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Text Mode – Text version of the exam 1. Which of the following terms is used to describe rapid, jerky, involuntary, purposeless movements of the extremities? 2. Which of the phases of a migraine headache usually lasts less than an hour? 3. The most common type of brain neoplasm is the 4. Which of the following diseases is a chronic, degenerative, progressive disease of the central nervous system characterized by the occurrence of small patches of demyelination in the brain and spinal cord? 5. Which of the following diseases is associated with decreased levels of dopamine due to destruction of pigmented neuronal cells in the substantia nigra in the basal ganglia of the brain? 6. Which of the following diseases is a chronic, progressive, hereditary disease of the nervous system that results in progressive involuntary dance-like movement and dementia? 7. Which of the following diseases is a rare, transmissible, progressive fatal disease of the central nervous system characterized by spongiform degeneration of the gray matter of the brain? 8. Bell’s palsy is a disorder of which cranial nerve? 9. The most common cause of acute encephalitis in the United States is 10. Which of the following reflects basic nursing measures in the care of the patient with viral encephalitis? 11. Nursing management of the patient with new variant Creutzfeldt-Jakob Disease (nvCJD) includes 12.Three medications referred to as the ‘ABC drugs’ are currently the main pharmacological therapy for multiple sclerosis. Which of the following statements reflects information to be included in patient teaching? 13. Korsakoff’s syndrome is characterized by 14. The primary North American vector transmitting arthropod-borne virus encephalitis is the 15. The initial symptoms of new variant Creutzfeldt-Jakob Disease (nvCJD) are 16. A patient with fungal encephalitis receiving amphotericin B complaints of fever, chills, and body aches. The nurse knows that these symptoms 17. The patient with Herpes Simplex Virus (HSV) encephalitis is receiving acyclovir (Zovirax). The nurse monitors blood chemistry test results and urinary output for 18. Medical management of arthropod-borne virus (arboviral) encephalitis is aimed at 19. The patient receiving mitoxantrone (Novantrone) for treatment of secondary progressive multiple sclerosis (MS) is closely monitored for 20. What percentage of patients who survived the polio epidemic of the 1950s are now estimated to have developed post-polio syndrome? 21. Which of the following statements describe the pathophysiology of post-polio syndrome? 22. Which of the following statements reflect nursing interventions of a patient with post-polio syndrome? 23. Which of the following terms is used to describe edema of the optic nerve? 24. Degenerative neurologic disorders include which of the following? 25. Bone density testing in patients with post-polio syndrome has demonstrated 26. Which of the following terms refers to mature compact bone structures that form concentric rings of bone matrix? 27. An osteon is defined as a 28. Which of the following terms refers to the shaft of the long bone? 29. Paresthesia is the term used to refer to 30. Which of the following terms refers to a grating or crackling sound or sensation? 31. Which of the following terms refers to muscle tension being unchanged with muscle shortening and joint motion? 32. During which stage or phase of bone healing after fracture does callus formation occur? 33. During which stage or phase of bone healing after fracture is devitalized tissue removed and new bone reorganized into its former structural arrangement? 34. Which nerve is assessed when the nurse asks the patient to spread all fingers? 35. Which nerve is assessed when the nurse asks the patient to dorsiflex the ankle and extend the toes? 36. Which of the following statements reflect the progress of bone healing? 37. Diminished range of motion, loss of flexibility, stiffness, and loss of height are history and physical findings associated with age-related changes of the 38. Fracture healing occurs in four areas, including the 39. Which of the following is an indicator of neurovascular compromise? 40. Which of the following terms refers to moving away from midline? 41. Surgical fusion of a joint is termed 42. Which of the following devices is designed specifically to support and immobilize a body part in a desired position? 43. When caring for the patient in traction, the nurse is guided by which of the following principles? 44. Meniscectomy refers to the 45. In order to avoid hip dislocation after replacement surgery, the nurse teaches the patient which of the following guidelines? 46. Injury to the ______ nerve as a result of pressure is a cause of footdrop. 47. The nurse teaching the patient with a cast about home care includes which of the following instructions? 48. A continuous passive motion (CPM) device applied after knee surgery 49. Which of the following terms refers to disease of a nerve root? 50. Of the following common problems of the upper extremities, which results from entrapment of the median nerve at the wrist?Practice Mode
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Choreiform movements, such as grimacing, may also be observed in the face.
Bradykinesia refers to very slow voluntary movements and speech.
Dyskinesia refers to impaired ability to execute voluntary movements.
Spondylosis refers to degenerative arthritis of the cervical or lumbar vertebrae.
The aura phase occurs in about 20% of patients who have migraines and may be characterized by focal neurological symptoms.
The prodrome phase occurs hours to days before a migraine headache.
The headache phase lasts from 4 to 72 hours.
During the post-headache phase, patients may sleep for extended periods.
Gliomas are the most common brain neoplasms, accounting for about 45% of all brain tumors.
Angiomas account for approximately 4% of brain tumors.
Meningiomas account for 15-20% of all brain tumors.
Neuromas account for 7% of all brain tumors.
The cause of MS is not known and the disease affects twice as many women as men.
Parkinson’s disease is associated with decreased levels of dopamine caused by destruction of pigmented neuronal cells in the substantia nigra in the basal ganglia of the brain.
Huntington’s disease is a chronic, progressive, hereditary disease of the nervous system that results in progressive involuntary dance-like movement and dementia.
Creutzfeldt-Jakob’s disease is a rare, transmissible, progressive fatal disease of the central nervous system characterized by spongiform degeneration of the gray matter of the brain.
In some patients, Parkinson’s disease can be controlled; however, it cannot be cured.
Multiple sclerosis is a chronic, degenerative, progressive disease of the CNS characterized by the occurrence of small patches of demyelination in the brain and spinal cord.
Huntington’s disease is a chronic, progressive, hereditary disease of the nervous system that results in progressive involuntary dance-like movement and dementia.
Creutzfeldt-Jakob’s disease is a rare, transmissible, progressive fatal disease of the central nervous system characterized by spongiform degeneration of the gray matter of the brain.
Because it is transmitted as an autosomal dominant genetic disorder, each child of a parent with HD has a 50% risk of inheriting the illness.
Multiple sclerosis is a chronic, degenerative, progressive disease of the CNS characterized by the occurrence of small patches of demyelination in the brain and spinal cord.
Parkinson’s disease is associated with decreased levels of dopamine due to destruction of pigmented neuronal cells in the substantia nigra in the basal ganglia of the brain.
Creutzfeldt-Jakob’s disease is a rare, transmissible, progressive fatal disease of the central nervous system characterized by spongiform degeneration of the gray matter of the brain.
The disease causes severe dementia and myoclonus.
Multiple sclerosis is a chronic, degenerative, progressive disease of the CNS characterized by the occurrence of small patches of demyelination in the brain and spinal cord.
Parkinson’s disease is associated with decreased levels of dopamine due to destruction of pigmented neuronal cells in the substantia nigra in the basal ganglia of the brain.
Huntington’s disease is a chronic, progressive, hereditary disease of the nervous system that results in progressive involuntary dance-like movement and dementia.
Bell’s palsy is characterized by facial dysfunction, weakness, and paralysis
Trigeminal neuralgia is a disorder of the trigeminal nerve and causes facial pain.
Meniere’s syndrome is a disorder of the vestibulocochlear nerve.
Guillain-Barre syndrome is a disorder of the vagus nerve.
Viral infection is the most common cause of encephalitis. HSV is the most common cause of acute encephalitis in the U.S.
C. neoformans is one of several fungi that may cause fungal encephalitis. Fungal infections of the central nervous system occur rarely in healthy people.
The Western equine encephalitis virus is one of four types of arboviral encephalitis that occur in North America.
C. albicans is one of several fungi that may cause fungal encephalitis. Fungal infections of the central nervous system occur rarely in healthy people.
Providing comfort measures directed at the headache, include dimmed lights, limited noise, and analgesics are the basic nursing measures in the care of the patient with a viral encephalitis.
Narcotic analgesics may mask neurologic symptoms; therefore, they are used cautiously.
With viral encephalitis, acyclovir therapy is commonly prescribed; Amphotericin B is used in the treatment of fungal encephalitis.
Nursing management of the patient with viral encephalitis includes monitoring of blood chemistry test results and urinary output to alert the nurse to the presence of renal complications related to acyclovir therapy.
The nvCJD is a progressive fatal disease with no treatment available. Due to the fatal outcome of nvCJD, nursing care is primarily supportive.
Prevention of disease transmission is an important part of providing nursing care. Although patient isolation is not necessary, use of standard precautions is important. Institutional protocols are followed for blood and body fluid exposure and decontamination of equipment.
Organ donation is not an option because of the risk for disease transmission.
Amphotericin B is used in the treatment of fungal encephalitis; no treatment is available for nvCJD.
Seventy-five percent of patients taking one of the interferons experience flu-like symptoms that can be controlled with NSAIDS and usually resolve after a few months of therapy.
Interferon beta-la is given by intramuscular injection once a week.
Interferon beta-1b is administered subcutaneously once a week.
Glatiramer acetate is administed by intramuscular injection once a week.
Korsakoff’s syndrome is a personality disorder characterized by psychosis, disorientation, delirium, insomnia, and hallucinations.
Creutzefeldt-Jacob disease results in severe dementia and myoclonus.
The three cardinal signs of Parkinson’s disease are tremor, rigidity, and bradykinesia.
Huntington’s disease results in progressive involuntary choreiform (dancelike) movement and dementia.
Arthropod vectors transmit several types of viruses that cause encephalitis. The primary vector in North America is the mosquito.
The primary vector in North America is the mosquito.
The primary vector in North America is the mosquito.
The primary vector in North America is the mosquito.
Anxiety, depression, and behavioral changes are the initial symptoms of nvCJD
Memory and cognitive impairment occur late in the course of nvCJD
Anxiety, depression and behavioral changes are the initial symptoms of nvCJD
Anxiety, depression and behavioral changes are the initial symptoms of nvCJD
Administration of amphotericin B may cause fever, chills and body aches. The administration of diphenhydramine (Benedryl) and acetaminophen (Tylenol) approximately 30 minutes prior to the administration of amphotericin B may prevent these side effects.
Renal toxicity due to amphotericin B is dose limiting. Monitoring the serum creatinine and blood urea nitrogen levels may alert the nurse to thedevelopment of renal insufficiency and the need to address the patients’ renal status.
Vascular changes are associated with C. immitis and Aspergillus Manifestations of vascular change may include arteritis or cerebral infarction.
Blood and CSF cultures help diagnosis fungal encephalitis.
Monitoring of blood chemistry test results and urinary output will alert the nurse to the presence of renal complications related to acyclovir therapy.
Monitoring of blood chemistry test results and urinary output will alert the nurse to the presence of renal complications related to acyclovir therapy.
Monitoring of blood chemistry test results and urinary output will alert the nurse to the presence of renal complications related to acyclovir therapy. To prevent relapse treatment with acyclovir should continue for up to 3 weeks.
Monitoring of blood chemistry test results and urinary output will alert the nurse to the presence of renal complications related to acyclovir therapy.
There is no specific medication for arboviral encephalitis. Medical management is aimed at controlling seizures and increased intracranial pressure.
Medical management is aimed at controlling seizures and increased intracranial pressure.
Medical management is aimed at controlling seizures and increased intracranial pressure.
Medical management is aimed at controlling seizures and increased intracranial pressure.
Mitoxantrone is an antineoplastic agent used primarily to treat leukemia and lyphoma but is also used to treat secondary progressive MS. Patients need to have laboratory tests ordered and the results closely monitored due to the potential for leukopenia and cardiac toxicity.
Patients receiving corticosteroids are monitored for side effects related to corticosteroids such as mood changes and fluid and electrolyte alterations.
Patients receiving mitoxantrone are closely monitored for leukopenia and cardiac toxicity.
Patients receiving mitoxantrone are closely monitored for leukopenia and cardiac toxicity.
Patients who survived the polio epidemic of the 1950s, many now elderly, are developing new symptoms of weakness, fatigue and musculoskeletalpain. It is estimated that between 60% and 80% of the 640,000 polio survivors are experiencing the phenomenon known as post-polio syndrome.
It is estimated that between 60 and 80% of patients who survived the polio epidemic of the 1950s are now experiencing post-polio syndrome.
It is estimated that between 60 and 80% of patients who survived the polio epidemic of the 1950s are now experiencing post-polio syndrome.
The exact cause of post-polio syndrome is not known but researchers suspect that with aging or muscle overuse the neurons not destroyed originally by the poliovirus are unable to continue generating axon sprouts.
The exact cause of post-polio syndrome is not known.
The exact cause of post-polio syndrome is not known.
The exact cause of post-polio syndrome is not known.
No specific medical or surgical treatment is available for this syndrome and therefore nursing plays a pivotal role in the team approach to assisting patients and families in dealing with the symptoms of progressive loss of muscle strength and significant fatigue. Nursing interventions are aimed at slowing the loss of strength and maintaining the physical, psychological and social well being of the patient.
No specific medical or surgical treatment is available for this syndrome.
Patients need to plan and coordinate activities to conserve energy and reduce fatigue. Important activities should be planned for the morning as fatigue often increases in the afternoon and evening.
Pain in muscles and joints may be a problem. Nonpharmacologic techniques such as the application of heat and cold are most appropriate because these patients tend to have strong reactions to medications.
Papilledema is edema of the optic nerve.
Scotoma is a defect in vision in a specific area in one or both eyes.
Lymphedema is the chronic swelling of an extremity due to interrupted lymphatic ciruclation, typically from an axillary dissection.
Angioneurotic edema is a condition characterized by urticaria and diffuse swelling of the deeper layers of the skin.
Huntington’s disease is a chronic, progressive, degenerative neurologic hereditary disease of the nervous system that results in progressive involuntary choreiform movement and dementia.
Paget’s disease is a musculoskeletal disorder, characterized by localized rapid bone turnover, most commonly affecting the skull, femur, tibia, pelvic bones, and vertebrae.
Osteomyelitis is an infection of the bone.
Malignant glioma is the most common type of brain tumor.
Bone density testing in patients with post-polio syndrome has demonstrated low bone mass and osteoporosis. Thus, the importance of identifying risks, preventing falls, and treating osteoporosis must be discussed with patients and their families.
Bone density testing in patients with post-polio syndrome has demonstrated low bone mass and osteoporosis.
Bone density testing in patients with post-polio syndrome has demonstrated low bone mass and osteoporosis.
Bone density testing in patients with post-polio syndrome has demonstrated low bone mass and osteoporosis.
Lamellae are mineralized bone matrix.
Endosteum refers to the marrow cavity lining of hollow bone.
Trabecula refers to lattice-like bone structure.
Cancellous bone refers to spongy, lattice-like bone structure.
The center of an osteon contains a capillary.
An osteoblast is a bone-forming cell.
An osteoclast is a bone resorption cell.
An osteocyte is a mature bone cell.
The diaphysis is primarily cortical bone.
An epiphysis is an end of a long bone.
Lordosis refers to an increase in lumbar curvature of spine.
Scoliosis refers to lateral curving of the spine.
Abnormal sensations, such as burning, tingling, and numbness, are referred to as paresthesias.
The absence of muscle tone suggesting nerve damage is referred to as paralysis.
Involuntary twitch of muscle fibers is referred to as fasciculation.
A muscle which holds no tone is termed flaccid.
Crepitus may occur with movement of ends of a broken bone or irregular joint surface.
Callus is fibrous tissue that forms at the fracture site.
Clonus refers to rhythmic contraction of muscle.
Fasciculation refers to involuntary twitch of muscle fibers.
Exercises such as swimming and bicycling are isotonic.
Isometric contraction is characterized by increased muscle tension, unchanged muscle length, and no joint motion.
Contracture refers to abnormal shortening of muscle, joint, or both.
Fasciculation refers to involuntary twitch of muscle fibers.
Callus formation occurs during the reparative stage but is disrupted by excessive motion at the fracture site
Remodeling is the final stage of fracture repair during which the new bone is reorganized into the bone’s former structural arrangement.
During inflammation, macrophages invade and debride the fracture area.
Revascularization occurs within about 5 days after the fracture.
Remodeling is the final stage of fracture repair.
During inflammation, macrophages invade and debride the fracture area.
Revascularization occurs within about 5 days after the fracture.
Callus formation occurs during the reparative stage but is disrupted by excessive motion at the fracture site.
Asking the patient to spread all fingers allows the nurse to assess motor function affected by ulnar innervation while pricking the fat pad at the top of the small finger allows assessment of the sensory function affected by the ulnar nerve.
The peroneal nerve is assessed by asking the patient to dorsiflex the ankle and extend the toes.
The radial nerve is assessed by asking the patient to stretch out the thumb, then the wrist, and then the fingers at the metacarpal joints.
The median nerve is assessed by asking the patient to touch the thumb to the little finger.
The motor function of the peroneal nerve is assessed by asking the patient to dorsiflex the ankle and extend the toes while the sensory function is assessed by pricking the skin between the great and center toes.
The radial nerve is assessed by asking the patient to stretch out the thumb, then the wrist, and then the fingers at the metacarpal joints.
The median nerve is assessed by asking the patient to touch the thumb to the little finger.
Asking the patient to spread all fingers allows the nurse to assess motor function affected by ulnar innervation.
Serial x-rays are used to monitor the progress of bone healing.
The type of bone fractured, the adequacy of blood supply, the surface contact of the fragments, and the general health of the person influence the rate of fracture healing.
The type of bone fractured, the adequacy of blood supply, the surface contact of the fragments, and the general health of the person influence the rate of fracture healing.
Adequate immobilization is essential until there is x-ray evidence of bone formation with ossification.
History and physical findings associated with age-related changes of the joints include diminished range of motion, loss of flexibility, stiffness, and loss of height.
History and physical findings associated with age-related changes of bones include loss of height, posture changes, kyphosis, flexion of hips and knees, back pain, osteoporosis, and fracture.
History and physical findings associated with age-related changes of muscles include loss of strength, diminished agility, decreased endurance, prolonged response time (diminished reaction time), diminished tone, a broad base of support, and a history of falls.
History and physical findings associated with age-related changes of ligaments include joint pain on motion that resolves with rest, crepitus, joint swelling/enlargement, and degenerative joint disease (osteoarthritis).
Fracture healing occurs in four areas, including the bone marrow, bone cortex, periosteum, and the external soft tissue, where a bridging callus (fibrous tissue) stabilizes the fracture.
Fracture healing occurs in four areas, including the bone marrow, bone cortex, periosteum, and the external soft tissue. Cartilage is special tissue at the ends of bone.
Fracture healing occurs in four areas, including the bone marrow, bone cortex, periosteum, and the external soft tissue. The bursae is a fluid-filled sac found in connective tissue, usually in the area of joints.
Fracture healing occurs in four areas, including the bone marrow, bone cortex, periosteum, and the external soft tissue. Fascia is fibrous tissue that covers, supports, and separates muscles.
Capillary refill more than 3 seconds is an indicator of neurovascular compromise. Other indicators include cool skin temperature, pale or cyanotic color, weakness, paralysis, paresthesia, unrelenting pain, pain on passive stretch, and absence of feeling.
Cool skin temperature is an indicator of neurovascular compromise.
Unrelenting pain is an indicator of neurovascular compromise.
Pain on passive stretch is an indicator of neurovascular compromise.
Abduction is moving away from midline.
Adduction is moving toward midline.
Inversion is turning inward.
Eversion is turning outward.
Arthrodesis of a joint is created surgically to treat chronic pain.
ORIF refers to surgery to repair and stabilize a fracture.
Heterotrophic ossification refers to formation of bone in the periprosthetic space.
Arthroplasty refers to surgical repair of a joint or joint replacement.
A splint may be applied to a fractured extremity initially until swelling subsides.
A brace is an externally applied device to support a body part, control movement, and prevent injury.
A CPM device is an instrument that moves a body part to promote healing and circulation.
A trapeze is an overhead patient-helping device to promote patient mobility in bed.
Skeletal traction is applied directly to the bone and is never interrupted.
In order to be effective, weights must hang freely and not rest on the bed or floor.
Knots in the rope or the footplate must not touch the pulley or the foot of the bed.
Traction must be continuous to be effective in reducing and immobilizing fractures.
The most common site for meniscectomy is the knee.
Fasciotomy refers to the incision and diversion of the muscle fascia to relieve muscle constriction.
Hemiarthroplsty refers to the replacement of one of the articular surfaces of a joint.
Amputation refers to the removal of a body part.
Crossing the affected leg may result in dislocation of the hip joint after total hip replacement.
The patient should be taught to keep the knees apart at all times.
The patient should be taught to put a pillow between the legs when sleeping.
The patient should be taught to avoid bending forward when seated in a chair.
Injury to the peroneal nerve as a result of pressure is a cause of footdrop.
Injury to the peroneal nerve as a result of pressure is a cause of footdrop.
Injury to the peroneal nerve as a result of pressure is a cause of footdrop.
Injury to the peroneal nerve as a result of pressure is a cause of footdrop.
Instruct the patient to keep the cast dry and to dry a wet fiberglass cast thoroughly using a hair dryer on a cool setting to avoid skin problems; do not cover it with plastic or rubber.
A cast should be kept dry; do not cover it with plastic or rubber because this causes condensation, which dampens the cast and skin.
A casted extremitiy should be elevated frequently to heart level to prevent swelling.
A broken cast should be reported to the physician; the patient should not attempt to fix it.
A CPM device applied after knee surgery promotes healing by increasing circulation and movement of the knee joint.
A CPM device provides passive range of motion.
A CPM device applied after knee surgery promotes healing by increasing circulation and movement of the knee joint.
A CPM device applied after knee surgery promotes healing by increasing circulation and movement of the knee joint.
When the patient reports radiating pain down the leg, he is describing radiculopathy.
Involucrum refers to new bone growth around the sequestrum.
Sequestrum refers to dead bone in an abscess cavity.
Contracture refers to abnormal shortening of muscle or fibrosis of joint structures.
Carpal tunnel syndrome is commonly due to repetitive hand activities.
A ganglion, a collection of gelatinous material near the tendon sheaths and joints, appears as a round, firm, cystic swelling, usually on the dorsum of the wrist.
Dupuytren’s contracture is a slowly progressive contracture of the palmar fascia.
Impingement syndrome is associated with the shoulder and may progress to a rotator cuff tear.
Medical-Surgical Nursing Exam 19
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