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Critical Care Nursing 7th Edition Urden Stacy Lough Test Bank

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Critical Care Nursing 7th Edition Urden Stacy Lough Test Bank

ISBN-13: 978-0323091787

ISBN-10: 0323091784

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Critical Care Nursing 7th Edition Urden Stacy Lough Test Bank

ISBN-13: 978-0323091787

ISBN-10: 0323091784

 

 

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Free Nursing Test Questions:

Chapter 22: Neurologic Anatomy and Physiology

 

MULTIPLE CHOICE

 

  1. Which of the following structures form(s) the blood–brain barrier?
a. Postsynaptic terminals c. Vascular endothelial cells
b. Pia mater d. Myelin sheath

 

 

ANS:  C

The blood–brain barrier operates on the concept of tight junctions between adjacent cells and actually consists of three separate barriers: the endothelial cells of cerebral blood vessels, the epithelial cells of the choroid plexus, and the cells that form the outermost layer of the arachnoid.

 

PTS:   1                    DIF:    Cognitive Level: Remembering        REF:   p. 594

OBJ:   Nursing Process Step: N/A              TOP:   Neurologic

MSC:  NCLEX: Physiologic Integrity

 

  1. CNS response to the periphery to produce contraction of the skeletal muscles is the result of
a. efferent fibers. c. myelin sheath.
b. afferent fibers. d. neurotransmitters.

 

 

ANS:  A

Efferent fibers (motor fibers) transmit the central nervous system (CNS) response to the periphery to produce a motor response such as contraction of skeletal muscles, contraction of the smooth muscles of organs, or secretion by endocrine glands. This sensory information is transmitted to the CNS by afferent fibers (sensory fibers). Fibers enclosed in the sheath are called myelinated fibers. Neurotransmitters help with nerve transmission from one neuron to the next.

 

PTS:   1                    DIF:    Cognitive Level: Remembering        REF:   p. 587

OBJ:   Nursing Process Step: N/A              TOP:   Neurologic

MSC:  NCLEX: Physiologic Integrity

 

  1. Neuronal function is driven by
a. nodes of Ranvier. c. repolarization–depolarization cycles.
b. saltatory conduction. d. depolarization–repolarization cycles.

 

 

ANS:  D

Neuronal function is driven by depolarization–repolarization cycles, similar to that described for cardiac physiology. Myelinated fibers use a process called saltatory conduction to support rapid axonal transmission of nerve impulses. Structurally, axons participating in this form of impulse transmission are laid out with a noncontinuous myelin cover, interrupted with 2-micrometer bare segments called the nodes of Ranvier.

 

PTS:   1                    DIF:    Cognitive Level: Applying               REF:   p. 589

OBJ:   Nursing Process Step: N/A              TOP:   Neurologic

MSC:  NCLEX: Physiologic Integrity

 

  1. Which type of hematoma results from traumatic injury involving the middle meningeal artery?
a. Subdural c. Subarachnoid
b. Epidural d. Intercerebral

 

 

ANS:  B

The main blood supply for the dura mater is the middle meningeal artery. This artery lies on the surface of the dura in the epidural space within grooves formed on the inside of the parietal bone. Traumatic disruption of the parietal bone may result in tearing of the middle meningeal artery and development of an epidural hematoma.

 

PTS:   1                    DIF:    Cognitive Level: Remembering        REF:   p. 591

OBJ:   Nursing Process Step: N/A              TOP:   Neurologic

MSC:  NCLEX: Physiologic Integrity

 

  1. Which area of the ventricular system is usually cannulated for intracranial pressure monitoring?
a. Frontal horn of the lateral ventricle c. Foramen of Monro
b. Aqueduct of Sylvius d. Fourth ventricle

 

 

ANS:  A

When cannulation of the ventricular system is required for intracranial pressure monitoring, cerebrospinal fluid (CSF) drainage, or placement of a CSF shunt, the frontal horn of the lateral ventricle on the nondominant side of the brain is most often selected.

 

PTS:   1                    DIF:    Cognitive Level: Remembering        REF:   p. 593

OBJ:   Nursing Process Step: N/A              TOP:   Neurologic

MSC:  NCLEX: Physiologic Integrity

 

  1. What percentage of the body’s total resting cardiac output is used by the brain?
a. 5% c. 20%
b. 10% d. 40%

 

 

ANS:  C

The brain constitutes 2% of the body’s weight but uses 20% of the body’s total resting cardiac output. It requires approximately 750 mL of blood flow per minute and can extract as much as 45% of arterial oxygen to meet normal metabolic needs.

 

PTS:   1                    DIF:    Cognitive Level: Remembering        REF:   p. 600

OBJ:   Nursing Process Step: N/A              TOP:   Neurologic

MSC:  NCLEX: Physiologic Integrity

 

  1. Which areas of the spinal cord have tenuous blood supply and are especially vulnerable to circulatory embarrassment?
a. C2 to C3 c. T8 to T10
b. C5 to C6 d. L4 to L5

 

 

ANS:  A

Arterial supply to the spinal cord is segmented at best, making portions of the spinal cord that receive blood supply from two separate sources vulnerable to low flow states. The most vulnerable of these areas are C2 to C3, T1 to T4, and L1 to L2.

 

PTS:   1                    DIF:    Cognitive Level: Remembering        REF:   p. 615

OBJ:   Nursing Process Step: N/A              TOP:   Neurologic

MSC:  NCLEX: Physiologic Integrity

 

  1. Damage to the upper portion of the reticular activating system results in which condition?
a. Seizures c. Apnea
b. Diabetes insipidus d. Impaired consciousness

 

 

ANS:  D

The reticular activating system (RAS) works through activation of the hypothalamus, which results in diffuse cortical stimulation and autonomic stimulation. Damage to the thalamic or hypothalamic RAS pathways results in impaired consciousness.

 

PTS:   1                    DIF:    Cognitive Level: Remembering        REF:   p. 600

OBJ:   Nursing Process Step: N/A              TOP:   Neurologic

MSC:  NCLEX: Physiologic Integrity

 

  1. A person with a cerebellar lesion will have difficulty with
a. breathing. c. memory.
b. equilibrium. d. speech.

 

 

ANS:  B

Cerebellar impulses are communicated to descending motor pathways to integrate spatial orientation and equilibrium with posture and muscle tone, ensuring synchronized adjustments in movement that maintain overall balance and motor coordination. Cerebellar monitoring and adjustment of motor activity occurs simultaneously with movement, enabling significant control of fine motor function.

 

PTS:   1                    DIF:    Cognitive Level: Applying               REF:   p. 600

OBJ:   Nursing Process Step: N/A              TOP:   Neurologic

MSC:  NCLEX: Physiologic Integrity

 

  1. The large opening at the base of the cranium is known as the
a. cisterna magna. c. foramen magnum.
b. median foramen. d. lateral foramen.

 

 

ANS:  C

The cranium is a solid, nonexpanding bony vault with only one large opening at the base called the foramen magnum, through which the brainstem projects and connects to the spinal cord.

 

PTS:   1                    DIF:    Cognitive Level: Remembering

REF:   p. 591, Figure 22-5 | p. 591, Figure 22-8                            OBJ:   Nursing Process Step: N/A

TOP:   Neurologic     MSC:  NCLEX: Physiologic Integrity

 

  1. Which statement best describes the role of neuroglial cells?
a. They are fewer in number than neurons.
b. They provide support to the neuron in nutrients and structural formation.
c. They protect the CNS from nonmetabolic primary neoplasms.
d. They produce a steady supply of neurotransmitters.

 

 

ANS:  B

These cells provide the neuron with structural support, nourishment, and protection (Table 26-1). They also retain their ability to replicate but can replicate abnormally and hence are the primary source of central nervous system neoplasms.

 

PTS:   1                    DIF:    Cognitive Level: Remembering        REF:   p. 588

OBJ:   Nursing Process Step: N/A              TOP:   Neurologic

MSC:  NCLEX: Physiologic Integrity

 

  1. Tissue that adheres directly to the brain tissue and is rich in small blood vessels that supply a large amount of arterial blood to the CNS is known as the
a. dura mater. c. pia mater.
b. arachnoid mater. d. CNS.

 

 

ANS:  C

The outermost layer of meninges directly beneath the skull is the dura mater. The arachnoid membrane is a delicate, fragile membrane that loosely surrounds the brain. Cerebrospinal fluid (CSF) circulates freely in the subarachnoid space fragile membrane that loosely surrounds the brain. The pia mater adheres directly to brain tissue. Rich in small blood vessels that supply a large volume of arterial blood to the central nervous system, this membrane closely follows all folds and convolutions of the brain’s surface.

 

PTS:   1                    DIF:    Cognitive Level: Remembering        REF:   p. 593

OBJ:   Nursing Process Step: N/A              TOP:   Neurologic

MSC:  NCLEX: Physiologic Integrity

 

  1. Obstructive hydrocephalus can occur in the presence of
a. blockage in the arachnoid villi.
b. malformation of the falx cerebelli.
c. blockage of CSF flow in the ventricular system.
d. increased production of CSF with poor outlet.

 

 

ANS:  C

Blockage of CSF flow occurring within the ventricular system obstructs the normal circulation of CSF, causing dilation of the ventricles, a condition called obstructive hydrocephalus.

 

PTS:   1                    DIF:    Cognitive Level: Remembering        REF:   p. 593

OBJ:   Nursing Process Step: N/A              TOP:   Neurologic

MSC:  NCLEX: Physiologic Integrity

 

  1. Substances most likely to pass across the blood–brain barrier have which of the following characteristics?
a. Low pH compared with body fluids c. Large particle size
b. Lipid solubility d. A close relation to toxic metabolites

 

 

ANS:  B

Passage of substances across the blood–brain barrier is a function of particle size, lipid solubility, and protein-binding potential. Most drugs or compounds that are lipid soluble and stable at body pH rapidly cross the blood–brain barrier. The blood–brain barrier is also very permeable to water, oxygen, carbon dioxide, and glucose.

 

PTS:   1                    DIF:    Cognitive Level: Understanding       REF:   p. 594

OBJ:   Nursing Process Step: N/A              TOP:   Neurologic

MSC:  NCLEX: Physiologic Integrity

 

  1. Control of the rate of respirations occurs in the
a. apneustic center. c. reticular activating system.
b. pneumotaxic center. d. midbrain.

 

 

ANS:  B

Two respiratory control centers are located in the pons, namely the apneustic and pneumotaxic centers. Whereas the apneustic center controls the length of inspiration and expiration, the pneumotaxic center controls respiratory rate.

 

PTS:   1                    DIF:    Cognitive Level: Understanding       REF:   p. 600

OBJ:   Nursing Process Step: N/A              TOP:   Neurologic

MSC:  NCLEX: Physiologic Integrity

 

  1. The sensory, motor, and cognitive functions are the primary functions of the
a. diencephalon. c. cerebellum.
b. basal ganglia. d. cerebrum.

 

 

ANS:  D

The outermost aspect of the cerebrum is called the cerebral cortex. The primary functions of the cerebral cortex include sensory, motor, and intellectual (cognitive) functions, making this area of the brain vital to normal human functioning and providing capabilities that make humans unique as a species.

 

PTS:   1                    DIF:    Cognitive Level: Remembering        REF:   p. 595

OBJ:   Nursing Process Step: N/A              TOP:   Neurologic

MSC:  NCLEX: Physiologic Integrity

 

  1. The region of the brain that acts as a relay station for both motor and sensory activity is the
a. cerebrum. c. thalamus.
b. cerebellum. d. hypothalamus.

 

 

ANS:  C

The thalamus consists of two connected ovoid masses of gray matter and forms the lateral walls of the third ventricle. The two thalami serve as a relay station and gatekeeper for motor and sensory stimuli, preventing or enhancing transmission of impulses based on the behavioral needs of the person.

 

PTS:   1                    DIF:    Cognitive Level: Remembering        REF:   pp. 598–599, Figure 22-12

OBJ:   Nursing Process Step: N/A              TOP:   Neurologic

MSC:  NCLEX: Physiologic Integrity

 

  1. When a patient with neurologic damage continues with extremely high core body temperature despite interventions to lower temperature, the area of the brain most likely affected is the
a. cerebrum. c. thalamus.
b. cerebellum. d. hypothalamus.

 

 

ANS:  D

Areas of the internal environment regulated and maintained by the hypothalamus include temperature regulation, autonomic nervous system responses, food and water intake, hormonal secretions, and behavioral responses.

 

PTS:   1                    DIF:    Cognitive Level: Understanding       REF:   p. 598

OBJ:   Nursing Process Step: N/A              TOP:   Neurologic

MSC:  NCLEX: Physiologic Integrity

 

  1. A lack or inadequate amount of which two substances can cause disruption in neuronal function and irreversible damage?
a. Oxygen and glucose c. Oxygen and protein
b. Protein and insulin d. Protein and glucose

 

 

ANS:  A

No reserve of either oxygen or glucose is found in the cerebral tissues. A lack or inadequate amount of either one rapidly disrupts cerebral function and produces irreversible damage.

 

PTS:   1                    DIF:    Cognitive Level: Understanding       REF:   p. 588

OBJ:   Nursing Process Step: N/A              TOP:   Neurologic

MSC:  NCLEX: Physiologic Integrity

 

  1. Based on the circle of Willis, if the right internal carotid artery is blocked so that inadequate blood flows to the cerebral arteries, oxygen and nutrients to the brain
a. can be supported by the circle of Willis. c. are diminished by 50%.
b. are diminished by 25%. d. are blocked.

 

 

ANS:  A

When complete, the circle of Willis is capable of supporting some degree of collateral blood flow in the case of arterial occlusion, although a sufficient arterial supply in the face of arterial obstruction is not guaranteed.

 

PTS:   1                    DIF:    Cognitive Level: Understanding       REF:   p. 609

OBJ:   Nursing Process Step: N/A              TOP:   Neurologic

MSC:  NCLEX: Physiologic Integrity

 

  1. The ability to access CSF by a lumbar puncture is attributable to the flow of CSF in the
a. dura mater. c. epidural cavity.
b. pia mater. d. subarachnoid space.

 

 

ANS:  D

Cerebrospinal fluid fills the ventricular system and surrounds the brain and spinal cord in the subarachnoid space.

 

PTS:   1                    DIF:    Cognitive Level: Understanding       REF:   p. 593

OBJ:   Nursing Process Step: N/A              TOP:   Neurologic

MSC:  NCLEX: Physiologic Integrity

 

  1. A patient is admitted to the critical care unit after a stroke. The patient has an altered level of consciousness and garbled speech. A computed tomography scan is performed to determine the cause of the stroke, and a lumbar puncture is performed for analysis of CSF. Because the patient’s speech is garbled, the nurse documents the occurrence of which type of aphasia?
a. Fluent c. Expressive
b. Receptive d. Global

 

 

ANS:  C

The area involved in the formulation of verbal speech is the Broca area. Damage to this area results in an expressive or nonfluent aphasia.

 

PTS:   1                    DIF:    Cognitive Level: Understanding       REF:   p. 595

OBJ:   Nursing Process Step: N/A              TOP:   Neurologic

MSC:  NCLEX: Physiologic Integrity

 

  1. A patient has coherent speech but the words are illogical. Which part of the brain has been affected?
a. The cerebellum c. The Wernicke area
b. The Broca area d. The hypothalamus

 

 

ANS:  C

The Wernicke area (Brodmann area 22) is partially located within the parietal lobe and partially in the temporal lobe, most commonly on the left side of the cerebral cortex. This area is concerned with reception of written and verbal language and includes many intricate connections to other parts of the brain associated with auditory and visual functions, cognitive appraisal, and expressive language. Injury to this area of the brain may result in disability ranging from minor receptive language dysfunction to receptive or fluent aphasia, in which expressive language function remains but is illogical in content or a “word salad.”

 

PTS:   1                    DIF:    Cognitive Level: Understanding       REF:   pp. 596–597, Figure 22-9

OBJ:   Nursing Process Step: N/A              TOP:   Neurologic

MSC:  NCLEX: Physiologic Integrity

 

  1. Which lobe of the brain deals primarily with sensory function?
a. Frontal lobe c. Occipital lobe
b. Temporal lobe d. Parietal lobe

 

 

ANS:  D

The parietal lobe is primarily concerned with sensory functions, including integration of sensory information; awareness of body parts; interpretation of touch, pressure, and pain; and recognition of object size, shape, and texture. Injury to these areas may result in tactile sensory loss on the opposite side of the body.

 

PTS:   1                    DIF:    Cognitive Level: Remembering        REF:   p. 595

OBJ:   Nursing Process Step: N/A              TOP:   Neurologic

MSC:  NCLEX: Physiologic Integrity

 

  1. The primary functions of which lobe are hearing, speech, behavior, and memory?
a. Frontal lobe c. Occipital lobe
b. Temporal lobe d. Parietal lobe

 

 

ANS:  B

The temporal lobe lies beneath the temporal bone in the lateral portion of the cranium. Separated from the frontal and parietal lobes by the lateral fissure, this lobe has the primary functions of hearing, speech, behavior, and memory.

 

PTS:   1                    DIF:    Cognitive Level: Remembering        REF:   p. 597

OBJ:   Nursing Process Step: N/A              TOP:   Neurologic

MSC:  NCLEX: Physiologic Integrity

 

  1. Cranial nerves IX, X, XI, and XII are located in which section of the brainstem?
a. Midbrain c. Medulla oblongata
b. Pons d. Reticular formation

 

 

ANS:  C

The medulla oblongata forms the last section of the brainstem, situated between the pons and the spinal cord. The cell bodies of cranial nerves IX (glossopharyngeal), X (vagus), XI (spinal accessory), and XII (hypoglossal) are located in the medulla oblongata

 

PTS:   1                    DIF:    Cognitive Level: Understanding       REF:   p. 600, Figure 22-14

OBJ:   Nursing Process Step: N/A              TOP:   Neurologic

MSC:  NCLEX: Physiologic Integrity

 

  1. Stimulation of this nerve will elicit the gag reflex.
a. Glossopharyngeal c. Spinal accessory
b. Facial d. Hypoglossal

 

 

ANS:  A

The glossopharyngeal nerve is a sensory nerve whose functions are taste in the posterior third of the tongue and sensation in the back of the throat; stimulation elicits the gag reflex.

 

PTS:   1                    DIF:    Cognitive Level: Understanding       REF:   p. 605, Table 22-3

OBJ:   Nursing Process Step: N/A              TOP:   Neurologic

MSC:  NCLEX: Physiologic Integrity

 

  1. An afferent pathway that carries sensory impulses from the body into the spinal cord is the
a. subarachnoid. c. ventral root.
b. spinal nerves. d. dorsal root.

 

 

ANS:  D

The dorsal root is an afferent pathway that carries sensory impulses from the body into the spinal cord. The ventral root is an efferent pathway that carries motor information from the spinal cord to the body.

 

PTS:   1                    DIF:    Cognitive Level: Understanding       REF:   p. 613

OBJ:   Nursing Process Step: N/A              TOP:   Neurologic

MSC:  NCLEX: Physiologic Integrity

 

MULTIPLE RESPONSE

 

  1. Examples of small-molecule transmitters include (Select all that apply.)
a. acetylcholine.
b. glucose.
c. norepinephrine.
d. dopamine.
e. epinephrine.
f. GABA receptors.

 

 

ANS:  A, C, D, E

Examples of small-molecule transmitters include acetylcholine, dopamine, norepinephrine, epinephrine, serotonin, histamine, γ-aminobutyric acid, glycine, and glutamate.

 

PTS:   1                    DIF:    Cognitive Level: Remembering        REF:   p. 590

OBJ:   Nursing Process Step: N/A              TOP:   Neurologic

MSC:  NCLEX: Physiologic Integrity

 

  1. Which cranial nerves are responsible for motor functions of the eye? (Select all that apply.)
a. Optic nerve
b. Oculomotor
c. Trochlear
d. Trigeminal
e. Abducens
f. Acoustic

 

 

ANS:  B, C, E

The oculomotor nerve is the motor nerve whose function is raising the eyelids and extraocular movement of the eyes. The trochlear nerve is the motor nerve whose function is the extraocular movement of the eyes. The abducens nerve is the motor nerve that functions with extraocular eye movement and rotates the eyeball outward. The optic nerve is the sensory nerve whose function is vision. The trigeminal nerve is the sensory nerve that gives sensation to the cornea, ciliary body, iris, and lacrimal gland. The acoustic nerve is the sensory nerve whose function is hearing.

 

PTS:   1                    DIF:    Cognitive Level: Understanding       REF:   pp. 602–605, Table 22-3

OBJ:   Nursing Process Step: N/A              TOP:   Neurologic

MSC:  NCLEX: Physiologic Integrity

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