Question 1

The nurse is caring for a patient diagnosed with Parkinsons disease. The patient is having increasing problems with rising from the sitting to the standing position. What should the nurse suggest to the patient to use that will aid in getting from the sitting to the standing position as well as aid in improving bowel elimination?

Accepted Answer

A)   Use of a bedpan
B)   Use of a raised toilet seat
C)   Sitting quietly on the toilet every 2 hours
D)   Following the outlined bowel program B

Question 2

A patient diagnosed with a pituitary adenoma has arrived on the neurologic unit. When planning the patients care, the nurse should be aware that the effects of the tumor will primarily depend on what variable?

Accepted Answer

A)   Whether the tumor utilizes aerobic or anaerobic respiration
B)   The specific hormones secreted by the tumor
C)   The patients pre-existing health status
D)   Whether the tumor is primary or the result of metastasis B

Question 3

The nurse is writing a care plan for a patient with brain metastases. The nurse decides that an appropriate nursing diagnosis is anxiety related to lack of control over the health circumstances. In establishing this plan of care for the patient, the nurse should include what intervention?

Accepted Answer

A)   The patient will receive antianxiety medications every 4 hours.
B)   The patients family will be instructed on planning the patients care.
C)   The patient will be encouraged to verbalize concerns related to the disease and its treatment.
D)   The patient will begin intensive therapy with the goal of distraction. C

Question 4

A patient newly diagnosed with a cervical disk herniation is receiving health education from the clinic nurse. What conservative management measures should the nurse teach the patient to implement?

Accepted Answer

A)   Perform active ROM exercises three times daily.
B)   Sleep on a firm mattress.
C)   Apply cool compresses to the back of the neck daily.
D)   Wear the cervical collar for at least 2 hours at a time.

Question 5

A patient with a new diagnosis of amyotrophic lateral sclerosis (ALS) is overwhelmed by his diagnosis and the known complications of the disease. How can the patient best make known his wishes for care as his disease progresses?

Accepted Answer

A)   Prepare an advance directive.
B)   Designate a most responsible physician (MRP)  early in the course of the disease.
C)   Collaborate with representatives from the Amyotrophic Lateral Sclerosis Association.
D)   Ensure that witnesses are present when he provides instruction.

Question 6

A patient with Parkinsons disease is undergoing a swallowing assessment because she has recently developed adventitious lung sounds. The patients nutritional needs should be met by what method?

Accepted Answer

A)   Total parenteral nutrition (TPN) 
B)   Provision of a low-residue diet
C)   Semisolid food with thick liquids
D)   Minced foods and a fluid restriction

Question 7

A patient who has been experiencing numerous episodes of unexplained headaches and vomiting has subsequently been referred for testing to rule out a brain tumor. What characteristic of the patients vomiting is most consistent with a brain tumor?

Accepted Answer

A)   The patients vomiting is accompanied by epistaxis.
B)   The patients vomiting does not relieve his nausea.
C)   The patients vomiting is unrelated to food intake.
D)   The patients emesis is blood-tinged.

Question 8

The nurse is caring for a boy who has muscular dystrophy. When planning assistance with the patients ADLs, what goal should the nurse prioritize?

Accepted Answer

A)   Promoting the patients recovery from the disease
B)   Maximizing the patients level of function
C)   Ensuring the patients adherence to treatment
D)   Fostering the familys participation in care

Question 9

A patient with an inoperable brain tumor has been told that he has a short life expectancy. On what aspects of assessment and care should the home health nurse focus? Select all that apply.

Accepted Answer

A)   Pain control
B)   Management of treatment complications
C)   Interpretation of diagnostic tests
D)   Assistance with self-care
E)   Administration of treatments

Question 10

A 37-year-old man is brought to the clinic by his wife because he is experiencing loss of motor function and sensation. The physician suspects the patient has a spinal cord tumor and hospitalizes him for diagnostic testing. In light of the need to diagnose spinal cord compression from a tumor, the nurse will most likely prepare the patient for what test?

Accepted Answer

A)   Anterior-posterior x-ray
B)   Ultrasound
C)   Lumbar puncture
D)   MRI

Question 11

A patient, brought to the clinic by his wife and son, is diagnosed with Huntington disease. When providing anticipatory guidance, the nurse should address the future possibility of what effect of Huntington disease?

Accepted Answer

A)   Metastasis
B)   Risk for stroke
C)   Emotional and personality changes
D)   Pathologic bone fractures

Question 12

The nurse is caring for a patient who is scheduled for a cervical discectomy the following day. During health education, the patient should be made aware of what potential complications?

Accepted Answer

A)   Vertebral fracture
B)   Hematoma at the surgical site
C)   Scoliosis
D)   Renal trauma

Question 13

An older adult has encouraged her husband to visit their primary care provider, stating that she is concerned that he may have Parkinsons disease. Which of the wifes descriptions of her husbands health and function is most suggestive of Parkinsons disease?

Accepted Answer

A)   Lately he seems to move far more slowly than he ever has in the past.
B)   He often complains that his joints are terribly stiff when he wakes up in the morning.
C)   Hes forgotten the names of some people that weve known for years.
D)   Hes losing weight even though he has a ravenous appetite.

Question 14

While assessing the patient at the beginning of the shift, the nurse inspects a surgical dressing covering the operative site after the patients cervical diskectomy. The nurse notes that the drainage is $75 \%$ saturated with serosanguineous discharge. What is the nurses most appropriate action?

Accepted Answer

A)   Page the physician and report this sign of infection.
B)   Reinforce the dressing and reassess in 1 to 2 hours.
C)   Reposition the patient to prevent further hemorrhage.
D)   Inform the surgeon of the possibility of a dural leak.

Question 15

A patient has just been diagnosed with Parkinsons disease and the nurse is planning the patients subsequent care for the home setting. What nursing diagnosis should the nurse address when educating the patients family?

Accepted Answer

A)   Risk for infection
B)   Impaired spontaneous ventilation
C)   Unilateral neglect
D)   Risk for injury

Question 16

A gerontologic nurse is advocating for diagnostic testing of an 81-year-old patient who is experiencing
Personality changes. The nurse is aware of what factor that is known to affect the diagnosis and treatment of brain tumors in older adults?

Accepted Answer

A)   The effects of brain tumors are often attributed to the cognitive effects of aging.
B)   Brain tumors in older adults do not normally produce focal effects.
C)   Older adults typically have numerous benign brain tumors by the eighth decade of life.
D)   Brain tumors cannot normally be treated in patient over age 75 .

Question 17

The nurse is planning the care of a patient who has been recently diagnosed with a cerebellar tumor. Due to the location of this patients tumor, the nurse should implement measures to prevent what complication?

Accepted Answer

A)   Falls
B)   Audio hallucinations
C)   Respiratory depression
D)   Labile BP

Question 18

A patient has just returned to the unit from the PACU after surgery for a tumor within the spine. The patient complains of pain. When positioning the patient for comfort and to reduce injury to the surgical site, the nurse will position to patient in what position?

Accepted Answer

A)   In the high Fowlers position
B)   In a flat side-lying position
C)   In the Trendelenberg position
D)   In the reverse Trendelenberg position

Question 19

A patient with suspected Parkinsons disease is initially being assessed by the nurse. When is the best time to assess for the presence of a tremor?

Accepted Answer

A)   When the patient is resting
B)   When the patient is ambulating
C)   When the patient is preparing his or her meal tray to eat
D)   When the patient is participating in occupational therapy

Question 20

A patient who was diagnosed with Parkinsons disease several months ago recently began treatment with levodopa-carbidopa. The patient and his family are excited that he has experienced significant symptom relief. The nurse should be aware of what implication of the patients medication regimen?

Accepted Answer

A)   The patient is in a honeymoon period when adverse effects of levodopa-carbidopa are not yet evident.
B)   Benefits of levodopa-carbidopa do not peak until 6 to 9 months after the initiation of treatment.
C)   The patients temporary improvement in status is likely unrelated to levodopa-carbidopa.
D)   Benefits of levodopa-carbidopa often diminish after 1 or 2 years of treatment.

Exam 69: Management of Patients With Oncologic or Degenerative Neurologic Disorders