Deck 38: Coordinating Care for Patients With Peripheral Nervous System Disorders

Question 1

The nurse provides care to a patient diagnosed with myasthenia gravis (MG) who is prescribed corticosteroid therapy. Which data require immediate notification of the healthcare provider?
1)Insomnia
2)Weight gain
3)Hyperglycemia
4)Truncal obesity

Answer 1

3

Question 2

The nurse is reviewing discharge instructions for a patient with myasthenia gravis. What should the nurse emphasize regarding medications?
1)Keep extra doses of medication in the car.
2)Store extra doses of medication in the refrigerator.
3)Take an extra dose of medication if a dose is missed .
4)Pack prescribed medications in a suitcase before departing to ensure they arrive.

Answer 2

1

Question 3

A patient with Guillain-Barré syndrome (GBS) is receiving plasmapheresis. The nurse monitors this patient for which complication of this treatment?
1)Septicemia
2)Flu-like symptoms
3)Aseptic meningitis
4)Acute renal failure

Answer 3

1

Question 4

Which statement by the patient with myasthenia gravis indicates the need for further teaching?
1)"My weakness will get worse when I exercise too much."
2)"It is important that I take my medications 30 minutes before or after eating."
3)"My eyes will get tired if I read too much."
4)"I need to wait for 30 minutes after taking medication to eat or drink."

Question 5

A patient is being prepared for a Tensilon test. What does the nurse ensure is available before the beginning of this test?
1)Oxygen
2)Atropine sulfate
3)Dexamethasone
4)Epinephrine

Question 6

A patient is diagnosed with myasthenia gravis. What information does the nurse include in an explanation of this disease process?
1)"Your nerve endings are no longer functional and that leads to muscle weakness."
2)"Your body has a disorder that destroys receptor sites at the neuromuscular junction, leading to decreased nerve conduction."
3)"Your body does not make enough of the neurotransmitter needed for movement."
4)"Your nerves have lost their protective covering and impulses are not as smooth."

Question 7

The nurse is planning care for a patient with Guillain-Barré syndrome (GBS). Which intervention will help with neuropathic pain?
1)Administer gabapentin
2)Turn and reposition every 2 hours
3)Apply sequential compression devices
4)Perform passive range-of-motion exercises several times a day

Question 8

The nurse correlates which data from a patient's history as a risk factor for trigeminal neuralgia?
1)Has a body mass index of 34
2)Takes birth control pills
3)History of hypertension
4)Works as a computer operator

Question 9

The nurse provides care for a patient diagnosed with myasthenia gravis (MG). Which is the priority when administering the prescribed dose of pyridostigmine (Mestinon)?
1)Administering the medication on awakening in the morning
2)Monitoring the patient for increased secretions
3)Administering the medication 30 to 60 minutes before each meal
4)Teaching the patient not to crush or chew the sustained-release form of medication

Question 10

The nurse notes that a patient with Guillain-Barré syndrome (GBS) sweats profusely. What should the nurse do about this finding?
1)Place on a cooling blanket.
2)Notify the healthcare provider.
3)Monitor body temperature every 2 hours.
4)Change linen and gown and keep comfortable.

Question 11

A patient with Guillain-Barré syndrome (GBS) asks how the illness develops. What should the nurse respond about the pathophysiology of the disorder?
1)"An infection destroys the nerve endings."
2)"An infection enters the spinal cord and erodes the nerves at the roots."
3)"The nerves are killed by infiltration of your body's white blood cells used to fight an infection."
4)"The covering of nerves that help conduct impulses is damaged."

Question 12

A patient with myasthenia gravis is experiencing sweating and pallor. After administering edrophonium (Tensilon), which finding suggests the patient is experiencing a cholinergic crisis?
1)Improved muscle strength
2)Fasciculations
3)Strong hand grasps
4)Equal shoulder shrugs

Question 13

A patient with progressively deteriorating lower extremity motor and sensory function is having a lumbar puncture. What finding suggests that this patient has Guillain-Barré syndrome (GBS)?
1)Elevated protein level
2)Elevated glucose level
3)Reduction in white blood cell count
4)Increased number of red blood cells

Question 14

A patient being evaluated for Guillain-Barré syndrome (GBS) presents with bilateral symmetrical muscle weakness and sensory changes of both feet and legs. The nurse correlates which key finding to this disease process?
1)Areflexia
2)Hyperreflexia
3)Hypothermia
4)Hyperanalgesia

Question 15

The nurse prioritizes which nursing diagnosis as the highest in the patient with Guillain-Barré syndrome (GBS)?
1)Risk for Aspiration related to related to loss of sensation in oropharynx secondary to progressive neuronal degeneration
2)Ineffective Airway Clearance related to decreased cough secondary to decreased acetylcholine at neuromuscular junction
3)Ineffective Breathing Pattern related to skeletal muscle weakness secondary to destruction of myelin sheath
4)Impaired Gas Exchange related to loss of respiratory muscle secondary to nerve root compression

Question 16

A patient seeks treatment for progressively deteriorating motor and sensory function. What question is essential for the nurse to ask when completing this patient's health history?
1)"Have you been around any small children?"
2)"When was the last time you had anything to eat?"
3)"When was the last time you traveled out of the country?"
4)"Have you recently experienced any lung or stomach infections?"

Question 17

A patient with myasthenia gravis has lost 6 kg of weight over the last 2 months. What should the nurse suggest to improve this patient's nutritional status?
1)Eat three large meals per day.
2)Plan medication doses to occur before meals.
3)Restrict drinking fluids before and during meals.
4)Increase the amount of fat and carbohydrates in meals.

Question 18

The nurse monitors for which clinical manifestation in the patient diagnosed with trigeminal neuralgia?
1)Acute onset of pain
2)Impaired swallowing
3)Visual disturbances
4)Impaired extraocular movements

Question 19

The nurse is caring for a patient with myasthenia gravis. Which assessment data provide the nurse with the earliest indication of the patient's potential respiratory deterioration?
1)Vital capacity
2)Pulse oximetry
3)Breath sounds
4)Arterial blood gas analysis

Question 20

The nurse provides care to a patient who is admitted to confirm a suspected diagnosis of myasthenia gravis (MG). Which medication prescription does the nurse question for this patient?
1)Prednisone
2)Erythromycin
3)Edrophonium
4)Pyridostigmine

Question 21

In reviewing orders written for a patient with myasthenia gravis, which medication order should the nurse question before administering? Select all that apply.
1)Verapamil
2)Furosemide
3)Erythromycin
4)Nicotine patch
5)Warfarin sodium

Question 22

A patient who takes pyridostigmine (Mestinon) 30 mg 4 times a day is scheduled for surgery. To determine the conversion dose for intravenous (IV) medication, how many milligrams of IV neostigmine (Prostigmin) should be prescribed for an entire day? Record your answer as a whole number. ______

Question 23

The nurse is reviewing teaching with a patient scheduled for percutaneous rhizotomy to treat trigeminal neuralgia. Which statement by the patient indicates that teaching is effective?
1)"I may have to wear an eye patch after this procedure."
2)"I will have permanent facial numbness in the area of the treatment."
3)"This procedure involves a dose of concentrated radiation."
4)"I will need to have a craniotomy."

Question 24

The nurse monitors for which clinical manifestations in the patient being evaluated for myasthenia gravis? Select all that apply.
1)Ptosis
2)Diplopia
3)Abdominal pain
4)Dysphagia
5)Epigastric pain

Question 25

A patient who weighs 176 lbs. is prescribed intravenous immunoglobulin 2 g/kg to be infused over 3 days. How many grams of the medication should the nurse have sent from the pharmacy? Record your answer as a whole number. ______

Question 26

A patient with trigeminal neuralgia asks if there are any nonpharmacological strategies to treat the pain. What should the nurse suggest to this patient?
1)Massage
2)Apply heat
3)Apply cold
4)Acupuncture

Question 27

The nurse correlates which clinical manifestations in the patient with myasthenia gravis to bulbar manifestations? Select all that apply.
1)Dysphagia
2)Difficulty opening eyes
3)Unequal smile
4)Difficulty moving the tongue
5)Decreased gag reflex

Question 28

The nurse correlates which clinical manifestations to the patient diagnosed with Guillain-Barré syndrome (GBS)? What should the nurse expect to assess during the acute stage of this syndrome?
Select all that apply.
1)Decreased level of consciousness
2)Hypotension
3)Difficulty breathing
4)Dysphagia
5)Numbness and tingling

Question 29

The nurse is reviewing orders for a patient admitted for evaluation of changes in neurological status. Which prescribed medication does the nurse correlate as a treatment for trigeminal neuralgia?
1)Cogentin
2)Compazine
3)Carbamazepine
4)Hydrochlorothiazide

Question 30

The nurse provides education to a patient who is diagnosed with trigeminal neuralgia. Which patient statement indicates the need for additional teaching?
1)"Baclofen may be prescribed to decrease pain."
2)"I should avoid cold weather as it may trigger increased pain."
3)"I should eat foods that are easily chewed to avoid weight loss."
4)"Carbamazepine may be prescribed to decrease my risk for seizure activity."