NGN Neuro disorders exam

A client is admitted with a neurologic disorder that is interfering with self-management and functional ability. The client reports problems with vision and is alarmed at seeing double images, which has affected balance, movement, and ability to read.
For each client finding, use an X to specify whether the finding is consistent with the disease process of multiple sclerosis, myasthenia gravis, or Guillain–Barré Syndrome. Each finding may support more than one disease process.

Mrs. Sullivan, a 58-year-old woman, visits her primary care physician for her annual checkup.
Given Mrs. Sullivan's clinical history, laboratory findings, and symptoms, which of the following are the most significant risk factors contributing to her increased risk of stroke? Select all that apply

Lucia, 52, recently admitted to the medical-surgical unit with a known history of a seizure disorder, is in the early stages of evaluation for possible surgical intervention. This morning, she experienced an unexpected seizure episode. At the same time, a nearby patient went into cardiac arrest, diverting the attention of the primary RN.
The RN quickly scans the surrounding staff and identifies an LPN/LVN and a nursing assistant as available to assist Lucia. Knowing the specific skill sets of each staff member, the RN must delegate tasks effectively and safely.
Considering the acuity of Lucia's condition and the complexities associated with her potential surgical evaluation, which of the following actions can be appropriately and safely delegated to an LPN/LVN during Lucia's seizure episode? Select all that apply

Sarah, a seasoned neurological nurse, begins her shift and is assigned seven patients with various neurological conditions, ranging from mild concussions to severe traumatic brain injuries.
Given a range of clinical scenarios, which patient would require Sarah's immediate assessment and management?

Ms. Clara, a 64-year-old librarian, suddenly develops difficulty speaking during a book reading at her local library. Her colleague, who recently attended a health seminar, tries to assess her.

Which symptoms align with the F.A.S.T mnemonic used to recognize a potential stroke? Select all that apply

Mr. James, a 65-year-old man, presents to the clinic complaining of severe, stabbing pain on one side of his face, described by him as electric shock-like.
Which nursing considerations are essential when caring for a patient with this condition?

Mr. Anderson, 62 years old, is undergoing a Tensilon test to diagnose myasthenia gravis. His nurse reviews the necessary precautions before the test.
What is a pivotal nursing precaution during the administration of the Tensilon test?

Mrs. Elise, 75, who had a recent left hemisphere stroke, displays difficulty in naming objects but can understand conversations.
Considering her presentation, which interventions would be most beneficial in communicating with her?Select all that apply

Mr. Elliot, a 38-year-old software developer with a T5 spinal cord injury sustained from a rock climbing accident five years ago, presents at the emergency department. He was working at his standing desk when he suddenly felt an intense pounding headache.
His colleague, who found him disoriented, also reported that Mr. Elliot's face appeared flushed, contrasting with his skin appearing cold and clammy below his chest level.

This colleague also noted that Mr. Elliot had recently been complaining about a malfunctioning catheter but hadn't yet seen his urologist. The triage nurse, recalling potential complications associated with spinal cord injuries, is now concerned about a specific hypertensive crisis.

Given the contextual clues and Mr. Elliot's presentation, which potential syndrome or condition should be considered, and what immediate nursing interventions should be prioritized in the notes from the nurse?

Nurse notes: Mr. Elliot's potential condition is   and the nursing interventions to be prioritized will be     and 

Miss. Parker, a 45-year-old woman with a history of migraines, recently underwent surgery to remove a deep-seated brain tumor located near the brainstem. Postoperatively, during a neurological assessment, you notice that while Miss. Parker is increasingly restless, she also exhibits periods of drowsiness. Her heart rate has slowed down, and her pupils are unequal in size. Additionally, her blood pressure readings show a widening gap between the systolic and diastolic numbers.

Given Miss. Parker's clinical manifestations and history, which of the following interventional steps should be prioritized to address her suspected condition?

Mr. Grayson, 60, has been diagnosed with Bell's palsy. He's concerned about potential damage to his eye since he cannot blink properly.

Which five combinations of strategies would be most effective in preventing corneal drying in this patient? 

Eleanor, a 66-year-old former concert pianist, recently experienced a right hemisphere cerebrovascular accident. She's been admitted for rehabilitation. During therapy, the rehab team noticed that she consistently ignores food on the left side of her tray, often bumps into objects on her left when mobilizing, and seems unaware of her left upper limb, despite it having preserved motor function. The team suspects she might be manifesting symptoms of Spatial Neglect Syndrome.

Given Eleanor's presentation, which of the following interventions and observations align with managing and assessing Spatial Neglect Syndrome resulting from a right hemisphere stroke?

Ms. Collins, a 28-year-old teacher, sustained a minor head injury from a cycling accident. As she prepares for discharge, the nurse reviews essential instructions for her home care.
Which instruction is essential for Ms. Collins to understand and follow after a head injury?

Mr. Dean, a 35-year-old construction worker, was hit by falling debris.
Which three clinical manifestations should raise suspicion of an epidural hematoma in Mr. Dean?

Mrs. Turner, a 75-year-old retired librarian, was found unconscious in her living room, where she was last seen reading a book approximately two hours earlier by her neighbor. 

Given the scattered clues, which combination of the following assessments forms the critical components of the Glasgow Coma Scale that the medical team should prioritize? Select all that apply

Ms. Patterson, a 42-year-old woman, has been diagnosed with Myasthenia Gravis and is on medication for the same. She arrives at the ER displaying muscle weakness and respiratory distress. The team is trying to determine whether she is experiencing a Myasthenic Crisis or a Cholinergic Crisis.
Which of the following assessments would help differentiate between a Myasthenic Crisis and a Cholinergic Crisis in Ms. Patterson? Select all that apply

Mr. Khan, a 55-year-old researcher, is scheduled for a lumbar puncture to rule out multiple sclerosis because an MRI is not available. As the procedure approaches, the nurse reviews critical aspects of care.

Which consideration is most crucial when preparing Mr. Khan for the lumbar puncture procedure?

Ms. Lillian, an 82-year-old woman, comes to the outpatient clinic accompanied by her daughter. 
Which of the following are typical signs of cognitive impairment in older adults?

Aditi, a 29-year-old researcher, was found unconscious in the laboratory following exposure to an unidentified chemical. Rushed to the emergency room, the attending physician instructs the nurse to place Aditi in a right-side-lying position to aid in ventilation and potential aspiration prevention.

In ensuring optimal positioning for Aditi, the nurse notes an assisting intern trying to position Aditi. Which observed action warrants immediate intervention by the nurse?

Based on the client's findings, complete the following sentence by choosing from the list of options provided. 

Upon physical examination, Samuel also showed the presence of which were characterized as , and a facial expression described as having a appearance.

Among the possible complications of this typical clinical presentation of   is which leads to and