ch 65- Oncologic or Degenerative Neurologic Disorders

The nurse is caring for a client with mid-to-late stage of an inoperable brain tumor. What teaching is important for the nurse to do with this client? Managing muscle weakness Explaining hospice care and services Offering family support groups Optimizing nutrition

Explaining hospice care and services Explanation: The nurse explains hospice care and services to clients with brain tumors that no longer are at a stage where they can be cured. Managing muscle weakness and offering family support groups are important, but explaining hospice is the best answer. Optimizing nutrition at this point is not a priority.

A client is admitted reporting low back pain. How will the nurse best determine if the pain is related to a herniated lumbar disc? Have the client lie on the back and lift the leg, keeping it straight. Ask if the client can walk. Ask if the client has had a bowel movement. Ask the client if there is pain on ambulation.

Have the client lie on the back and lift the leg, keeping it straight.

A nurse is providing care to a client who has been diagnosed with metastatic brain cancer. When developing the client's plan of care, which outcome would the nurse most likely identify? Reduced incidence of recurrence Removal of all or part of the tumor Elimination of distressing signs and symptoms Improved quality of life

Improved quality of life

Which disease is associated with decreased levels of dopamine due to destruction of pigmented neuronal cells? Creutzfeldt-Jakob disease Parkinson disease Huntington disease Multiple sclerosis A 55-year-old female client presents at the walk-in clinic complaining of feeling like a mask is on her face. While doing the initial assessment, the nurse notes the demonstration of a pill-rolling movement in the right hand and a stooped posture. Physical examination shows bradykinesia and a shuffling gait. What would the nurse suspect is the causative factor for these symptoms? Myasthenia gravis Huntington's disease Multiple sclerosis Parkinson's disease

Parkinson disease

Which statement indicates appropriate nursing intervention for a client with post-polio syndrome? Provide care aimed at slowing the loss of strength and maintaining overall well-being. Plan activities for evening hours rather than morning hours Administer antiretroviral agents Avoid the use of heat applications in the treatment of muscle and joint pain

Provide care aimed at slowing the loss of strength and maintaining overall well-being.

3. The nurse teaches the patient that corticosteroids will be used to treat his brain tumor forwhich reason?A. Prevent extension ofthe tumorB. Facilitate regenerationof neuronsC. Reduce cerebral edemaD. Identify preciselocation of the tumor

Reduce cerebral edema

A client has a herniated disk in the region of the third and fourth lumbar vertebrae. Which nursing assessment finding most supports this diagnosis? Weakness and atrophy of the arm muscles Sensory deficits in one arm Hypoactive bowel sounds Severe lower back pain

Severe lower back pain

A client diagnosed with Huntington's disease has developed severe depression. What would be most important for the nurse to assess for? Suicidal ideations Choreiform movements Emotional apathy Loss of bowel and bladder control

Suicidal ideations

The nurse is providing education to a client who is being discharged with an outpatient treatment plan that includes taking a chemotherapeutic agent. What instructions should the nurse include? Select all that apply. The client should seek emergency help if nausea or vomiting occur. The client should seek emergency care if he or she develops a fever. Hair loss should be expected when taking the medication. The client should ensure no one else handles the medication. If a dose is missed, the client should take double the amount at the regular time the following day.

The client should seek emergency care if he or she develops a fever. Hair loss should be expected when taking the medication. The client should ensure no one else handles the medication.

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 client is having an exacerbation. The client is exhibiting signs of medication overdose. Medication needs to be adjusted to higher doses. The disease has entered the late stages.

The disease has entered the late stages.

A patient with myasthenia gravis is in the hospital for treatment of pneumonia. The patient informs the nurse that it is very important to take pyridostigmine bromide on time. The nurse gets busy and does not administer the medication until after breakfast. What outcome will the patient have related to this late dose? The patient will require a double dose prior to lunch. The muscles will become fatigued and the patient will not be able to chew food or swallow pills. The patient will go into cardiac arrest. There should not be a problem, since the medication was only delayed by about 2 hours.

The muscles will become fatigued and the patient will not be able to chew food or swallow pills.

The nurse is seeing the mother of a client who states, "I'm so relieved because my son's doctor told me his brain tumor is benign." The nurse knows what is true about benign brain tumors? They are all metastatic. The prognosis is very poor. They do not require surgical removal. They can affect vital functioning.

They can affect vital functioning.

A client with suspected Parkinson disease is initially being assessed by the nurse. When is the best time to assess for the presence of a tremor? When the client is participating in occupational therapy When the client is resting When the client is preparing his or her meal tray to eat When the client is ambulating

When the client is resting

A client is suspected of having amyotrophic lateral sclerosis (ALS). To help confirm this disorder, the nurse prepares the client for various diagnostic tests. The nurse expects the physician to order: quantitative spectral phonoangiography. Doppler ultrasonography. Doppler scanning. electromyography (EMG).

electromyography (EMG).

The nurse is providing discharge teaching for a client who was admitted to hospital after having complex partial seizures secondary to a glioma. The client has been prescribed levetiracetam to manage the seizures. What should the nurse include in the discharge teaching for this medication? "Suicidal ideation is a common side effect of this medication and should be reported immediately." "Driving a car should be avoided until the you know how this medication effects you." "If a corticosteroid has been prescribed, do not take it at the same time as this medication." "If the previous day's dose was forgotten, take two at the regular time the next day."

"Driving a car should be avoided until the you know how this medication effects you."

The daughter of a patient with Huntington's disease asks the nurse what the risk is of her inheriting the disease. What is the best response by the nurse? "If one parent has the disorder, there is an 75% chance that you will inherit the disease." "The disease is inherited and all offspring of a parent will develop the disease." "The disease is not hereditary and therefore there is no risk to you." "If one parent has the disorder, there is a 50% chance that you will inherit the disease."

"If one parent has the disorder, there is a 50% chance that you will inherit the disease."

A client with a malignant glioma is scheduled for surgery. The client demonstrates a need for additional teaching about the surgery when he states which of the following? "My headache and nausea should be lessened somewhat." "Any tissue that was dead will be removed." "There will be less cancer left that might be resistant to chemotherapy." "The surgeon will be able to remove all of the tumor."

"The surgeon will be able to remove all of the tumor."

A client with Parkinson's disease is prescribed amantadine hydrochloride 100 mg twice a day. The pharmacy supplies amantadine syrup, because the client has a history of difficulty swallowing tablets. The label reads 50 mg/5 mL. How many milliliters would the nurse administer to the client for each dose? Enter the correct number ONLY.

10

A client with cerebral metastasis suddenly experiences a seizure for which phenytoin 10 mg/kg intravenously is ordered as an initial loading dose. The client weighs 165 pounds. How many milligrams of phenytoin should the client receive? Enter the number ONLY.

750 Explanation: First, change the client's weight in pounds to kilograms by dividing the weight by 2.2 (2.2 pounds = 1 kg). The client's weight is 75 kg. Next, set up a proportion: 10/1 = x/75; cross multiply and solve for x, which is 750.

Which anticholinergic agent is used to control tremor and rigidity in Parkinson disease?

Benztropine Mesylate Explanation: Benztropine Mesylate is an anticholinergic agent used to control tremor and rigidity in Parkinson disease. Bromocriptine mesylate is a dopamine agonist. Amantadine is an antiviral agent. Levodopa is a dopaminergic.

The nurse reviews the patient's drug regimen for treatment of a brain tumor. She explains to the patient why one of the following drugs would not be prescribed, even though it might have therapeutic benefits. Which drug would not be prescribed for this patient? Decadron Dilantin Coumadin Paclitaxel

Coumadin (warfarin)

The nurse is caring for a client who underwent surgery to remove a spinal cord tumor. When conducting the postoperative assessment, the nurse notes the presence of a bulge at the surgical site. The nurse suspects the client is experiencing what complication from the surgery? Growth of a secondary tumor Cerebrospinal fluid leakage Infection at the surgical site Impaired tissue healing

Cerebrospinal fluid leakage

Which diagnostic is most commonly used for spinal cord compression? Positron emission tomography (PET) Computed tomography (CT) Magnetic resonance imaging (MRI) X-ray

Magnetic resonance imaging (MRI)

A client is scheduled for a laminectomy to repair a herniated intervertebral disk. When developing the postoperative care plan, the nurse should include which action? Keeping a pillow under the client's knees at all times Turning the client from side to side, using the logroll technique Placing the client in semi-Fowler's position Maintaining bed rest for 72 hours after the laminectomy

Turning the client from side to side, using the logroll technique

A client asks the nurse to explain the development of Parkinson disease (PD). Which response will the nurse provide the client? "While there is no average age of onset, studies suggest neurologic aging deficits put clients at risk after age 70." "It is a genetic disorder that has a strong corralation to women who began menopause earlier than age 45." "It has been linked by untreated or poorly managed bacterial or viral infections in early adolescence." "It is caused by low levels of dopamine that are not available to counteract the effects of acetylcholine."

"It is caused by low levels of dopamine that are not available to counteract the effects of acetylcholine."

A client who has just been diagnosed with mixed muscular dystrophy asks the nurse about the usual course of this disease. How should the nurse respond? "This form of muscular dystrophy is a relatively benign disease that progresses slowly." "You should ask your physician about that." "The strength of your arms and pelvic muscles will decrease gradually, but this should cause only slight disability." "You may experience progressive deterioration in all voluntary muscles."

"You may experience progressive deterioration in all voluntary muscles."

A client with spinal cord compression from a tumor must undergo diagnostic testing. Which of the following is the most likely procedure for this client? Computed tomography Ultrasonography Core needle biopsy Magnetic resonance imaging

Magnetic resonance imaging

The nurse explains to the client with projectile vomiting and severe headache that a medication is being prescribed to reduced edema surrounding the brain and lessen these symptoms. What medication is the nurse preparing to Mannitoladminister? Temozolomide Everolimus Bevacizumab Mannitol

Mannitol

A patient is diagnosed with a spinal cord tumor and has had a course of radiation and chemotherapy. Two months after the completion of the radiation, the patient complains of severe pain in the back. What is pain an indicator of in a patient with a spinal cord tumor? Spinal metastasis Hematoma formation The development of a skin ulcer from the radiation Lumbar sacral strain

Spinal metastasis

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 a slow, shuffling gait and then will be able to move at a faster pace. The patient will have a period when medication with levodopa will be unnecessary. The patient will have periods of near immobility, followed by a sudden return of effectiveness of the medication. The patient will have unilateral resting tremors and then will have a period of no tremors present. SUBMIT ANSWER

The patient will have periods of near immobility, followed by a sudden return of effectiveness of the medication.

A nurse is caring for a client who underwent a lumbar laminectomy 2 days ago. Which finding requires immediate intervention? Paresthesia in the dermatomes near the wounds More back pain than the first postoperative day Temperature of 99.2° F (37.3° C) Urine retention or incontinence

Urine retention or incontinence Urine retention or incontinence may indicate cauda equina syndrome, which requires immediate surgery. An increase in back pain is more common because on the second postoperative day the long-acting local anesthetic, which may have been injected during surgery, will wear off. Although paresthesia is common after surgery, progressive weakness or paralysis may indicate spinal nerve compression. A mild fever is also common after surgery but is considered significant only if the temperature reaches 101° F (38.3° C).

A client comes to the clinic for evaluation because of complaints of dizziness and difficulty walking. Further assessment reveals a staggering gait, marked muscle incoordination, and nystagmus. A brain tumor is suspected. Based on the client's assessment findings, the nurse would suspect that the tumor is located in which area of the brain? Motor cortex Occipital lobe Frontal lobe Cerebellum

Cerebellum

Which of the following diagnostic studies provides visualization of cerebral blood vessels? Computer-assisted stereotactic biopsy Cytologic studies of cerebrospinal fluid (CSF) Positron emission tomography (PET) Cerebral angiography

Cerebral angiography

A nurse helps a patient recently diagnosed with a pituitary adenoma understand that: Most tumors are malignant (>90%). The cause is directly related to prior exposure to radiation. Most tumors produce too much of one or more hormones. Transcranial surgery is usually necessary to remove the tumor.

Most tumors produce too much of one or more hormones.

The nurse is caring for a client who was diagnosed with a glioma 5 months ago. Today, the client was brought to the emergency department by his caregiver because he collapsed at home. The nurse suspects late signs of rising intracranial pressure (ICP) when which blood pressure and pulse readings are noted? BP = 150/90 mm Hg; HR = 90 bpm BP =130/80 mm Hg; HR = 55 bpm BP = 175/45 mm Hg; HR = 42 bpm BP = 90/50 mm Hg; HR = 75 bpm

BP = 175/45 mm Hg; HR = 42 bpm

The nurse responds to the call light of a client who has had a cervical discectomy earlier in the day. The client states that she is having severe pain that had a sudden onset. What is the nurse's most appropriate action? Administer a dose of an NSAID. Call the surgeon to report the client's pain. Palpate the surgical site. Remove the dressing to assess the surgical site.

Call the surgeon to report the client's pain.

The nurse is caring for a client hospitalized after a motor vehicle accident. The client has a comorbidity of Parkinson's disease. Why should the nurse closely monitor the condition and the drug regimen of a client with Parkinson's disease? Drugs administered may not cause the requisite therapeutic effect. Clients take an assortment of different drugs. Clients generally do not adhere to the drug regimen. Drugs administered may cause a wide variety of adverse effects.

Drugs administered may cause a wide variety of adverse effects.

While assessing the client at the beginning of the shift, the nurse inspects a surgical dressing covering the operative site after the clients' cervical discectomy. The nurse notes that the drainage is 75% saturated with serosanguineous discharge. What is the nurse's most appropriate action? Reposition the client to prevent further hemorrhage. Reinforce the dressing and reassess in 1 to 2 hours. Page the health care provider and report this sign of infection. Inform the surgeon of the possibility of a dural leak.

Inform the surgeon of the possibility of a dural leak.

Which term is used to describe edema of the optic nerve? Papilledema Scotoma Angioneurotic edema Lymphedema

Papilledema