NUR426 Test 3

Which of the following is an initial sign of PD? 1. Rigidity 2. Tremor 3. Bradykinesia 4. Akinesia

2

A nurse is caring for a client who was admitted for status epilepticus and is on seizure precautions. Which of the following actions should the nurse plan to take? 1. assess hourly for a spike in blood pressure 2. maintain the client on bed rest 3. keep a padded tongue blade at the bedside 4. establish IV access

D

Which statement by a client with a seizure disorder taking topiramate indicates the client has understood the nurse's instructions? 1. I will take the medicine before going to bed 2. I will drink six to eight glasses of water a day 3. I will eat plenty of fresh fruit 4. I will take the medicine with a meal or snack.

2

A 22 y.o. who hit his head while playing football has a tonic-clonic seizure. Upon awakening from the seizure, the client asks the nurse, "What caused me to have a seizure? I've never had one before." Which cause should the nurse include in the response as a primary cause of tonic-clonic seizures in adults older than 20? 1. head trauma 2. electrolyte imbalance 3. congenital defect 4. epilepsy

1

A 48 y.o. man was just diagnosed with HD. His 20 y.o. son is upset about his father's diagnosis. How can the nurse best help this young man? 1. provide emotional and psychologic support 2. encourage him to get diagnostic genetic testing done 3. tell him the cognitive deterioration will be treated with counseling 4. tell him the chorea and psychiatric disorders can be treated with haloperidol.

1

A nurse is assisting a provider with a cholinesterase inhibitor test for a client who has previously diagnosed with MG. After administration of the medication, the client demonstrates increased muscle weakness and twitching. The nurse concludes that the client is exhibiting which of the following? 1. Cholinergic Crisis 2. Myasthenic Crisis 3. Thyrotoxicosis 4. Thyoma

1

A nurse is caring for a client who just had a generalized seizure. WHich of the following actions should the nurse first perform? 1. keep the client in a side-lying position 2. monitor client's vital signs 3. reorient the client to the environment 4. check the client for injuries.

1

A nurse is reinforcing teaching with a client who has PD and has received a prescription for bromocriptine. Which of the following instructions should the nurse include in the teaching? 1. Rise slowly when standing 2. Increase carbohydrate intake 3. Limit exposure to heat 4. Report any skin discoloration

1

A nurse is talking to a client's spouse about degenerative complications associated with PD. The highest priority topic for the nurse to talk about is the risk for 1. Aspiration 2. Emotional lability 3. Impaired speech 4. Self-care dependency

1

A nurse understands that a client with a seizure disorder, who frequently experiences an aura is describing a 1. Sensory warning that a seizure is immenent. 2. Continuous seizure state in which seizures occur in rapid succession 3. Period of sleepiness following the seizure, during which arousal is difficult 4. Brief loss of consciousness accompanied by staring

1

A patient is brought to the emergency department. The family members express that the patient suddenly fell down and became unconscious, and his left leg had jerky movements for a few seconds. Which type of seizure should the nurse suspect? 1 Clonic seizure 2 Atonic seizure 3 Focal seizure 4 Absence seizure

1

The nurse is assessing a client in the postictal phase of generalized tonic-clonic seizure. The nurse should determine if the client has: 1. drowsiness 2. inability to move 3. paresthesia 4. hypotension

1

The patient with type 1 DM with hypoglycemia is having a seizure. Which medication should the nurse anticipate administering to stop the seizure? 1. IV dextrose solution 2. IV diazepam 3. IV phenytoin 4. Oral carbamazepine

1

Which measure should the nurse prioritize when providing care for a patient with a diagnosis of MS? 1. vigilant infection control and adherence to standard precautions 2. careful monitoring of neurologic assessment and frequent reorientation 3. maintenance of a calorie count and hourly assessment of intake and output 4. assessment of blood pressure and monitoring for signs of OH.

1

Which of the following goals is collaboratively established by the client with PD, nurse, and PT? 1. to maintain joint flexibility 2. to build muscle strength 3. to improve muscle endurance 4. to reduce ataxia

1

Which of the following is an expected outcome for a client with PD who has a pallidotomy improved? 1. functional ability 2. emotional stress 3. alertness 4. appetite

1

A nurse is caring for a client who has MG and has developed drooping eyelids. Which of the following actiosn should the nurse take? select all that apply. 1. apply lubricating eye drops 2. encourage use of sunglasses 3. supprt the head with pillows 4. tape eyes closed at night 5. provide for periods of rest during the day

1 & 4

A patient diagnosed with seizures is advised to take phenytoin (Dilantin). Which common side effects of phenytoin (Dilantin) should the nurse inform the patient about? Select all that apply. 1 Gingival hyperplasia 2 Neuropathy 3 Memory loss 4 Hirsutism 5 Weight gain

1 & 4

A 21 y.o. female client takes clonazepam. What should the nurse ask this client about? select all that apply. 1. seizure activity 2. pregnancy status 3. alcohol use 4. cigarette smoking 5. intake of caffein and surgary drinks

1, 2, & 3

A nurse is reviewing trigger factors that can cause seizures with a client who has a new diagnosis of generalized seizures. Which of the following information should the nurse include in this review? select all that apply. 1. overwhelming fatigue should be avoided 2. caffeinated products should be removed from the diet 3. looking at flashing lights should be limited 4. aerobic exercise may be performed 5. episodes of hypoventilation should be limited 6. use of aerosol hairspray is recommended

1, 2, & 3

A patient is advised to use diazepam (Valium) for multiple sclerosis. What patient teaching is important for those taking this drug? Select all that apply 1 Avoid driving while on the drug. 2 Do not stop the drug abruptly. 3 Avoid taking alcohol with the drug. 4 Monitor blood pressure regularly. 5 Avoid contact with large crowds.

1, 2, & 3

The nurse sees a client walking in the hallway who begins to have a seizure. The nurse should do which of the following in priority order? 1. maintain a patent airway 2. record the seizure activity observed 3. ease the client to the floor 4. obtain vital signs

3, 1, 4, 2

The nurse is caring for a patient with Parkinson's disease. What adjustments should the nurse make in the dietary habits of the patient to prevent malnutrition and constipation? Select all that apply. 1 Include whole grains and fruits in the diet. 2 Cut food into bite-size pieces. 3 Serve hot foods on a warmed plate. 4 Include plenty of food items high in protein. 5 Provide three large meals rather than six small meals.

1, 2, & 3

The parent of a child newly diagnosed with a typical absence seizure is worried. What information should the nurse provide to the parent regarding typical absence seizures? Select all that apply. 1 The occurrence of seizures usually subsides during adolescence. 2 The seizures are characterized by brief staring spells. 3 The seizures are usually precipitated by flashing lights. 4 A seizure is associated with loss of postural tone. 5 The child will usually seem confused after a seizure.

1, 2, & 3

A nurse is assessing a client who has a seizure disorder. The client reports he thinks he is about to have a seizure. Which of the following actions should the nurse implement? Select all that apply. 1. provide safety 2. ease the patient to the floor if standing 3. move furniture away from the patient 4. loosen the patient's clothing 5. protect the patient's head with padding 6. restrain the patient.

1, 2, 3, 4, & 5

The nurse who is caring for a patient with multiple sclerosis understands that the neuropathologic changes in multiple sclerosis include various processes. Arrange the processes in the order of occurrence. 1. An environmental factor or virus triggers the activation of T-cells in genetically susceptible individuals. 2. The activated T-cells in the systemic circulation migrate to the central nervous system (CNS), disrupting the blood-brain barrier. 3. The underlying axon gets damaged, disrupting transmission of nerve impulses and loss of nerve function. 4. The antigen-antibody reaction within the CNS activates the inflammatory response, causing demyelination of axons. 5. The ongoing inflammation affects the nearby oligodendrocytes, and the myelin loses the ability to regenerate. 6. The inflammation subsides, and the glial scar tissue replaces the damaged tissue, forming hard, sclerotic plaques.

1,2,6

A 50 y.o. male patient has been diagnosed with ALS. What nursing intervention is most important to help prevent a common cause of death for patients with ALS? 1. reduce fat intake 2. reduce the risk of aspiration 3. decrease injury related to falls 4. decrease pain secondary to muscle weakness

2

A 50-year-old male patient has been diagnosed with amyotrophic lateral sclerosis (ALS). What nursing intervention is most important to help prevent a common cause of death for patients with ALS? 1 Reduce fat intake 2 Reduce the risk of aspiration 3 Decrease injury related to falls 4 Decrease pain secondary to muscle weakness

2

A client who has had seizrues asks the nurse about being able to drive becasue of the seizures. Which response by the nurse is best? 1. a person with a history of seizures can drive only during daytime hours 2. A person with evidence that the seizures are under medical control can drive 3. A person with evidence that seizures occur no more often than every 12 months can drive 4. A person with a history of seizures can drive if he or she carries a medical identification card

2

A client with PD is prescribed levodopa therapy. Improvement in which of the following indicates effective therapy? 1. mood 2. muscle rigidity 3. appetite 4. alertness

2

A client with PD needs a long time to complete morning care, but becomes annoyed when the nurse offers assistance and refuses all help. Which action is the nurse's best initial response in this situation? 1. tell the client firmly that he or she needs assistance and help with the morning care 2. praise the client for the desire to be independent and give extra time and encouragment 3. tell the client that he or she is bein unrealistc about the abilities and must accept the fact that they need help 4. suggest to the client to at least modify the morning care routine if he or she insists on self-care.

2

A client with a seizure disorder is being discharged. The clients family has many questions about what to do if the client has a seizure while at home. The nurse tells the family members that the first action to take in the event of a seizure is to 1. support and protect the client's head 2. ease the client to the floor if standing or seated 3. loosen constrictive clothing 4. turn the client on his side

2

A nurse explains to a family of a client recently diagnosed with ALS that early manifestations typically include 1. sensory dysfunction 2. weakness of the distal extremities 3. decreased cognitive function 4. altered temperature regulation

2

A nurse in the emergency department is assessing a client who has MG. The client reports recent increasing muscle weakness and the nurse suspects the client is experiencing a myasthenic crisis. Which of the following actions is the nurse's priority? 1. administer artificial tears 2. Assist with Tensilon test 3. Administer immunosuppressants 4. assist with plasmapheresis

2

A nurse is caring for a client who has ALS and is being admitted to the hospital with pneumonia. Which of the following is the priority assessment finding? 1. Temperature of 101.4 2. Increased respiratory secretions 3. Fluid intake of 200 mL in the prior 8 hr 4. Limited ROM

2

A nurse observes a client in the hallway who is having a generalized tonic-clonic seizure. The client has become cyanotic. Which of the following interventions is appropriate for this client? 1. perform neurologic checks 2. turn client onto her side 3. provide oxygen @ 2L/min 4. obtain vital signs

2

A patient aged 20, who developed seizures after a head injury, tells the nurse he or she feels like he or she has lost control over his or her life since the seizures. Initially, what is the most appropriate response by the nurse? 1 "With medications and your health care provider's assistance, I am sure you will be able to achieve your life goals." 2 "Tell me about what you would like to do and how the seizures affect you." 3 "New treatments come out every year, so don't give up." 4 "You are young and can still heal from the injury. It has only been a few months."

2

A patient has been receiving scheduled doses of phenytoin and begins to experience diplopia. The nurse immediately assess the patient for: 1. an aura or focal seizure 2. nystagmus or confusion 3. abdominal pain or cramping 4. irregular pulse or palpitations

2

At what time of day should the nurse encourage a client with PD to schedule the most demanding physcial activities to minimize the effects of hypokinesia? 1. early in the morning, when the client's energy level is high 2. To coincidie with the peak action of drug therapy 3. immediately after a rest period 4. when family members will be available.

2

The nurse admits the 24-year-old female patient with epilepsy to the trauma unit following a motor vehicle accident. The patient asks the nurse about the incidence of her condition. What response by the nurse is most appropriate? 1 In younger patients, epilepsy generally is caused by some birth injury, infection, trauma, or genetic factor. 2 30% of all epilepsy cases are not attributable to a specific cause. 3 New cases of epilepsy are most common in Hispanic patients. 4 Females are more likely to develop epilepsy than males.

2

The nurse observes that when a client with PD unbuttons the shirt, the upper arm tremors disappear. Which statement best guides the nurse's analysis of this observation about the client's tremors? 1. the tremors are probably psychological and can be controlled at will 2. the tremors sometimes disappear with purposeful and voluntary movements 3. the tremors disappear when the client's attention is diverted by some activity 4. there is no explanation for the observation; it is a chance occurrence

2

The nurse should instruct the patient on phenytoin (Dilantin) to perform which action to prevent gingival hyperplasia? 1 Rinse with an oral antifungal solution twice per day. 2 Brush the teeth at least twice per day. 3 Visit a dentist annually. 4 Use a firm-bristle toothbrush.

2

When preparing to teach a client about phenytoin sodium therapy, the nurse should urge the client not to stop the drug suddenly because: 1. physcial dependency on the drug develops 2. status epilepticus may develop 3. a hypoglycemic reaction develops 4. heart block is likely to develop

2

Which characteristic of a patient's recent seizure is consistent with a focal seizure? 1. the patient lost consciousness during the seizure 2. the seizure involved lip smacking and repetitive movement 3. the patient fell to the ground and became stiff for 20 seconds 4. the etiology of the seizure involved both sides of the patient's brain

2

Which of the following is not a typical clinical manifestation of MS? 1. double vision 2. sudden burst of energy 3. weakness in the extremities 4. muscle tremors

2

Which of the following should the nurse include in the teaching pl,an for a client with seizures who is going home with a prescription for gabapentin? 1. Take all the medication until it is gone 2. Notify the physician if vision changes occur 3. Store gabapentin the refrigirator 4. Take gabapentin with an antacid to protect against ulcers

2

A patient is advised to use teriflunomide (Aubagio) for multiple sclerosis. What nursing interventions are important for this patient? Select all that apply. 1 Instruct the patient to avoid driving. 2 Monitor liver function tests. 3 Instruct the patient to avoid pregnancy. 4 Ask the patient to restrict salt intake. 5 Monitor blood pressure levels.

2 & 3

What instructions should a nurse give to a patient who has focal seizures well controlled with phenytoin (Dilantin) and who has mild gingival hyperplasia? Select all that apply. 1 The drug should be changed immediately. 2 Regular flossing can control gingival tissue growth. 3 Surgical repair of gingival tissue will be required. 4 Regular tooth brushing can limit hyperplasia. 5 Gingival hyperplasia is not related to phenytoin (Dilantin).

2 & 4

A nurse is caring for a client who is having a tonic-clonic seizure while in bed and has become cyanotic. Which of the following actions should the nurse take? Select all that apply. 1. Restrain the client 2. Prepare to suction the client's airway 3. Insert a tongue blade in the client's mouth 4. Raise the HOB to semi-Fowler's position 5. Loosen restrictive clothing on the client

2 & 5

The nurse is teaching a client with bladder dysfunction from MS about bladder training at home. Which instruction should the nurse include in the teaching plan? select all that apply. 1. restrict fluid to 1 L per day 2. drink 400 to 500 mL with each meal 3. Drink fluids midmorning, midafternoon, and late afternoon 4. attempt to void at least every 2 hours 5. use intermittent catheterization as needed

2, 3, 4, & 5

A nurse is assessing a client for manifestations of PD. Which of the following are expected findings? select all that apply. 1. decreased vision 2. pill-rolling tremor of the fingers 3. shuffling gait 4. drooling 5. bilateral ankle edema 6. lack of facial expressions

2, 3, 4, & 6

A nurse is developing a plan of care for the nutritonal needs of client who has stage 4 PD. Which actions should the nurse include in the plan of care? select all that apply. 1. provide three large balanced meals daily 2. record diet and fluid intake daily 3. document weight every other week 4. add thickener to liquids 5. offer nutritional supplements between meals.

2, 4, & 5

The nurse is caring for a patient with a spastic bladder secondary to multiple sclerosis. What manifestations of spastic bladder should the nurse expect to find in the patient? Select all that apply. 1 There is no sensation of urge to void or no desire to void. 2 Bladder contractions are unchecked. 3 The patient experiences urinary retention. 4 The bladder has a small capacity for urine. 5 The patient experiences incontinence and dribbling.

2, 4, & 5

The nurse should conduct a focused assessment with the client with MS for risk of which of the following? select all that apply. 1. dehydration 2. falls 3. seizures 4. skin breakdown 5. fatigue

2, 4, & 5

When establishing a diagnosis of MS, the nurse should teach the patient about what diagnostic studies (select all that apply)? 1. EEG 2. CT scan 3. Carotid duplex scan 4. Evoked response testing 5. Cerebrospinal fluid analysis

2, 4, & 5

A client is being switched from levodopa to carbidopa-levodopa. The nurse should monitor for which of the following possible complications during medication changes and dosage adjustment? 1. euphoria 2. jaundice 3. vital sign fluctuation 4. s/s of DM

3

A client with MS is receiving baclofen. The nurse determines that the drug is effective when it achieves which of the following? 1. induces sleep 2. stimulates the client's appetite 3. relieves muscle spasticity 4. reduces the urine bacterial count

3

A female patient complains of a throbbing headache. When her history is obtained, the nurse discovers that the patient has had this type of headache before and experience photophobia before the headache occurred. The nurse should know that what is probably the cause of this patient's headache? 1. polycythemia vera 2. cluster headache 3. migraine headache 4. hemorrhagic stroke

3

A male patient with a diagnosis of PD has been admitted recently to a long-term care facility. Which action should the health care team take in order to promote adequate nutrition for this patient? 1. provide multivitamins with each meal 2. provide a diet that is low in complex carbohydrates and high in protein 3. provide small, frequent meals throughout the day that are easy to chew and swallow 4. provide a patient with a minced or pureed diet that is high in potassium and low in sodium

3

A nurse instructs a client who has MG about home care and the risk factors that can exacerbate the disease. Which of the following client statements indicates a need for further teaching? 1. I should take my medication 45 min before meals 2. I have suction equipment at home in case I start to choke. 3. I will soak in warm bath every day 4. I ordered a medical identification bracelet to wear.

3

A nurse is caring for a client who displays signs of stage 3 PD. Which of the following actions should the nurse include in the plan of care? 1. recommend a community support group 2. integrate a daily exercise routine 3. provide a walker for ambulation 4. consultation with a dietition

3

A nurse is caring for a client who has MS. WHich of the following findings should the nurse expect? 1. Hypoactive DTR 2. ascending paralysis 3. intention tremors 4. increased lacrimation

3

A nurse is caring for a client who has advancing ALS. WHich of the following interventions is the nurse's priority? 1. provide for frequent rest periods throughout the day 2. medicate for pain on a regular schedule 3. monitor pulse oximetry findings 4. administer baclofen for spasticity

3

A nurse is caring for a client with Guillian-Barre Syndrome (GBS). Upon assessment, the nurse should anticipate that the client will exhibit which of the following? 1. Tonic-clonic seizures 2. Complaints of severe headache and nausea 3. Weakness of the lower extremities 4. Decreased level of consciousness

3

A nurse is completing discharge teaching to a client who has seizures and received a vagal nerve stimulator to decrease seizure activity. Which of the following information should the nurse include in the teaching? 1. The use of a microwave to heat food is permitted 2. Inform a provider to order only MRI when a scan is needed 3. place a magnet over the implantable devices when an aura occurs 4. the use of ultrasound diathermy for pain management is recommended.

3

A nurse is preparing to admit a client with MG who has been having increasingly frequent episodes of myasthenic crisis. Because of the clients history, which of the following equipment should the nurse ask the UAP to place at the client's bedside? 1. Metered dose inhaler and peak flow meter 2. incintive spirometer and cough pillow 3. suction machine and suction catheters 4. external defibrillator pads and telemetry monitor

3

A nurse is providing discharge instructions to a female client who has a prescription for phenytoin. Which of the following information should the nurse include? 1. consider taking oral contraceptives when on this medication 2. watch for receding gums when taking this medicine 3. take the medicine at the same time everyday 4. provide a urine sample to determine therapeutic levels of the medicine

3

A nurse is providing teaching regarding a new prescription for carbidopa-levodopa for a client who has PD. Which of the following client statements indicates an understanding of the teaching? 1. I should expect a slight increase in my blood pressure 2. I should take my medication with a high-protein food 3. I should expect my urine to be a darker color 4. I will expect it to take up to a week for this medication to work.

3

A nurse is teaching a client who has ALS about a new prescription for riluzole. Which of the following instructions should the nurse give the client? 1. take this medication immediately prior to eating 2. drink a glass of milk with the medication 3. avoid consuming alcoholic beverages. 4. monitor your blood pressure daily

3

A patient displays jerky muscle movements of the extremities and is incontinent of bowel and bladder. The nurse recognizes that these clinical manifestations are associated with: 1 Aura seizures 2 Postictal seizures 3 Generalized seizures 4 Simple partial seizures

3

A patient is prescribed carbamazepine (Tegretol) for a new onset seizure disorder. The nurse is educating the patient about this drug. What teaching comment by the nurse is most accurate? 1 This medication is given to treat absence and myloclonic seizures. 2 Don't be concerned if any visual disturbances occur while taking this medication. 3 Do not take this medication with grapefruit. 4 The goal of this medication is to cure your condition and prevent any more seizures.

3

The client is scheduled to receive phenytoin through a NGT and has a tube feeding supplement running continuously. The HOB is elevated to 30 degrees. Prior to administering the medication, the nurse should: 1. Elevate the HOB to 60 degrees 2. draw blood to determine the phenytoin level after giving the mronign dose in order to determine if client has toxic blood level 3. stop the tube feeding 1 hour before giving phenytoin and hold tube feeding for 1 hour after giving phenytoin 4. flush the NGT with 150 mL of water before and after giving the Dilantin

3

The client will have an EEG in the morning. The nurse should instruct the client to have which of the following for breakfast? 1. No food or fluids 2. Only coffee or tea if needed 3. A full breakfast as desired w/o coffee, tea, or energy drinks 4. A liquid breakfast of fruit juice, oatmeal, or smoothie

3

The nurse develops a teaching plan for a client newly diagnosed with PD. Which of the following topics that the nurse plans to discuss is the most important? 1. maintaining a balanced nutritional diet 2. enhancing the immune system 3. maintaining a safe environment 4. engaging in diversional activity

3

The nurse is teachign a client to recognize an aura. THe nurse should instruct the client to note: 1. a postictal state of amnesia 2. a hallucination that occurs during a seizure 3. a symptom that occurs just before a seizure 4. a feeling of relaxation as the seizure begins to subside.

3

The nurse performs a pull test on a patient with suspected Parkinson's disease. The nurse stands behind the patient and gives a tug backward on the shoulder. What would be the patient's reaction if he has Parkinson's disease? 1 Lose balance and sit down 2 Lose balance and fall forward 3 Lose balance and fall backward 4 Lose balance and become unconscious

3

The patient with epilepsy is due for a dose of carbamazepine (Tegretol). The serum carbamazepine level today is 18 mcg/mL. What is the priority nursing action? 1 Give the scheduled dose immediately to maintain the therapeutic level. 2 Ask the laboratory to draw a new level to check for error in measurement. 3 Withhold the dose and telephone the health care provider with the result. 4 Telephone the health care provider to obtain a prescription for an increased dose.

3

What is the priority nursing intervention in the postictal phase of a seizure? 1. reorient the client to time, person, and place 2. determine the client's level of sleepiness 3. assess the client's breathing pattern 4. position the client comfortably

3

Which clinical manifestation is a typcial reaction to long-term phenytoin sodium therapy? 1. weight gain. 2. insomnia 3. excessvie growth of gum tissue 4. deteriorating eyesigth

3

Which nursing diagnosis is likely to be a priority in the care of a patient with MG? 1. acute confusion 2. bowel incontinence 3. activity intolerance 4. disturbed sleep pattern

3

Which of the following is contraindicated for a client with seizure precautions? 1. Encouraging him to perform his own personal hygiene 2. Allowing him to wear his own clothing 3. assessing his oral temperature with a glass thermometor 4. encourgaing him to be out of bed

3

A nurse is caring for a client admitted to the hospital with respiratory difficulty after being diagnosed with ALS approximately 1 year ago. Which of the following client findings should the nurse anticipate. select all that apply. 1. loss of sensation 2. fluctuations in blood pressure 3. incontinence 4. ineffective cough 5. loss of cognitive function

3 & 4

A health care provider has prescribed carbidopa-levodopa four times per day for a client with PD. The clietn wants "to end it all now that the PD has progressed." What should the nurse do? select all that apply. 1. explain that the new prescription for sinemet will treat the depression 2. encourage the client to discuss feelings as the sinemet is being administered 3. contact the health care provider before administering the sinemet 4. determine if the client is on antidepressants or MAOIs 5. determine if the client is at risk for suicide

3, 4, & 5

When performing a physical assessment of a patient with myasthenia gravis, what are the manifestations that the nurse is likely to find? Select all that apply. 1 Muscle atrophy 2 Abnormal reflexes 3 Impaired facial mobility 4 Difficulty in swallowing food 5 Voice fading after a long conversation

3, 4, & 5

A new medication regimen is prescribed for a client with PD. At which time should the nurse make certain that the medication is take? 1. at bedtime 2. all at one time 3. two hours before mealtime 4. at the time scheduled.

4

A nurse is caring for a client who is in an acute care facility and at risk for seizures. Which of the following precautions should the nurse implement? 1. Restrict the client's access to televeision 2. keep the side rails lowered on the client's bed 3. maintain the client's bed at hip level 4. ensure that the client has a patent IV

4

A nurse is teachign a client who has epilepsy and is to start therapy with phenytoin. Whic of the following instructions should the nurse include in the clients medication teaching plan? 1. Rinse with antiseptic mouthwash in place of using dental floss 2. use OTC antihistamines if rash develops 3. slowly taper the medication after 6 consecutive months without seizure activity 4. take medications at a consistent time each day to maintain therapeutic blood levels

4

It is the night before a client is to have a CT scan of the head w/o contrast. The nurse should tell the client: 1. You must shampoo your hair tonight to remove all oil and dirt 2. you may drink fluids until midnight, but after that drink nothing until the scan is completed 3. you will have some hair shaved to attach the small electrode to your scalp 4. you will need to hold your head very still during the examination

4

The nurse assesses a patient for signs of petit mal or absence seizures. What is the classic sign of this seizure disorder? 1 Dizziness 2 Intense anxiety 3 Stiffening of the body Correct 4 Vacant facial expression

4

What nursing assessments should be documented at the beginning of the ictal phase of a seizure? 1. heart rate, respirations, pulse oximeter, and blood pressure 2. last dose of anticonvulsant and circumstances at the time 3. type of visual, auditory, and olfactory aura the client experienced 4. movement of head and eyes and muscle rigidity

4

Which goal is the most realistic for a client diagnosed with PD? 1. to cure the disease 2. to stop progression of the disease 3. to begin preparations for terminal care 4. to maintain optimal body function

4

Which intervention is most effective in minimizing the risk of seizure activity in a client who is undergoing diagnostic studies after having experienced several episodes of seizures? 1. maintain the client on bed rest 2. administer butabarbtial sodium 30 mg PO TID 3. close the door to the room to minimize stimulation 4. administer carbamazepine 200 mg PO BID

4

Which of the following will the nurse observe in the client in the ictal phase of a generalized tonic-clonic seizure? 1. jerking in one extremity that spreads gradually to adjacent areas 2. vacant staring and abruptly ceasing all activity 3. facial grimaces, patting motions, and lip smacking 4. loss of consciousness, body stiffening, and violent muscle contractions

4

Which criterion is included to establish that a patient has Parkinson's disease? Select all that apply. 1 Decreased serum dopamine levels. 2 Tumor present in the thymus gland. 3 Magnetic resonance imaging (MRI) shows areas of plaque on cranial nerves. 4 Presence of two of the three classic features: rigidity, bradykinesia, and tremor. 5 Positive response to antiparkinsonian medications.

4,5