Brain Tumors: Gliomas, Meningiomas, Metastatic brain tumors

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Question 1: A nurse is caring for a client who has a glioma. The nurse knows that this type of brain tumor originates from which of the following cells?

Explanation

Choice A reason:

Meningeal cells are not the origin of gliomas, but of meningiomas, which are benign brain tumors that develop from the meninges, the membranes that cover the brain and spinal cord.

Choice B reason:

Neuroglial cells are the origin of gliomas, as explained above.

Choice C reason:

Pituitary cells are not the origin of gliomas, but of pituitary adenomas, which are benign brain tumors that grow from the pituitary gland and may cause endocrine dysfunction.

Choice D reason:

Acoustic nerve cells are not the origin of gliomas, but of acoustic neuromas, which are benign brain tumors that arise from the acoustic cranial nerve and may cause hearing loss or ringing in the ears.


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Question 2: A nurse is teaching a client who has a newly diagnosed metastatic brain tumor. Which of the following statements should the nurse include in the teaching? (Select all that apply.)

Explanation

Choice A reason:

This statement is true. Metastatic brain tumors are lesions that spread from a primary cancer site outside of the body, such as breast, kidney, lung, or gastrointestinal tract cancers.

Choice B reason:

This statement is true. Metastatic brain tumors are more common than primary brain tumors, accounting for about half of all brain tumors.

Choice C reason:

This statement is true. Metastatic brain tumors can be treated with surgery, radiation therapy, or chemotherapy, depending on the location, size, number, and type of tumor.

Choice D reason:

This statement is false. Metastatic brain tumors usually have a worse prognosis than primary brain tumors, because they indicate a systemic disease and often recur after treatment.

Choice E reason:

This statement is true. Metastatic brain tumors can cause increased intracranial pressure and neurological deficits by applying pressure to surrounding brain tissue and impairing cerebral blood flow and cerebrospinal fluid drainage.


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Question 3: A nurse is assessing a client who has a meningioma. The nurse should expect to find which of the following manifestations?

Explanation

Choice A reason:

This statement is not indicative of a meningioma, but of a pituitary adenoma, which is a benign brain tumor that grows from the pituitary gland and may cause endocrine dysfunction such as diabetes insipidus (excessive thirst and urination).

Choice B reason:

This statement is not indicative of a meningioma, but of an acoustic neuroma, which is a benign brain tumor that arises from the acoustic cranial nerve and may cause hearing loss or ringing in the ears.

Choice C reason:

This statement is indicative of a meningioma, as explained above.

Choice D reason:

This statement is not indicative of a meningioma, but of a supratentorial tumor, which occurs in the cerebral hemispheres above the tentorium cerebelli and may cause loss of voluntary movement or hemiparesis (weakness or numbness on one side of the body).


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Question 4: A client who has a brain tumor is scheduled for surgery. The client asks the nurse what are the possible complications of the surgery. How should the nurse respond?

Explanation

Choice A reason:

This statement is true, as explained above.

Choice B reason:

This statement is not specific to the surgery, but to the brain tumor itself. Brain tumors can cause seizures, memory loss, or changes in personality by affecting the function of different areas of the brain.

Choice C reason:

This statement is not specific to the surgery, but to the increased intracranial pressure caused by the brain tumor. Increased intracranial pressure can cause nausea, vomiting, or difficulty swallowing by compressing the brainstem and affecting the autonomic nervous system.

Choice D reason:

This statement is not specific to the surgery, but to the location of the brain tumor. Brain tumors that involve the cranial nerves can cause hearing loss, vision loss, or facial paralysis by impairing their function.


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Question 5: A nurse is administering chemotherapy to a client who has a malignant brain tumor. The nurse should monitor the client for which of the following adverse effects of chemotherapy?

Explanation

Choice A reason:

This statement is true, as explained above.

Choice B reason:

This statement is not an adverse effect of chemotherapy, but of the brain tumor itself. Brain tumors can cause cerebral edema by applying pressure to surrounding brain tissue and impairing cerebral blood flow and cerebrospinal fluid drainage.

Choice C reason:

This statement is not an adverse effect of chemotherapy, but of the brain tumor itself. Brain tumors can cause increased intracranial pressure by applying pressure to surrounding brain tissue and impairing cerebral blood flow and cerebrospinal fluid drainage.

Choice D reason:

This statement is not an adverse effect of chemotherapy, but of the brain tumor itself. Brain tumors can cause seizures by affecting the function of different areas of the brain and disrupting the electrical activity of neurons.


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Question 6: A nurse is caring for a client who has a primary malignant brain tumor and reports a new onset of blurred vision and difficulty reading. The nurse should recognize that these findings indicate which of the following types of tumors?

Explanation

Choice A reason:

This statement is not correct. Gliomas are malignant brain tumors that arise from neuroglial tissue and may cause various neurological deficits depending on their location and size, but they do not typically affect vision or reading ability.

Choice B reason:

This statement is not correct. Meningiomas are benign brain tumors that develop from the meninges and may cause severe headaches that are worse in the morning, seizures, or cranial nerve dysfunction, but they do not typically affect vision or reading ability.

Choice C reason:

This statement is correct, as explained above.

Choice D reason:

This statement is not correct. Acoustic neuromas are benign brain tumors that arise from the acoustic cranial nerve and may cause hearing loss or ringing in the ears, vertigo, facial drooping, or difficulty swallowing, but they do not typically affect vision or reading ability.


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Question 7: A nurse is reviewing a client's magnetic resonance imaging (MRI) report that shows an infratentorial tumor in the cerebellum. The nurse should expect to find which of the following manifestations in the client? (Select all that apply.)

Explanation

Choice A reason:

This statement is true. Ataxia is a lack of coordination of voluntary movements that can affect the gait, balance, speech, or eye movements. It is caused by damage to the cerebellum, which is responsible for coordinating muscle activity and maintaining posture and equilibrium.

Choice B reason:

This statement is true. Nystagmus is a rapid involuntary movement of the eyes that can be horizontal, vertical, or rotary. It is caused by damage to the cerebellum or the vestibular system, which regulates the sense of balance and spatial orientation.

Choice C reason:

This statement is true. Dysphagia is difficulty swallowing that can affect the oral, pharyngeal, or esophageal stages of swallowing. It is caused by damage to the cerebellum or the brainstem, which control the muscles involved in swallowing.

Choice D reason:

This statement is false. Aphasia is a loss or impairment of language function that can affect the expression, comprehension, reading, or writing of speech. It is caused by damage to the cerebral cortex, especially the left hemisphere, which is responsible for language processing.

Choice E reason:

This statement is false. Hemiparesis is weakness or paralysis of one side of the body that can affect the face, arm, or leg. It is caused by damage to the cerebral cortex or the corticospinal tract, which control voluntary movement.


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Question 8: A nurse is evaluating a client who has a brain tumor and received radiation therapy. Which of the following findings should the nurse report to the provider as a sign of radiation necrosis? (Select all that apply.)

Explanation

Choice A reason:

This statement is true. New onset of seizures is a sign of radiation necrosis, which is a delayed complication of radiation therapy that occurs when normal brain tissue dies due to radiation exposure. Radiation necrosis can cause neurological deficits such as seizures by affecting the function of different areas of the brain and disrupting the electrical activity of neurons.

Choice B reason:

This statement is true. Increased intracranial pressure is a sign of radiation necrosis, which is a delayed complication of radiation therapy that occurs when normal brain tissue dies due to radiation exposure. Radiation necrosis can cause increased intracranial pressure by applying pressure to surrounding brain tissue and impairing cerebral blood flow and cerebrospinal fluid drainage.

Choice C reason:

This statement is false. Hair loss at the radiation site is not a sign of radiation necrosis, but a common side effect of radiation therapy that occurs when hair follicles are damaged by radiation exposure. Hair loss at the radiation site is usually temporary and reversible.

Choice D reason:

This statement is true. Cognitive impairment is a sign of radiation necrosis, which is a delayed complication of radiation therapy that occurs when normal brain tissue dies due to radiation exposure. Radiation necrosis can cause cognitive impairment such as memory loss, confusion, or dementia by affecting the function of different areas of the brain and disrupting the cognitive processes.

Choice E reason:

This statement is false. Skin erythema at the radiation site is not a sign of radiation necrosis, but a common side effect of radiation therapy that occurs when skin cells are damaged by radiation exposure. Skin erythema at the radiation site is usually mild and self-limiting.


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