Pts 1 ref p 2001 nat client needs physiological

PTS: 1 REF: p. 2001
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 61: Management of Clients With Neurologic Dysfunction
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
NOT: Multiple Choice
26. The nurse is admitting a client to the unit who is scheduled for removal of an
intracranial mass. What diagnostic procedures might be included in this client's
admission orders? Select all that apply.

A. Transcranial Doppler flow study
B. Cerebral angiography
C. MRI
D. Cranial radiography
E. Electromyography (EMG)
ANS: A, B, C
Rationale: Preoperative diagnostic procedures may include a CT scan to demonstrate the
lesion and show the degree of surrounding brain edema, the ventricular size, and the
displacement. An MRI scan provides information similar to that of a CT scan with
improved tissue contrast, resolution, and anatomic definition. Cerebral angiography may
be used to study a tumor's blood supply or to obtain information about vascular lesions.
Transcranial Doppler flow studies are used to evaluate the blood flow within intracranial
blood vessels. Regular x-rays of the skull would not be diagnostic for an intracranial
mass. An EMG would not be ordered prior to intracranial surgery to remove a mass.
PTS: 1 REF: p. 2011
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 61: Management of Clients With Neurologic Dysfunction
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand
NOT: Multiple Select
27. A client is recovering from intracranial surgery performed approximately 24 hours
ago and is reporting a headache that the client rates at 8 on a 10-point pain scale. What
nursing action is most appropriate?
A. Administer morphine sulfate as prescribed.
B. Reposition the client in a prone position.
C. Apply a hot pack to the client's scalp.
D. Implement distraction techniques.
ANS: A
Rationale: The client usually has a headache after a craniotomy as a result of stretching

and irritation of nerves in the scalp during surgery. Morphine sulfate may also be used in
the management of postoperative pain in clients who have undergone a craniotomy.
Prone positioning is contraindicated due to the consequent increase in ICP. Distraction
would likely be inadequate to reduce pain and a hot pack may cause vasodilation and
increased pain.
PTS: 1 REF: p. 2012
NAT: Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
TOP: Chapter 61: Management of Clients With Neurologic Dysfunction
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
NOT: Multiple Choice
28. A client is recovering from intracranial surgery that was performed using the
transsphenoidal approach. The nurse should be aware that the client may have required
surgery on what neurologic structure?