Medical Surgical Nursing Patient Centered Collaborative Care, 7th Edition by Donna D.
Medical Surgical Nursing Patient Centered Collaborative Care, 7th Edition by Donna D.
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Chapter 47: Care of Critically Ill Patients with Neurologic Problems
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
MULTIPLE CHOICE
| a. | Seizures |
| b. | Psychotropic drug use |
| c. | Atrial fibrillation |
| d. | Cerebral aneurysm |
ANS: C
Clients with a history of hypertension, heart disease, atrial fibrillation, diabetes, obesity, and hypercoagulopathy are at risk for embolic stroke. The other disorders are not risk factors for an embolic stroke.
DIF: Cognitive Level: Knowledge/Remembering REF: p. 1012
TOP: Client Needs Category: Health Promotion and Maintenance (Health Screening)
MSC: Integrated Process: Nursing Process (Assessment)
| a. | Two episodes of speech difficulties in the last month |
| b. | Sudden loss of motor coordination |
| c. | A grand mal seizure 2 months ago |
| d. | Chest pain and nuchal rigidity |
ANS: A
Thrombotic stroke is characterized by a gradual onset of symptoms that often are preceded by transient ischemic attacks (TIAs), causing a focal neurologic dysfunction. Two episodes of speech difficulties would correlate with TIAs. The other manifestations are not related to a thrombotic stroke.
DIF: Cognitive Level: Comprehension/Understanding REF: Table 47-1, p. 1006
TOP: Client Needs Category: Physiological Integrity (Physiological Adaptation—Pathophysiology)
MSC: Integrated Process: Nursing Process (Analysis)
| a. | “How many hours does your mother usually sleep at night?” |
| b. | “Did your mother complain recently of weakness in her lower extremities?” |
| c. | “Is any history of seizures known among your mother’s immediate family?” |
| d. | “Does your mother drink any alcohol or take any medications?” |
ANS: D
Conditions such as drug or alcohol intoxication, as well as hypoxemia and metabolic disturbances, can cause profound changes in level of consciousness (LOC) when accompanied by a brain attack. Alcohol abuse and medication toxicity can be especially problematic in older adults. The other manifestations are related to a stroke but would not increase the client’s risk of coma.
DIF: Cognitive Level: Application/Applying or higher REF: N/A
TOP: Client Needs Category: Physiological Integrity (Physiological Adaptation—Pathophysiology)
MSC: Integrated Process: Nursing Process (Assessment)
| a. | Impaired proprioception |
| b. | Aphasia |
| c. | Agraphia |
| d. | Impaired olfaction |
ANS: A
A stroke to the right cerebral hemisphere causes impaired visual and spatial awareness. The client may present with impaired proprioception and may be disoriented as to time and place. The right cerebral hemisphere does not control speech, smell, or the client’s ability to write.
DIF: Cognitive Level: Application/Applying or higher REF: N/A
TOP: Client Needs Category: Physiological Integrity (Physiological Adaptation—Pathophysiology)
MSC: Integrated Process: Nursing Process (Assessment)
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