Deck 25: Care of Patients With Peripheral Nerve and Degenerative Neurologic Disorders

Question 1

The nurse anticipates that drug therapy for an acute severe attack of multiple sclerosis (MS)will be:

A)intravenous methylprednisolone.
B)intramuscular injections of interferon beta-1b.
C)massive doses of antibiotics.
D)muscle relaxants and opioids.

Answer 1

intravenous methylprednisolone.

Question 2

The nurse is aware that the diagnosis of multiple sclerosis (MS)is based on:

A)blood tests revealing identifiable MS markers.
B)lumbar puncture results revealing inflammatory response.
C)muscle biopsies revealing characteristic lesions.
D)signs and symptoms assessed and reported by the patient.

Answer 2

signs and symptoms assessed and reported by the patient.

Question 3

The technical or vocational nurse agrees that an appropriate nursing diagnosis for a person with Parkinson's disease would be:

A)Risk for falls related to unsteady gait.
B)Ineffective airway clearance related to drooling.
C)Risk for impaired skin integrity related to tremor.
D)Nutrition: less than body requirements related to nausea.

Answer 3

Risk for falls related to unsteady gait.

Question 4

The nurse is explaining Parkinson's disease to the student nurse.Which statement by the nurse is correct regarding the pathophysiology of the disease?

A)"Regardless of the actual etiology, Parkinson's is caused by depletion of dopamine and excess of acetylcholine."
B)"The pathophysiology of the disease is caused by the deterioration of the myelin sheath of the basal ganglia."
C)"Excess dopamine and deficient acetylcholine are the cause of Parkinson's disease."
D)"When there is decreased dopamine uptake at receptors in brain cells, Parkinson's disease results."

Question 5

The nurse explains that multiple sclerosis (MS)is most likely caused by:

A)environmental factors and genetic predisposition.
B)allergic response to antiviral medications.
C)autoimmune reaction attacking the myelin.
D)bacterial infection of the myelin.

Question 6

The nurse encourages the patient with multiple sclerosis (MS)that his disease appears to be the most common type,which is:

A)secondary progressive.
B)primary progressive.
C)relapsing-remitting.
D)relapsing-progressive.

Question 7

The nurse is preparing a care plan for a person with late-stage Parkinson's disease.What complications should the nurse plan interventions to address? (Select all that apply.)

A)Dysphagia
B)Hallucinations
C)Immobility
D)Insomnia
E)Urinary incontinence

Question 8

A patient with multiple sclerosis is seen by the home health nurse and complains of severe fatigue.What is the best suggestion by the nurse to help diminish the effects of fatigue?

A)Relaxing in a warm bath
B)Performing deep-breathing exercises
C)Scheduling rest periods during the day
D)Including daily-dose multivitamins

Question 9

The patient with myasthenia gravis asks the nurse if she will be able to use the computer for her job.Which symptom will most affect the patient's ability to use the computer?

A)Ptosis
B)Diplopia
C)Dysphagia
D)Aphasia

Question 10

The nurse is assessing a patient diagnosed with myasthenia gravis.Which symptom would the nurse expect to assess?

A)Ptosis
B)Tremors of the hands during voluntary movement
C)Dizziness on sudden movement of the head
D)Postural hypotension

Question 11

The caregiver of a patient with Parkinson's disease is concerned with the patient's recent weight loss.What suggestion by the home health nurse will be most helpful to the caregiver in enhancing the patient's nutrition?

A)Provide six mini-meals throughout the day.
B)Be sure to include milk and cheese daily in the diet.
C)Limit the fluid intake in order to increase the appetite.
D)Prepare larger meals of fibrous foods.

Question 12

The nurse is planning care for a patient with Parkinson's disease.Which nursing diagnosis is most appropriate for the patient experiencing bradykinesia?

A)Risk for falls
B)Impaired swallowing
C)Acute confusion
D)Risk for suicide

Question 13

To enhance more erect posture in the patient with Parkinson's disease,the nurse would encourage the patient to practice which activity?

A)Periodically reach for the ceiling.
B)Sleep in the prone position.
C)Walk with a marching step.
D)Walk guided by an imaginary straight line.

Question 14

The nurse is educating the family of a patient in the late stages of amyotrophic lateral sclerosis (ALS).What teaching point is most important for the nurse to include?

A)The patient's ability to move the upper limbs may be affected.
B)The patient's cognitive and mental capacity will most likely remain intact throughout the disease progression.
C)The patient's breathing should not be affected by the disease.
D)The patient's ability to swallow will remain intact.

Question 15

The home care nurse is visiting a patient in the late stages of amyotrophic lateral sclerosis (ALS).Which statement by the patient indicates the acceptance of grief from the condition and prognosis?

A)The patient often cries about his incapacity.
B)The patient makes jokes about this approaching death.
C)The patient talks with his family about his desires for his funeral.
D)The patient begins to sleep for longer periods of time during the day.

Question 16

The person who has Huntington's disease asks if his disease will affect children he might have.Which statement by the nurse is most accurate?

A)"No. Huntington's disease has no genetic link."
B)"Yes. Your children will either have Huntington's disease or be carriers."
C)"No. Huntington's disease is caused by an autoimmune response."
D)"Yes. Because of the nature of Huntington's disease, 50% of your children will have the disease."

Question 17

The nurse is assessing a patient with Parkinson's disease.What does the nurse anticipate to assess in regard to tremors?

A)Occurring 100% of the time
B)Decreasing when there is voluntary movement
C)Being absent when the body is at rest
D)Characterized by a tonic and clonic muscle activity

Question 18

The nurse is aware that the signs and symptoms of Guillain-Barré syndrome (GBS)occur following a virus infection at about _____ days postinfection.

A)2 to 3
B)7
C)10 to 21
D)30

Question 19

The home health nurse assesses the patient with Parkinson's disease who has just been placed on carbidopa-levodopa.What side effects should the nurse be alert for when assessing this patient? (Select all that apply.)

A)Urinary retention
B)Rash
C)Increased diaphoresis
D)Orthostatic hypotension
E)Hematuria

Question 20

The home health nurse caring for a patient with multiple sclerosis (MS)is planning an exercise program with the patient.Which is the best type of exercise for this patient?

A)Swimming
B)Progressive walking
C)Weight training
D)Isometric exercises

Question 21

The student nurse is researching relapsing progressive forms of multiple sclerosis.What characteristics would the student discover as typical of this form of the disease? (Select all that apply.)

A)Steady worsening
B)Partial remissions
C)Clear acute relapses
D)Temporary minor improvements
E)Long plateau periods

Question 22

The test for the diagnosis of myasthenia gravis in which muscle strength is increased within 1 minute of the injection is the __________ test.

Question 23

The nurse outlines nutritional needs for the patient with multiple sclerosis (MS).What interventions should be emphasized for inclusion in the dietary intake? (Select all that apply.)

A)Intake of at least 1500 mL of fluid daily
B)Inclusion of high-fiber foods
C)A high carbohydrate level in the diet
D)Adding calcium and vitamin D
E)Ensuring a high fat content

Question 24

The nurse is caring for a patient with Huntington's chorea.Which symptoms typically would be seen in the patient with this disease? (Select all that apply.)

A)Fidgeting
B)Restlessness
C)Constant movement
D)Dementia
E)Difficulty swallowing

Question 25

The triad of Parkinson's disease is __________,__________,and __________.

Question 26

Two viruses that are especially associated with the etiology of Guillain-Barré syndrome (GBS)are ___________ and ___________.

Question 27

The nurse is caring for a patient with Guillain-Barré syndrome.What will be the focus of nursing care? (Select all that apply.)

A)Assessment of advancing paralysis
B)Provision for ventilation support
C)Maintenance of adequate nutrition
D)Prevention of complications of immobility
E)Assessment of hypertension