Management of Patients with Oncologic or Degenerative Neurologic Disorders

An older adult has encouraged the spouse husband to visit their primary provider, stating that concern that spouse may have Parkinson disease. Which description of the spouse's health and function is most suggestive of Parkinson disease? 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. "He's forgotten the names of some people that we've known for years." D. "He's losing weight even though he has a ravenous appetite."

A. "Lately he seems to move far more slowly than he ever has in the past."

A nurse is planning discharge education for a client who underwent a cervical discectomy. What strategies would the nurse assess that would aid in planning discharge teaching? A. Care of the cervical collar B. Technique for performing neck ROM exercises C. Home assessment of ABGs D. Techniques for restoring nerve function

A. Care of the cervical collar

The nurse is planning the care of a client who has been recently diagnosed with a cerebellar tumor. Due to the location of this client's tumor, the nurse should implement measures to prevent what complication? A. Falls B. Audio hallucinations C. Respiratory depression D. Labile BP

A. Falls

A client has been admitted to the neurologic ICU with a diagnosis of a brain tumor. The client is scheduled to have a tumor resection/removal in the morning. Which of the following assessment parameters should the nurse include in the initial assessment? A. Gag reflex B. Deep tendon reflexes C. Abdominal girth D. Hearing acuity

A. Gag reflex

A client is exhibiting late signs of increased intracranial pressure. Which finding would the nurse most likely assess? Select all that apply. A. Hypertension B. Bradycardia C. Respiratory depression D. Headache E. Papilledema

A. Hypertension B. Bradycardia C. Respiratory depression

A family member of a client diagnosed with Huntington disease calls the clinic. The family member is requesting help from the Huntington Disease Society of America. What kind of help can this client and family receive from this organization? Select all that apply. A. Information about this disease B. Referrals C. Public education D. Individual assessments E. Appraisals of research studies

A. Information about this disease B. Referrals C. Public education

A nurse is assessing a client with an acoustic neuroma who has been recently admitted to an oncology unit. What symptoms is the nurse likely to find during the initial assessment? A. Loss of hearing, tinnitus, and vertigo B. Loss of vision, change in mental status, and hyperthermia C. Loss of hearing, increased sodium retention, and hypertension D. Loss of vision, headache, and tachycardia

A. Loss of hearing, tinnitus, and vertigo

A client with an inoperable brain tumor has been told that the client has a short life expectancy. On what aspects of assessment and care should the home health nurse focus? Select all that apply. A. Pain control B. Management of treatment complications C. Interpretation of diagnostic tests D. Assistance with self-care E. Administration of treatments

A. Pain control B. Management of treatment complications D. Assistance with self-care E. Administration of treatments

A client with a new diagnosis of amyotrophic lateral sclerosis (ALS) is overwhelmed by the diagnosis and the known complications of the disease. How can the client best make known their wishes for care as the disease progresses? A. Prepare an advance directive. B. Designate a most responsible health care provider (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.

A. Prepare an advance directive.

A male client presents at the free clinic with reports of erectile dysfunction. Upon physical examination, the nurse practitioner notes the presence of hypogonadism. What diagnosis should the nurse suspect? A. Prolactinoma B. Angioma C. Glioma D. Adrenocorticotropic hormone (ACTH)-producing adenoma

A. Prolactinoma

The nurse caring for a client diagnosed with Parkinson disease has helped prepare a plan of care that would include which goal? A. Promoting effective communication B. Controlling diarrhea C. Preventing optic nerve damage D. Managing choreiform movements

A. Promoting effective communication

A gerontologic nurse is advocating for diagnostic testing of an 81-year-old client 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? 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 clients over age 75.

A. The effects of brain tumors are often attributed to the cognitive effects of aging.

A nurse is conducting an assessment of a client who is suspected of having a brain tumor. Assessment reveals reports of a headache, for which the nurse gathers additional information. The nurse determines that these reports support the suspicion of a brain tumor when the client reports that the headache occurs: A. early in the morning. B. around lunchtime. C. in the middle of the afternoon. D. at bedtime

A. early in the morning.

A female client is admitted to the medical unit for evaluation of cerebral metastasis from a primary site. When reviewing the client's history, the nurse would most likely find which site as being the primary site? A. lung B. prostate C. renal D. uterus

A. lung

A client is diagnosed with an acoustic neuroma. When assessing this client, which manifestation would the nurse expect to find? Select all that apply. A. tinnitus B. vertigo C. staggering gait D. seizures E. headache

A. tinnitus B. vertigo C. staggering gait

The clinic nurse caring for a client with Parkinson disease notes that the client has been taking levodopa and carbidopa (Sinemet) for 7 years. For what common side effect should the nurse assess this client? A. Pruritus B. Dyskinesia C. Lactose intolerance D. Diarrhea

B. Dyskinesia

A 25-year-old client with brain metastases is considering life expectancy after the client's most recent meeting with her oncologist. Based on the fact that the client is not receiving treatment for the brain metastases, what is the nurse's most appropriate action? A. Promoting the client's functional status and ADLs B. Ensuring that the client receives adequate palliative care C. Ensuring that the family does not tell the client that the condition is terminal D. Promoting adherence to the prescribed medication regimen

B. Ensuring that the client receives adequate palliative care

The nurse is caring for a client who is scheduled for a cervical discectomy the following day. During health education, the client should be made aware of what potential complications? A. Vertebral fracture B. Hematoma at the surgical site C. Scoliosis D. Renal trauma

B. Hematoma at the surgical site

A client has been admitted to the neurologic unit for the treatment of a newly diagnosed brain tumor. The client has just exhibited seizure activity for the first time. What is the nurse's priority response to this event? A. Identify the triggers that precipitated the seizure. B. Implement precautions to ensure the client's safety. C. Teach the client's family about the relationship between brain tumors and seizure activity. D. Ensure that the client is housed in a private room.

B. Implement precautions to ensure the client's safety.

A client has just returned to the unit from the PACU after surgery for a tumor within the spine. The client reports pain. When positioning the client for comfort and to reduce injury to the surgical site, the nurse will position to client in what position? A. In the high Fowler position B. In a flat side-lying position C. In the Trendelenburg position D. In the reverse Trendelenburg position

B. In a flat side-lying position

The nurse in an extended care facility is planning the daily activities of a client with post-polio syndrome. The nurse recognizes the client will best benefit from physical therapy when it is scheduled at what time? A. Immediately after meals B. In the morning C. Before bedtime D. In the early evening

B. In the morning

The nurse is caring for a boy who has muscular dystrophy. When planning assistance with the client's ADLs, what goal should the nurse prioritize? A. Promoting the client's recovery from the disease B. Maximizing the client's level of function C. Ensuring the client's adherence to treatment D. Fostering the family's participation in care

B. Maximizing the client's level of function

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

B. Sleep on a firm mattress.

A client diagnosed with a pituitary adenoma has arrived on the neurologic unit. When planning the client's care, the nurse should be aware that the effects of the tumor will primarily depend on what variable? A. Whether the tumor utilizes aerobic or anaerobic respiration B. The specific hormones secreted by the tumor C. The client's pre-existing health status D. Whether the tumor is primary or the result of metastasis

B. The specific hormones secreted by the tumor

A client with Parkinson disease is experiencing episodes of constipation that are becoming increasingly frequent and severe. The client reports achieving relief for the past few weeks by using over-the-counter laxatives. How should the nurse respond? A. "It's important to drink plenty of fluids while you're taking laxatives." B. "Make sure that you supplement your laxatives with a nutritious diet." C. "Let's explore other options, because laxatives can have side effects and create dependency." D. "You should ideally be using herbal remedies rather than medications to promote bowel function."

C. "Let's explore other options, because laxatives can have side effects and create dependency."

The nurse is caring for a client newly diagnosed with a primary brain tumor. The client asks the nurse where the tumor came from. What would be the nurse's best response? A. "Your tumor originated from somewhere outside the CNS." B. "Your tumor likely started out in one of your glands." C. "Your tumor originated from cells within your brain itself." D. "Your tumor is from nerve tissue somewhere in your body."

C. "Your tumor originated from cells within your brain itself."

A client with a brain tumor has begun to exhibit signs of cachexia. What subsequent assessment should the nurse prioritize? A. Assessment of peripheral nervous function B. Assessment of cranial nerve function C. Assessment of nutritional status D. Assessment of respiratory status

C. Assessment of nutritional status

A client, brought to the clinic by the client's spouse and son, is diagnosed with Huntington disease. When providing anticipatory guidance, the nurse should address the future possibility of what effect of Huntington disease? A. Metastasis B. Risk for stroke C. Emotional and personality changes D. Pathologic bone fractures

C. Emotional and personality changes

The nurse is writing a care plan for a client 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 client, the nurse should include which intervention? A. Antianxiety medications every 4 hours B. Family instruction on planning the client's care C. Encouragement to verbalize concerns related to the disease and its treatment D. Intensive therapy with the goal of distraction

C. Encouragement to verbalize concerns related to the disease and its treatment

A client with amyotrophic lateral sclerosis (ALS) is being visited by the home health nurse who is creating a care plan. Which of the following nursing diagnoses is most likely for a client with this condition? A. Chronic confusion B. Impaired urinary elimination C. Impaired verbal communication D. Bowel incontinence

C. Impaired verbal communication

The nurse is caring for a client with a brain tumor who is experiencing symptoms due to compression and infiltration of normal tissue. The pathophysiologic changes that result can cause what manifestations? Select all that apply. A. Intracranial hemorrhage B. Infection of cerebrospinal fluid C. Increased ICP D. Focal neurologic signs E. Altered pituitary function

C. Increased ICP D. Focal neurologic signs E. Altered pituitary function

A client with Parkinson disease is undergoing a swallowing assessment because the client has recently developed adventitious lung sounds. The client's nutritional needs should be met by what method? 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

C. Semisolid food with thick liquids

A client 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 client's vomiting is most consistent with a brain tumor? A. The client's vomiting is accompanied by epistaxis. B. The client's vomiting does not relieve his nausea. C. The client's vomiting is unrelated to food intake. D. The client's emesis is blood-tinged.

C. The client's vomiting is unrelated to food intake.

A nurse is reading a journal article about brain tumors and the various types that can occur. The nurse demonstrates understanding of the article by identifying which type as being classified as an intracerebral tumor? Select all that apply. A. meningioma B. schwannoma C. glioblastoma D. astrocytoma E. medulloblastoma

C. glioblastoma D. astrocytoma E. medulloblastoma

A client with a metastatic brain tumor of the frontal lobe experiences a generalized seizure for the first time. The nurse should prepare for what action? A. Intubation B. STAT computed tomography (CT) health care provider C. A STAT MRI D. Administration of anticonvulsants

D. Administration of anticonvulsants

The nurse is caring for a client with Huntington disease who has been admitted to the hospital for treatment of malnutrition. What independent nursing action should be implemented in the client's plan of care? A. Firmly redirect the client's head when feeding. B. Administer phenothiazines after each meal as prescribed. C. Encourage the client to keep his or her feeding area clean. D. Apply deep, gentle pressure around the client's mouth to aid swallowing.

D. Apply deep, gentle pressure around the client's mouth to aid swallowing.

A 37-year-old client is brought to the clinic by the spouse because the client is experiencing loss of motor function and sensation. The health care provider suspects the client has a spinal cord tumor and hospitalizes the client for diagnostic testing. In light of the need to rule out spinal cord compression from a tumor, the nurse will most likely prepare the client for what test? A. Anterior-posterior x-ray B. Ultrasound C. Lumbar puncture D. MRI

D. MRI

A client, diagnosed with cancer of the lung, has just been told the cancer has metastasized to the brain. What change in health status would the nurse attribute to the client's metastatic brain disease? A. Chronic pain B. Respiratory distress C. Fixed pupils D. Personality changes

D. Personality changes

A client has just been diagnosed with Parkinson disease and the nurse is planning the client's subsequent care for the home setting. What nursing diagnosis should the nurse address when educating the client's family? A. Risk for infection B. Impaired spontaneous ventilation C. Unilateral neglect D. Risk for injury

D. Risk for injury