Question: During a client assessment, the nurse has the client close the eyes. The nurse then places a finger on the client’s right thigh. The nurse asks the client where the client is being touched. The client answers “my right thigh.” Which neurological assessment is the nurse making?
Answer Choices:
A Tactile
B Gustatory
C Olfactory
D Auditory
Answer: A – Tactile.
Question: After assessing a client, a nurse documents the state of awareness as confused. What part of the brain controls awareness?
Answer Choices:
A Reticular activating system
B Medulla
C Cranial nerves
D Hypothalamus
Answer: A – Reticular activating system.
Question: A nurse is caring for a client who is unconscious. Which guideline is recommended for communication with this client?
Answer Choices:
A. Do not assume the person can hear you.
B. Keep environmental noise level high to stimulate the client.
C. Be careful what is said in front of the client as they might hear you.
D. Touch the person before speaking to them.
Answer: C. Be careful what is said in front of the client as they might hear you.
Question: During a client assessment, the nurse has the client close the eyes. The nurse then places a finger on the client’s right thigh. The nurse asks the client where the client is being touched. The client answers “my right thigh.” Which neurological assessment is the nurse making?
Answer Choices:
A. Auditory
B. Olfactory
C. Gustatory
D. Tactile
Answer: D. Tactile
Question: A client is diagnosed with narcolepsy. What is a characteristic of this disorder?
Answer Choices:
A uncontrollable desire to sleep
B waking during sleep
C restless leg syndrome
D decrease in the amount or quality of sleep
Answer: A – uncontrollable desire to sleep.
Question: Which natural chemical does the body produce at night to decrease wakefulness and promote sleep?
Answer Choices:
A endorphins
B melatonin
C dopamine
D serotonin
Answer: B – melatonin.
Question: When clients are pulled up in bed rather than lifted, they are at increased risk for the development of pressure injuries. What is the name given to the factor responsible for this risk?
Answer Choices:
A ischemia
B necrosis of tissue
C friction
D shearing force
Answer: D – shearing force.
Question: A nurse is caring for a client who is sleeping for abnormally long periods of time. This condition may be caused by injury to which body structure?
Answer Choices:
A Hypothalamus
B Pancreas
C Spinal cord
D Thyroid
Answer: A – Hypothalamus.
Question: The nurse is working in a clinic and sees a resident of a long-term-care facility, age 82 years, who has come in to be checked by the health care provider. The caregiver accompanying the client reports that the client has been displaying the following: drowsiness, excessive sleeping, decreased attention span, irritability, and signs of depression. The client’s adult child and family, who usually visit, moved away from the area 6 weeks ago due to a job relocation. The nurse suspects which concern?
Answer Choices:
A. Sensory deprivation
B. Disturbed sensory perception
C. Residential psychosis
D. Locked-in syndrome
Answer: A. Sensory deprivation
Question: After assessing a client, a nurse documents the state of awareness as confused. What part of the brain controls awareness?
Answer Choices:
A. Cranial nerves
B. Reticular activating system
C. Hypothalamus
D. Medulla
Answer: B. Reticular activating system
Question: In which health care setting is a client more likely to be at risk for sensory deprivation?
Answer Choices:
A. Hospital newborn nursery
B. Community health center
C. Emergency department
D. Long-term care
Answer: D. Long-term care
Question: A nurse documents the following on a client chart: “Client exhibits difficulties with spatial orientation, memory, language, and changes in personality.” What state of arousal/awareness does this describe?
Answer Choices:
A. Delirium
B. Dementia
C. Confusion
D. Locked-in syndrome
Answer: B. Dementia
Question: After a blow to the head, the nurse assesses the client who is aware of self, sleepy and slow to respond. Which action will the nurse take first?
Answer Choices:
A. Contact the health care provider immediately.
B. Continue to observe the client.
C. Document vital signs.
D. No action is needed at this time.
Answer: A. Contact the health care provider immediately
Question: Which client likely is at risk for having difficulty remaining asleep?
Answer Choices:
A a client whose physical therapy has been scheduled for 4:30 p.m.
B a client whose opioid analgesics result in central nervous system depression
C a client who receives IV antibiotics every 3 hours
D a client who requires blood glucose checks four times daily
Answer: C – a client who receives IV antibiotics every 3 hours.
Question: A home care client has both visual and hearing deficits. Although all of the following are important, what would be a high priority concern when planning and implementing care?
Answer Choices:
A. Nutrition
B. Comfort
C. Safety
D. Communication
Answer: C. Safety
Question: Which individual is likely to require more hours of sleep?
Answer Choices:
A a person 15 years of age
B a person 25 years of age
C a person 75 years of age
D a person 43 years of age
Answer: A – a person 15 years of age.
Question: The parents of a 10-year-old child are worried about the child’s sleepwalking (somnambulism). What topic should the nurse discuss with the parents?
Answer Choices:
A privacy
B sleep deprivation
C schoolwork
D safety
Answer: D – safety.
Question: What name is given to the rhythmic biologic clock that exists in humans?
Answer Choices:
A sleep-wake cycle
B yo-yo theory
C circadian rhythm
D alert-unaware process
Answer: C – circadian rhythm.
Question: A client tells the nurse that they have difficulty hearing related to working in a loud factory setting for 15 years. What is the term for this condition?
Answer Choices:
A. Sensory deficit
B. Sensory deprivation
C. Sensory overload
D. Sensory stimulation
Answer: A. Sensory deficit
Question: In which health care setting is a client more likely to be at risk for sensory deprivation?
Answer Choices:
A Long-term care
B Hospital newborn nursery
C Emergency department
D Community health center
Answer: B – Hospital newborn nursery.
Question: A home care client has both visual and hearing deficits. Although all of the following are important, what would be a high priority concern when planning and implementing care?
Answer Choices:
A Safety
B Comfort
C Nutrition
D Communication
Answer: A – Safety.