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Question 1 of 50
1. Question
1 point(s)A 68-year-old male patient who had a left-sided stroke is admitted to the hospital. The patient has right-sided weakness and is unable to perform activities of daily living without assistance. The nurse is providing oral hygiene to the patient and is preparing to use a padded tongue blade to open the patient’s mouth. Which nursing measure is inappropriate when providing oral hygiene to the patient who had a stroke?
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Question 2 of 50
2. Question
1 point(s)A 64-year-old client with a history of hypertension is admitted to the emergency department with sudden onset right-sided weakness, facial droop, and difficulty speaking. Which nursing intervention is the highest priority in the initial management of this client?
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Question 3 of 50
3. Question
1 point(s)A client arrives in the emergency department with an ischemic stroke and receives tissue plasminogen activator (t-PA) administration. Which is the priority nursing assessment?
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Question 4 of 50
4. Question
1 point(s)During the first 24 hours after thrombolytic therapy for ischemic stroke, the primary goal is to control the client’s:
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Question 5 of 50
5. Question
1 point(s)What is a priority nursing assessment in the first 24 hours after admission of the client with a thrombotic stroke?
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Question 6 of 50
6. Question
1 point(s)What is the expected outcome of thrombolytic drug therapy?
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Question 7 of 50
7. Question
1 point(s)The client diagnosed with atrial fibrillation has experienced a transient ischemic attack (TIA). Which medication would the nurse anticipate being ordered for the client on discharge?
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Question 8 of 50
8. Question
1 point(s)Which client would the nurse identify as being most at risk for experiencing a CVA?
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Question 9 of 50
9. Question
1 point(s)Which assessment data would indicate to the nurse that the client would be at risk for a hemorrhagic stroke?
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Question 10 of 50
10. Question
1 point(s)The nurse and unlicensed assistive personnel (UAP) are caring for a client with right-sided paralysis. Which action by the UAP requires the nurse to intervene?
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Question 11 of 50
11. Question
1 point(s)A client admitted to the hospital with a subarachnoid hemorrhage has complaints of severe headache, nuchal rigidity, and projectile vomiting. The nurse knows lumbar puncture (LP) would be contraindicated in this client in which of the following circumstances?
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Question 12 of 50
12. Question
1 point(s)A client with a subdural hematoma becomes restless and confused, with dilation of the ipsilateral pupil. The physician orders mannitol for which of the following reasons?
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Question 13 of 50
13. Question
1 point(s)A client with subdural hematoma was given mannitol to decrease intracranial pressure (ICP). Which of the following results would best show the mannitol was effective?
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Question 14 of 50
14. Question
1 point(s)Which of the following values is considered normal for ICP?
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Question 15 of 50
15. Question
1 point(s)Which of the following symptoms may occur with a phenytoin level of 32 mg/dl?
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Question 16 of 50
16. Question
1 point(s)Which of the following signs and symptoms of increased ICP after head trauma would appear first?
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Question 17 of 50
17. Question
1 point(s)Problems with memory and learning would relate to which of the following lobes?
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Question 18 of 50
18. Question
1 point(s)While cooking, your client couldn’t feel the temperature of a hot oven. Which lobe could be dysfunctional?
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Question 19 of 50
19. Question
1 point(s)The nurse is assessing the motor function of an unconscious client. The nurse would plan to use which of the following to test the client’s peripheral response to pain?
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Question 20 of 50
20. Question
1 point(s)The client is having a lumbar puncture performed. The nurse would plan to place the client in which position for the procedure?
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Question 21 of 50
21. Question
1 point(s)A nurse is assisting with caloric testing of the oculovestibular reflex of an unconscious client. Cold water is injected into the left auditory canal. The client exhibits eye conjugate movements toward the left followed by a rapid nystagmus toward the right. The nurse understands that this indicates the client has:
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Question 22 of 50
22. Question
1 point(s)The nurse is caring for the client with increased intracranial pressure. The nurse would note which of the following trends in vital signs if the ICP is rising?
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Question 23 of 50
23. Question
1 point(s)The nurse is evaluating the status of a client who had a craniotomy 3 days ago. The nurse would suspect the client is developing meningitis as a complication of surgery if the client exhibits:
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Question 24 of 50
24. Question
1 point(s)A client is arousing from a coma and keeps saying, “Just stop the pain.” The nurse responds based on the knowledge that the human body typically and automatically responds to pain first with attempts to:
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Question 25 of 50
25. Question
1 point(s)During the acute stage of meningitis, a 3-year-old child is restless and irritable. Which of the following would be most appropriate to institute?
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Question 26 of 50
26. Question
1 point(s)Which of the following would lead the nurse to suspect that a child with meningitis has developed disseminated intravascular coagulation?
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Question 27 of 50
27. Question
1 point(s)When interviewing the parents of a 2-year-old child, a history of which of the following illnesses would lead the nurse to suspect pneumococcal meningitis?
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Question 28 of 50
28. Question
1 point(s)The nurse is assessing a child diagnosed with a brain tumor. Which of the following signs and symptoms would the nurse expect the child to demonstrate? Select all that apply.
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Question 29 of 50
29. Question
1 point(s)A lumbar puncture is performed on a child suspected of having bacterial meningitis. CSF is obtained for analysis. A nurse reviews the results of the CSF analysis and determines which of the following results would verify the diagnosis?
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Question 30 of 50
30. Question
1 point(s)A nurse is planning care for a child with acute bacterial meningitis. Based on the mode of transmission of this infection, which of the following would be included in the plan of care?
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Question 31 of 50
31. Question
1 point(s)A nurse is reviewing the record of a child with increased ICP and notes that the child has exhibited signs of decerebrate posturing. On assessment of the child, the nurse would expect to note which of the following if this type of posturing was present?
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Question 32 of 50
32. Question
1 point(s)Which of the following assessment data indicated nuchal rigidity?
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Question 33 of 50
33. Question
1 point(s)Meningitis occurs as an extension of a variety of bacterial infections due to which of the following conditions?
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Question 34 of 50
34. Question
1 point(s)Which of the following pathologic processes is often associated with aseptic meningitis?
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Question 35 of 50
35. Question
1 point(s)You are preparing to admit a patient with a seizure disorder. Which of the following actions can you delegate to LPN/LVN?
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Question 36 of 50
36. Question
1 point(s)If a male client experienced a cerebrovascular accident (CVA) that damaged the hypothalamus, the nurse would anticipate that the client has problems with:
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Question 37 of 50
37. Question
1 point(s)A female client admitted to an acute care facility after a car accident develops signs and symptoms of increased intracranial pressure (ICP). The client is intubated and placed on mechanical ventilation to help reduce ICP. To prevent a further rise in ICP caused by suctioning, the nurse anticipates administering which drug endotracheally before suctioning?
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Question 38 of 50
38. Question
1 point(s)After striking his head on a tree while falling from a ladder, a young man age 18 is admitted to the emergency department. He’s unconscious and his pupils are nonreactive. Which intervention would be the most dangerous for the client?
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Question 39 of 50
39. Question
1 point(s)When obtaining the health history from a male client with retinal detachment, the nurse expects the client to report:
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Question 40 of 50
40. Question
1 point(s)Which nursing diagnosis takes highest priority for a client with Parkinson’s crisis?
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Question 41 of 50
41. Question
1 point(s)The nurse has given the male client with Bell’s palsy instructions on preserving muscle tone in the face and preventing denervation. The nurse determines that the client needs additional information if the client states that he or she will:
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Question 42 of 50
42. Question
1 point(s)A female client is admitted to the hospital with a diagnosis of Guillain-Barre syndrome. The nurse inquires during the nursing admission interview if the client has a history of:
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Question 43 of 50
43. Question
1 point(s)A female client with Guillain-Barre syndrome has ascending paralysis and is intubated and receiving mechanical ventilation. Which of the following strategies would the nurse incorporate in the plan of care to help the client cope with this illness?
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Question 44 of 50
44. Question
1 point(s)A male client has an impairment of cranial nerve II. Specific to this impairment, the nurse would plan to do which of the following to ensure the client to ensure client safety?
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Question 45 of 50
45. Question
1 point(s)A female client has a neurological deficit involving the limbic system. Specific to this type of deficit, the nurse would document which of the following information related to the client’s behavior.
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Question 46 of 50
46. Question
1 point(s)A client is admitted with a diagnosis of Sturge-Weber syndrome. Which of the following information would you expect to find in this client?
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Question 47 of 50
47. Question
1 point(s)A client is admitted to the emergency room with a spinal cord injury. The client is complaining of lightheadedness, flushed skin above the level of the injury, and headache. The client’s blood pressure is 160/90 mm Hg. Which of the following is a priority action for the nurse to take?
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Question 48 of 50
48. Question
1 point(s)A client who had a stroke is seen bumping into things on the side and is having difficulty picking up the beginning of the next line of what he is reading. The client is experiencing which of the following conditions?
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Question 49 of 50
49. Question
1 point(s)Which of the following medical treatments should the nurse anticipate administering to a client with increased intracranial pressure due to brain hemorrhage, except?
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Question 50 of 50
50. Question
1 point(s)Which of the following symptoms would you expect to a client with a phenytoin level of 35 mg/dL?
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