NUR 242 Exam 4 Neuro Practice Exam
Questions And Already Passed Answers.
What is included in the central nervous system? - Answer brain and spinal cord
What is included in the peripheral nervous system? - Answer cranial nerves, spinal
nerves, ganglia
What does the peripheral nervouse system act as? - Answer relay station
What three types of headaches impact quality of life? - Answer migraine, tension,
cluster
What is the pain assessment guideline for migraine headaches? - Answer P-
provoking (what triggers)
Q - quality (is it pulsating or throbbing)
R - radiation (is it unilateral and supra retro orbital)
S - severity (where is it on pain scale)
T - time (typically 4-72 hours)
What factors make migraines worse? - Answer light, sound, movement
Pathophysiology of migraine - Answer most popular theory is that extracranial arteries
expand and irritate nerves due to vasodilation
Why are migraines a problem? - Answer productivity, sick days, quality of life
Migraine triggers - Answer chocolate, red wine, hard cheeses, monosodium
glutamate, hormonal changes, exertion, fatigue, and stress
manifestation of migraine - Answer Aura (20% of cases), steady throbbing pain,
unilateral, sensitive to light, sound, odors
What does POUND stand for as it relates to migraines - Answer Pulsatile
One day
Unilateral
Nausea/vomitting
Disabiling
What are the abortive therapies for migraines? - Answer Fioricet, NSAIDS, Triptans
and ergotamines
,When is abortive therapy contraindicated for migraine treatment? - Answer heart
disease
What is the best initial treatment for migraine - Answer triptan derivative (ex: Imitrex)
What is epilepsy? - Answer recurrent, unprovoked seizures (at least 2, with no
immediately identifiable cause)
What is a seizure? - Answer Uncontrolled electrical activity in the brain that causes
disruption in brain activity
Assesssment of epilepsy - Answer details about the seizure activity, family history,
collateral medical conditions (stroke, HTN, TBI)
Seizure risk factors - Answer Vascular
Infection or Inherited condition
Trauma
Alzheimers or Autoimmune
Metabolic derangements
Idiopathic
Neoplasm
S - pSychiatric/pSeudoseizure
What can trigger a seizure? - Answer sleep deprivation, stress, alcohol withdrawl,
food
What auras have been associated with epilepsy? - Answer somatic rising epigastric
sensation, hallucinations, halos
What is a partial seizure? - Answer a seizure that affects only one part of brain
What is a simple partial seizure? - Answer (also known as focal aware) is where the
person has no loss of consciousness and localized signs such as jerking movements;
last 10-20 seconds; autonomic symptoms
What is a complex partial seuizure? - Answer altered and impaired, may not have an
aura but can lead to a general seizure; lasts 1-2 minutes
What is a generalized seizure? - Answer affects the brain as a whole; differentiated by
how they appear during observation
absence seizure - Answer seizure involving a brief loss of consciousness without
motor involvement; look to be staring off into space; lasts seconds
tonic-clonic seizure - Answer generalized seizure in which the patient loses
consciousness and has jerking movements of paired muscle groups
, myoclonic seizure - Answer sudden jerk of the body or extremities that lasts seconds
atonic seizure - Answer loss of muscle tone
Acute seizure management - Answer gather history, determine underlying cause,
observation and documentation, side lying position, no restraints, DO NOT ATTEMPT
TO STOP MOVEMENTS
What are you observing and documenting during a seizure? - Answer durations, types
of movements, ongoing observations, post-ictal assessment, patient safety
Acute seizure treatment - Answer patent IV, suction, oxygen, padded side rails, pillow,
privacy, benzodiazapines(ativan, valium), antiepileptics (phenytoin,phosphenytoin)
status epilepticus - Answer A condition in which seizures recur every few minutes or
last more than 30 minutes
Priorities for status epilepticus - Answer establish airway, ABGs, IV push
lorazepam/diazepam, rectal diazepam (if not IV), loading dose of IV phenytoin
Dilantin is caustic to the veins and should not be pushed any faster than - Answer
50mg per min
Diagnostic workup for epilepsy - Answer EEG, CT/MRI, excluse other causes, labs
What labs are needed epilepsy? - Answer electrolytes, drug levels
What is the normal level for phenytoin - Answer 10-20
What is the normal level for cabamazepine - Answer 8-12
What is the normal level for valproic acid - Answer 50-125
AED - Answer Antiepileptic drug
treatment of epilepsy - Answer Medication Therapy:
-Antiepileptic drugs (AED's)
Other Therapies:
-Ketogenic diet
-Rest
-Stress reduction
patient education points for epilepsy - Answer medication compliance, follow up drug
levels, neurologist, medic alert bracelet, evaluation of employment safety, vocational
rehab, social service resources for medications, driving restrictions based on state laws
