Mr. Snyder is admitted to your unit with a brain tumor. The type of tumor he has is currently unknown. You begin to think about the way brain tumors are classified.
30. Glioma is an intracranial tumor. Which of the following statements about gliomas do you know to be false?
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Solution
gliomas are usually benign
Option B: Gliomas are malignant tumors.
A client with muscle contraction headache will exhibit a pattern different for Julie’s. Which of the following is more compatible with tension headache?
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Solution
feeling of tightness bitemporally, occipitally, or in the neck
Options A and B: These describe sinus headache; option A may also be compatible with headache secondary to eyestrain; option B is also compatible with migraine.
Option C: This would be correct if stated a bandlike “tightness” around the head instead of “burning”
A thorough history reveals that hormonal changes associated with menstruation may have triggered Julie’s migraine attack. In investigating Julie’s history what factors would be least significant in migraine?
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Solution
seasonal allergies
Option A: Sinus headache often accompanies seasonal allergies.
Option C: Many factors may contribute to migraine. Usually the client comes from a family that has migrated, which may have been called “sick headache” due to accompanying nausea and vomiting.
Option D: Often there is an aura.
Option B: Stress, diet, hormonal changes, and fatigue may all be implicated in migraine.
You explain to Julie and her mother that migraine headaches are caused by:
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Solution
dilation of cerebral arteries
Option B: The vascular theory best explains migraine and often diagnosis is confirmed through a trial of ergotamine, which constricts the dilated, pulsating vessels.
During your assessment of Julie, she tells you all visual symptoms are gone but that she now has a severe pounding headache over her left eye. You suspect Julie may have:
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Solution
the aura and headache of migraine
Option B: The warning sign or aura is associated with migraine although not everyone with migrane has an aura. Migraine is usually unilateral and described as pounding. Julie’s symptoms are most compatible with migraine.
Upper motor neuron disease may be manifested in which of the following clinical signs?
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Solution
spastic paralysis, hyperreflexia, presence of babinski reflex
Options B, C, and D: These describe lower motor neuron disease.
Mr. Liberatore suffers a left-sided CVA. He is right-handed. The nurse should expect:
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Solution
visual loss
Option B: Visual field loss is a common side effect of CVA. In right-handed persons the speech center (Broca’s area) is most commonly in the left brain.
Option A: Because of the crossover of the motor fibers, a CVA in the left brain will produce a right-sided hemiplegia.
Option C: Thus, Mr. Liberatore will probably have some speech disturbance and right-sided paralysis.
Option D: Often bladder control is diminished following CVA.
Mr. Liberatore, age 76, is admitted to your unit. He has a past medical history of hypertension, DM, hyperlipidemia. Recently he has had several episodes where he stops talking mid-sentence and stares into space. Today the episode lasted for 15 minutes. The admission diagnosis is impending CVA.
23. The episodes Mr. Liberatore has been experiencing are probably:
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Solution
TIA’s or transient ischemic attacks
Option B: A TIA is a temporary reduction in blood flow to the brain, manifesting itself in symptoms like those Mr. Liberatore experiences.
Options C and D: Although hypoglycemia and hyperglycemia can cause some drowsiness and/or disorientation, the episodes Mr. Liberatore experiences fit the pattern of TIA because of his quick recovery with no sequelae and no treatment.
Which of the following operative procedures of the thorax is paired with the correct definition?
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Solution
Pneumonectomy: removal of the entire lung
Option B: Wedge resection is the removal of part of a segment of the lung.
Option C: Decortication is the removal of a fibrous membrane that develops over the visceral pleura.
Option D: Thoracoplasty is the removal of ribs or sections of ribs.
Chemotherapy may be used in combination with surgery in the treatment of lung cancer. Special nursing considerations with chemotherapy include all but which of the following?
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Solution
Explaining that the reactions to chemotherapy are minimal
Option B: There are numerous severe reactions to chemotherapy such as stomatitis, alopecia, bone marrow depression, nausea and vomiting.
Options A, C, and D: These are important nursing considerations.