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Galen NUR 242 Exam 4 – Neuro Study Guide Latest
update 2025/2026 GRADED A+, Exams of Nursing
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What is included in the central nervous system? - ANSWER -
brain and spinal cord
What is included in the peripheral nervous system? - ANSWER -
cranial nerves, spinal nerves, ganglia
What does the peripheral nervouse system act as? - ANSWER -
relay station What three types of headaches impact quality of life? -
ANSWER -migraine, tension, cluster
What is the pain assessment guideline for migraine headaches? -
ANSWER -P - provoking (what triggers)
Q - quality (is it pulsating or throbbing) R - radiation (is it unilateral and supra retro orbital) S - severity (where is it on pain scale) T - time (typically 4-72 hours)
What factors make migraines worse? - ANSWER -light, sound,
movement
Pathophysiology of migraine - ANSWER -most popular theory is
that extracranial arteries expand and irritate nerves due to vasodilation
Why are migraines a problem? - ANSWER -productivity, sick
days, quality of life
Migraine triggers - ANSWER -chocolate, red wine, hard cheeses,
monosodium glutamate, hormonal changes, exertion, fatigue, and stress
manifestation of migraine - ANSWER -Aura (20% of cases),
steady throbbing pain, unilateral, sensitive to light, sound, odors What does POUND stand for as it relates to migraines -
ANSWER -Pulsatile
One day Unilateral Nausea/vomitting Disabiling
What are the abortive therapies for migraines? - ANSWER -
Fioricet, NSAIDS, Triptans and ergotamines When is abortive therapy contraindicated for migraine treatment?
What is a partial seizure? - ANSWER -a seizure that affects only
one part of brain
What is a simple partial seizure? - ANSWER -(also known as focal
aware) is where the person has no loss of consciousness and localized signs such as jerking movements; last 10-20 seconds; autonomic symptoms
What is a complex partial seuizure? - ANSWER -altered and
impaired, may not have an aura but can lead to a general seizure; lasts 1-2 minutes
What is a generalized seizure? - ANSWER -affects the brain as a
whole; differentiated by how they appear during observation
absence seizure - ANSWER -seizure involving a brief loss of
consciousness without motor involvement; look to be staring off into space; lasts seconds
tonic-clonic seizure - ANSWER -generalized seizure in which the
patient loses consciousness and has jerking movements of paired muscle groups
myoclonic seizure - ANSWER -sudden jerk of the body or
extremities that lasts seconds
atonic seizure - ANSWER -loss of muscle tone
Acute seizure management - ANSWER -gather history,
determine underlying cause, observation and documentation, side lying position, no restraints, DO NOT ATTEMPT TO STOP MOVEMENTS What are you observing and documenting during a seizure? -
ANSWER -durations, types of movements, ongoing observations,
post-ictal assessment, patient safety
Acute seizure treatment - ANSWER -patent IV, suction, oxygen,
padded side rails, pillow, privacy, benzodiazapines(ativan, valium), antiepileptics (phenytoin,phosphenytoin)
status epilepticus - ANSWER -A condition in which seizures recur
every few minutes or last more than 30 minutes
Priorities for status epilepticus - ANSWER -establish airway,
ABGs, IV push lorazepam/diazepam, rectal diazepam (if not IV), loading dose of IV phenytoin Dilantin is caustic to the veins and should not be pushed any
faster than - ANSWER -50mg per min
Diagnostic workup for epilepsy - ANSWER -EEG, CT/MRI, excluse
other causes, labs
Pathophysiology of Parkinson Disease - ANSWER -familial,
progressive and chronic, degradation of dopamine
Onset of Parkinson Disease - ANSWER -asymmetric, resting
tremor in upper extremity, restlessness during sleep, gradual decreased sense of smell
Cardinal signs of Parkinson Disease - ANSWER -bradykinesia
(slow movement, shuffling gait, drag feet), resting tremor, rigidity, postural instability
Additional signs of Parkinson Disease - ANSWER -pill rolling,
reduction in dexterity, masked facial expression, sleep distrurbances, autonomic dysfunction, bradyphrenia, dementia, night time drooling
Physical exam findings in Parkinson disease - ANSWER -resting
tremor, cogwheel rigidity, decreased speed of movement, micrographia, small & quiet voice with proper articulation, festinating gait
Nursing Care for Parkinson Disease - ANSWER -fall precautions,
aspiration precautions, nutritional assessment, I&O, high calorie high protein high fiber meanls, meds on time EVERY time, screen for depression/psychosis
Drug therapy for Parkinson disease - ANSWER -dopaminergic,
dopamine agonists, COMTs, anticholinergic, MAOI-B
What is the gold standard treatment for Parkinson disease -
ANSWER -carbidopa-levodopa
mutiple sclerosis - ANSWER -progressive autoimmune disorder
characterized by inflammation demyelination of the myelin sheath
Types of Multiple Sclerosis - ANSWER -relapsing remitting
primary progressive secondary progressive progressive relapsing
Typical presentation of Multiple Sclerosis - ANSWER -young,
otherwise healthy with history of transient focal defecit that resolves without treatment
Where is Multiple Sclerosis more prominent? - ANSWER -Upper
Northern US
Assessment of multiple sclerosis - ANSWER -Vision, mobility and
sensory changes; LOPDUV, Charcot's Triad
LOPDUV - ANSWER -Limb weakness
Optic neuritis Paresthesia Diplopia
Long-term: Interferon Beta, oral drugs are second line but do have less side effects (natalizumab, fingolimod) Symptom: Baclofen, Valium, Amantadine, Modafinil, phenytoin, pregabalin,carbamazepine,oxybutynin
TIA - ANSWER -transient ischemic attack
transient ischemic attack - ANSWER -brief interruption in
cerebral blood flow; lasts 30-60 minutes
Symptoms of TIA - ANSWER -blurred vision, diplopia, ataxia,
extremity weakness, numbess, vertigo, aphasia, dysarthria
Care consideration for TIA - ANSWER -reduce hypertension,
control diabetes, heart healthy diet, stop smoking
Medication management for TIA - ANSWER -statins, anti-
hypertensives, and anti-platelets
What is a stroke? - ANSWER -brain attack where the perfusion to
the brain suddenly becomes interrupted
Classifications of stroke - ANSWER -ischemic, hemorrhagic
Ischemic stroke categories - ANSWER -thrombotic -
atherosclerotic plaque embolic - dislodged clot
Pathophysiology of stroke - ANSWER -Thrombotic - HTN,
vascular disease, prodromal TIA Embolic - Afib, endocarditis Hemorrhagic - HTN, vessel disorders
Symptoms of stroke - ANSWER -altered level of consciousness,
face, arm, speech alerations, gait distrubances
Risk factors of stroke - ANSWER -smoking, AFIB, age, illicit drug
use, alcoholism, uncontrolled hypertension, sedentary livestyle, obesity, hypercoagulability, hyperlipidemia, oral contraceptives, sickle cell disease, diabetes mellitus
Assessment of stroke - ANSWER -Facial drooping
Arm drift Speech articulation Time
Diagnostic exams for stroke - ANSWER -CT scan at stroke
center, MRI, carotid ultrasound
Immediate interventions for stroke patient - ANSWER -ABC, GCS,
routine labs, EKG, assess for hypoglycemia, or hypoxia, INR, NIH stoke scale, NPO
Dysphagia care post stroke - ANSWER -aspiration precautions,
NPO until swallow screening, thickened liquids, nutritional alteration
Speech care post stroke - ANSWER -be clear, use cues, avoid
yes and no questions, alternative forms of communication
