Med Surg 2- Module 2-Neuro NCLEX Chapter Review

The client with myasthenia gravis is suspected of having cholinergic crisis. Which sign/symptom indicates this crisis is taking place?

Hypertension

Carbidop-levodopa (Sinemet) is prescribed for a client with Parkinson's disease, and the nurse monitors the client for advers effects of teh medication. Which sign/symptom indicated the client is experiencing an adverse effect?

Imparied voluntary movements

A 12-year-old has a history of generalized tonic-clonic seizures. The nurse educates the patient and his family by including which teaching points?

It is not uncommon to lose consciousness during this type of seizure.

A 13-year-old student is admitted to the pediactric unit with possible meningitis. The nurse finds that the patient cannot extend her legs completely without experiencing extreme pain. The nurse correctly documents this as which sign?

Kernig's Sign

A right-handed patient has right-sided hemiplegia and aphasia from a stroke. What is the most likely location of the lesion?

Left frontal lobe

The nursing care plan for a patient with increaed intracranial pressure will include what as the most therapeutic position for the patient?

Maintain the head of the bed at 30 degrees

The nurse is caring for a patient who suffered a cervical spinal cord injury. What injury can most likely be anticipated?

Paraplegia

During admission of a patient with a severe head injury to the emergency department, what is the highest priority assessment for the nurse?

Patency of airway

When reviewing the medical plan of treatment for a patient with Guillain-Barre syndrome, what therapies are considered to be most therapeutic?

Plasmapheresis and intravenous immune globulin

When caring for a patient who has undergone a craniotomy, what is the primary nursing intervention?

Preventing increased intracranial pressure

The client with myasthenia gravis is receiving pryridostigmine (Mestinon). The nurse monitors for signs and symptoms of cholinergic crisis caused by overdose of the medication. The nurse checks the medication supply to ensure that which medication is available for administration if a cholinergic crisis occurs?

Protamine sulfate

A patient was involved in a snowmobile accident. On admission ot the emergency department, he is recieving oxygen and is intubated. His Glasgow Coma Sacle score is 6. About 10 minutes after arrival, he is noted to have a widened pulse pressure, increased systolic blood pressure, and bradycardia. Which finding inficates to the nurse that late-stage increased ICP is present?

Supratentorial shift

Ibuprofen (Advil) is prescribed for a client. Which instructin should the nurse give the client about taking this medication?

Take with 8oz of milk

A patinet is diagnosed with Bell's palsy as indicated by a feeling of stiffness and a drawing sensation of the face. What is important to teach her about the disease?

The eye is susceptible to injury if the eyelid dose not close

The nurse is caring for a client who is taking phenytoin (Dilantin) for contol of seizures. During data collection, the nurse notes that the client is taking birth control pills. Which information should the nurse provide to the client?

The potential for decreased effectiveness of the birth control pills exists which taking phenytoin (Dilantin)

What plan of care is considered benefical for select patient who have experienced an ischemic stroke?

Thromybolytic such as TPA in the first 3 hours

The nursing assessment of an 80-year-old who has had a stroke found that she had difficulty swallowing. A video fluoroscopy with barium was performed to rule out aspiration. The rehabilitation team in the skilled nursing facility determined that she can eat a soft diet with one-to-one supervision. Which action is important to prevent aspiration?

Tipping the head toward the unaffected side while swallowing

The client with trigeminal neuralgia is being treated with carbamazepine (Tegretol). Which laboratory result indicates that the client is experiencing an adverse effect of the medicaiton?

White blood cell count, 3000 cells/mm3

A patient is admitted to the hospital with a diagnosis of transient ischemic attack (TIA). The patient asks the nurse to explain to him what a TIA is. Which statment by the nurse is most accurate?

"A TIA is often the precursor to a stroke."

The nurse is caring for a patient with myasthenia gravis. The patient asks the nurse about the causes of the disease. Which response by the nurse is correct?

"Antibodies attacking the acetylcholine receptors, damaging them, and resducing their number is the most likely cause of Myasthenia gravis."

Phenytoin (Dilantin), 100 mg orally three times daily, has been prescirbed for a client for seizure control. The nurse reinforces instructions regarding the medication to the client. Which statement by the client indicates an understanding of the instructions?

"I will use a soft toothbrush to brush my teeth."

When teaching a patient with Parkinson's disease, whihc response would indicate the need for further education?

"If I miss an occasional dose of the medication, it doesn't matter much."

A patient experiencing TIAs is scheduled for a carotid endarterectomy. The patient asks the nurse what this procedure is. The nurse correctly responds with which response?

"This procedure helps prevent a stoke by removing atherosclerotic plaques obstructing crainal circulation."

A 70-year-old with back pain is scheduled to have a myelogram in the morning to rule out a pathologic condition of the spine. In preparing him for the procedure, what statment by the nurse is accurate?

"We will ask you if you have any numbness or tingling in your legs after the procedure."

What nursing interventions should the nurse include inn the plan of care for a patient who has had a stroke with right-sided hemiplegia and expressive aphasia? (Select all that apply)

-Allow the patient ample time to verbalize his needs -Encourage self-help behaviors as much as possible, such as feeding.

A 35-year-old paitent is being seen for complaints of headache, which she has experienced for the past month. Her health care provider wants to rule out a brain turmor. What diagnositc tests will be mose helpful in formulating this diagnosis? (Select all that apply)

-Brain scan -PET scan -Electroencephalography -MRI

Which sign or symptom of late-stage increased intracranial pressure should the LPN/LVN be aware of? (Select all that apply)

-Increased in systolic blood pressure -widening of pulse pressure -Bradycardia

The client is recieving meperidine hydrochloride (Demerol) for pain. Which are side/adverse effects of this medication? (Select all that apply)

-Tremors -Hypotension -Drowsiness

A nurse in the emergency department of her community hospital is teaching a group of high school students how to prevent head and spine injuries. What should the nures include in the presentation? (select all that apply)

-Use helmets when participating in contact sports -Never dive or ride with someone under the influence or alcohol or drugs. -Wear seatbelts and shoulder harnesses when driving or riding in a car.

The client is taking phenytoin (Dilantin) for seizure control, and a blood sample for a serum durg level is drawn. Whcih laoratory dinding indicates a therapeutic serum drug result?

15 mcg/ml

The client with myasthenia gravis becomes increasingly weak. The health care provider prepares to identify whether the client is reacting to an overdose or the medication (cholinergic crisis) or increasing severity of the disease (myasthenic crisis). An injection of edrophonium (Enlon) is administered. Which indicated that the clietn is in cholinergic crisis?

A inprovement of the weakness

The nurse is caring for a patient with a spinal cord injury who displays sysmptoms of autonomic dysreflexia. What intervention should the nurse implement first?

Assess vital signs

A 76-year-old who has had Parkinson's disease for the past 6 years has now been admitted to a long-term care facility. The nurse doing the admission interview and assessment notices which characteristc sign of the disease?

Bradykinesia

A patient has been diagnosed with Bell's palsy. THis condition impacts which cranial nerve?

Cranial nerve VII