NEURO NCLEX QUESTIONS

A patient with a spinal cord injury is experiencing neurogenic shock, what should the nurse expect?

- Hypotension and bradycardia - Decreased CO - Peripheral vasodilation - Venous pooling Loss of vasomotor tone secondary to SCI Loss of SNS innervation and autoregulation ---> Leading to loss of tissue perfusion

A female 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? A. "You may have difficulty believing this, but the paralysis caused by this disease is temporary." B."You'll have to accept the fact that you're permanently paralyzed. However, you won't have any sensory loss." C. "It must be hard to accept the permanency of your paralysis." D. "You'll first regain use of your legs and then your arms."

A. "You may have difficulty believing this, but the paralysis caused by this disease is temporary." - D not correct because remyelination occurs in the opposite direction than the demyelination (descending remyelination). Will resolve proximal ---> distal

Which of the following is an autoimmune disease caused by lack of acetylcholine receptor sites? A. Myasthenia Gravis B. Multiple Sclerosis C. Schizophrenia D. Huntingtons Disease

A. Myasthenia Gravis

What is the pathophysiology of Multiple Sclerosis? A. attacks myelin sheath of nerve fibers leaving neuritic plaques B. lack of nerve impulses at the myoneural junction C. neurotrasmitter imbalance leads to decreased nerve impulses

A. attacks myelin sheath of nerve fibers leaving neuritic plaques

What is a myasthenic crisis in patients with Myasthenia Gravis? A. sudden, temporary exacerbation of symptoms including severe weakness and possible respiratory distress B. overdosing of acetylcholinesterase inhibitors C. involuntary muscle twitching D. decreased LOC and vision changes

A. sudden, temporary exacerbation of symptoms including severe weakness and possible respiratory distress. - Can be secondary to viral infxn or from nonadherence to the strict med schedule

A PT WITH QUADRIPLEGIA IS IN SPINAL SHOCK, WHAT SHOULD THE NURSE EXPECT?

Absence of reflexes and sensation along with flaccid paralysis below the level of injury

IN SOME CLIENTS WITH MYASTHENIA GRAVIS, PLASMAPHERESIS DIMINISHES SYMPTOMS, THIS EFFECT IS ACHIEVED BY REMOVING? A. CATHECHOLAMINES B. ANTIBODIES C. PLASMA PROTEINS D. LYMPHOCYTES

B. ANTIBODIES

A female client with amyotrophic lateral sclerosis (ALS) tells the nurse, "Sometimes I feel so frustrated. I can't do anything without help!" This comment best supports which nursing diagnosis? A. Anxiety B. Powerlessness C. Ineffective denial D. Risk for disuse syndrome

B. Powerlessness

The nurse is teaching a female client with multiple sclerosis. When teaching the client how to reduce fatigue, the nurse should tell the client to: A. take a hot bath. B. rest in an air-conditioned room C. increase the dose of muscle relaxants D. avoid naps during the day

B. rest in an air-conditioned room

A female client has experienced an episode of myasthenic crisis. The nurse would assess whether the client has precipitating factors such as: A. Getting too little exercise B. Taking excess medication C. Omitting doses of medication D. Increasing intake of fatty foods

C. Omitting doses of medication

A female client with Guillian-Barre syndrome has ascending paralysis and is intubated and receiving mechanical ventilation. Which of the following strategies would the nurse incorporate in the plan of care to help the client cope with this illness? A. Giving client full control over care decisions and restricting visitors B. Providing positive feedback and encouraging active range of motion C. Providing information, giving positive feedback, and encouraging relaxation D. Providing intravaneously administered sedatives, reducing distractions and limiting visitors

C. Providing information, giving positive feedback, and encouraging relaxation

What is the primary characteristic of Myasthenia Gravis? A. dysphagia B. weak respiratory muscles C. weak skeletal muscles D. optic neuritis

C. weak skeletal muscles

Which of the following is not a stage of Multiple Sclerosis? A. Acute Attack B. Remission-Relapse C. Chronic progressive D. Chronic Attack

D. Chronic Attack

What are the two main forms of onset for Amyotrophic lateral sclerosis (ALS)? Answers: A. Anterior and posterior onset B. Nerve and muscle onset C. Reflexive and tensive onset D. Limb and bulbar onset

D. Limb and bulbar onset

A male client with a spinal cord injury is prone to experiencing automatic dysreflexia. The nurse would avoid which of the following measures to minimize the risk of recurrence? A. Strict adherence to a bowel retraining program B. Keeping the linen wrinkle-free under the client C. Preventing unnecessary pressure on the lower limbs D. Limiting bladder catheterization to once every 12 hours

D. Limiting bladder catheterization to once every 12 hours - Should maintain strict bowel/bladder program to avoid distention and irritation that causes autonomic dysreflexia

Female client is admitted to the hospital with a diagnosis of Guillain-Barre syndrome. The nurse inquires during the nursing admission interview if the client has history of: A. Seizures or trauma to the brain B. Meningitis during the last 5 years C. Back injury or trauma to the spinal cord D. Respiratory or gastrointestinal infection during the previous month

D. Respiratory or gastrointestinal infection during the previous month - GBS usually occurs 1-3 weeks after initial insult (infxn/flu shot)

A female client is admitted in a disoriented and restless state after sustaining a concussion during a car accident. Which nursing diagnosis takes highest priority in this client's plan of care? A. Disturbed sensory perception (visual) B. Self-care deficient: Dressing/grooming C. Impaired verbal communication D. Risk for injury

D. Risk for injury

The nurse is teaching the female client with myasthenia gravis about the prevention of myasthenic and cholinergic crises. The nurse tells the client that this is most effectively done by: A. Eating large, well-balanced meals B. Doing muscle-strengthening exercises C. Doing all chores early in the day while less fatigued D. Taking medications on time to maintain therapeutic blood levels

D. Taking medications on time to maintain therapeutic blood levels

A PT IS UNDERGOING TESTING TO CONFIRM MYASENTHIA GRAVIS, THE NURSE EXPLAINS MUSCLE FUNCTION IMPROVES AFTER GIVING IV ADMINISTRATION OF WHICH MEDICATION, THIS TEST IS AKA TENSILON TEST?

EDROPHONIUM(ENLON)

A CLIENT WITH SUSPECTED MULTIPLE SCLEROSIS UNDERGOES A LUMBAR PUCNTURE. WHICH ABNORMALITY IS TYPICALLY FOUND IN THE CSF OF CLIENTS WITH MS?

ELEVATED GAMMA GLOBULIN FRACTION

3 HOURS AFTER A PT RECEIVED A SPINAL CORD INJURY AT C6, THE MD PRESCRIBES METHYLPRENDISOLONE TO SUPPRESS BREAKDOWN OF TISSUE AT INJURY SITE. WHAT OTHER MED SHOULD THE NURSE SUSPECT WILL ALSO BE PRESCRIBED WITH METHYLPRENDISOLONE?

FAMOTIDINE(PEPCID) CORTICOSTEROIDS CAUSE GI DISTRESS/BLEED

THE NURSE IS GIVING NEOSTIGMINE TO A PT. WHAT INTERVENTION SHOULD THE NURSE IMPLEMENT?

GIVE 45 MINS BEFORE MEALS GIVE WITH CRACKERS TO REDUCE GI DISTRESS GIVE AT CONSISTENT TIMES TO ENSURE BLOOD LEVELS

USED FOR ACUTE RELAPSES OF MYASENTHIA GRAVIS?

IMMUNOGLOBULIN G

A patient is diagnosed with Myasthenia Gravis and an order is placed for pyridostigmine, an acetylcholinesterase inhibitor. What preexisting condition would be contraindicated with this medication?

INTESTINAL OBSTRUCTION PERITONITIS

A PT WITH MULTIPLE SCLEROSIS IS STARTED ON 20 MG OF GLATIRAMER(COPAXONE) SUBCUTANEOUS DAILY. IMMEDIATELY AFTER INJECTION THE CLIENT EXPERIENCES CHEST PAIN AND FLUSHING. WHAT WOULD BE THE MOST APPROPRIATE NURSING INTERVENTION?

MONITOR SYMPTOMS(TEMPORARY)

WHICH SYMPTOM OCCURS EARLY IN MULTIPLE SCLEROSIS?

OPTIC NEURITIS WITH EYE PAIN

5. Huntington's disease is a heritable disorder that involves: a. Sudden paralysis b. Chorea, loss of cognitive abilities, and emotional disturbance c. Uncontrollable swearing and repetitive actions d. Inability to recognize faces

b. Chorea, loss of cognitive abilities, and emotional disturbance

15. All of the following statements about amyotrophic lateral sclerosis are true except: a. It causes degeneration and death of upper and lower motor neurons b. Patients lose strength and control of voluntary muscles c. It impairs cognition and senses d. It progresses rapidly and is fatal

c. It impairs cognition and senses

2. All of the following may be associated with Guillain-Barré Syndrome except: a. Weakening or tingling sensation in the legs b. Weakness in the arms and upper body c. Nearly complete paralysis d. First symptom is altered mental status

d. First symptom is altered mental status