Question 1

A 42-year-old patient who was adopted at birth is diagnosed with early Huntington's disease (HD). When teaching the patient, spouse, and children about this disorder, the nurse will provide information about the

Accepted Answer

A)   use of levodopa-carbidopa (Sinemet)  to help reduce HD symptoms.
B)   need to take prophylactic antibiotics to decrease the risk for pneumonia.
C)   lifestyle changes, such as increased exercise, that delay disease progression.
D)   availability of genetic testing to determine the HD risk for the patient's children. D

Question 2

A patient with Parkinson's disease is admitted to the hospital for treatment of an acute infection. Which nursing interventions will be included in the plan of care? (Select all that apply.)

Accepted Answer

A)   Cut patient's food into small pieces.
B)   Provide high protein foods at each meal.
C)   Observe for sudden exacerbation of symptoms.
D)   Remind the patient to keep eyes ahead when ambulating.
E)   Place an arm chair at the patient's bedside.F)  Use an elevated toilet seat. A, E, F

Question 3

A patient is seen in the health clinic with symptoms of a stooped posture, shuffling gait, and pill rolling-type tremor. The nurse will anticipate teaching the patient about

Accepted Answer

A)   preparation for an MRI.
B)   purpose of EEG testing.
C)   antiparkinsonian drugs.
D)   oral corticosteroids. C

Question 4

A patient has a tonic-clonic seizure while the nurse is in the patient's room. During the seizure, it is important for the nurse to

Accepted Answer

A)   insert an oral airway during the seizure to maintain a patent airway.
B)   restrain the patient's arms and legs to prevent injury during the seizure.
C)   avoid touching the patient to prevent further nervous system stimulation.
D)   time and observe and record the details of the seizure and postictal state.

Question 5

A patient who has been taking bromocriptine (Parlodel) and benztropine (Cogentin) for Parkinson's disease is experiencing a worsening of symptoms. The nurse will anticipate that patient may benefit from

Accepted Answer

A)   complete drug withdrawal for a few weeks.
B)   use of levodopa (L-dopa) -carbidopa (Sinemet) .
C)   withdrawal of anticholinergic therapy.
D)   increasing the dose of bromocriptine.

Question 6

A hospitalized patient with myasthenia gravis (MG) has a nursing diagnosis of imbalanced nutrition: less than body requirements related to impaired swallowing. To promote nutrition, the nurse suggests that before meals the patient should avoid

Accepted Answer

A)   watching television.
B)   talking on the phone.
C)   typing on the computer.
D)   ambulating in the halls.

Question 7

A hospitalized patient complains of a moderate bilateral headache that radiates from the base of the skull. Which of the following medications ordered on a PRN basis for the patient should the nurse administer initially?

Accepted Answer

A)   Lorazepam (Ativan) 
B)   Acetaminophen (Tylenol) 
C)   Morphine sulfate (Roxanol) 
D)   Butalbital and aspirin (Fiorinal)

Question 8

The health care provider is considering the use of sumatriptan (Imitrex) for a patient with migraine headaches. Which information obtained by the nurse is most important to report to the health care provider?

Accepted Answer

A)   The patient has a history of a recent acute myocardial infarction.
B)   The patient has had migraine headaches for 30 years.
C)   The patient has been taking topiramate (Topamax)  for 2 months.
D)   The patient has at least 1 to 2 cups of coffee daily.

Question 9

A patient has a new prescription for levodopa (L-dopa) to control symptoms of Parkinson's disease. Which assessment data obtained by the nurse may indicate a need for a decrease in the dose?

Accepted Answer

A)   The patient has a chronic dry cough.
B)   The patient has 4 loose stools in a day.
C)   The patient develops a deep vein thrombosis.
D)   The patient's blood pressure is 90/46 mm Hg.

Question 10

A patient seen at the health clinic with a severe migraine headache tells the nurse about having four similar headaches in the last 3 months. The patient says, "I am afraid to make social plans because I never know when I will have these headaches." The most appropriate nursing action at this time is to

Accepted Answer

A)   refer the patient for counseling to assist with stress reduction.
B)   ask the patient to keep a diary with details about headaches.
C)   encourage the patient to learn muscle-relaxation techniques to minimize headache frequency.
D)   teach the patient about the effectiveness of the triptan drugs in treating migraine headaches.

Question 11

A patient with multiple sclerosis (MS) has a nursing diagnosis of urinary retention related to sensorimotor deficits. An appropriate nursing intervention for this problem is to

Accepted Answer

A)   decrease fluid intake in the evening.
B)   teach the patient how to use the Credé method.
C)   suggest the use of incontinence briefs for nighttime use only.
D)   assist the patient to the commode every 2 hours during the day.

Question 12

When teaching the patient with newly diagnosed multiple sclerosis (MS) about the disease, the nurse explains that

Accepted Answer

A)   MS is a congenitally acquired illness that causes progressive neurologic deterioration.
B)   impulses travel too fast over nerves that have lost their myelin coat and cause overstimulation of muscle fibers.
C)   autoimmune processes cause gradual destruction of the myelin sheath of nerves in the brain and spinal cord.
D)   antibodies are produced against acetylcholine receptors at the synapse and result in blocked muscle contraction.

Question 13

A patient with amyotrophic lateral sclerosis (ALS) is hospitalized with pneumonia. Which nursing action will be included in the plan of care?

Accepted Answer

A)   Observing for agitation and paranoia
B)   Assisting the patient with active range of motion (ROM) 
C)   Using simple words and phrases to explain procedures
D)   Administer muscle relaxants as needed for muscle spasms

Question 14

When planning care for a patient with MS who has a nursing diagnosis of risk for activity intolerance related to extremity weakness secondary to stress, the most appropriate patient goal is

Accepted Answer

A)   "The patient will express minimal stress level."
B)   "Strength in arms and legs will be maintained."
C)   "The patient will complete ADLs without fatigue."
D)   "Intake of high-nutrition foods will be adequate."

Question 15

A 28-year-old woman has had multiple sclerosis (MS) for 3 years and wants to have children before her disease worsens. When she asks about the risks associated with pregnancy, the nurse explains that

Accepted Answer

A)   MS is associated with a slightly increased risk for congenital defects.
B)   symptoms of MS are likely to become worse during her pregnancy.
C)   women with MS frequently have premature labor.
D)   MS symptoms may be worse after the pregnancy.

Question 16

When preparing to admit a patient who has been treated for status epilepticus in the emergency department, which equipment should the nurse have available in the room? (Select all that apply.)

Accepted Answer

A)   Suction tubing
B)   Oxygen mask
C)   Nasogastric tube
D)   Siderail pads
E)   Tongue bladeF)  Oral airway

Question 17

The nurse witnesses a patient with a seizure disorder as the patient suddenly jerks the arms and legs, falls to the floor, and regains consciousness immediately. It will be most important for the nurse to

Accepted Answer

A)   document the timing and description of the seizure.
B)   notify the patient's health care provider about the seizure.
C)   give the scheduled dose of divalproex (Depakote) .
D)   assess the patient for a possible head injury.

Question 18

The health care provider prescribes phenytoin (Dilantin) for control of complex partial seizures. After the nurse has taught the patient about phenytoin, which patient statement indicates understanding of the medication?

Accepted Answer

A)   "I should use soft swabs rather than a toothbrush to clean my mouth."
B)   "After I have a seizure, I should call an ambulance to take me to the hospital."
C)   "I may need to have my blood taken frequently to check the level of the Dilantin."
D)   "I will take the medication at the beginning of the seizure when I experience an aura."

Question 19

A patient found in a tonic-clonic seizure reports afterward that the seizure was preceded by numbness and tingling of the arm. The nurse knows that this finding indicates a(n) _____ seizure.

Accepted Answer

A)   absence
B)   simple partial
C)   complex partial
D)   generalized myoclonic

Question 20

When obtaining a health history and physical assessment for a patient with possible multiple sclerosis (MS), the nurse should

Accepted Answer

A)   confirm patient information with family members.
B)   ask about a recent history of temperature spikes.
C)   question the patient about any leg weakness or spasm.
D)   determine whether hypersexuality has caused problems.

Exam 59: Nursing Management: Chronic Neurologic Problems

A 42-year-old patient who was adopted at birth is diagnosed with early Huntington's disease (HD) . When teaching the patient, spouse, and children about this disorder, the nurse will provide information about the