Review Practice Exercise 2

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Practice Exercise 2

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Total Questions : 5

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Question 1:

A client has a hearing loss from a suspected acoustic neuroma. Which diagnostic test should a nurse plan to prepare the client to confirm the presence of a tumor?

A. Tympanometry B. Arteriogram of the cranial vessels C. Magnetic resonance imaging (MRI) D. Auditory canal biopsy

Answer and Explanation

Choice A:

Tympanometry: Evaluates middle ear function and eardrum compliance. It does not detect tumors of cranial nerve VIII.

Choice B:

Arteriogram of the cranial vessels: Visualizes blood vessels but is not useful for identifying a solid tumor in the auditory canal.

Choice C:

Magnetic resonance imaging (MRI): MRI with contrast can detect even small acoustic neuromas. It allows for precise visualization of the tumor’s location and size for surgical planning.

Choice D:

Auditory canal biopsy: Rarely indicated and highly risky because acoustic neuromas are located internally along the nerve, not in the accessible canal.

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Question 2:

A patient with a brain tumor of the temporal lobe is most likely to experience which of the following focal symptoms?

A. Paralysis on one side of the body. B. Difficulty with spatial orientation. C. Auditory or olfactory hallucinations. D. Balance and coordination problems.

Answer and Explanation

Choice A:

Paralysis on one side of the body: This is more characteristic of frontal lobe or motor cortex involvement, not the temporal lobe.

Choice B:

Difficulty with spatial orientation: This is typically associated with parietal lobe dysfunction, which processes spatial awareness.

Choice C:

Auditory or olfactory hallucinations: Temporal lobe tumors irritate sensory pathways for hearing and smell. This leads to hallucinations or unusual sensory experiences as focal neurological signs.

Choice D:

Balance and coordination problems: These symptoms suggest cerebellar involvement, not temporal lobe pathology.

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Question 3:

A nurse is caring for a patient with a cerebellar tumor. The nurse should be vigilant for which of the following clinical manifestations? Select all that apply.

A. Ataxia. B. Personality changes. C. Dizziness. D. Nystagmus. E. Speech difficulties.

Answer and Explanation

Choice A:

Ataxia: The cerebellum controls voluntary coordination, so a tumor often causes unsteady gait and poor balance.

Choice B:

Personality changes: These are typically associated with frontal lobe involvement, not cerebellar pathology.

Choice C:

Dizziness: Cerebellar and vestibular pathway involvement can produce vertigo and disequilibrium.

Choice D:

Nystagmus: Abnormal, rapid eye movements occur due to impaired coordination between the cerebellum and ocular motor nerves.

Choice E:

Speech difficulties: Dysarthria or slurred speech occurs when the cerebellum’s coordination of tongue and facial muscles is disrupted.

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Question 4:

Which diagnostic tool is considered the "gold standard" for imaging a brain tumor, providing detailed images of brain structures and tumor location?

A. Computed Tomography (CT) scan. B. Cerebral Angiography. C. Magnetic Resonance Imaging (MRI). D. Positron Emission Tomography (PET) scan.

Answer and Explanation

Choice A:

Computed Tomography (CT) scan: CT is useful for initial screening or detecting calcifications and bleeding but is less detailed than MRI for tumor evaluation.

Choice B:

Cerebral Angiography: This is primarily used to visualize cerebral blood vessels or assess tumor vascularity, not for first-line tumor detection.

Choice C:

Magnetic Resonance Imaging (MRI): MRI provides superior soft tissue contrast and detailed anatomical views. It is ideal for localizing tumors and evaluating surrounding brain involvement.

Choice D:

Positron Emission Tomography (PET) scan: PET evaluates metabolic activity and recurrence but is less precise for initial tumor localization than MRI.

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Question 5:

Which of the following statements about the diagnostic process for brain tumors are correct? Select all that apply.

A. A CT scan is useful in an emergency to rule out hemorrhage. B. A cerebral angiography is used to visualize the tumor's blood supply. C. A PET scan is the definitive diagnostic method for all brain tumors. D. A stereotactic biopsy is necessary for a definitive tissue diagnosis. E. A spinal tap is the first-line diagnostic test for primary brain tumors.

Answer and Explanation

Choice A:

A CT scan is useful in an emergency to rule out hemorrhage: CT is fast and readily available, making it ideal for detecting bleeding or large masses in acute settings.

Choice B:

A cerebral angiography is used to visualize the tumor's blood supply: Angiography helps determine if a tumor is highly vascular, which is critical for surgical planning and embolization.

Choice C:

A PET scan is the definitive diagnostic method for all brain tumors: PET scans assess metabolic activity but are not definitive; they are usually used in combination with MRI or CT.

Choice D:

A stereotactic biopsy is necessary for a definitive tissue diagnosis: Imaging shows the presence of a mass, but biopsy confirms the tumor type and grade under microscopic examination.

Choice E:

A spinal tap is the first-line diagnostic test for primary brain tumors: Lumbar puncture is not first-line due to the risk of herniation in the presence of increased ICP; it's only used in select cases like suspected leptomeningeal spread.

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Practice Exercise 2

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