hi everybody welcome back to U world's next gen enlex review session my name is Jackie and I'm a nurse here at uor we're so glad to have you guys with us today we are going to be doing a neurology question drill so all things brain um but we're glad to have you guys here with us if this is your first time to join one of our question drill sets what you can expect is I'll pull up a question I'll read through it give you guys some time to answer and then we will walk through why the correct answer is right um be sure you guys are following us on all of your Channel or all of our channels and your channels um share this session the more the merer and be sure and check us out at eorld nursing.com we have tons of great information on our website as always ask lots of questions we have nurse Samantha moderating for us today and uh with that being said let's go ahead and get started all right question one we have eight questions today the nurse is observing a staff member caring for a client who sustained a traumatic brain injury without cervical spinal injury the nurse should interview if the staff member is observed option one turning the client using the r the Rog roll the log roll technique to remove soiled linen option two checking the client's pupils for size and reaction to light option three monitoring the client's gag and cough reflexes option four placing the client in the Trendelenburg position all right I'll put 30 seconds on the clock drop those answers in the chat let us know what you guys think um again if you guys are just joining we are doing neurology questions today so covering all things from stroke brain injury Alzheimer's I think a Parkinson's question um I think that might kind of cover a good bit of it um seizure precautions um but yeah we have a lot of great questions for you let's definitely um see those answers in the chat and we will pull up our answers here in just a second all right I love seeing all these answers come in we're glad to have you guys all here with us today all right our correct answer on this one is going to be option four placing the client in the trendelenberg position so starting with the question just kind of at the beginning what we're seeing here is an intervene question so the nurse should intervene if the staff member is observ so what we're looking for our correct answer is going to be an incorrect action something that's not going to keep the client safe that's going to need us to kind of stop whatever's going on and redirect in a in a more appropriate and safe manner so when we're talking about a traumatic brain injury even with or without a cervical spine injury we're worried about the brain we're worried about blood flow profusion and making sure that we're um creating as much stability in terms of um blood flow in and out of the brain so placing the client in the Trendelenburg position that's not going to be good for this client we want to avoid any extremes so extreme flexion or extension of the neck um we want the head to be midline and in a neutral position and most importantly we want that head of the bed around $30 to 45° so not in a Trendelenburg position um if the client's too upright which is Trendelenburg Um this can cause hypotention um we also um want to adjust the bed slowly so if we see this client in an inappropriate position we want to adjust them slowly so that um we're not you know causing any worsening injury to the brain um but what we see in options 1 two and three these are all appropriate using the log R technique again that's going to keep the head and the neck in in a stable midline position um that's good we want to do that um checking the pupils this is part of like how we would um use the Glascow Coma Scale that's going to indicate our brain function and then um monitoring the client's gag and cough reflexes we want to prevent any aspiration so good job you guys I saw a ton of right answers so good work you guys all right question two the nurse is preparing to administer alop place to a client who is experiencing an es schic stroke which of the following findings would require followup prior to administering the medication option one symptoms started 2 hours ago option two left total hip replacement one year ago option three blood pressure of 190 over 110 option four right-sided muscle weakness all right go ahead and drop those answers in the chat 30 seconds on the clock let's see what you guys think and as always we love to know if anybody is getting ready to take oh we do have some passers in here okay let us know if you pass let us know on your testing so we can wish you guys good luck um we have um uh a mod uh Pastor enlux congratulations on YouTube that's amazing that is so good you guys um let's see let us know again when you guys are testing we want to shout you out and if you guys pass make sure you visit uh eorld nursing.com we have a link on there where you can share some of your study tips or just share your success story we'd love to um share your story with all of our you world nursing community so check that out um we also have our events calendar up on there as well all right so I'm seeing a lot of answer three so good work you guys I'll give you guys about five more seconds and again it's not too late to share this video the more or this live the more the merrier um again we're covering neurology questions today all right so our correct answer on this one is going to be option three blood pressure of 190 over 110 um so again would require follow kind of the same principle of as intervene so um we're going to be looking for an incorrect action so with this we're talking about outop place we're looking for those um contraindications why we shouldn't give it to a client and an elevated blood pressure um that is definitely one we can cause um you know instead of let me back up let's talk about alop place so alop place is like TPA um it's a clot Busters so if we have a client that is um experiencing an es schemi stroke es schic stroke is going to mean we have an obstruction in our brain like a thrombus in our brain so that outop place is going to go in it's going to um kind of bust that clot allow blood to continue to peruse and hopefully we can save as much brain tissue as possible but it's such a high-risk medication that there are some um absolute contraindications to it that we would you know explore other um avenues for treatment so um some of those contraindications are going to be obviously hemorrhagic Strokes so if the client's bleeding we don't want to make them have a um bleed any worse than the Rd are um active bleeding coagulation disorders um recent head trauma previous intracranial hemorrhage um recent surgery within the last 14 days and uncontrolled hypertension which is what we're seeing in option three this can cause um intracerebral Hemorrhage so again a brain bleed um so if we have that as a finding we need to notify the healthcare provider we need to kind of stop the chain right there um and make sure that that's brought to the attention and that maybe blood pressure is managed before outop place can be given um but what we see in um options 1 2 and four symptoms that started 2 hours ago this is within that safe window to give outa place so as long as we're within 4 and 1 half hours typically that's what we're looking for um total hip replacement one year ago one year ago is good again if it was 14 days ago for a major surgery that would be more alarming and then option four right sided muscle weakness this is really going to be indicative of this is is um confirming that what our client is experiencing is likely a stroke so seeing some of those manifestations of um impaired profusion to our brain tissue so this is a reason why we want to give out the place so good job you guys you did awesome on that one all right question three the nurse is caring for a client who had a right-sided stroke which of the following complications is the client at risk for developing select all that apply option one aspiration option two joint contractures option three impul of behavior option four numbness of the feet option five impaired concept of time all right I'll give you guys a little bit longer on this one maybe 40 seconds um it's a select all that apply so you're going to have more than one right answer um we've done a few uh different kind of practice question drill sets around select all that apply questions um just giving you as much practice on those as possible I know those are kind of like a dreaded thing when you see those bold words at the end of your question SEL all it apply but again just take it one answer at a time try and answer them true false to what the question is asking and you it's just like one extra option compared to a regular question um but you guys have got this you can do it all right let's see and again be sure you guys um check us out at uworld nursing.com we have our event calendar up there study tips um a place where you can tell us your study tips so you can kind of pass the batana to other um student nurses and um help more people pass their end clicks so very good you guys um and one other thing to note too um we are really proud to offer um you guys um a firm so you can study now pay later um so check us out at our website you can see all of our different subscription um programs and offers um and lengths and um find the the subscription that's right for you guys all right let's go our correct answer on this one options 1 2 3 and five so again we're talking about a right-sided stroke we're looking thinking about complications of a stroke again um what you know when we see a select all that apply question we're just going to take a true false approach to each of these so the right hemisphere of our brain so if we're saying we have a right sided stroke that right hemisphere is associated with spatial processing um it tends to be activated um more for task involving emotion art music so clients experiencing that right sided stroke are more likely to have difficulty do a spatial perception impaired concept of time impulsivity um and left-sided hemiplegia so right-sided stroke is going to affect the muscle movements of the left side and this can lead to Joint contractures so that's kind of what's covering our options 2 three and five um and then option one swallow evaluations have to be performed after um stroke to make sure that um our oral intake um isn't going to cause any aspiration we want to make sure and assess our client for dysphasia or difficulty swallowing um numbness of the feet this can be something maybe more so related to peripheral neuropathy not something we typically would see with a stroke so good work you guys all right question four the nurse has attended a staff education program about implementing seizure precautions which of the following statements by the nurse would require follow-up option one I should ensure the client has a preferral Venus access device in place option two I should remove any restrictive clothing or jewelry the client is wearing option three I will place oxygen and section equipment in the client's room option four I will keep tongue blades at the client's bedside all right 30 seconds let's see those answers again these are seizure precautions um really important to know for nursing school the enlex and especially when you get into practice um there's always a bunch of precautions you have to keep straight in your head for depending on what your client might be experiencing um so and again thank you to everybody who is sharing this video we appreciate it again we want to um grow our Ur World nursing Community as much as possible we have so many amazing resources available for you guys um on our social channels and on our website as well so um be sure you guys check that out all right I'm seeing the answers coming you guys did really good on that one all right so our correct answer on this one is going to be option four I will keep tongue blades at the client's bedside again followup we have a lot of these today so um when we see that word followup that means we are looking for the action um that's incorrect it's not safe we need to intervene um so tongue blades are not something that are going to be part of seizure precautions we want to avoid putting anything in the client's mouth not only can it cause a risk of aspiration but it can cause injury as well if they bite on it um break it dislodge it anything like that so we don't want to have anything in the client's mouth um when we are talking about seizure precautions um we definitely want to make sure that we have um what we're seeing in options 1 2 and three we want to make sure have peripheral um um access so we can push medications to help slow seizures down stop seizures um uh keep the client safe so you know a lot of times the client's not going to be able to take any type of medication we need quick acting medication which is where IVs come in um option two I should remove any restrictive clothing or jewelry this is true again we don't want anything to cause harm or injury to the client in the case they have a seizure and then option three um definitely we need oxygen insection equipment at the client's bedside we want to make sure that in the event of seizure happens that we can offer at least that blow by oxygen while they're seizing obviously nothing on the face but it get giving them what they can um take in and then providing that high flow oxygen when um the seizure is over and then also suction we want to make sure that um we're keeping our Airways just think ABCs um always and that's kind of where that falls so good job you guys again no tongue blades we don't want to put anything in the client's mouth all right question five the nurse and the emergency department is caring for for a client who has slurge speech and left-sided facial droop and weakness which of the following actions would be a priority for the nurse to take option one administer IV dextrous to the client option two prepare the client for a 12 lead ECG option three obtain a blood specman to check the client's serum potassium level option four transport the client to the radiology department for a CT scan of the head all right 30 seconds on the clock let's see what you guys think good work you guys and we are at the halfway mark we are on our uh our descent into question eight so good job you guys awesome work awesome work all right and thanks to everybody for following us um we appreciate it and again share this live we'd love to um reach some new some new nursing students out there some new viewers all right good job you guys all right okay so our uh correct answer on this one is going to be um option four transport the client to the radiology department for a CT scan of the head so what we're seeing here in this question just kind of starting with our context clues um we first see the word priority bolded we need to think ABCs Airway breathing circulation we also are seeing what appears to be some signs or symptoms of a stroke we don't know yet but that's what we can infer so as we're looking through these clients or as we're looking through these options option four is definitely going to be like kind of following our nursing process we have our assessment in the question um we need to diagnose the way we're going to diagnose what we're can we're guessing as a stroke is going to be a CT scan so that's what's going to be the first thing we do um what we see in option one um administer IV dextr to the client sometimes hypoglycemia and stroke can kind of present themselves the same way so this is maybe alluding to um if our clients experiencing hypoglycemia but before we give that we need to check their blood sugar so that's definitely not our right answer um option two a 12 lead eccg this is going to be more so for our cardiac like our Mi um situations but we're a little bit more worried about the brain not that we're not going to check the heart but um it's not going to be our priority and then option three um serum potassium level again um we need to prioritize the brain um you know we're not as worried about the electrolytes right now we know they can affect a brain but we need to see if um our brain has been impacted if we have an es schic stroke a hemorrhagic stroke and that's really going to um kind of indicate what our next steps are so you guys great on that well done well done okay question six the nurse has attended a staff education program about Alzheimer disease which of the following statements by the nurse would require followup option one clients with Al or we'll just say ad0 may initially experience difficulty with short-term memory but retain long-term memory option two the caregiver of a client with AD should be offered referrals for support to reduce caregiver strain option three physical restraint should be used for clients with ad to manage agitation and confusion option for a client who has a family member with ad is at higher risk for developing ad all right 30 seconds on the clock drop those answers in the chat again thank you so much for all of the follows we love to see it we really appreciate it um let us know too what uh where you guys are in nursing school if you're in your first year in nursing school second year doing your clinicals getting ready to take your enclex all that kind of stuff we want to know and um we want to be supportive of where you are and make sure that as we're growing and developing our content that it's kind of meeting your needs for a nursing school so good job you guys all right oh last semester to Tracy on Tik Tok you're in the home stretch hang in there I feel like when Halloween hits the rest of the year flies by so you're almost there good work getting ready to take your enclex um stash stasha um on Tuesday Good Luck Good Luck that's amazing graduating Sunday Laura that's amazing throw that hat in the air that's awesome okay um good job you guys a lot of passers and testers good job Med surge too that was tricky okay anyways back to our content good job um okay our correct answer on this one is going to be option three um so again followup again we SE I didn't realize I gave you so many of these followup questions today but we're looking for um the action the intervention that's wrong it's not safe so physical restraints are never Goto option um you know they're Last Resort so there's a lot of other things in any situation we can try before physical restraints um so when we're talking about a client with Alzheimer's disease a lot of times it's all about kind of meeting them where they are um orienting orienting them um we're we're not going to jump to physical or strengths we're going to try other things to um calm them down if they're agitated or confused a lot of time that agitation or confusion is exasperated by this situation or scenario they're in so kind of informing them Orient or ing them the best we can um talking calmly bringing anything that can help um kind of comfort them or U regain their memory um is beneficial but what again what we see in options 1 two and four these are all true statements about Alzheimer's disease um again we know Alzheimer's is a neurocognitive condition it's um a decline in memory loss leading to personality changes inability to perform um self-care some disruptive behaviors come from it like agitation and aggression and um again a lot of that kind of generates from the um the challenges associated with commun uh communicating needs like physical discomfort um so again um when we we're talking about option one clients um a lot of this is a true statement so they can have difficulty with short-term but they're going to retain that long-term memory kind of one of the unique features of Alzheimer's disease um caregiver strain is a big part and something we definitely want to include in our assessments and our teaching for Alzheimer's making sure caregivers have an opportunity to um kind of um have a space where they can communicate and talk about their struggles and um get the care they need as well and then um there is a genetic component to alzheimer's which is what we see in option four all right good job you guys okay question seven the nursse is planning care for a client with Parkinson disease which of the following interventions should the nurse include in the client's plan of care select all that apply option one discourage the client from consuming snacks between meals option two remind the client to move slowly when transitioning from a sitting to standing position option three instruct the client's spouse to remove throw rugs from the home option four teach the client to use visualization techniques when experiencing freezing episodes option five encourage the client to take Carbidopa L aopa with high protein meals all right 30 seconds on the clock drop those answers in the chat good job everybody I love seeing the um chat's so busy today good job good job all right and thanks again for all of the follows um if make sure you guys come back again tomorrow at 3 p.m. central Time on your favorite social media channel we'll be doing another question drill um this one is fundamentals so if you guys are new in your nursing school Journey hopefully this one can be helpful for you guys um and again yeah be sure and follow us we have our website e World nursing.com um in the link in our bio and again you can check out from there our event schedule study tips um where you can share your success story um everything you need to know to kind of get you started with you world is right there so um and of course also our free trial all right um someone asked what time the review is tomorrow 3 p.m. central Time so come back to your favorite Channel all right um our correct answers on this one are going to be options 2 three and four so this type of question is like a plan of care question so when we're thinking of a plan of care and we're thinking of those activity statements those appropriate interventions that's what we're looking for here things that we would include in that client's plan of care so when we're talking about Parkinson's disease it's a progressive neurodegenerative disorder um It's associated with deficient dopamine levels so um not only deficient dopamine but also uncontrolled acetycholine activity and then we also have the formation of these protein clusters called Louis bodies so all of that together is going to present with the manifestations we know as Parkinson's so these clients um are at risk for complications due to that decreasing number of dopam um dopa dopamine receptors and dopamine neurons in the brain so complications a big one is going to be Falls and so that's where a lot of the safety and the teaching comes when we're um talking about Parkinson's so when we're talking about option two REM um remind the client to move slowly we're also worried about orthostatic hypotension in these clients as well so you know encouraging them to go from laying to sitting sitting to standing taking their time letting their body adjust to that change everything's a little bit slowed down responses are slowed not only um you know from our brain to our muscles but think about you know all the other muscles that are organs in our body like our heart so we want to allow our heart time to adjust and peruse um peruse everywhere it needs to to not cause any type of fall um option three instruct the client spouse to remove throw rugs clients with Parkinson's are going to have that shuffling gate throw rugs can be a fall risk um we want to make sure that there's no obstacles for these clients and then um phrasing episode is another thing that happens with these clients so we can teach them a visualization to help kind of reconnect some of those Pathways from brain to muscles um so visualization techniques like um visualizing stepping over a box can help with those freezing episodes again it's all about creating those um um you know uh new Pathways new communication channels from brain to muscle so good job you guys all right home stretch last question the nurse is preparing to administer photoin to a client with seizure with a seizure disorder the nurse should recognize that adverse effects of photoin include option one hypertension option two acute kidney injury option three DVT deep Venus thosis option four central nervous system depression all right 30 seconds on the clock drop those answers in the chat let's see what you guys think awesome work you guys awesome work and be sure you guys check out our free trial we have a a 7-Day free trial available for you guys go to eorld nursing.com um you can get everything you need to um know there but you can get a great sample of our questions case studies Indian items um our explanations which is really the heart and soul of you world so we have the most amazing talented team of nurses here that um you know really want you guys to be successful in your nursing Journey so um be sure you guys check it out all right and again before we're done today drop any other subject you guys want to know about you want to learn about in our lectures or do question practice on um in the comments we're always looking we're tracking those down and incorporating them into our content calendar all right so our correct answer on this one is going to be option four central nervous system depression um so when we are looking at this medication the pharmacology is definitely um maybe kind of a daunting subject topic to kind of take on for your studies either nursing school or and Collex cuz there's so many medications out there but we have a ton of lecture videos on a lot of different Med classes um in our product at uroll so be sure you guys check them out but when we're talking about fenin um this medication acts on our central nervous system and a relatively selective fashion it's going to suppress seizures but it can still cause those generalized CNS side effects especially when the dosage is too high or excessive so there's a therapeutic index for this medication so at therape itic levels sedation and other CNS effects are mild but if our the medication's not therapeutic in our blood um we can have toxicity so we can see things like nagus um which is like the back and forth kind of ticktock of her eyes um this is relatively common other things can be sedation a taxia which is like a staggering gate a diplopia which is double vision and cognitive impairment so that's um kind of that would be an adverse effect of this medication when that therapeutic index is no longer therapeutic in her blood and we're experiencing toxicity um but what we see in options um one hypertension we would expect um an adverse effect would be hypotension with this medication um acute kidney injury not so much Associated and then DVT it's going to be the opposite we would worry about um increased bleeding risk so you guys did great on that one let us know how you did out of eight drop your score in the oh we got a few little perfect scores in here on to our viewer on YouTube congratulations um there's always bonus points and no matter how you did we're just glad to have you guys here with us today um as always we encourage you to check out our website uworld nursing.com try our free trial check out our events calendar come back tomorrow at 3m. central time we'll be doing another question drill set we hope this was helpful and we look forward to seeing you guys next time bye