EAQs

A client is diagnosed with Parkinson disease and receives a prescription for Levodopa therapy. Which mechanism of action would the nurse identify for this medication? A. Blocks the effects of acetylcholine B. Increases the production of dopamine C. Restores the dopamine levels in the brain D. Promotes the production of acetylcholine

C.

Which clinical manifestations are consistent with Sjögren syndrome? Select all that apply A. Iritis B. Scleritis C. Xerostomia D. Baker's cyst E. Keratoconjunctivitis sicca

C., E. Xerostomia is dry mouth Keratoconjunctivitis sicca is dry eyes

Which action would the nurse perform immediately according to priority of care for a client with tonic-clonic seizures? A. Ensuring patent airway B. Administering IV fluids C. Monitoring level of consciousness D. Protecting the client from injury during seizures

A.

Which client has an increased risk of developing IgE antibodies? A. client with pollen allergy B. client undergoing poison ivy reaction C. client with a bacterial infection D. client undergoing a blood transfusion

A.

Which first-line medication would the nurse use to treat anaphylactic reactions? A. Epinephrine B. Norepinephrine C. Dexamethasone D. Diphenhydramine

A. Dexamethasone and Diphenhydramine are second line for anaphylactic reactions

Which clinical indicators would the nurse expect to find when assessing a patient with Parkinson disease? Select all that apply A. Resting tremors B. Flattened affect C. Muscle flaccidity D. Tonic-clonic seizures E. Slow voluntary movements

A., B., E.

The nurse is obtaining a health history from a client with HIV with a low viral load who has been asymptomatic for years. Which statement by the client indicates the need for additional teaching? A. I inform all my partners of my HIV positive status B. I should not skip any doses of antiretroviral medication C. I occasionally have oral sex without the use of protection D. I have never shared or reused any of my diabetic supplies

C.

A client on antipsychotic medication therapy develops parkinsonism. Which medications would the nurse anticipate being beneficial for the client? Select all that apply A. Levodopa B. Benztropine C. Amantadine D. Bromocriptine E. Diphenhydramine

B., C., E. Levodopa is for non-drug-induced-Parkinsons

Which assessments are the most significant for a client who is believed myasthenia gravis? A. Capacity to smile and close eyelids B. Ability to chew and speak words distinctly C. Effectiveness of respiratory exchange and ability to swallow D. Degree of anxiety and concern about the suspected diagnosis

C.

Which clinical finding would the nurse expect to find with a new diagnosis of myasthenia gravis? A. Tearing B. Diplopia C. Nystagmus D. Exophthalmos

B. Diplopia - double vision Nystagmus - MS Exophthalmos - hyperthyroidism

Which is the priority assessment for the client who has Guillain-Barré syndrome with rapidly ascending paralysis? A. Monitoring urine output B. Assessing nutritional status C. Monitoring respiratory status D. Assessing communication needs

C.

A client exposed to pollen reports a runny, stuffy nose and itchy, watery eyes. The nasal examination reveals swollen and pink nasal mucosa. Which laboratory finding would the nurse expect to identify? A. IgE level of 150 IU/mL B. Eosinophil count of 2% C. Percentage of neutrophils of 80% D. total WBC of 3 billion

A.

The nurse is assessing an adolescent after the administration of epinephrine. Which side effect is most important for the nurse to identify? A. Tachycardia B. Hypoglycemia C. Constricted pupils D. Decreased blood pressure

A. Tachycardia

Which findings would the nurse expect when completing an admission physical for a client with a diagnosis of Parkinson disease? Select all that apply A. Muscle rigidity B. Blank facial expression C. Leaning toward affected side D. Intention tremors with movement E. Hyperextension of the affected extremity

A., B. (nonintention tremors w/ Parkinsons)

Which would the nurse identify as increasing the risk of human immunodeficiency virus (HIV) transmission? Select all that apply A. Childbirth B. Monogamy C. Breast-feeding D. Needle sharing E. Sharing plates and utensils

A., C., D.

Which clinical manifestations would the nurse expect to find in a client who has acute human immunodeficiency virus? Select all that apply A. Malaise B. Confusion C. Constipation D. swollen lymph nodes E. oropharyngeal candidiasis

A., D. (Think flu symptoms)

A client newly diagnosed with multiple sclerosis asks the nurse, "Will I experience pain?" Which response would the nurse give? A. Tell me about your fears regarding pain B. Analgesics will be prescribed to control the pain C. Pain is not a characteristic symptoms of this condition D. Let's make a list of things to ask your primary health care provider

C.

Which information would the nurse consider when planning care for a group of clients with myasthenia gravis, Guillain-Barré, and ALS? A. Progressive deterioration until death B. Deficiencies of essential neurotransmitters C. Increased risk for respiratory complications D. Involuntary twitching of small muscle groups

C.

Which statement by a client who has myasthenia gravis indicates understanding for managing self care? A. Plan my activities for later in the day B. Eat meals in semirecumbent position C. Avoid people with respiratory infections D. Take muscle relaxants when under stress

C.

A client is scheduled to have a Tensilon test. Which response to the test would confirm the diagnosis of myasthenia gravis? A. Brief exaggeration of symptoms B. Prolonged symptomatic improvement C. Rapid but brief symptomatic improvement D. Symptomatic improvement of only the ptosis

C. Tensilon is like a treatment? a quick one

A client asks the nurse what causes sudden loss of vision common in persons with multiple sclerosis? A. Virus-induced iritis B. Intracranial pressure C. Closed-angle glaucoma D. Optic nerve inflammation

D.

A client with Guillain-Barré syndrome has been hospitalized for 3 days. Which assessment data would the nurse plan to monitor frequently for this client? A. Localized seizures B. Skin desquamation C. Hyperactive reflexes D. Ascending weakness

D.

A client is admitted to the hospital after having a tonic-clonic seizure and is diagnosed with a seizure disorder. Which is most important for the nurse to include in a teaching program? A. Explain strategies a client might use to prevent physical trauma from occurring during a seizure B. Teach the client to take anticonvulsant medications on an empty stomach C. Teach the client that the symptoms and treatment of seizure disorders are similar, regardless of the cause D. Explain that sharing the knowledge of their illness with others is not necessary, because the medications will control the seizures

A.

A client's phenytoin level is 16 mcg/L. Which action will the nurse take? A. Hold the medication and notify the provider B. Administer the next dose as prescribed C. Hold the next dose and then resume administration D. Call the health care provider to obtain a higher dose

B.

Which action would the nurse include in the plan of care for a client who just had a posterior lumbar laminectomy? A. Encourage the client to cough B. Reposition the client by log rolling C. Assess the client for indications of peritonitis D. Instruct the client to bend the knees when turning

B.

According to the CDC, which stage of HIV is present in the client with 350 cells/mm3 of CD4+T-cell count? A. Stage 1 B. Stage 2 C. Stage 3 D. Stage 4

B. (Stage 1 is 500 Stage 2 is 499-201 Stage 3 is 200 Stage 4 is when there is no info)

A client is admitted to the hospital with a tentative diagnosis of Guillain-Barré syndrome. Which question by the nurse will elicit information consistent with this diagnosis? A. Have you experienced an infection recently? B. Is there a history of the disorder in your family? C. Did you receive a head injury in the past year? D. What medications have you taken in the past year?

A. it's linked to several other diseases and comes a few weeks laters

A diagnosis of myasthenia gravis is suspected for a client who sees the primary health care provider because of fatigue, double vision, and muscle weakness. Which information would the nurse expect the client to report? A. Muscle weakness improving after a period of rest B. Symptoms worse in the morning upon awakening C. Intermittent periods of hyperactivity D. Slow, insidious onset of muscle weakness

A. weakness and fatigue come quickly and fade with rest

A back brace is prescribed for a client who had a laminectomy. What should the nurse include in the client's teaching plan? A. Use the brace when the back feels tired. B. Apply the brace before getting out of bed. C. Put the brace on while in the sitting position. D. Wear the brace when performing twisting exercises.

B.

A client is admitted to the emergency department after experiencing a seizure. Which action would the nurse take first? A. Ask the emergency provider for a prophylactic anticonvulsant B. Obtain a history of seizure type and incidence C. Ask the client to remove any dentures and eyeglasses D. Observe the client for increased restlessness and agitation

B.

A client presents with cutaneous lesions with swelling of the face, eyelids, and lips from dilation and engorgement of the capillaries. The nurse does not observe welts or vesicles. Which hypersensitivity condition does the nurse suspect the client is experiencing? A. Urticarial dermatitis B. Angioedema C. Atopic dermatitis D. Systemic Lupus Erythematosus (SLE)

B.

A client with a seizure disorder is receiving phenytoin and phenobarbital. Which client statement indicates that the instructions regarding the medications are understood? A. I will not have any seizures on this medication B. These medicines must be continued to prevent falls and injury C. Stopping the medications can cause continuous seizures and I may die D. By staying on the medications I will prevent postseizure confusion

C.

Corticosteroid therapy is prescribed for a patient with multiple sclerosis. In response to the therapy, which symptom would a nurse expect to decrease? A. Emotional lability B. Muscular Contractions C. Pain in the extremities D. Visual impairment

D. Corticosteroids decrease inflammation around the optic nerve !Visual impairment is the most common physiological manifestation of MS!

Which identified clinical manifestation is a sign of allergic rhinitis? A. Presence of a high grade fever B. Reduced breathing through the mouth C. Presence of pinkish nasal discharge D. Reduced transillumination on the skin over the sinuses

D. because of inflammation and stuffiness

A nurse is counseling a client with amyotrophic lateral sclerosis (ALS) about management of this disorder. What important suggestion should the nurse make to the client? A. Eye surgery may improve your vision B. Activities should be spaced throughout the day C. Opioids may be necessary for the pain in your legs D. Leg restraints will decrease the chance of physical injury

B. Conserve energy and space activities because a progressive disease

A client with Parkinson disease is admitted to the hospital. Which medication is prescribed to improve the physical manifestations of Parkinson disease? A. Carbidopa-Levodopa B. Isocarboxazid C. Dopamine D. Pyridoxine

A.

When assisting a client with Parkinson disease to ambulate, which instruction would the nurse provide the client? A. Avoid leaning forward B. hesitate between steps C. Rest when tremors are experienced D. Keep arms close to the center of gravity

A.

A client suspected of having myasthenia gravis is scheduled for an edrophonium chloride test. To treat a common complication associated with the test, the nurse will have which medication available? A. Atropine B. Phenytoin C. Neostigmine D. Diphenhydramine

A. Atropine treats sudden muscle weakness that can cause respiratory distress

Which procedure would the nurse expect as a treatment option for a client newly diagnosed with Guillain-Barré syndrome? A. Hemodialysis B. Plasmapheresis C. Thrombolytic therapy D. Immunosuppression therapy

B. its like fixing the plasma

Which information would the nurse include in the teaching plan for a client diagnosed with epilepsy? A. The client will take anticonvulsant medications for life B. Individuals taking phenytoin must floss their teeth regularly C. A diagnosis of epilepsy prevents individuals from ever obtaining a driver's license D. Loss of consciousness during a seizure requires emergency evaluation

B. Gingival hyperplasia is a common side effect of phenytoin

Which term would a nurse use to document observing the characteristic gait associated with Parkinson's disease? A. Ataxic B. Shuffling C. Scissoring D. Asymmetric

B. Shuffling

Which actions transmit the human immunodeficiency virus (HIV)? Select all that apply A. Multiple mosquito bites B. Sharing syringe needles C. Breast-feeding a newborn D. Dry kissing an infected individual E. Anal intercourse F. Sharing drinking glasses

B., C., E.

Which complication would the nurse assess in both clients who have Parkinson disease and clients who have myasthenia gravis? A. Cogwheel gait B. Impaired cognition C. Difficulty swallowing D. Nonintention tremors

C.

Which nursing interventions is the priority for a client on an IV medication who is experiencing an anaphylactic reaction? A. Elevate the lower extremities B. Start a normal saline infusion C. Report to primary care provider immediately D. Stop IV medication and administer epinephrine

D.

A client reports nasal discharge, sneezing, lacrimation, and itching all over the body. During an assessment, the client reports exposure to dusts and molds. The nurse observes swelling and a pink color at the itching site. Which class of medications would the nurse anticipate administering to treat this client's condition? A. Medications containing antihistamines B. Antipruritic medications C. Mast cell-stabilizing medications D. Leukotriene receptor antagonists

A. ! Mast-cell stabilizing are used to manage not treat allergic rhinitis !

Which condition presents with elevated IgE levels, positive allergic skin test reactivity, and widespread skin vesicles A. Allergic rhinitis B. Atopic dermatitis C. Contact dermatitis D. Goodpasture syndrome

B. Allergic rhinitis is seasonal allergies Goodpasture involves the lungs and kidneys Contact dermatitis is delayed reaction

Which clinical manifestation are found in the client diagnosed with stage 3 Parkinson Disease? Select all that apply A. Akinesia B. Mask-like face C. Postural Instability D. Unilateral limb involvement E. Increased gait disturbances

B., C., E. Akinesia is in Stage 4 and Unilateral in stage 1 because turns to bilateral later Stage 3 characterized by posture and gait Mask face starts in stage 2 and continues into stage 3

On the first evening after a lumbar laminectomy, a client states, "My feet are as numb as they were before the operation." Which response would the nurse make? A. Let me elevate your feet so the numbness will decrease more quickly B. That's important to know. I will contact your health care provider about the numbness C. Continue to let me know how you feel. It often takes time before that feeling subsides D. There is no cause for concern. The numbness will disappear when the anesthesia wears off

C.

The nurse reviews the history to find that an adolescent has a tattoo on the neck and piercings on the ear and eyebrow. During the next visit, the nurse finds a new tattoo on the upper right arm and another piercing on the nose. Which would be priority nursing interventions? Select all that apply A. Prepare a proper diet plan for the adolescent B. Instruct the adolescent to get an electrocardiogram C. Instruct the adolescent to perform regular exercises D. Screen the adolescent for HIV E. Schedule the adolescent for administering the hepatitis vaccine

D., E.

Status epilepticus develops in an adolescent with a seizure disorder who is taking antiseizure medication. Which reason would the nurse identify as the most common reason for this development? A. The provider failed to account for growth spurt B. The amount prescribed is insufficient to cover activities C. The prescribed antiseizure medication is not taken consistently D. The client is prescribed a medication that is ineffective in preventing seizures

C.