnewspatientstosthesunit.sOnesofsthespatientssadmittingsorde
rssissforsan
adrenergicsmedication.sThesnursesknowssthatsthissmedicationswillshaveswhatseffectsonst
hescirculatory
system?
A)sThin,swateryssaliva
B)sIncreasedsheartsrate
C)sDecreasedsBP
D)sConstrictedsbronchioless-sANSWER:B
Feedback:
Thestermsadrenergicsrefersstosthessympatheticsnervousssystem.sSympatheticseffectssin
cludesansincreased
ratesandsforcesofsthesheartbeat.sCholinergicseffects,swhichscorrespondstosthesparasymp
atheticsdivisionsof
thesautonomicsnervousssystem,sincludesthin,swateryssaliva,sdecreasedsratesandsforcesof
sheartbeat,sand
decreasedsBP.
5.sAsnursesissassessingsreflexessinsaspatientswithshyperactivesreflexes.sWhensthespatient
ssfootsissabruptly
dorsiflexed,sitscontinuesstosbeatstwostosthreestimessbeforessettlingsintosasrestingspositio
n.sHowswouldsthe
nursesdocumentsthissfinding?
A)sRigidity
B)sFlaccidity
C)sClonus
D)sAtaxias-sANSWER:C
Feedback:
Whensreflexessaresveryshyperactive,sasphenomenonscalledsclonussmaysbeselicited.sIfsth
esfootsissabruptly
dorsiflexed,sitsmayscontinuestosbeatstwostosthreestimessbeforesitssettlessintosaspositions
ofsrest.sRigiditysis
ansincreasesinsmusclestonesatsrestscharacterizedsbysincreasedsresistancestospassivesstre
tch.sFlacciditysis
lacksofsmusclestone.sAtaxiasissthesinabilitystoscoordinatesmusclesmovements,sresultingsi
nsdifficulty
walking,stalking,sandsperformingsself-caresactivities.
,6.sThesnursesissdoingsansinitialsassessmentsonsaspatientsnewlysadmittedstosthesunitswiths
asdiagnosissof
cerebrovascularsaccidents(CVA).sThespatientshassdifficultyscopyingsasfiguresthatsthesnur
seshassdrawnsand
issdiagnosedswithsvisual-
receptivesaphasia.sWhatsbrainsregionsissprimarilysinvolvedsinsthissdeficit?
A)sTemporalslobe
B)sParietal-occipitalsarea
C)sInferiorsposteriorsfrontalsareas
D)sPosteriorsfrontalsareas-sANSWER:B
Feedback:
Difficultyscopyingsasfiguresthatsthesnurseshassdrawnswouldsbesconsideredsvisual-
receptivesaphasia,swhichsinvolvessthesparietal-
occipitalsarea.sExpressivesaphasia,sthesinabilitystosexpresssoneself,sissoften
associatedswithsdamagestosthesfrontalsarea.sReceptivesaphasia,sthesinabilitystosunderst
andswhatssomeone
elsesisssaying,sissoftensassociatedswithsdamagestosthestemporalslobesarea.
7.sWhatstermsissusedstosdescribesthesfibroussconnectivestissuesthatshugssthesbrainsclose
lysandsextendssinto
everysfoldsofsthesbrainsssurface?
A)sDurasmater
B)sArachnoid
C)sFascia
D)sPiasmaters-sANSWER:D
Feedback:
Thestermsmeningessdescribessthesfibroussconnectivestissuesthatscoverssthesbrainsandss
pinalscord.sThe
meningesshavesthreeslayers,sthesdurasmater,sarachnoid,sandspiasmater.sThespiasmatersis
sthesinnermost
membranesthatshugssthesbrainscloselysandsextendssintoseverysfoldsofsthesbrainsssurface
.sThesdurasmater,
thesoutermostslayer,scoverssthesbrainsandsspinalscord.sThesarachnoid,sthesmiddlesmem
brane,sis
responsiblesforsthesproductionsofscerebrospinalsfluid.
8.sThesnursesisscaringsforsaspatientswithsansuppersmotorsneuronslesion.sWhatsclinicalsma
nifestationssshould
thesnursesanticipateswhensplanningsthespatientssneurologicsassessment?
A)sDecreasedsmusclestone
B)sFlaccidsparalysis
C)sLosssofsvoluntaryscontrolsofsmovement
D)sSlowsreflexess-sANSWER:C
Feedback:
Uppersmotorsneuronslesionssdosnotscausesmusclesatrophy,sflaccidsparalysis,sorsslowsrefl
exes.sHowever,suppersmotorsneuronslesionssnormallyscauseslosssofsvoluntaryscontrol.
, 9.sThesnursesissadmittingsaspatientstosthesunitswhosissdiagnosedswithsaslowersmotorsneu
ronslesion.sWhat
entrysinsthespatientsselectronicsrecordsissmostsconsistentswithsthissdiagnosis?
A)sPatientsexhibitssincreasedsmusclestone.
B)sPatientsdemonstratessnormalsmusclesstructureswithsnosevidencesofsatrophy.
C)sPatientsdemonstratesshyperactivesdeepstendonsreflexes.
D)sPatientsdemonstratessansabsencesofsdeepstendonsreflexes.s-sANSWER:D
Feedback:
Lowersmotorsneuronslesionsscausesflaccidsmusclesparalysis,smusclesatrophy,sdecreased
smusclestone,sand
losssofsvoluntaryscontrol.
10.sAnselderlyspatientsissbeingsdischargedshome.sThespatientslivessalonesandshassatroph
ysofshissolfactory
organs.sThesnursestellssthespatientssfamilysthatsitsissessentialsthatsthespatientshaveswhat
sinstalledsinsthe
home?
A)sGrabsbars
B)sNonslipsmats
C)sBaseboardsheaters
D)sAssmokesdetectors-sANSWER:D
Feedback:
Thessensesofssmellsdeterioratesswithsage.sThesolfactorysorganssaresresponsiblesforssmel
l.sThissmay
presentsassafetyshazardsforsthespatientsbecauseshesorsshesmaysnotssmellssmokesorsgassle
aks.sSmoke
detectorssaresuniversallysnecessary,sbutsespeciallysforsthisspatient.
11.sThespatientsinsthesEDshassjustshadsasdiagnosticslumbarspuncture.sTosreducesthesincid
encesofsaspostlumbarspuncturesheadache,swhatsissthesnursessmostsappropriatesaction?
A)sPositionsthespatientsprone.
B)sPositionsthespatientssupineswithsthesheadsofsbedsflat.
C)sPositionsthespatientsleftsside-lying.
D)sAdministersacetaminophensassordered.s-sANSWER:A
Feedback:
Theslumbarspuncturesheadachesmaysbesavoidedsifsassmall-
gaugesneedlesissusedsandsifsthespatientsremains
pronesaftersthesprocedure.sAcetaminophensissnotsadministeredsassaspreventativesmeas
uresforspost-lumbar
puncturesheadaches.
12.sThesnursesissconductingsasfocusedsneurologicsassessment.sWhensassessingsthespati
entsscranialsnerve
function,sthesnurseswouldsincludeswhichsofsthesfollowingsassessments?
A)sAssessmentsofshandsgrip
B)sAssessmentsofsorientationstosperson,stime,sandsplace
C)sAssessmentsofsarmsdrift
