(Osborn) Chapter 29 Learning Outcomes (Number and Title)

[Osborn] chapter 29
Learning Outcomes [Number and Title ]

Learning Outcome 1
Describe the basic pathophysiology of increased intracranial
pressure as presented in this chapter.
Learning Outcome 2
List possible signs or symptoms of increased intracranial
pressure.
Learning Outcome 3
Explain the rationale of nursing interventions in caring for
patients with increased intracranial pressure.
Learning Outcome 4
Identify various types and causes of head trauma according to
level of injury.
Learning Outcome 5
Compare and contrast differences between bacterial meningitis
and viral meningitis, including causes, signs and symptoms,
diagnostic evaluation, and treatment.
Learning Outcome 6
Identify and distinguish between the major types of brain
tumors: intra-axial, extra-axial, and metastatic.
Learning Outcome 7
Explain treatment options for brain tumors.
Learning Outcome 8
Explain the role of the nurse in family teaching of patients with
acute brain disorders.
Osborn, et al., Test Item File for Medical-Surgical Nursing:

Preparation for Practice Copyright 2010 by Pearson Education, Inc.
1. A client has experienced a subarachnoid hemorrhage and is at risk for intracranial pressure
(ICP) due to the initiation of the vasodilatory cascade. The primary risk factor for this series of
events is:
1.
2.
3.
4.
Cerebral tissue ischemia.

Cerebral edema.
Vasoconstriction of cerebral vessels.
Decreased cerebral perfusion pressure.
Correct Answer: Cerebral tissue ischemia.

Rationale: The vasodilatory cascade is a series of events triggered by hypoxia, with the result
being increased ICP. Vasoconstriction of cerebral blood vessels is not a cause of ICP.
Depressed cerebral perfusion pressure (CPP) is a decrease in the pressure gradient that drives
cerebral blood flow. Cerebral edema may be a result of the vasodilatory cascade but is not its
cause.
Cognitive Level: Applying
Nursing Process: Assessment
Client Needs: Physiological Integrity
LO: 1

2. The nurse caring for a client who has experienced a brain abscess understands the
importance of maintaining medium arterial blood pressure (MAP) since it:
1.
2.
3.
4.
Identifies risk for tissue ischemia.

Affects diastolic blood pressure.
Determines intracranial pressure.
Affects systolic blood pressure.
Correct Answer: Identifies risk for tissue ischemia.

Rationale: MAP is considered to be the perfusion pressure seen by organs in the body. It is
believed that a MAP that is greater than 60 mmHg is enough to sustain the organs of the
average person. If the MAP falls significantly below this number for an appreciable time, the
end organ will not get enough blood flow, and will become ischemic. MAP does not determine
ICP. MAP does not affect, but rather is affected by, systolic and diastolic blood pressure.
LO: 1

3. A client at risk for increased intracranial pressure (ICP) is likely to experience involuntary
compensatory mechanisms. The nurse recognizes that these alterations may include:
Select all that apply.
1.
2.
3.
4.
5.
Increased absorption of cerebral spinal fluid (CSF).

Decreased production of cerebral spinal fluid (CSF).
Decreased metabolic energy needs.
Vasodilation of the cerebral vessels.
Vasoconstriction of cardiac vessels.
Correct Answer:
1. Increased absorption of cerebral spinal fluid (CSF).
2. Decreased production of cerebral spinal fluid (CSF).
3. Decreased metabolic energy needs.
Rationale: Increased absorption of cerebral spinal fluid (CSF). In order for the brain to
maintain a normal ICP, attempts are made to compensate for changes in any of the three
components within the brain. Initial mechanisms for ICP may include changing the volume of
CSF by decreasing production. Decreased production of cerebral spinal fluid (CSF). In
order for the brain to maintain a normal ICP, attempts are made to compensate for changes in
any of the three components within the brain. Initial mechanisms for ICP may include
changing the volume of CSF by increasing absorption. Decreased metabolic energy needs. A
decrease in metabolic energy needs is likely. Vasodilation of the cerebral vessels.
Vasoconstriction of the cerebral blood vessels will result as space becomes compressed.
Vasoconstriction of cardiac vessels. Vasoconstriction of cardiac vessels is not a normal
compensatory mechanism seen for ICP.
LO: 1

4. Which of the following statements made by a nurse reflects the best understanding of the
symptomology of increasing intracranial pressure (IICP)?
1. If a client shows drowsiness or restlessness, I get concerned.
2. The primary focus is the clients pupils.
3. Acute muscle weakness, regardless of how severe, is a red flag.
4. When the client reports a headache, I know we have a problem.
Correct Answer: If a client shows drowsiness or restlessness, I get concerned.
Rationale: Alterations in the patients level of consciousness (LOC) are usually the first sign of
impending increase in ICP. While changes to pupil size and reactivity and decreased motor
strength are signs of possible IICP, they are usually preceded by a change in the clients LOC.
Headaches are generally not a specific indication of IICP.
Step of the Nursing Process: Assessment
Cognitive Level: Analyzing
Category of Client Need: Physiological Integrity
LO: 2

5. The nurse recognizes that a client being monitored via an external ventricular drain is
experiencing normal intracranial pressure if the reading is:
1. 14 mmHg.
2. 23 mmHg.
3. 73 mmHg.
4. 89 mmHg.
Correct Answer: 14 mm Hg.
Rationale: The desired range of ICP is 0 to 15 mm Hg. ICPs are considered elevated when
sustained at greater than 20 mmHg. Normal cerebral perfusion pressure (CPP) is 70 to 100 mm
Hg.
LO: 2

6. A client with a right temporal lobe lesion is displaying Cheyne-Stokes respirations. The
nurse recognizes:
1.
2.
3.
4.
This client requires surgical decompression of the brain.

There is no medical treatment appropriate for this symptomology.
The next likely sign will be sluggish pupil reaction ipsilaterally.
This type of brain pathophysiology is usually self-limiting.
Correct Answer: This client requires surgical decompression of the brain.

Rationale: This client is experiencing a symptom of uncal herniation. Late signs include altered
respiratory patterns, such as Cheyne-Stokes respirations. Urgent surgical intervention to
decompress the brain is often the treatment of choice. Often, the first sign of impending uncal
herniation is a sluggishly reactive pupil on the ipsilateral (same) side of the lesion. Herniation
syndromes are life-threatening neurological emergencies that, left untreated, can progress
rapidly to death.
LO: 2

7. A client with increased intracranial pressure (ICP) is being repositioned. The nurse performs
this intervention incorporating which of the following?
1.
2.
3.
4.
5.
Manage the repositioning with slow, smooth, and gentle movement.

Inform the client regarding what is going to occur during the intervention.
Elevate the head of the bed to 30 degrees.
Accompany each repositioning with passive range-of-motion exercises.
Reposition the client every 1 to 2 hourss.
Correct Answer:
1. Manage the repositioning with slow, smooth, and gentle movement.
2. Inform the client regarding what is going to occur during the intervention.
3. Elevate the head of the bed to 30 degrees.
Rationale: Manage the repositioning with slow, smooth, and gentle movement. It is
especially important that clients with increased ICP should be repositioned slowly and with
smooth, gentle movements, because rapid changes can cause the pressure to increase. Inform
the client regarding what is going to occur during the intervention. Clients should always
be informed about what is going to occur. Elevate the head of the bed to 30 degrees. The
head of the bed should be elevated. The degree depends on the reaction of the client to the
position; 30 degrees is usually appropriate, but this can vary by the client. Accompany each
repositioning with passive range-of-motion exercises. Position changes should be done less
frequently for clients with ICP because turning, skin care, and passive ROM exercises can
elicit involuntary posturing, which also causes increased ICP. Reposition the client every 1 to
2 hourss. Position changes should be done less frequently for clients with ICP because turning,
skin care, and passive ROM exercises can elicit involuntary posturing, which also causes
increased ICP.
Nursing Process: Implementation
Client Need: Physiological Integrity
LO: 3

8. The nurse is monitoring the blood glucose levels of a client with a closed head injury to
maintain the client in a euglycemic state. The nurse can best accomplish this goal by:
1. Administering insulin to keep glucose blood levels between 80 and 120 mg/dl.
2. Assessing the blood glucose levels every 4 hours by glucometer testing.
3. Minimizing the clients energy requirements by anticipating and meeting needs
promptly.
4. Arranging for a diet that allows for carbohydrate loading.
Correct Answer: Administering insulin to keep glucose blood levels between 80 and 120 mg/dl.
Rationale: A euglycemic state refers to one where blood glucose levels are kept between 80 and
120 mg/dl. Administering insulin, which facilitates the proper utilization of glucose, will be the
most beneficial intervention in maintaining normal glucose levels (80120 mg/dl). While
monitoring the clients blood glucose every 4 hours is appropriate, it does not bring about
normal blood glucose levels. Minimizing energy requirements by anticipating and meeting
needs promptly is an appropriate intervention for such a client, but it will have no affect on
blood glucose control. Carbohydrate loading or the ingestion of large amounts of carbohydrates
will contribute to the elevation of blood glucose levels.
LO: 3

9. Which of the following statements made by a nurse shows the most informed knowledge
regarding the positioning of the head of a client being monitored for increasing intracranial
pressure (ICP) related to a brain injury that is not vascular in nature?
1. The clients intracranial pressure dictates how high I position the head of the bed.
2. I am careful to elevate the head of the clients bed to 30 degrees.
3. The most controllable factor in managing intracranial pressure (ICP) is head
elevation.
4. I elevate the clients head when the intracranial pressure is increasing.
Correct Answer: The clients intracranial pressure dictates how high I position the head of the
bed.
Rationale: The suggestion is that head positioning, both in terms of elevation and rotation, has
a definite effect on ICP. However, it is recommended that head position be established on an
individual basis, with the help of monitoring devices. A 30-degree elevation, while traditionally
accepted, should not be universally accepted for all clients. There are several factors that affect
the clients intracranial pressure. Head elevation is used to minimize or prevent IICP and
should not be reserved for implementation only after an increase is observed.
Nursing Process: Planning
LO: 3

10. The parent of a 2-year-old child who fell and sustained a scalp laceration that will require
suturing asks the nurse, How serious an injury is this? The nurse responds by stating:
1. From the description of the fall it doesnt appear serious, but the x-ray will tell us for
sure.
2. There is a lot of bleeding, but it is really a rather superficial injury.
3. Children this age are really resilient, but you never know until the x-rays are read.
4. Hell need a few stitches and a tetanus injection, but that should do it.
Correct Answer: From the description of the fall it doesnt appear serious, but the x-ray will
tell us for sure.
Rationale: Scalp lacerations account for a large number of emergency department visits and are
usually not serious, but with any scalp laceration, the possibility of an underlying skull fracture
must be addressed. An accurate history of the event surrounding the injury is very important. If
there is any reason to suspect a skull fracture, a computerized tomography (CT) scan or a plain
x-ray of the skull should be obtained. Telling the parents that the wound is superficial without
the benefit of radiological confirmation is inappropriate. Stating that children are resilient is
minimizing the parents concern, and stating that a few stitches and a tetanus injection is all
that is needed is minimizing the potential of the injury.
LO: 4

11. Which of the following observations by the nurse are representative of the symptomology
of an epidural hematoma (EDH)?
1.
2.
3.
4.
5.
History of unconsciousness immediately after trauma

Dilated pupil on the same side as the injury
Rapid deterioration of level of consciousness
Period of lucidity prior to onset of symptoms
Muscle weakness on the side opposite the head injury
Correct Answer:
1. History of unconsciousness immediately after trauma
2. Dilated pupil on the same side as the injury
3. Rapid deterioration of level of consciousness
4. Period of lucidity prior to onset of symptoms
Rationale: History of unconsciousness immediately after trauma. Classic clinical
presentation of EDH is characterized by an immediate post-traumatic period of
unconsciousness, followed by a lucid interval, which can last from minutes to hours. Dilated
pupil on the same side as the injury. Possible signs and symptoms include an enlarging pupil
on the same side of the injury (ipsilateral). Rapid deterioration of level of consciousness. A
rapid deterioration in level of consciousness may follow. Period of lucidity prior to onset of
symptoms. Classic clinical presentation of EDH is characterized by an immediate posttraumatic period of unconsciousness, followed by a lucid interval, which can last from minutes
to hours. Muscle weakness on the side opposite the head injury. Hemiparesis (muscle
weakness) of the contralateral arm and leg (opposite side from the injury) may be present with
an acute subdural hematoma.
LO: 4

12. The client riding in a car that hit a tree is diagnosed with cerebral contusions resulting
from an acceleration/deceleration injury. The nurse explains this injury to the clients daughter
as:
1.
Your dads brain was injured once when his head hit the windshield and again when it
rebounded against the back of his skull.
2. The injuries were a result of repeated contact with the dashboard of the car.
3. His head was traumatized by the force the car exerted against the trunk of the tree.
4. The brain was bruised severely several different times from the impact it suffered
when he bounced around in the car after hitting the tree.
Correct Answer: Your dads brain was injured once when his head hit the windshield and
again when it rebounded against the back of his skull.
Rationale: Contusions occurring from acceleration/deceleration injuries may include motor
vehicle crashes, falls, and assault. These contusions occur as a result of the brain moving
within the skull, and bruising itself during acceleration/deceleration movement. Injuries
sustained by repeated contact with a stationary object are called deceleration injuries.
LO: 4

13. The nurse is caring for a client who is recovering from a lumbar puncture and is concerned
that the client may contract bacterial meningitis. The common early symptomology that nurse
should be alert to includes:
1.
2.
3.
4.
5.
Headache.
Fever.
Confusion.
Seizures.
Rhinorrhea.
Correct Answer:
1. Headache.
2. Fever.
3. Confusion.
4. Seizures.
Rationale: Headache. Headache is a common and early symptom of meningitis. Fever. Fever
is a common and early symptom of meningitis. Confusion. Confusion is a common and early
symptom of meningitis. Seizures. Seizures are a common and early symptom of meningitis.
Rhinorrhea. Clients with skull fractures may experience rhinorrhea, which is the leaking of
cerebral spinal fluid via the nose.
LO: 5

14. A client is being admitted for possible meningitis. The nurse recognizes that which of the
following assessment data are significant to the confirmation of that diagnoses?
1.
2.
3.
4.
A history of flulike symptoms resolving 5 days ago

Blood pressure of 100/62
Sluggish pupils bilaterally
A cervical lymph node palpable on physical examination
Correct Answer: A history of flulike symptoms resolving 5 days ago

Rationale: The presence of systemic viral infections such as a flulike illness is significant
and may indicate the original source of the viral invasion. None of the remaining options of
hypotension, sluggish pupils, or an enlarged cervical lymph node is considered a risk factor for
meningitis.
LO: 5

15. The nurse is caring for a client receiving intravenous antibiotic therapy for bacterial
meningitis. The client has a history of seizures that are currently being controlled with
phenytoin (Dilantin). The nurse institutes seizure precautions for this client because:
1.
2.
3.
4.
Antibiotics can decrease the effect of phenytoin (Dilantin).

Emotional stress increases the occurrence of seizure activity.
Administration of drugs intravenously can initiate seizure activity.
Physical stress decreases the effectiveness of antiseizure medication.
Correct Answer: Antibiotics can decrease the effect of phenytoin (Dilantin).

Rationale: While both mental and physical stress cause changes in the body that increase the
brains excitability and activity, it is important to note that some antibiotics interfere with the
metabolism of other drugs, including phenytoin. This is significant because it generally
decreases the blood levels of phenytoin, leaving the patient more susceptible to seizure
activity; this is the reason for instituting seizure precautions for this client. There is no known
relationship between intravenous drug administration and seizure activity. Physical and
emotional stresses are not linked to the effectiveness of anti-seizure medications or an
increased incidence of seizures.
LO: 5

16. A client has been diagnosed with a grade 1 astrocytoma, an intra-axial brain tumor. When
asked what his chances of surviving this thing are, the nurses response is based on the
knowledge that:
1.
2.
3.
4.
Age is the greatest predictor of client survival.

A grade 1 is a very aggressive form of this type of tumor.
It depends on whether the tumor metastasizes outside the brain.
This type of tumor has a survival rate of 3 years.
Correct Answer: Age is the greatest predictor of client survival.

Rationale: The strongest predictor of survival with low-grade (grades 1 and 2) astrocytoma (a
type of glioma) is age. One study reported a mean survival time of 8.5 years for adults less than
40 years of age; this contrasts with 4.9 years for adults 40 years of age and older. Astrocytomas
(grade III) are noted to be more aggressive than lower-grade astrocytomas, with a median
survival rate of approximately 3 to 5 years. Though astrocytomas may spread into surrounding
normal brain tissue, it is rare for them to spread outside the brain and CSF system.
LO: 6

17. A client has had a surgical resection of an acoustic neuroma. The nurses postoperative
assessment should focus on:
1.
2.
3.
4.
Identifying damage to cranial nerves VII, IX, X, and XII.

Utilization of the House/Brackmann assessment scale.
Documenting complaints of tinnitus and dizziness.
Determining the degree of hearing loss.
Correct Answer: Identifying damage to cranial nerves VII, IX, X, and XII.
Rationale: Surgical resection of acoustic neuromas can cause damage to cranial nerves in
proximity to the tumor. Damage to cranial nerves VII, IX, X, and XII is possible. Therefore, a
thorough cranial nerve assessment is important, both preoperatively and postoperatively. If the
facial nerve is damaged, it is important to note the degree of facial weakness exhibited using
the House/Brackmann scale. Acoustic neuromas usually are diagnosed when the patient
experiences gradual hearing loss, tinnitus, and/or dizziness.
LO: 6

18. A client has been diagnosed with a pituitary adenoma. Which of the following assessment
findings supports that it is a nonfunctioning form?
1.
2.
3.
4.
20/40 vision using a Snellen chart

A protruding lower jaw
A round, moon-shaped face
Report of insomnia
Correct Answer: 20/40 vision using a Snellen chart

Rationale: Nonfunctioning pituitary adenomas produce symptoms caused by pressure of the
tumor on surrounding structures, such as the optic nerve. Frequently, visual loss is the
presenting symptom and it may be in the form of decreased acuity. Functioning pituitary
adenomas produce endocrine symptoms, such as acromegaly or Cushings syndrome. A
protruding lower jaw, moon-shaped face, and insomnia are not associated with nonfunctioning
pituitary adenomas.
LO: 6

19. A client diagnosed with a benign brain tumor asks, What is a gamma knife? The nurse
explains that It is:
1.
2.
3.
4.
A method of providing a focused dose of radiation at your tumor.

A radioactive seed or capsule implanted into the tumor.
A robotic arm device that delivers multiple beams of radiation to the tumor.
The traditional method of providing radiation to a tumor.
Correct Answer: A method of providing a focused dose of radiation at your tumor.

Rationale: Gamma knife radiosurgery is a system that uses focused radiation in a single dose.
Brachytherapy is the surgical implantation of radioactive capsules, or seeds, directly into the
tumor bed. Cyber knife radiosurgery is a radiosurgical system that consists of a robotic arm
used to deliver multiple beams of radiation. To say that a gamma knife is the traditional method
of providing radiation to a tumor is not accurate.
LO: 7

20. A client with terminal metastatic brain cancer asks, Why should I agree to radiation
therapy? The nurses response is based on the knowledge that radiation therapy:
Select all that apply
1.
2.
3.
4.
5.
Provides improved quality of life.

Slows the growth of the tumor.
Helps decrease cancer-related pain.
Has the greatest affect on brain cancer cells.
Produces the least side effects of all treatment regimes.
Correct Answer:
1. Provides improved quality of life.
2. Slows the growth of the tumor.
3. Helps decrease cancer-related pain.
Rationale: Provides improved quality of life. The addition of radiation therapy to the
treatment regimen of brain tumor patients increases survival time and adds to the clients
quality of life. Slows the growth of the tumor. The addition of radiation therapy to the
treatment regimen of brain tumor patients increases survival time and slows tumor growth.
Helps decrease cancer-related pain. The addition of radiation therapy to the treatment
regimen of brain tumor patients adds to the clients comfort. Has the greatest affect on brain
cancer cells. The effectiveness of the radiation therapy depends on a variety of factors.
Produces the least side effects of all treatment regimes. Radiation therapy produces serious
side effects.
LO: 7

21. A client diagnosed with a brain tumor is reluctant to agree to a surgical excision of the
lesion. The nurse addresses the clients concern best by:
1.
2.
3.
4.
Asking the client to be more specific about what concerns him.

Notifying the neurosurgeon of the clients concerns.
Assuring the client that the procedure is necessary.
Providing detailed written information on the benefits of the proposed
procedure.
Correct Answer: Asking the client to be more specific about what concerns him.
Rationale: The nurse has a responsibility to the client to help address his concerns, but this
cannot be done until the nurse fully understands the clients concerns. The neurosurgeon may
be notified of the concern if it is outside the nurses scope of responsibility. Merely assuring the
client about the necessity of the procedure does not address the clients concerns. While written
reinforcement of the information is appropriate, the client needs personal involvement on the
part of the nurse to address specific concerns.
LO: 7

22. A client who has developed a seizure disorder as a result of a traumatic brain injury is being
prepared for discharge. Which of the following should the nurse include in discharge teaching
regarding the information the family/caregiver should report concerning a seizure at home?
1.
2.
3.
4.
5.
How long did the seizure last?

Was the client injured?
Did the client lose consciousness?
Was the client confused after the seizure?
Has the client been taking his seizure medication?
Correct Answer:
1. How long did the seizure last?
2. Was the client injured?
3. Did the client lose consciousness?
4. Was the client confused after the seizure?
Rationale: How long did the seizure last? It is important to note the duration of the seizure
activity. Was the client injured? It is important to note any injuries that resulted. Did the
client lose consciousness? It is important to note whether the client lost consciousness. Was
the client confused after the seizure? It is important to note whether the client was confused
following the event. Has the client been taking his seizure medication? Description of the
event would not include whether the client had taken medication.
LO: 8

23. When the daughter of a client being treated for a traumatic brain injury asks why her
mothers blood is being tested for sodium, the nurse responses:
1.
2.
3.
4.
If you mother is lacking sodium, she is at risk for serious complications.

To be sure her serum sodium level is between 135 and 145 mEg/L.
Monitoring sodium levels is routine for injuries like your mothers.
Its a simple diagnostic test that gives her health care provider a lot of
information.
Correct Answer: If you mother is lacking sodium, she is at risk for serious complications.
Rationale: Close monitoring of serum sodium levels is important because low levels of serum
sodium, especially less than 130 mEq/L, can facilitate cerebral edema, causing decreased levels
of consciousness, confusion, seizures, and even death. Educating the family about normal
sodium levels does not answer the question that was asked. Suggesting that the test is done
routinely for general informational purposes does not address the question effectively.
LO: 8

24. A client has developed postsurgical muscle weakness after the removal of a brain tumor. To
minimize this clients risk for developing deep vein thrombosis (DVT), the nurse initially:
1.
2.
3.
4.
Applies antiembolism hose.

Instructs the client to perform leg exercises.
Includes regular leg massages in the clients care plan.
Determines through questioning whether the client has a history of DVT.
Correct Answer: Applies antiembolism hose.

Rationale: If the patient is experiencing motor weakness postoperatively, great care must be
taken to avoid DVT due to immobility. The use of antiembolism hose or pneumonic stockings
is highly recommended, and they should be applied as soon as possible. The client with muscle
weakness is not capable of performing leg exercises. Massaging the legs is not an appropriate
nursing intervention and may result in serious injury to the client. Determining a history of
DVT is not an intervention.
LO: 8


(Osborn) Chapter 29 Learning Outcomes (Number and Title)

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[Osborn] chapter 29

Learning Outcomes [Number and Title ]

Osborn, et al., Test Item File for Medical-Surgical Nursing:

Cerebral tissue ischemia.

Correct Answer: Cerebral tissue ischemia.

Osborn, et al., Test Item File for Medical-Surgical Nursing:

Identifies risk for tissue ischemia.

Correct Answer: Identifies risk for tissue ischemia.

Osborn, et al., Test Item File for Medical-Surgical Nursing:

Increased absorption of cerebral spinal fluid (CSF).

Osborn, et al., Test Item File for Medical-Surgical Nursing:

Osborn, et al., Test Item File for Medical-Surgical Nursing:

Osborn, et al., Test Item File for Medical-Surgical Nursing:

This client requires surgical decompression of the brain.

Correct Answer: This client requires surgical decompression of the brain.

Osborn, et al., Test Item File for Medical-Surgical Nursing:

Manage the repositioning with slow, smooth, and gentle movement.

Osborn, et al., Test Item File for Medical-Surgical Nursing:

Osborn, et al., Test Item File for Medical-Surgical Nursing:

Osborn, et al., Test Item File for Medical-Surgical Nursing:

Osborn, et al., Test Item File for Medical-Surgical Nursing:

History of unconsciousness immediately after trauma

Osborn, et al., Test Item File for Medical-Surgical Nursing:

Osborn, et al., Test Item File for Medical-Surgical Nursing:

Osborn, et al., Test Item File for Medical-Surgical Nursing:

A history of flulike symptoms resolving 5 days ago

Correct Answer: A history of flulike symptoms resolving 5 days ago

Osborn, et al., Test Item File for Medical-Surgical Nursing:

Antibiotics can decrease the effect of phenytoin (Dilantin).

Correct Answer: Antibiotics can decrease the effect of phenytoin (Dilantin).

Osborn, et al., Test Item File for Medical-Surgical Nursing:

Age is the greatest predictor of client survival.

Correct Answer: Age is the greatest predictor of client survival.

Osborn, et al., Test Item File for Medical-Surgical Nursing:

Identifying damage to cranial nerves VII, IX, X, and XII.

Osborn, et al., Test Item File for Medical-Surgical Nursing:

20/40 vision using a Snellen chart

Correct Answer: 20/40 vision using a Snellen chart

Osborn, et al., Test Item File for Medical-Surgical Nursing:

A method of providing a focused dose of radiation at your tumor.

Correct Answer: A method of providing a focused dose of radiation at your tumor.

Osborn, et al., Test Item File for Medical-Surgical Nursing:

Provides improved quality of life.

Osborn, et al., Test Item File for Medical-Surgical Nursing:

Asking the client to be more specific about what concerns him.

Osborn, et al., Test Item File for Medical-Surgical Nursing:

How long did the seizure last?

Osborn, et al., Test Item File for Medical-Surgical Nursing:

If you mother is lacking sodium, she is at risk for serious complications.

Osborn, et al., Test Item File for Medical-Surgical Nursing:

Applies antiembolism hose.

Correct Answer: Applies antiembolism hose.

Osborn, et al., Test Item File for Medical-Surgical Nursing:

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