A nurse is reviewing the health record of a client who has a malignant brain tumor and notes the client has a positive Romberg sign. Which of the following actions should the nurse take to assess for this sign?

Tumors in the frontal lobe often cause behavioral, cognitive, and personality changes because this area controls judgment, emotions, problem-solving, and voluntary movement. These changes can be distressing for families, as the patient may display inappropriate behavior, impaired decision-making, or apathy. Assisting the family to understand and cope with these changes helps reduce stress, improve support, and facilitate safer home care. Family education is a key nursing role in managing the psychosocial impact of frontal lobe tumors.

Rationale for correct answer:
B. Frontal lobe: Responsible for personality, behavior, and decision-making. Tumors here often cause dramatic changes that are difficult for families to understand without guidance.

Rationale for incorrect answers:

A. Ventricles: Tumors here mainly affect CSF flow and can lead to hydrocephalus. They are less likely to cause personality or behavior changes that families would struggle to interpret.

C. Parietal lobe: Primarily responsible for sensory processing and spatial awareness. Tumors may cause sensory loss or neglect but rarely dramatic personality changes.

D. Occipital lobe: Primarily involved in vision and visual interpretation. Tumors here typically result in visual field deficits without major behavioral effects.

Take home points

• Frontal lobe tumors frequently lead to behavioral and personality changes.
• Family education and support are crucial to help caregivers cope with emotional and cognitive changes.
• Other lobes mainly affect sensory or visual functions, with less psychosocial impact.

Stereotactic radiosurgery (SRS) is a highly precise, noninvasive radiation therapy used to treat brain tumors and vascular malformations. It works by focusing multiple beams of radiation on a single target to destroy abnormal cells without opening the skull. This therapy is particularly useful for small or inoperable tumors, as it minimizes damage to healthy brain tissue. SRS offers shorter recovery times and fewer complications compared to traditional brain surgery.

Rationale for correct answer:
B. Very precisely focused radiation destroys tumor cells: SRS delivers converging radiation beams that effectively target and kill tumor cells. It avoids the need for open craniotomy while preserving surrounding brain tissue.

Rationale for incorrect answers:

A. Radioactive seeds are implanted in the brain: This describes brachytherapy, which involves direct radioactive implantation rather than external focused radiation.

C. Tubes are placed to redirect CSF from one area to another: This is a shunt procedure for hydrocephalus and does not treat brain tumors.

D. The cranium is opened with removal of a bone flap to open the dura: This is a craniotomy, an invasive surgical procedure unlike the noninvasive SRS.

Take home points

• SRS is a noninvasive radiation therapy that destroys tumor cells without open surgery.
• Brachytherapy, shunts, and craniotomy are invasive procedures used for different purposes.
• Precision targeting in SRS reduces damage to healthy brain tissue and shortens recovery.