N4,N7, A Stimulating Coma Test

Coma Stimulation
From the Nursing Center
1.
A coma stimulation program (CSP) should be
a. avoided in a patient who is dependent.
b. initiated as early as 72 hours to one (1) week post injury.
c. initiated once the Glascow Coma Scale Score is greater than 10.
d. avoided in a patient with a Rancho Los Amigos Scale (RLA) less than V.

2.
According to this author, an expected finding when assessing a patient in a coma is
a. an absence of a sleep/-wake cycle.
b. eye opening limited to painful stimulation.
c. a Rancho Los Amigos Scale (RLA) score of III.
d. a deep state of unconsciousness lasting less than one (1) week.

3.
To avoid habituation, Wood suggests
a. exposing the patient to soft background noise.
b. speaking to the patient at a normal conversational rate.
c. limiting nursing activities to 15 minutes out of each one (1) hour.
d. providing uninterrupted sleep rest periods of at least 30–45 minutes.

4.
Before starting any stimulation program it is important for the nurse to
a. document the patient's cerebral perfusion pressure.
b. explain the procedure to the family at the patient's bedside.
c. determine that the patient has just exited a true sleep/rest period.
d. determine that the patient's vital signs have been stable for the past 48 hours.

5.
Which of the following activities should be performed to help "normalize" a patient's environment?
a. Keeping the door to the patient's room open
b. Limiting the number of people in the patient's room to 2 or 3
c. Exposing the patient to casual conversation between family members
d. Playing the patient's favorite music while performing activities of daily living

6.
Auditory stimulation requires the use of
a. Cranial Nerve III.
b. Cranial Nerve IV.
c. Cranial Nerve VIII.
d. Cranial Nerve X.

7.
When providing auditory stimulation to a patient the nurse should
a. avoid placing headphones on the patient.
b. avoid turning on the radio or television.
c. recognize that the startle response is an expected finding.
d. recognize that blinking may be considered a favorable response.

8.
Vision requires impulse conduction via
a. Cranial nerve I.
b. Cranial nerve II.
c. Cranial nerve VII.
d. Cranial nerve IX.

9.
When providing visual stimulation, the nurse should
a. avoid having the patient in the supine position.
b. recognize that closing of eyes is a favorable response.
c. use variations of light if the blink response is not intact.
d. stop the stimulation if the patient demonstrates a change in pupil size.

10.
Which of these is the most commonly injured cranial nerve?
a. Cranial nerve I
b. Cranial nerve III
c. Cranial nerve V
d. Cranial nerve VI

11.
When performing olfactory stimulation it is important to
a. withhold the stimulation if the patient has a nasogastric tube in place.
b. expose the patient to the aromatic stimuli for at least 30 seconds.
c. avoid getting the aromatic stimuli on the patient's skin.
d. initially use a strong scent such as vinegar.

12.
Which of these cranial nerves is not involved in eliciting an effective gustatory response?
a. Cranial nerve X
b. Cranial nerve IX
c. Cranial nerve VII
d. Cranial nerve II

13.
When performing gustatory stimulation
a. avoid massaging the gums if the patient is intubated.
b. discontinue stimulation if the patient demonstrates spitting or grimacing.
c. avoid sweet sweet-tasting stimuli if the patient has a hard time managing secretions.
d. discontinue stimulation if the patient exhibits a defensive reaction to oral care.

14.
When performing tactile stimulation, it would be appropriate for the nurse or family member to
a. gently rub the patient's sternum.
b. avoid firmly stretching any tendon.
c. briefly apply ice to the patient's face.
d. stop the session if a sucking response is elicited.

15.
Which of these is an effective strategy for performing kinesthetic stimulation?
a. Spinning the patient
b. Raising and lowering the patient's bed
c. Placing the patient on a cooling blanket
d. Rolling the patient from side to side repetitively