CCRN Domain 4: Musculoskeletal/Neurological/Psychosocial Welcome to your CCRN Domain 4: Musculoskeletal/Neurological/Psychosocial 1. CCRN: Musculoskeletal/Neurological/Psychosocial A patient with a spinal cord injury at the T4 level is experiencing a sudden onset of hypertension, bradycardia, and sweating above the level of the injury. What is the most appropriate initial action? Administer a beta-blocker Perform a bladder scan Apply a cold compress Elevate the patient's legs None 2. CCRN: Musculoskeletal/Neurological/Psychosocial A patient with multiple sclerosis (MS) presents with nystagmus, scanning speech, and intention tremor. This triad of symptoms is known as: Lhermitte's sign Charcot's triad Uhthoff's phenomenon Marburg's variant None 3. CCRN: Musculoskeletal/Neurological/Psychosocial A critical care nurse is assessing a patient who recently underwent a craniotomy. The nurse observes cerebrospinal fluid (CSF) leaking from the patient's nose. This complication is known as: Meningitis Encephalocele Rhinorrhea Otorrhea None 4. CCRN: Musculoskeletal/Neurological/Psychosocial In assessing a patient with a traumatic brain injury, the nurse notes decerebrate posturing. This is characterized by: Flexion of arms, wrists, and fingers with adduction in upper extremities Extension of arms with pronation, extension of legs with plantar flexion Flexion in the arms held close to the body with extension and internal rotation of legs None of the above accurately describe decerebrate posturing None 5. CCRN: Musculoskeletal/Neurological/Psychosocial A nurse is caring for a patient with amyotrophic lateral sclerosis (ALS). Which of the following is a priority nursing intervention? Encouraging daily strenuous exercise Implementing a high-carbohydrate diet Monitoring for respiratory compromise Frequent orientation to time, place, and person None 6. CCRN: Musculoskeletal/Neurological/Psychosocial Which of the following is the most appropriate nursing action when caring for a patient with Parkinson's disease experiencing severe "on-off" phenomena? Administering additional doses of levodopa/carbidopa during "off" periods Encouraging the patient to perform high-intensity exercises Adjusting the timing and dosage of medication to minimize fluctuations Recommending surgery as the first line of treatment None 7. CCRN: Musculoskeletal/Neurological/Psychosocial A patient with a recent below-knee amputation (BK is experiencing intense burning and itching sensations where the limb was amputated. This is most likely: A) A sign of infection at the surgical site Normal post-operative pain that requires analgesics Phantom limb pain Indicative of poor wound healing None 8. CCRN: Musculoskeletal/Neurological/Psychosocial A patient diagnosed with a herniated lumbar disc complains of numbness and tingling in the right leg. The nurse understands that these symptoms correspond to: Radiculopathy Cauda equina syndrome Spinal stenosis Myelopathy None 9. CCRN: Musculoskeletal/Neurological/Psychosocial When evaluating a patient with a suspected stroke, the nurse knows that the most important piece of information to obtain is: The patient's blood pressure The time when the patient was last known to be at baseline The patient's cholesterol levels A history of similar symptoms None 10. CCRN: Musculoskeletal/Neurological/Psychosocial A patient with bipolar disorder is experiencing a manic episode. Which of the following is a priority nursing intervention? Engage the patient in deep psychoanalytical conversations to explore underlying issues. Monitor the patient's fluid and food intake to prevent dehydration and malnutrition. Encourage participation in physical restraint to prevent harm. Provide complex puzzles and games to help the patient focus and reduce manic energy. None 11. CCRN: Musculoskeletal/Neurological/Psychosocial In assessing a patient with myasthenia gravis, which of the following symptoms would indicate a myasthenic crisis? Improved muscle strength after administration of edrophonium Sudden increase in blood pressure and heart rate Difficulty swallowing and breathing A sudden decrease in antibody levels None 12. CCRN: Musculoskeletal/Neurological/Psychosocial The nurse is caring for a patient following a stroke who is now exhibiting signs of neglect syndrome. This syndrome is characterized by: The patient's denial of the existence of the affected side Hyperattention to stimuli on the affected side Inability to recognize one's own body parts Lack of awareness or inattention to one side of the body None 13. CCRN: Musculoskeletal/Neurological/Psychosocial When caring for a patient with acute delirium, the nurse's first priority is to: Restrain the patient to prevent harm. Identify and treat the underlying cause. Administer antipsychotic medication. Engage the patient in cognitive exercises. None 14. CCRN: Musculoskeletal/Neurological/Psychosocial A nurse is assessing a patient with suspected neurogenic shock following a spinal cord injury. Which of the following findings is most indicative of neurogenic shock? Tachycardia and hypotension Hypertension and bradycardia Hypotension and bradycardia Tachycardia and hypertension None 15. CCRN: Musculoskeletal/Neurological/Psychosocial For a patient with a diagnosis of schizophrenia, which of the following nursing interventions is most appropriate during an acute psychotic episode? Encourage detailed discussions about hallucinations. Maintain a safe distance while communicating with the patient. Promote social interactions with large groups. Offer complex problem-solving tasks to distract the patient. None 16. CCRN: Musculoskeletal/Neurological/Psychosocial A patient with a history of chronic alcohol abuse is admitted with signs of Wernicke's encephalopathy. Which of the following treatments should the nurse anticipate administering immediately? Intravenous thiamine Oral folic acid supplements Intramuscular vitamin B12 High-dose oral niacin None 17. CCRN: Musculoskeletal/Neurological/Psychosocial In assessing a patient with a traumatic brain injury, the nurse notes an abnormal posturing where the patient exhibits flexion of arms, wrists, and fingers with adduction in the upper extremities. This is known as: Decerebrate posturing Decorticate posturing Basal ganglion posturing Opisthotonos None 18. CCRN: Musculoskeletal/Neurological/Psychosocial A nurse is caring for a patient who recently underwent an amputation and reports feeling pain in the amputated limb. The nurse recognizes this as: Neuropathic pain Somatic pain Phantom limb pain Visceral pain None 19. CCRN: Musculoskeletal/Neurological/Psychosocial A patient with Parkinson's disease is showing signs of dysphagia. What is the most appropriate nursing intervention to assist with feeding? Encourage the patient to eat quickly to reduce fatigue. Offer thin liquids and encourage the use of a straw. Provide small, frequent meals and ensure the patient is in an upright position. Increase the patient's intake of dry, solid foods to promote chewing. None 20. CCRN: Musculoskeletal/Neurological/Psychosocial A critical care nurse is monitoring a patient with a severe head injury. Which of the following signs would indicate an increase in intracranial pressure (ICP)? Sudden onset of hypotension Widened pulse pressure and bradycardia Rapid reduction in body temperature Sudden improvement in the patient's level of consciousness None 1 out of 20 Time is Up! Time's up