Passpoint Neuro | A client comes to the emergency department complaining of headache, malaise, chills, fever, and a stiff neck. Vital sign assessment reveals a temperature elevation, increased heart and respiratory rates, and normal blood pressure.

Passpoint-Neuro A client comes to the emergency department complaining of headache, malaise, chills, fever, and a stiff

neck. Vital sign assessment reveals a temperature elevation, increased heart and respiratory rates, and

normal blood pressure. On physical examination, the nurse notes confusion, a petechial rash, nuchal

rigidity, Brudzinski's sign, and Kernig's sign. What do these manifestations indicate?

You Selected:

 Increased intracranial pressure (ICP)

Correct response:

 Meningeal irritation

Explanation:

Remediation:

Question 2 See full question

What should a nurse do when administering pilocarpine?

You Selected:

 Apply pressure on the outer canthus to prevent adverse reactions.

Correct response:

 Apply pressure on the inner canthus to prevent systemic absorption.

Explanation:

Remediation:

Question 3 See full question

A registered nurse (RN) and licensed practical nurse (LPN) are administering medications on the

neurologic floor. The LPN prepares to administer phenytoin to a client with a history of seizures. As the

LPN walks into the room, she hands the medication to a nursing assistant. The LPN asks the nursing

assistant to give the client the medication after completing the client's morning care. What should the

registered nurse do?

You Selected:

 Take the medication from the nursing assistant and administer it.

Correct response:

 Remind the LPN that she must administer the medications herself.

Explanation:

Remediation:

Question 4 See full question

A nurse is caring for an older adult client with advanced Parkinson's disease. Which client statement

about advance directives indicates a need for further instruction?

You Selected:

 "I know that I'll eventually be unable to make decisions. Signing an advance directive now will

save my family grief."

Correct response:

 "I don't really need to sign anything. I'm depending on my physician to tell my family what to do

if something bad happens."

Explanation:

Remediation:

Question 5 See full question

A nurse caring for a client who had a stroke is using the unit's new computerized documentation system.

The nurse uses the information technology appropriately when she:

You Selected:

 documents medications before administration.

Correct response:

 documents medications after administration.

Explanation:

Remediation:

Question 6 See full question

A 70-year-old, previously well client asks the nurse, "I notice I have tremors. Is this just normal for my

age?" What should the nurse tell the client?

You Selected:

 "You should have your blood pressure checked when this occurs."

Correct response:

 “You should report this to the health care provider because it may indicate a problem.”

Explanation:

Remediation:

Question 7 See full question

Following an infection, the client is having ototoxic effects of the vestibular branch of the acoustic nerve.

The nurse should assess the client for: (Select all that apply.)

You Selected:

 tinnitus

 vertigo

 ataxia

Correct response:

 vertigo

 nausea

 ataxia

Explanation:

Question 8 See full question

A client returns to the recovery room following left supratentorial surgery for treatment of a brain tumor.

The nurse should place the client in which position to facilitate venous drainage?

You Selected:

 lying flat without a pillow with the client's head turned to the right

Correct response:

 head of the bed elevated to 30 degrees with the client's head in a neutral position

Explanation:

Question 9 See full question

The nurse is caring for a client with an injury to the thalamus. The nurse should plan to:

You Selected:

 monitor the temperature of the bathwater.

Correct response:

 monitor the temperature of the bathwater.

Explanation:

Question 10 See full question

Which statement would provide the best guide for activity during the rehabilitation period for a client

who has been treated for retinal detachment?

You Selected:

 Activity level can return to normal; clients can resume regular aerobic exercises.

Correct response:

 Activity is resumed gradually; the client can resume usual activities in 5 to 6 weeks.

Explanation:

Remediation:

Question 11 See full question

A client with glaucoma is to receive 3 gtt of acetazolamide in the left eye. What should the nurse do?

You Selected:

 Ask the client to close his right eye while administering the drug in the left eye.

Correct response:

 Have the client look up while the nurse administers the eyedrops.

Explanation:

Remediation:

Question 12 See full question

As a first step in teaching a woman with a spinal cord injury and quadriplegia about her sexual health,

the nurse assesses her understanding of her current sexual functioning. Which statement by the client

indicates she understands her current ability?

You Selected:

 "I cannot have sexual intercourse because it causes hypertension, but other sexual activity is

okay."

Correct response:

 "I can participate in sexual activity but might not experience orgasm."

Explanation:

Remediation:

Question 13 See full question

A client with a spinal cord injury who has been active in sports and outdoor activities talks almost

obsessively about his past activities. In tears, one day he asks the nurse, “Why am I unable to stop talking

about these things? I know those days are gone forever.” Which response by the nurse conveys

the best understanding of the client’s behavior?

You Selected:

 "It is a simple escape mechanism to go back and live again in happier times."

Correct response:

 "Reviewing your losses is a way to help you work through your grief and loss."

Explanation:

Remediation:

Question 14 See full question

A client is at risk for increased intracranial pressure (ICP). Which finding is the priority for the nurse to

monitor?

You Selected:

 decreasing systolic blood pressure

Correct response:

 unequal pupil size

Explanation:

Question 15 See full question

The nurse is preparing a client with multiple sclerosis (MS) for discharge from the hospital to home. The

nurse should tell the client:

You Selected:

 "Keep active, use stress reduction strategies, and avoid fatigue."

Correct response:

 "Keep active, use stress reduction strategies, and avoid fatigue."

Explanation:

Remediation:

Question 16 See full question

An unlicensed assistive personnel (UAP) is providing care to a client with left-sided paralysis. Which

action by the UAP requires the nurse to provide further instruction?

You Selected:

 elevating the foot of the bed to reduce edema

Correct response:

 pulling up the client under the left shoulder when getting the client out of bed to a chair

Explanation:

Question 17 See full question