chapter 69 exam 3 content

which of the following is the priority nursing intervention for a patient in myasthenic crisis? a. assessing respiratory effort b. preparing for plasmapheresis c. administering intravenous immunoglobin (IVIG) per orders d. ensuring adequate nutritional support

a. assessing respiratory effort

medical management of arthropod-borne (arboviral) encephalitis is aimed at a. controlling seizures and increased intracranial pressure b. maintaining hemodynamic stability and adequate cardiac output c. preventing muscular atrophy d. preventing renal insufficiency

a. controlling seizures and increased intracranial pressure

the diagnosis of multiple sclerosis is based upon which of the following tests? a. neuropsychological testing b. MRI c. evoked potential studies d. CSF electrophoresis

b. MRI

myasthenia gravis occurs when antibodies attach which receptor sites? a. serotonin b. acetylcholine c. dopamine d. GABA

b. acetylcholine

which of the following is the most common clinical manifestation of multiple sclerosis? a. ataxia b. fatigue c. spasticity d. pain

b. fatigue

a patient with fungal encephalitis recieving amphotericin B complains of fever, chills, and body aches. the nurse knows that these symptoms a. indicate renal toxicity and a worsening of the patient's condition b. may be controlled by the administration of diphenhydramine (Benadryl) and acetaminophen (tylenol) approx. 30 minutes prior to administration of amphotericin c. indicate the need for immediate blood an dcerebral spinal fluid (CSF) cultures d. are primarily associated with infection with Coccidioides immitis and aspergillus

b. may be controlled by the administration of diphenhydramine (Benadryl) and acetaminophen (tylenol) approx. 30 minutes prior to administration of amphotericin

the parents of a patient intubated due to the progression of GBS ask if their child will die. what is the best response by the nurse? a. its too early to give a prognosis b. there are no guarantees. but a large portion of people with GBS survive c. once GBS progresses to the diaphragm there is a significant decrease in surviving d. don't worry, your child will be fine

b. there are no guarantees. but a large portion of people with GBS survive

a patient has been diagnosed with a frontal lobe brain abscess. which of the following nursing interventions is appropriate? a. assess for facial weakness b. ensure that patient takes nothing by mouth (NPO) c. initiate seizure precautions d. assess visual acuity

c. initiate seizure precautions

which drug should be available to counteract the effect of tensilon? a. prednisone b. mestinon c. imuran d. atropine

d. atropine

the nurse has been educating a patient newly diagnosed with MS. which of the following statements by the patient indicates an understanding of the education? a. the exercises should be completed quickly to reduce fatigue b. i will take hot tub baths to decrease spasms c. i should participate in non weight bearing exercises d. i will stretch daily as directed by the physical therapist

d. i will stretch daily as directed by the physical therapist

a patient is recieving mitoxantrone (Novantrone) for treatment of secondary progressive multiple sclerosis (MS). this patient should be closely monitored for a. hypoxia b. mood changes and fluid and electrolyte alterations c. renal insufficency d. leukopenia and cardiac toxicity

d. leukopenia and cardiac toxicity

the primary north american vector transmitting arthropod-borne virus encephalitis is the a. horse b. tick c. flea d. mosquito

d. mosquito

which of the following manifestations is inconsistent with the diagnosis of Guillain-Barr syndrome? a. orthostatic hypotension b. ascending weakness c. cognitive decline d. areflexia

c. cognitive decline

a patient is suspected to have bacterial meningitis. what is the priority nursing intervention? a. administer prescribed antibiotics b. assess the CSF fluid lab results c. encourage fluid intake by mouth (PO) d. prepare patient for a CT scan

a. administer prescribed antibiotics

the nurse is preparing the patient for an aceytlcholinesterase inhibitor test to rule out Myesthenia gravis. which of the following is the priority nursing action? a. ensure atropine is readily avaliable b. assess facial weakness 5 minutes after injection c. document the results d. administer edrophonium chloride (Tensilon) per orders

a. ensure atropine is readily avaliable

which of hte following are the most commonly reported clinical manifestations of MS? SATA a. pain b. depression c. numbness d. spasticity e. fatigue f. aphasia

a. pain b. depression c. numbness d. spasticity e. fatigue

which diagnostic test is used for early diagnosis of HSV-1 encephalitis? a. polymerase chain reaction (PCR) b. electroencephalography (EEG) c. MRI d. lumbar puncutre

a. polymerase chain reaction (PCR)

which well-recognized sign of meningitis is exhibited when the patient's neck is flexed and flexion of the knees and hips is produced? a. positive brudzinski sign b. nuchal rigidity c. photophobia d. positive kerning's sign

a. positive brudzinski sign

a patient with herpes simplex virus (HSV) encephalitis is receiving acyclovir (Zovirax). the nurse monitors blood chemistry test results and urinary output for a. renal complications related to acyclovir therapy b. signs of improvement in the patients condition c. signs of relapse d. signs and symptoms of cardiac insufficiency

a. renal complications related to acyclovir therapy

the initial symptoms of vCJD include which of the following? a. sensory disturbance, limb pain, and behavioral changes b. diplopia and bradykinesia c. akathisia and dysphagia d. muscle rigidity, memory impairment, and cognitive impairment

a. sensory disturbance, limb pain, and behavioral changes

a patient with fungal encephalitis receiving IV amphotericin B complains of fever, chills, and body aches. what action by the nurse is appropriate? a. stop the infusion immediately b. administer diphenhydramine (Benadryl) and acetaminophen (Tylenol) per orders c. assess lab values for renal insufficiency d. notify the physician and prepare for a lumbar puncture to obtain CSF cultures.

b. administer diphenhydramine (Benadryl) and acetaminophen (Tylenol) per orders

a nurse is caring for a patient diagnosed with GBS. the patient states "its getting harder to take a deep breath". which of the following actions by the nurse is most appropriate? a. explain the progression of the syndrome b. call the physician and prepare for intubation c. encourage patient to cough d. assess lung sounds

b. call the physician and prepare for intubation GBS can lead to resp. failure in most patients so intubation is needed

Bell's palsy is a disorder of which cranial nerve? a. vestibulocochlear (VIII) b. facial (VII) c. Trigeminal (V) d. Vagus (X)

b. facial (VII)

which of the following is the most common cause of acute encephalitis in the US? a. western equine bacteria b. herpes simplex virus (HSV) c. st. louis virus d. western nile virus

b. herpes simplex virus (HSV)

a patient has been brought to the ED with altered LOC, high fever, and purpura rash on the lower extremities. the family states the patient was complaining of neck stiffness earlier in the day. what action should the nurse do first? a. administer prescribed antibiotics b. initiate isolation precautions c. ensure the family receives phophylaxis antibiotic treatment d. apply a cooling blanket

b. initiate isolation precautions

which of the following is a component of the nursing management of the patient with new variant Creutzfeldt-Jakob disease (nvCJD) a. preparing for organ donation b. administering amphotericin B c. providing supporting care d. initiating isolation procedures

c. providing supporting care

which of the following is a component of the nursing management of the patient with variant Creutzfeldt-Jakob disease (vCJD) a. preparing for organ donation b. administering amphotericin B c. providing supporting care d. initiating isolation procedures

c. providing supporting care

a frontal lobe brain abscess produces which manifestations? a. nystagmus b. localized headache c. seizures d. ataxia

c. seizures

which of the following is a rare, transmissible, progressive fatal disease of the CNS characterized by spongiform degeneration of the gray matter of the brain? a. huntington disease b. parkinson's disease c. multiple sclerosis d. Creutzfeldt-Jakob disease

d. Creutzfeldt-Jakob disease

the initial symptoms of nvCJD include which of the following? a. akathisia and dysphagia b. memory and cognitive impairment c. diplopia and bradykinesia d. anxiety, depression, and behavioral changes

d. anxiety, depression, and behavioral changes

which of the following nursing interventions is appropriate for a patient with double vision in the right eye due to MS? a. administer eye drops as needed b. place needed items on the right side c. exercise the right eye 2x per day (BID) d. apply an eye patch to the right eye

d. apply an eye patch to the right eye

which of the following is a chronic, degenerative, progressive disease of the CNS characterized by the occurrence of small patches of demyelination in the brain and spinal cord? a. parkinson's disease b. huntington disease c. Creutzfeldt-Jakob disease d. multiple sclerosis

d. multiple sclerosis

which of the following reflects basic nursing measures in the care of the patient with viral encephalitis? a. administering narcotic analgesics b. monitoring cardiac output c. administering amphotericin B d. providing comfort measures

d. providing comfort measures

a patient with herpes simplex virus (HSV) encephalitis is receiving acyclovir (Zovirax). to ensure early intervention, the nurse monitors lab values and urine output for which of the following adverse reactions? a. hepatic b. musculoskeletal c. integumentary d. renal

d. renal

a patient is newly diagnosed with relapsing-remitting MS (RRMS). which instruction should the nurse provide? a. you will have a steady and gradual decline in function b. you should take your medications only during times of relapse c. your type of MS is the least common, making it difficult to manage d. you must avoid stress and extreme fatigue, because these can trigger a relapse

d. you must avoid stress and extreme fatigue, because these can trigger a relapse