Deck 34: Chronic and Degenerative Neurologic Disorders

Question 1

The nurse is obtaining a history on a client who reports recent, severe headaches. Which factor(s) in the client's history most likely cause the nurse to identify migraine headaches?
1)Female gender, 58 years of age
2)History of closed head injury
3)Male, history of alcohol abuse
4)Recurrent upper respiratory infections

Answer 1

1

Question 2

The nurse is caring for a client with a history of head injury in a motor vehicle accident. The client reports a lack of coordination and imbalance since the accident. Which part of the cerebrum does the nurse suspect to have been damaged?
1)Cerebrum
2)Brainstem
3)Cerebellum
4)Diencephalon

Answer 2

3

Question 3

After a theoretical session about edrophonium (Tensilon) testing, the nurse educator asks a staff nurse to select a client from a group with different neurological disorders on which to perform the test. Which client is the nurse expected to select?
1)A client with multiple sclerosis
2)A client with myasthenia gravis
3)A client with Huntington's disease
4)A client with Guillain-Barré syndrome

Answer 3

2

Question 4

A client comes to the clinic and asks for a test to determine the possibility of developing Huntington's disease (HD). Which preparation does the nurse make to fulfill the request?
1)Acquires saliva to test for a genetic biomarker
2)Assesses the client for emotional symptoms
3)Obtains a small sample of blood from the client
4)Prepares testing to determine cognitive symptoms

Question 5

Which neurotransmitter is depleted in clients with Parkinson's disease?
1)Acetylcholine
2)Serotonin
3)Dopamine
4)Glutamate

Question 6

A client is suspected to have a narrowing of the spinal cord. Which test does the health-care provider prescribe to confirm this diagnosis?
1)Angiography
2)Evoked potentials
3)Computerized tomography (CT)
4)Electronystagmography

Question 7

Which instruction does the nurse provide to a client who is prescribed an anticholinergic drug for symptomatic relief of Parkinson's disease?
1)"Watch out for side effects such as dry mouth and double vision after taking the medication."
2)"You will be able to perform daily activities at a normal pace after taking the medication."
3)"It is dangerous to participate in exercise therapy during the course of medication."
4)"Remember the medication may precipitate tremors during the initiation of therapy."

Question 8

The nurse is counseling a client newly diagnosed with multiple sclerosis (MS). Which explanation does the nurse provide if the client asks, "Why all of a sudden do I have this disease?"
1)"Your brain has scar tissue called gliotic plaques from infection."
2)"At some time you had an infection and did not seek medical care."
3)"Your body created antibodies that are attacking the covering of nerve cells."
4)"This is an inherited disease for which you have no responsibility."

Question 9

The nurse is discussing the interictal period with staff nurses. Which statement made by a nurse indicates understanding of the terminology?
1)"It is the actual time of the episode of the seizure."
2)"It is the time after the completion of the seizure."
3)"It is measured when the brain activity is abnormal."
4)"It is the phase between seizures if multiple seizures occur."

Question 10

The nurse is providing care for a client who is prescribed to undergo a polysomnogram. Which explanation of the test does the nurse provide?
1)"The test reveals the amount of spinal nerve injury present."
2)"Small temperature differences in an organ can be measured."
3)"The test measures brain and body activity during sleep."
4)"Your response to sensory stimulus can be monitored."

Question 11

While reviewing the medication prescribed for a client, the nurse finds the client is on a therapy to decrease the release of the excitatory neurotransmitter glutamate. Which disorder does the nurse recognize in the client?
1)Myasthenia gravis
2)Huntington's disease
3)Guillain-Barré syndrome
4)Amyotrophic lateral sclerosis

Question 12

The nurse is performing a Babinski reflex test on a client to assess the neurologic system. Which is the correct interpretation by the nurse?
1)A negative Babinski reflex indicates an upper motor neuron disorder.
2)Flaring of the toes in response to stimulation indicates an upper motor neuron disorder.
3)When the toes flex inward upon stimulation of the sole of the foot, the test is positive.
4)A negative reflex occurs with flaring of the toes in response to stimulation of the sole of the foot.

Question 13

In a client with Guillain-Barré syndrome, the health-care provider finds the possibility of performing plasmapheresis is low. Which other alternative treatment is recommended to produce the same effect as that of plasmapheresis?
1)Corticosteroids
2)Cerebrospinal fluid filtration
3)IV immunoglobulin
4)Immunomodulating agents

Question 14

The nurse is reviewing the most important intervention for clients with myasthenic crisis with staff nurses. Which statement by an attending nurse indicates understanding?
1)"The most important intervention is to constantly monitor the arterial blood gases."
2)"The forced vital capacity and negative inspiratory force are monitored every 2 to 4 hours."
3)"The client is closely monitored in an intensive care unit for decreased heart rate."
4)"Immunosuppressant agents are completely withdrawn during a myasthenic crisis."

Question 15

Which neurotransmitter dysfunction has been implicated in Tourette's syndrome?
1)Serotonin
2)Dopamine
3)Acetylcholine
4)Gamma amino butyric acid (GABA)

Question 16

The nurse educator is teaching a family about athetosis movements in clients with Huntington's disease. Which statement made by a family member indicates understanding?
1)"Athetosis refers to twisting and writhing movements."
2)"Athetosis refers to brief, irregular, dancing-like movements."
3)"When athetosis is severe, there are thrashing motions referred to as ballismus."
4)"Antipsychotic medications are symptomatically beneficial to treat athetosis."

Question 17

Which pathophysiological condition particularly activates the trigeminovascular system?
1)Epilepsy
2)Cluster headache
3)Parkinson's disease
4)Tension headache

Question 18

The nurse is providing care for a client with multiple sclerosis (MS). Which treatment modality does the nurse expect to be prescribed for this client?
1)Long-term corticosteroid therapy
2)Immune-modulating therapy
3)Physical and occupational therapy
4)Pain management therapy

Question 19

The nurse is providing care for multiple clients being treated for seizure disorder. Which client does the nurse expect to be diagnosed with status epilepticus?
1)A client experiencing a series of three tonic-clonic seizures
2)A client experiencing rapid alternate contraction and relaxation of muscles
3)A client experiencing seizure who appears to be staring into space for a few moments
4)A conscious client with rhythmic jerking movements of the arms and legs

Question 20

The nurse is providing care for multiple clients who are reporting headaches. The nurse's goal is to provide preventive care for the development of a migraine. Which client does the nurse prioritize as the first needing preventive therapy?
1)A client who experiences one or two migraine attacks per month
2)A young female client who stopped the use of oral contraceptives
3)A female client who is on therapy with vasodilators
4)A client who withdrew from consuming alcohol

Question 21

Ion channel disorders, also called channelopathies, are responsible for a growing number of neurological diseases. Which type of ion channel disorders are identified? Select all that apply.
1)Treatment is with chemotherapy
2)Mutations in ion channel genes
3)Manifestations tend to be intermittent
4)Autoantibodies formed against ion channel proteins
5)Example of a resulting condition is myasthenia gravis
Other

Question 22

The nurse is preparing to assist with a lumbar puncture. In which order does the nurse prioritize the steps performed during the procedure? (Enter the number of each step in the proper sequence; do not use commas or spaces.)
1) The area of and around the site is cleaned.
2) The puncture site is located in the lower back.
3) The client is instructed to lean forward while sitting on a table or bed.
4) A special needle is inserted into the spinal sac to remove a small amount of fluid.
5) Local anesthetic is injected into the selected location.

Question 23

The health-care provider is monitoring a client who is unconscious. Which assessments does the nurse expect the health-care provider to prescribe? Select all that apply.
1)Hearing
2)Vital signs
3)Orientation
4)Pupil response
5)Glasgow Coma Scale

Question 24

A client with cluster headaches is prescribed dihydroergotamine. Which client manifestations indicate the effectiveness of the therapy? Select all that apply.
1)Decreased nasal discharge
2)Reduced tearing from the eye
3)Relaxed cervicothoracic muscle
4)Reduced bradykinesia
5)Normalized deep tendon reflexes

Question 25

Which supportive care is provided to a client diagnosed with Guillain-Barré syndrome? Select all that apply.
1)Provide mechanical ventilation.
2)Monitor hemodynamics continuously.
3)Provide physical and occupational therapy.
4)Administer antipsychotic medications as prescribed.
5)Provide speech therapy and swallowing interventions.