Understanding Medical Surgical Nursing 3rd Edition Williams Hopper Test Bank
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Chapter 47: Neurological Function, Assessment, and Therapeutic Measures
- What part of the brain initiates voluntary movement?
- A) Parietal lobe
- B) Hypothalamus
- C) Cerebellum
- D) Frontal lobe
- What part of a neuron carries impulses toward the cell body?
- A) Dendrite
- B) Schwann cell
- C) Axon
- D) Myelin sheath
- What part of the brain regulates heart rate and blood pressure?
- A) Medulla
- B) Hypothalamus
- C) Cerebrum
- D) Cerebellum
- Motor neurons compose which spinal nerve root?
- A) Lateral
- B) Dorsal
- C) Ventral
- D) Medial
- Which of the following carries nerve impulses at synapses?
- A) Schwann cells
- B) Depolarizations
- C) Cell membrane
- D) Neurotransmitters
- What types of neurons transmit impulses from receptors in the internal organs to the central nervous system?
- A) Somatic sensory neurons
- B) Visceral sensory neurons
- C) Interneurons
- D) Efferent neurons
- What structure electrically insulates neurons?
- A) Gray matter
- B) Myelin sheath
- C) Interneurons
- D) Astrocytes
- What part of the brain regulates coordination and muscle tone?
- A) Cerebellum
- B) Medulla
- C) Frontal lobes
- D) Hypothalamus
- Which of the following structures and functions describes the ascending tracts of the spinal cord?
- A) They are made of white matter and carry motor impulses.
- B) They are made of gray matter and carry motor impulses.
- C) They are made of white matter and carry sensory impulses.
- D) They are made of gray matter and carry sensory impulses.
- What is the term used to describe unequal pupils?
- A) Anisocoria
- B) Aphasia
- C) Nystagmus
- D) Dystopia
- Which finding is a normal neurological change in an aging patient?
- A) Confusion
- B) Depression
- C) Slowed reflexes
- D) Reduced reasoning capacity
- Which assessment scale can help the nurse determine a patient’s level of consciousness?
- A) Visual analogue
- B) Romberg
- C) Glasgow
- D) Babinski
- What function is the nurse checking when assessing a patient’s pupils for reactivity to light?
- A) Cranial nerve III function
- B) Cranial nerve IV function
- C) Cerebellar function
- D) Sensory function
- A neurologist has a patient stick out the tongue to test which cranial nerve?
- A) IV (trochlear)
- B) I (olfactory)
- C) XII (hypoglossal)
- D) VII (facial)
- A man narrowly misses another car while driving through a busy intersection. His sympathetic nervous system is activated; his heart pounds, and his breathing is rapid. As he calms down, his heart rate and breathing return to normal. Which neurotransmitter is in charge now that the excitement is over and he is calmed down?
- A) Norepinephrine
- B) Acetylcholine
- C) Prostaglandin
- D) Serotonin
- A patient is diagnosed with a cerebral tumor. The nurse can anticipate the patient’s needs understanding that the cerebrum controls which of the following functions?
- A) Heart rate and respiratory rate
- B) Coordination and posture
- C) Reflex movement
- D) Movement and speech
- A 22-year-old female patient is 2 days post-craniotomy for a brain tumor. She has been doing well until 2 a.m. She has a Glasgow Coma Scale of 15, and pupils are equal and reactive. She begins crying and asks for her mother. Her mother is sleeping in the visitors’ lounge. What nursing action would be most appropriate at this time?
- A) Administer an as-needed sedative to calm the patient.
- B) Notify the neurosurgeon that the patient is upset and crying.
- C) Ask the mother to come and stay with the patient.
- D) Reassure the patient, and sit with her until she falls back asleep.
- A patient has impaired functioning of the left glossopharyngeal (IX) nerve and the vagus (X) nerve. What safety intervention should the nurse plan based on these findings?
- A) Withhold oral fluid or foods.
- B) Insert an oral airway.
- C) Apply eye patches to keep the eyes closed.
- D) Obtain a picture board and a Magic Slate.
- A patient is scheduled for a computed tomography scan of the brain because of new onset of headaches. What statement the nurse is most accurate when preparing the patient for the scan?
- A) “You must shampoo your hair thoroughly tonight to remove oil and dirt.”
- B) “You may take fluids until about 8 a.m. Then we will give you a cleansing enema.”
- C) “We will partially shave your head tonight so that electrodes can be attached securely to your scalp.”
- D) “There is no special preparation necessary. You will need to hold your head completely still during the examination.”
- When preparing a patient for an electroencephalogram, what information should be given to the patient?
- A) The hair at the temporal area will have to be shaved.
- B) Little needles will be stuck into the scalp.
- C) The hair must be clean and dry before the test.
- D) The patient must withhold fluids and food for 12 hours before the test.
- A patient is referred to a neurologist because of facial muscle weakness. When the neurologist asks the patient to identify different odors, which nerve is being tested?
- A) I (olfactory)
- B) II (optic)
- C) VIII (acoustic)
- D) X (vagus)
- Which of the following actions should the nurse take when preparing a patient with headaches for a lumbar puncture?
- A) Administer enemas until clear.
- B) Remove all metal jewelry.
- C) Place the patient in a side lying position.
- D) Remove the patient’s dentures.
- After a lumbar puncture, which of the following orders does the nurse anticipate?
- A) Have the patient lie flat for 6 hours.
- B) Keep the patient NPO for 4 hours.
- C) Monitor the patient’s pedal pulses every 4 hours.
- D) Keep the head of the bed elevated 30 degrees for 8 hours.
- A patient is scheduled for a magnetic resonance imaging scan (MRI). What explanation should be provided to the patient and family?
- A) “An MRI measures muscle contraction after stimulation tiny needle electrodes.”
- B) “An MRI uses electrodes placed on the scalp to measure activity of the brain.”
- C) “A scan of the brain will be done after injection of a radioisotope.”
- D) “An MRI is a noninvasive test that uses magnetic energy to visualize internal parts.”
- A patient who is severely brain damaged has decerebrate posturing with extended extremities. This occurs with damage to which area of the brain?
- A) Cerebellum
- B) Cerebrum
- C) Brainstem
- D) Hypothalamus
- A patient who has had a stroke (brain attack) is unable to understand what the nurse is saying and appears frustrated. How should the nurse describe this when documenting the finding?
- A) Dysphagia
- B) Expressive aphasia
- C) Receptive aphasia
- D) Confusion
- A neurosurgeon does a neurological examination and tells the nurse that the patient has a positive Babinski reflex. When checking for this abnormal finding later, what assessment finding would the nurse expect to see?
- A) The leg flexes when the patellar tendon is struck.
- B) The leg extends when the patellar tendon is struck.
- C) Toes curl downward when the sole of the foot is stroked.
- D) The big toe extends when the sole of the foot is stroked.
- A patient recovering from a craniotomy is admitted to the medical unit. The LVN assists the patient to turn and notes a pink spot with a yellow ring around it on the pillow. What should the nurse do?
- A) Change the patient’s cranial dressing.
- B) Notify the RN immediately.
- C) Change the patient’s pillowcase.
- D) Do a basic neurological assessment.
- What is a sympathetic response?
- A) Decreased peristalsis
- B) Constriction of the bronchioles
- C) Decreased heart rate
- D) Relaxed urethral sphincter
- When the nurse shines a light in a patient’s left pupil, both of the pupils constrict. What type of response is this?
- A) Direct
- B) Abnormal
- C) Accommodation
- D) Consensual
- A patient with dysphagia should avoid which of the following foods?
- A) Dry breads
- B) Meats
- C) Thin fluids
- D) Ice cream
- A patient who opens the eyes to painful stimuli, makes incomprehensible sounds, and withdraws from pain has a Glasgow Coma Scale score of __________.
- A Glasgow Coma Scale score of <______ indicates a comatose state.
- A patient who experiences swaying or leaning to one side when standing with feet together and eyes closed for _____ seconds is said to have a positive Romberg test result.
- There are ___ pairs of spinal nerves.
- Which of the following occur during a sympathetic nervous system response? Select all that apply.
- A) Dilation of bronchioles
- B) Decrease in peristalsis
- C) Increase in salivary gland secretion
- D) Decrease in heart rate to normal
- E) Relaxation of bladder to prevent urination
- Which of the following should be included in the preprocedure preparation of a patient scheduled to undergo a computed tomography scan with contrast? Select all that apply.
- A) Question the patient about allergies to dye, shellfish, or iodine.
- B) Determine if the patient has aneurysm clips or metal pins in the body.
- C) Check blood urea nitrogen and creatinine levels.
- D) Explain to the patient that a sensation of warmth may be felt when dye is injected.
- E) Tell the patient to report any nausea, itchiness, or difficulty breathing during the scan.
- Which of the following are functions of the hypothalamus? Select all that apply.
- A) Regulation of body temperature
- B) Production of growth hormone
- C) Regulation of food and liquid intake
- D) Production of epinephrine
- E) Production of antidiuretic hormone and oxytocin
- Which of the following are nursing interventions for a patient before and after a lumbar puncture? Select all that apply.
- A) Ensure that the patient has given informed consent to the procedure.
- B) Position the patient prone on the bed.
- C) Keep the patient on bed rest with the head of the bed flat for 6 hours after the procedure.
- D) Limit fluid intake.
- E) Assess movement and sensation of lower extremities frequently for several hours after the procedure.
- F) Check the puncture site for swelling or drainage.
- Rank the following in order to indicate worsening of motor response.
____ Abnormal extension
____ Withdrawal from pain
____ Abnormal flexion
____ No response
- A, B, E
- A, C, D, E
- A, C, E
- A, C, E, F