neuro II quiz
A patient with Parkinson's disease asks the nurse what can be done to prevent problems with bowel elimination. What would be an intervention that would assist this patient with a regular stool pattern?
Adopt a diet with moderate fiber intake.
A public health nurse plans teaching on the neurological morbid diseases and conditions associated with obesity. Which diseases or conditions will the nurse identify in the teaching? Select all that apply.
Alzheimer disease Anxiety Depression Stroke
Which disease includes loss of motor neurons in the anterior horns of the spinal cord and motor nuclei of the lower brain stem?
Amyotrophic lateral sclerosis
A rapid, jerky, involuntary, and purposeless movement of the extremities or facial muscles is
Chorea
Bell palsy is a disorder of which cranial nerve?
Facial (VII)
A nurse is working with the family of a patient with Alzheimer's disease to develop an appropriate plan of care. Which of the following would the nurse suggest to foster socialization?
Limiting visitors to one or two at a time
A client is diagnosed with a tumor of the temporal lobe. When developing the client's plan of care the nurse would plan interventions to address problems with which areas of functioning? Select all that apply.
Understanding language Emotions Memory
A nurse is caring for a client with a diagnosis of trigeminal neuralgia. Which activity is altered as a result of this diagnosis?
chewing
Which nursing diagnosis takes the highest priority for a client with parkinsonian crisis?
ineffective airway clearance
A client is receiving mitoxantrone for treatment of secondary progressive multiple sclerosis (MS). This client should be closely monitored for
leukopenia and cardiac toxicity.
A nurse is preparing a teaching plan for a client diagnosed with amyotrophic lateral sclerosis (ALS) and his family about the disorder and changes that may occur. Which of the following would the nurse least likely include in the discussion?
loss of bladder control
A client diagnosed with a brain tumor is exhibiting focal symptoms. Which assessment findings are the nurse likely to note? Select all that apply.
muscle weakness, sensory loss, aphasia, visual changes
What is a nurse's role in providing home care for a client with Alzheimer disease?
provide emotional and physical support
A patient with amyotrophic lateral sclerosis (ALS) asks if the nurse has heard of a drug that will prolong the patient's life. The nurse knows that there is a medication that may prolong the life by 3 to 6 months. To which medication is the patient referring?
riluzole
The home health nurse is caring for a client with Parkinson's disease. The nurse understands that the purpose of adding selegiline with carbidopa-levodopa to the medication regime should result in which purpose?
slows the progression of the disease
A nurse is assessing a client diagnosed with multiple sclerosis (MS). Which symptom does the nurse expect to find?
vision changes
An older adult develops sudden onset of confusion and is hospitalized. The family expresses concern that their loved one is developing Alzheimer disease. What response by the nurse is most appropriate?
"Several possible underlying factors could be causing the confusion. Alzheimer's usually does not present with sudden confusion."
The nurse is planning care for a client with Guillain-Barre syndrome. The priority client outcome would be which of the following?
Maintains effective respirations and airway clearance
A client is diagnosed with amyotrophic lateral sclerosis (ALS) in the early stages. Which medication would the nurse most likely expect to be prescribed as treatment?
Riluzole
A nurse is providing care to a client with Parkinson's disease. The nurse understands the client's signs and symptoms are related to a depletion of which of the following?
dopamine
The nurse is completing an assessment on a client with myasthenia gravis. Which of the following historical recounting provides the most significant evidence regarding when the disorder began?
drooping eyelids
Which is often the most disabling clinical manifestation of multiple sclerosis?
fatigue
Excessive levels of which neurotransmitter has been implicated in amyotrophic lateral sclerosis (ALS)?
glutamate
Which nursing interventions might need to be considered in a care plan for a client with advanced multiple sclerosis? Select all that apply.
-Ensure access to a language board when communicating with the client. -Establish a voiding time schedule. -Encourage the client to walk with feet wide apart
A 34-year-old patient is diagnosed with relapsing-remitting MS. The nurse explains to the patient's family that they should expect:
Acute attacks with full recovery or residual deficit upon recovery
The nurse teaches the client diagnosed with Huntington disease that it is transmitted as which type of genetic disorder?
Autosomal dominant
Corticosteroids are used in the treatment of brain tumors for which of the following clinical manifestations? Select all that apply.
Cerebral edema Headache Altered level of consciousness
A client has just been diagnosed with Parkinson's disease. The nurse is teaching the client and family about dietary issues related to this diagnosis. Which of the following are risks for this client? Select all that apply.
Dysphagia Choking Constipation
A client who has a pituitary adenoma would report which symptoms related to the presence of this type of tumor? Select all that apply.
Morning headaches Chiasmal syndrome Polydipsia Anorexia
A patient with Huntington's disease is prescribed medication to reduce the chorea. What medication will the nurse administer that is the only drug approved for the treatment of this symptom?
Tetrabenazine (Xenazine
A client diagnosed with Parkinson's disease has developed slurred speech and drooling. The nurse knows that these symptoms indicate which of the following?
The disease has entered the late stages
Which are the most commonly reported clinical manifestations of multiple sclerosis? Select all that apply.
Pain Fatigue Spasticity Depression Numbness
Which anticholinergic agent is used to control tremor and rigidity in Parkinson disease?
Benztropine Mesylate
A client is experiencing muscle weakness and an ataxic gait. The client has a diagnosis of multiple sclerosis (MS). Based on these symptoms, the nurse formulates "Impaired physical mobility" as one of the nursing diagnoses applicable to the client. What nursing intervention should be most appropriate to address the nursing diagnosis?
Help the client perform range-of-motion (ROM) exercises every 8 hours -Helping the client perform ROM exercises every 8 hours helps in promoting joint flexibility and muscle tone in a client with muscle weakness. Measures such as using pressure-relieving devices or changing the body positions every 2 hours prevents skin breakdown. The nurse should use a footboard and trochanter rolls to promote a neutral body position that will keep the body in good alignment.
Which disease is a chronic, progressive, hereditary disease of the nervous system that results in progressive, involuntary dancelike movements and dementia?
Huntington disease
A client is admitted to the hospital with pneumonia. He has a history of Parkinson disease, which his family says is worsening. Which assessment should the nurse expect?
Impaired speech
Which of the following are disease-modifying agents used in the treatment of multiple sclerosis (MS)? Select all that apply.
Interferon beta-1a (Rebif) Interferon beta-1b (Betaseron) Interferon beta-1a (Avonex) Glatiramer acetate (Copaxone
Which of the following is considered a central nervous system (CNS) disorder?
Multiple sclerosis
The nurse is caring for a client with trigeminal neuralgia (tic douloureux). The care plan for this client reflects the client's problem eating due to jaw pain. To assist the client in meeting the adequate nutritional needs, what should the nurse suggest?
Take small meals of soft consistency
A client with Guillain-Barré syndrome has paralysis affecting the respiratory muscles and requires mechanical ventilation. When the client asks the nurse about the paralysis, how should the nurse respond?
"The paralysis caused by this disease is temporary." -Return of motor function begins proximally and extends distally in the legs.
An older adult patient exhibiting clinical manifestations of a brain tumor is admitted to the hospital for testing. What tumor types does the nurse know are commonly seen in the older adult?
Anaplastic astrocytoma Cerebral metastasis from other sites Glioblastoma
The nurse is advising a client with multiple sclerosis on methods to minimize spasticity and contractures. Which of the following techniques would the nurse instruct the client to perform?
Apply warm packs to the affected area. -Warm packs to the affected area may be beneficial. The client should avoid hot baths because of risk of burn injury secondary to sensory loss and increasing symptoms that may occur with elevation of the body temperature. Swimming and stationary bicycling are useful, and progressive weight-bearing can relieve spasticity in the legs. The client should not be hurried in exercise (as can occur in circuit training), because rushing often increases spasticity.
The nurse identifies a nursing diagnosis of imbalanced nutrition, less than body requirements related to difficulty in chewing and swallowing for a client with Parkinson's disease. Which of the following would be most appropriate for the nurse to integrate into the client's plan of care?
Encourage the client to massage the facial and neck muscles before eating
A nurse is assessing a client with Parkinson's disease. Which of the following would the nurse expect to find?
Slowing of activity -Clients with Parkinson's disease typically manifest bradykinesia (slowing of all active movement), a propulsive, forward leaning gait, tremors that disappear with active movement, and muscle rigidity.
A patient with Parkinson's disease is experiencing an on-off syndrome. What does the nurse recognize that the patient's clinical symptoms will be?
The patient will have periods of near immobility, followed by a sudden return of effectiveness of the medication.
A nurse is teaching a client who was recently diagnosed with myasthenia gravis. Which statement should the nurse include in her teaching?
This disease doesn't cause sensory impairment."
Nursing students are reviewing information about Parkinson's disease in preparation for class the next day. The students demonstrate understanding of the material when they identify which of the following as a cardinal sign of this disorder? Select all that apply.
Tremor Rigidity Bradykinesia Postural instability
A 45-year-old client is admitted to the facility with excruciating paroxysmal facial pain. He reports that the episodes occur most often after feeling cold drafts and drinking cold beverages. Based on these findings, the nurse determines that the client is most likely suffering from which neurologic disorder?
Trigeminal neuralgia
A patient is diagnosed with amyotrophic lateral sclerosis, also known as ALS or Lou Gehrig's disease. The nurse understands that the symptoms of the disease will begin in what way?
Weakness starting in the muscles supplied by the cranial nerves
A home care nurse makes a visit to a client with Parkinson's disease who is being cared for by his spouse. During the visit, the spouse says, "I'm just so tired. I have to do just about everything for him." Which response by the nurse would be most appropriate?
You sound a bit overwhelmed. Tell me more about what's happening."
A nurse is teaching a client who has facial muscle weakness and has recently been diagnosed with myasthenia gravis. The nurse should teach the client that myasthenia gravis is caused by:
a lower motor neuron lesion.
The client with a brain tumor may be at increased risk for aspiration. What does the nurse determine is the most important nursing intervention?
Evaluation of gag reflex and ability to swallow
The nurse practitioner prescribes the medication of choice for an MS patient who is experiencing disabling episodes of muscles spasms, especially at night. Which of the following is the drug most likely prescribed in this scenario?
Lioresal
A client with weakness and tingling in both legs is admitted to the medical-surgical unit with a tentative diagnosis of Guillain-Barré syndrome. On admission, which assessment is most important for this client?
Lung auscultation and measurement of vital capacity and tidal volume
A new ancillary staff member is assisting the nurse with a client diagnosed with Parkinson's disease. The client needs assistance with eating but doesn't require thickened liquids to aid swallowing. Which instruction should the nurse give the ancillary staff member about eating assistance?
Make sure the client is sitting with the head of bed elevated to 90 degrees
What nursing intervention will best assist the client with chorea?
Monitor the client on bed rest rationale- Chorea is a rapid, jerky, involuntary, purposeless movement of the extremities that interferes with walking, sitting, and activities of daily living. It can involve facial muscles. For safety reasons, the client should be monitored on bed rest.
The nurse is performing an initial nursing assessment on a client with possible Guillain-Barre syndrome. Which of the following findings would be most consistent with this diagnosis?
Muscle weakness and hyporeflexia of the lower extremities
The nursing instructor is teaching the senior nursing class about neuromuscular disorders. When talking about Multiple Sclerosis (MS) what diagnostic finding would the instructor list as being confirmatory of a diagnosis of MS?
Oligoclonal band -Electrophoresis of the CSF, a technique for electrically separating and identifying proteins, demonstrates abnormal immunoglobulin G bands, described as oligoclonal bands. An elevated acetylcholine receptor antibody titer and IV administration of edrophonium are diagnostic of Myasthenia Gravis. Episodes of muscle fasciculations are characteristic of ALS.
Which of the following is a disorder due to a lesion in the basal ganglia?
Parkinson's disease
While performing an initial nursing assessment on a client admitted with suspected tic douloureux (trigeminal neuralgia), for which of the following would the nurse expect to observe?
Facial pain in the areas of the fifth cranial nerve
The nurse is performing an initial assessment on a client with suspected Bell's palsy. Which of the following findings would the nurse be most focused on related to this medical diagnosis?
Facial distortion and pain -Bell's palsy is manifested by facial distortion, increased tearing, and painful sensations in the face, behind the ear, and in the eye. Ptosis and diplopia are associated with myasthenia gravis. Hyporeflexia and weakness of the lower extremities are associated with Guillain-Barre syndrome. Fatigue and depression are associated with multiple sclerosis