Nokea
A nurse is caring for a patient diagnosed with Mnires disease. While completing a neurologic examination on the patient, the nurse assesses cranial nerve VIII. The nurse would be correct in identifying the function of this nerve as what?
- A. Movement of the tongue
- B. Visual acuity
- C. Sense of smell
- D. Hearing and equilibrium
Correct Answer: D
Rationale: Cranial nerve VIII (acoustic) governs hearing and balance, relevant in Mnires disease. Tongue movement is cranial nerve XII, visual acuity is II, and smell is I.
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A trauma patient in the ICU has been declared brain dead. What diagnostic test is used in making the determination of brain death?
- A. Magnetic resonance imaging (MRI)
- B. Electroencephalography (EEG)
- C. Electromyelography (EMG)
- D. Computed tomography (CT)
Correct Answer: B
Rationale: EEG confirms brain death by showing no electrical activity. MRI, CT, and EMG are not standard for this determination.
A patient with lower back pain is scheduled for myelography using metrizamide (a water-soluble contrast dye). After the test, the nurse should prioritize what action?
- A. Positioning the patient with the head of the bed elevated 45 degrees
- B. Administering IV morphine sulfate to prevent headache
- C. Limiting fluids for the next 12 hours
- D. Helping the patient perform deep breathing and coughing exercises
Correct Answer: A
Rationale: Elevating the head 30-45 degrees post-myelography prevents contrast dye irritation in the brain, reducing headache risk. Fluids are encouraged, morphine is not standard, and breathing exercises are unnecessary.
The nurse educator is reviewing the assessment of cranial nerves. What should the educator identify as the specific instances when cranial nerves should be assessed? Select all that apply.
- A. When a neurogenic bladder develops
- B. When level of consciousness is decreased
- C. With brain stem pathology
- D. In the presence of peripheral nervous system disease
- E. When a spinal reflex is interrupted
Correct Answer: B,C,D
Rationale: Cranial nerve assessment is indicated for altered consciousness, brain stem issues, or peripheral nervous system disease. Neurogenic bladder and spinal reflexes involve spinal, not cranial, nerves.
The physician has ordered a somatosensory evoked responses (SERs) test for a patient for whom the nurse is caring. The nurse is justified in suspecting that this patient may have a history of what type of neurologic disorder?
- A. Hypothalamic disorder
- B. Demyelinating disease
- C. Brainstem deficit
- D. Diabetic neuropathy
Correct Answer: B
Rationale: SERs detect slowed nerve conduction, common in demyelinating diseases like multiple sclerosis. They are not used for hypothalamic, brainstem, or diabetic neuropathy diagnoses.
A patient is scheduled for a myelogram and the nurse explains to the patient that this is an invasive procedure, which assesses for any lesions in the spinal cord. The nurse should explain that the preparation is similar to which of the following neurologic tests?
- A. Lumbar puncture
- B. MRI
- C. Cerebral angiography
- D. EEG
Correct Answer: A
Rationale: Myelography involves contrast injection via lumbar puncture, so preparation is similar. MRI, angiography, and EEG have different preparation requirements.