N4 - Test - Assessment of the Nervous System

Ignatavicius & Workman: Medical-Surgical Nursing: Critical Thinking for Collaborative Care, 4th Edition

Chapter 41: Assessment of the Nervous System

1. What function would be altered if a person’s ability to synthesize or maintain oligodendrocytes within the central nervous system was disrupted?

A. Initiation of impulse transmission
B. Production of myelin sheath
C. Nutrition and support of neurons
D. Formation of the blood-brain barrier

2. Which of the following modifications should the nurse suggest to an elderly client whose irises no longer fully dilate?

A. Wear dark glasses whenever you are outside.
B. Use eye drops on a regular basis to prevent dryness.
C. Avoid rubbing your eyes to prevent corneal abrasions.
D. Increase room lights when reading or doing close work.

3. Which of the following client responses during the history-taking alerts you to the possibility of a neurologic problem? The client:

A. asks you to repeat a question.
B. requires a long time to answer a question correctly.
C. has a difficult time forming his or her words.
D. does not remember your name at the end of the interview.

4. In performing an initial assessment of the client, which of the following behaviors or skills should you expect to be impaired in a client who has experienced an injury to the Wernicke’s area of the brain?

A. Pronouncing words correctly
B. Planning activities for a week
C. Recognizing his or her spouse
D. Processing words into coherent thoughts

5. A client who has been admitted for a neurological disorder has been assigned a Glasgow Coma Scale score of 2. What is your interpretation of this finding? The client:

A. is in a deep coma.
B. is alert, but disoriented.
C. can obey commands, but lacks speech.
D. is alert and oriented to time, place, and person.

6. The client returns to the unit for recovery immediately after digital subtraction angiography. Which of the following actions should you perform first?

A. Assess pedal pulses
B. Assess neurological signs
C. Compare blood pressure in both arms
D. Apply a sandbag to the injection site