med surg exam 4 ch 58 practice questions
Upon review of a patient's medical history, which question would the nurse ask the patient with a history of restless legs syndrome (RLS)?
"Are you able to sleep well and feel rested?"
atonic seizure
-sudden loss of muscle tone -drop attack pt. falls to the ground
Upon review of a patient's admission orders for treatment of a migraine headache, the nurse notes that the medication list includes sumatriptan (Imitrex). During the admission assessment, which intervention would the nurse implement when the patient reports having experienced a stroke last month?
Contact the health care provider about the patient's history and prescribed sumatriptan.
Initially, which response would the nurse use when a patient who developed seizures after a head injury reports feeling as though he or she has lost control over his or her life?
"Tell me about what you would like to do and how the seizures affect you.
A relapsing-remitting initial course followed by the disease with or without relapses are characteristics of which type of multiple sclerosis?
Secondary-progressive
A 27-year-old patient who has been treated for status epilepticus in the emergency department will be transferred to the medical nursing unit. Which equipment should the nurse have available in the patients assigned room (select all that apply)?
Side-rail pads Oxygen mask Suction tubing
Which clinical manifestation is exclusive to a complex focal seizure?
Smacking of the lips
A hospitalized 31-year-old patient with a history of cluster headache awakens during the night with a severe stabbing headache. Which action should the nurse take first?
Start the ordered PRN oxygen at 6 L/min.
Which statement would the nurse include when teaching a patient about the medication classification of triptans, of which a newly prescribed medication belongs?
Triptans are most effective when taken during an aura
When a patient presents with hypertension and reports paresthesia, tingling, and a pins-and-needles sensation, which disorder would the nurse associate the health care provider's prescription for gabapentin (Neurontin)?
Restless legs syndrome (RLS)
how long does a migraine headache last
4-72 hours, nausea is typical,y associated
Which disorder would the nurse associate with a patient's clinical manifestations of a throbbing headache and photophobia occurring prior to the headache's onset, as well as a history of this type of headache?
A migraine headache
For which condition would the nurse administer 100% oxygen immediately?
Cluster headache
A hospitalized patient complains of a bilateral headache, 4/10 on the pain scale, that radiates from the base of the skull. Which prescribed PRN medications should the nurse administer initially?
Acetaminophen (Tylenol)
Which prescribed intervention will the nurse implement first for a patient in the emergency department who is experiencing continuous tonic-clonic seizures?
Administer lorazepam (Ativan) 4 mg IV.
Which medication would the nurse associate with the treatment of rebound headaches?
Amitriptyline (Elavil)
A 22-year-old patient seen at the health clinic with a severe migraine headache tells the nurse about having other similar headaches recently. Which initial action should the nurse take?
Ask the patient to keep a headache diary.
For the patient with multiple sclerosis, which action would the nurse classify as a priority intervention when developing the patient's plan of care?
Assist the patient in identifying the factors that precipitate exacerbations. 4
A 64-year-old patient who has amyotrophic lateral sclerosis (ALS) is hospitalized with pneumonia. Which nursing action will be included in the plan of care?
Assist with active range of motion (ROM).
"Drop attacks" are a characteristic of which type of seizure?
Atonic seizure
Which parameter would the nurse assess when examining a patient with a history of tension-type headaches (TTHs)?
Auscultate carotid artery sounds
Which potential medications would the nurse anticipate administering to a patient with myasthenia gravis who reports difficulty with swallowing, chewing, eye movement, and facial mobility? Select all that apply.
Azathioprine (Imuran) Prednisone (Deltasone) Pyridostigmine (Mestinon)
Which nerve also has the label of cranial nerve (CN) V?
Trigeminal nerve
Which medication taken by a patient with restless legs syndrome should the nurse discuss with the patient?
Diphenhydramine (Benadryl)
A 46-year-old patient tells the nurse about using acetaminophen (Tylenol) several times every day for recurrent bilateral headaches. Which action will the nurse plan to take first?
Discuss the need to stop taking the acetaminophen.
Which prescribed diagnostic test, used to diagnose a tension-type headache (TTH), would the nurse anticipate explaining to the patient?
Electromyography
A high school teacher who has just been diagnosed with epilepsy after having a generalized tonic-clonic seizure tells the nurse, I cannot teach anymore, it will be too upsetting if I have a seizure at work. Which response by the nurse is best?
Epilepsy usually can be well controlled with medications.
clinical manifestations of a cluster headache
Facial flushing and constriction of the pupils
A patient reports feeling numbness and tingling of the left arm before experiencing a tonic-clonic seizure. The nurse determines that this history is consistent with what type of seizure?
Focal
Which seizure activity would the nurse associate with a patient's jerky muscle movements of the extremities, as well as bowel and bladder incontinence during the event?
Generalized seizures
A 49-year-old patient with multiple sclerosis (MS) is to begin treatment with glatiramer acetate (Copaxone). Which information will the nurse include in patient teaching?
How to draw up and administer injections of the medication
Which degenerative neurologic disorder is an example of a genetically transmitted, autosomal dominant disorder?
Huntington's disease
Which extracranial condition would the nurse associate with a patient's seizures?
Hypertension
The nurse determines that teaching about management of migraine headaches has been effective when the patient says which of the following?
I will lie down someplace dark and quiet when the headaches begin.
A patient has been taking phenytoin (Dilantin) for 2 years. Which action will the nurse take when evaluating for adverse effects of the medication?
Inspect the oral mucosa.
Which diagnostic test would the nurse anticipate for a patient with progressive weakness suspected of having multiple sclerosis?
MRI
A 31-year-old woman who has multiple sclerosis (MS) asks the nurse about risks associated with pregnancy. Which response by the nurse is accurate?
MS symptoms may be worse after the pregnancy.
For the treatment of a patient's tension-type headache (TTH), about which newly prescribed medication would the nurse prepare information for the patient?
Mirtazapine (Remeron)
symptoms of tension-type headaches
Neck pain
Following a thymectomy, a 62-year-old male patient with myasthenia gravis receives the usual dose of pyridostigmine (Mestinon). An hour later, the patient complains of nausea and severe abdominal cramps. Which action should the nurse take first?
Notify the patients health care provider.
Which clinical manifestation would the nurse associate with those of a migraine?
Paralysis
motor symptoms of a migraine
Paralysis, weakness, and feeling of limb movements
Which neurodegenerative disorder has the characteristics of rigidity and bradykinesia?
Parkinson's disease
A degeneration of dopamine-producing neurons and decreased levels of dopamine are characteristics of which disease?
Parkinsons
Which information about a 72-year-old patient who has a new prescription for phenytoin (Dilantin) indicates that the nurse should consult with the health care provider before administration of the medication?
Patient has minor elevations in the liver function tests.
After change-of-shift report, which patient should the nurse assess first?
Patient with myasthenia gravis who is reporting increased muscle weakness
Which medication would the nurse associate with the primary drug of choice when treating tonic-clonic seizures?
Phenytoin (Dilantin)
When evaluating the presence of an initial symptom of Parkinson's disease, which clinical manifestation would the nurse evaluate?
Pill-rolling tremors
The home health registered nurse (RN) is planning care for a patient with a seizure disorder related to a recent head injury. Which nursing action can be delegated to a licensed practical/vocational nurse (LPN/LVN)?
Place medications in the home medication organizer.
When teaching a community group, which conditions would the nurse discuss as precipitating the development or intensity of restless legs syndrome (RLS)? Select all that apply.
Pregnancy Hypertension Iron deficiency
Regarding the patient with Parkinson's disease (PD) who recently entered a long-term care facility, which action would the health care team implement to promote adequate nutrition for this patient?
Provide small, frequent meals throughout the day that are easy to chew and swallow.
For patients with amyotrophic lateral sclerosis (ALS), which treatment goal focuses on preventing a common cause of death in patients with ALS?
Reduced risk of aspiration 3
Which assessment is most important for the nurse to make regarding a patient with myasthenia gravis?
Respiratory effort
For which major complication would the nurse monitor development in a patient experiencing a myasthenic crisis?
Respiratory insufficiency
For the patient who sustained a head trauma, which type of seizure might he or she experience while on a ventilator and receiving sedation medications in the intensive care unit?
Subclinical seizure
Which intervention will the nurse include in the plan of care for a patient with primary restless legs syndrome (RLS) who is having difficulty sleeping?
Suggest that the patient exercise regularly during the day.
A 73-year-old patient with Parkinsons disease has a nursing diagnosis of impaired physical mobility related to bradykinesia. Which action will the nurse include in the plan of care?
Suggest that the patient rock from side to side to initiate leg movement.
Which medication would the nurse anticipate administering as a first-line therapy in treatment of severe migraines?
Sumatriptan (Imitrex)
Which action will the nurse plan to take for a 40-year-old patient with multiple sclerosis (MS) who has urinary retention caused by a flaccid bladder?
Teach the patient how to use the Cred method.
The health care provider is considering the use of sumatriptan (Imitrex) for a 54-year-old male patient with migraine headaches. Which information obtained by the nurse is most important to report to the health care provider?
The patient had a recent acute myocardial infarction.
Which information about a 60-year-old patient with MS indicates that the nurse should consult with the health care provider before giving the prescribed dose of dalfampridine (Ampyra)?
The patient has an increased serum creatinine level.
A 62-year-old patient who has Parkinsons disease is taking bromocriptine (Parlodel). Which information obtained by the nurse may indicate a need for a decrease in the dose?
The patients blood pressure is 92/52 mm Hg.
While the nurse is transporting a patient on a stretcher to the radiology department, the patient begins having a tonic-clonic seizure. Which action should the nurse take?
Time and observe and record the details of the seizure and postictal state.
If taken daily, which prescribed medication prevents the development of a migraine attack?
Topiramate (Topamax)
A 76-year-old patient is being treated with carbidopa/levodopa (Sinemet) for Parkinsons disease. Which information is most important for the nurse to report to the health care provider?
Uncontrolled head movement
When teaching the clinical manifestations of cluster headaches to a group, which statement would the nurse include?
Unilateral pain radiating up or down the eye
When assessing a patient for the presence of petit mal, or absence, seizures, which classic sign would the nurse associate with this disorder?
Vacant facial expression
Multiple sclerosis
a chronic progressive degenerative disorder of the central nervous system characterized by progressive, chronic demyelination of nerve fibers of the spinal cord and brain
Huntington's disease
a genetically transmitted, autosomal dominant disorder characterized by chorea movements and cognitive and psychiatric disorders.
Lou Gehrig's disease
a rare progressive neurologic disorder involving degeneration of motor neurons in the spinal cord and brain; characteristics include limb weakness, dysarthria, and dysphagia
Ictal stage of a seizure
actual seizure activity
About which food item would the nurse teach a patient as being a potential trigger for cluster headaches?
alcohol
When a 74-year-old patient is seen in the health clinic with new development of a stooped posture, shuffling gait, and pill rollingtype tremor, the nurse will anticipate teaching the patient about
antiparkinsonian drugs.
prodromal stage of seizure
any activity that triggers seizure
The nurse observes a patient ambulating in the hospital hall when the patients arms and legs suddenly jerk and the patient falls to the floor. The nurse will first
assess the patient for a possible head injury.
when is a patient with MG most weak?
at the end of the day
amyotrophic lateral sclerosis (ALS)
condition of progressive deterioration of motor nerve cells resulting in total loss of voluntary muscle control; symptoms advance from muscle weakness in the arms and legs, to the muscles of speech, swallowing, and breathing, to total paralysis and death; also known as Lou Gehrig disease
Which identified clinical manifestation would the nurse associate with those exhibited with a cluster headache?
conjunctivitis
Which seizure disorder would the patient have when medication therapy failed, and the patient had a resection of epileptogenic tissue?
focal seizures
Which nursing diagnosis is of highest priority for a patient with Parkinsons disease who is unable to move the facial muscles?
imbalanced nutrition: less than body requirements
When obtaining a health history and physical assessment for a 36-year-old female patient with possible multiple sclerosis (MS), the nurse should
inquire about urinary tract problems
Which clinical manifestation would the nurse associate with a cluster headache?
lacrimation
Tonic phase of seizure
loss of breathing and intense muscle contraction
When teaching a patient with cluster headaches, which factor would the nurse include as a potential trigger?
napping
A 40-year-old patient is diagnosed with early Huntingtons disease (HD). When teaching the patient, spouse, and children about this disorder, the nurse will provide information about the
option of genetic testing for the patients children to determine their own HD risks.
The nurse advises a patient with myasthenia gravis (MG) to
perform physically demanding activities early in the day.
Which clinical manifestation would the nurse associate with a tension-type headache (TTH)?
phonophobia
Which seizure phase would the nurse identify when a patient with systemic lupus erythematosus presents to the emergency department with warm skin, pallor, lethargy, and an altered level of consciousness?
postictal phase
ketogenic diet
prevents seizures; high fat, low carb, mimics effects of fasting and puts body in constant state of ketosis
myoclonic seizure (generalized)
quick, repetitive jerks
What is the surgical therapy for MG?
removal of the thymus gland
When planning the care for a patient with multiple sclerosis who has an exacerbation of sensory deficits, for which patient problem would the nurse develop nursing interventions?
risk for injury
focal seizure
seizure in only one limb or body part
Subclinical seizure
seizure under sedation
what should the diet consist of with patient with myasthenia gravis (MG)
semisolid foods
aural stage
sensory warning before seizure
clonic phase of seizure
state of alternating contraction and relaxation of muscles
postictal phase
the period of time immediately following a tonic-clonic seizure in which the patient goes from full loss of consciousness to full mental status
The nurse will assess a 67-year-old patient who is experiencing a cluster headache for
unilateral ptosis.
