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

Question 1

The nurse is reading the results of a single-fiber electromyography completed on a patient suspected of having myasthenia gravis.Which information would validate this patient's diagnosis?

A) Increased jitter
B) Nerve compression
C) Increased antibodies
D) Decreased muscle response

Answer 1

Increased jitter

Question 2

A patient is experiencing bilateral symmetrical muscle weakness and sensory changes of both feet and legs.What should the nurse expect to assess that determines the presence of Guillain-Barré syndrome (GBS)?

A) Areflexia
B) Hyporeflexia
C) Hyperreflexia
D) Hyperanalgesia

Answer 2

Areflexia

Question 3

A patient with myasthenia gravis is experiencing sweating and pallor.After administering edrophonium (Tensilon),which finding suggests the patient is experiencing a cholinergic crisis?

A) Clear vision
B) Fasciculations
C) Strong hand grasps
D) Equal shoulder shrugs

Answer 3

Fasciculations

Question 4

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)?

A) Elevated protein level
B) Elevated glucose level
C) Reduction in white blood cell count
D) Increased number of red blood cells

Question 5

The nurse is reviewing discharge instructions for a patient with myasthenia gravis.What should the nurse emphasize regarding medications?

A) Keep extra doses of medication in the car
B) Store extra doses of medication in the refrigerator
C) Take an extra dose of medication before leaving the house
D) Pack prescribed medications in a suitcase before flying on an airplane

Question 6

A patient with Guillain-Barré syndrome (GBS)is receiving plasmapheresis.What finding should the nurse identify as being a complication of this treatment?

A) Septicemia
B) Flu-like symptoms
C) Aseptic meningitis
D) Acute renal failure

Question 7

The nurse is caring for a patient with myasthenia gravis.Which assessment should the nurse complete to determine respiratory functioning?

A) Vital capacity
B) Pulse oximetry
C) Auscultate lung sounds
D) Arterial blood gas analysis

Question 8

A patient with Guillain-Barré syndrome (GBS)asks how the illness develops.What should the nurse respond about the pathophysiology of the disorder?

A) "An infection eats away at the nerve endings."
B) "An infection enters the spinal cord and erodes the nerves at the roots."
C) "The nerves are killed by infiltration of your body's white blood cells used to fight an infection."
D) "After an infection your immune system created antibodies that affect the covering of the nerves."

Question 9

The nurse is planning care for a patient with Guillain-Barré syndrome (GBS).Which intervention will help with neuropathic pain?

A) Administer gabapentin
B) Turn and reposition every two hours
C) Apply sequential compression devices
D) Perform passive range of motion several times a day

Question 10

The nurse is reviewing orders written for a patient with trigeminal neuralgia.Which medication should the nurse expect to be prescribed for this patient?

A) Cogentin
B) Compazine
C) Carbamazepine
D) Hydrochlorothiazide

Question 11

The nurse notes that a patient with Guillain-Barré syndrome (GBS)sweats profusely.What should the nurse do about this finding?

A) Place on a cooling blanket
B) Notify the health-care provider
C) Monitor body temperature every two hours
D) Change linen and gown and keep comfortable

Question 12

The nurse is conducting a physical examination on a female patient experiencing trigeminal neuralgia.What observation indicates that the pain is triggered by hygienic practices?

A) Limited talking
B) Hair not combed
C) Wearing tennis shoes
D) Not wearing makeup

Question 13

A patient with Guillain-Barré syndrome (GBS)loses respiratory function three weeks into the acute phase.When should the nurse expect respiratory function to return in this patient?

A) During the plateau phase
B) Early in the recovery stage
C) At the end of the plateau stage
D) At the end of the recovery stage

Question 14

A client is diagnosed with myasthenia gravis.What should the nurse explain about this disease process?

A) "Your nerve endings are worn out."
B) "Your body does not recognize the neurotransmitter needed for movement."
C) "Your body does not make enough of the neurotransmitter needed for movement."
D) "Your nerves have lost their protective covering and impulses cannot reach body areas."

Question 15

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?

A) "Have you been around any small children?"
B) "When was the last time you had anything to eat?"
C) "When was the last time you traveled out of the country?"
D) "Have you recently experienced any lung or stomach infections?"

Question 16

A patient with myasthenia gravis has lost 6 kg of weight over the last two months.What should the nurse suggest to improve this patient's nutritional status?

A) Eat three large meals per day
B) Plan medication doses to occur before meals
C) Restrict drinking fluids prior to and during meals
D) Increase the amount of fat and carbohydrates in meals

Question 17

The nurse notes that a patient has been diagnosed with trigeminal neuralgia.What should the nurse expect the patient to be experiencing?

A) Pain
B) Nausea
C) Sensory deficit
D) Motor weakness

Question 18

The nurse notes that a patient's primary complaint is burning pain on the right side of the face.What should the nurse realize this patient is describing?

A) Referred pain
B) Atypical pain
C) Vascular compression
D) Peripheral neuropathy

Question 19

The nurse is concerned that a patient is at risk for trigeminal neuralgia.What information in the patient's medical record did the nurse use to make this clinical decision?

A) Has a BMI of 34
B) Takes birth control pills
C) History of hypertension
D) Works as a computer operator

Question 20

A patient is being prepared for a tensilon test.What should the nurse ensure is available prior to the beginning of this test?

A) Oxygen
B) Atropine sulfate
C) Intravenous fluids
D) Nasogastric suction

Question 21

A patient is scheduled for surgery to treat trigeminal neuralgia.For which procedure should the nurse explain that a complication resulting in permanent numbness of the facial area might occur?

A) Plasmapheresis
B) Percutaneous rhizotomy
C) Stereotactic radiosurgery
D) Microvascular decompression

Question 22

A patient with trigeminal neuralgia asks if there are any nonpharmacological strategies to treat the pain.What should the nurse suggest to this patient?

A) Massage
B) Apply heat
C) Apply cold
D) Acupuncture