Test Bank Brunner and Suddarths Canadian
Textbook of Medical-Surgical Nursing 3rd, 4th
Edition El Hussein
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?
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