Chapter 65- Management of Patients with Oncologic or Degenerative Neurologic Disorders

Which disease includes loss of motor neurons in the anterior horns of the spinal cord and motor nuclei of the lower brain stem? Huntington disease Parkinson disease Alzheimer disease Amyotrophic lateral sclerosis

Amyotrophic lateral sclerosis

An acoustic neuroma is a benign tumor of which cranial nerve? Ninth Eighth Seventh Fifth

Eighth

Which disease is associated with decreased levels of dopamine due to destruction of pigmented neuronal cells? Huntington disease Parkinson disease Multiple sclerosis Creutzfeldt-Jakob disease

Parkinson disease

A client with Parkinson's disease has been receiving levodopa as treatment for the past 7 years. The client comes to the facility for an evaluation and the nurse observes facial grimacing, head bobbing, and smacking movements. The nurse interprets these findings as which of the following? Dyskinesia Bradykinesia Micrographia Dysphonia

Dyskinesia

The nurse is performing an assessment for a patient in the clinic with Parkinson's disease. The nurse determines that the patient's voice has changed since the last visit and is now more difficult to understand. How should the nurse document this finding? Dysphonia Micrographia Hypokinesia Dysphagia

Dysphonia

A client newly diagnosed with Huntington diease asks for information concerning management of symptoms. Which action would the nurse first take to address this request? Recommend the immediate use of levodopa by the client. Provide a referral for the client to a Huntington disease multidisciplnary team. Establish the client's willingness to adhere to prescribed treatments. Perform a focused assessment on the client's needs and capabilities.

Perform a focused assessment on the client's needs and capabilities.

Which statement indicates appropriate nursing intervention for a client with post-polio syndrome? 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.

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

A client has undergone surgery for a spinal cord tumor that was located in the cervical area. The nurse would be especially alert for which of the following? Skin breakdown Hemorrhage Bowel incontinence Respiratory dysfunction

Respiratory dysfunction

The nurse educator is providing orientation to a new group of staff nurses on an oncology unit. Part of the orientation is to help nurses understand the differences between various types of brain tumors. The nurse educator correctly identifies that glioma tumors are classified based on the fact that they originate where in the brain? In the cranial nerves From the coverings of the brain Within the brain tissue From metastasis of a primary tumor

Within the brain tissue

A nurse is conducting a presentation about brain cancer for a local community group. During the presentation, one of the group members asks, "What causes brain tumors?" Which response by the nurse would be most appropriate? "There is scientific evidence that cigarette smoking is high on the list of causes." "The cause of most brain tumors is still really not known." "Exposure to residential power lines is a definite cause of brain tumors." "It's a known fact that using cell phones increases your risk for a tumor."

"The cause of most brain tumors is still really not known."

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? "The strength of your arms and pelvic muscles will decrease gradually, but this should cause only slight disability." "This form of muscular dystrophy is a relatively benign disease that progresses slowly." "You may experience progressive deterioration in all voluntary muscles." "You should ask your physician about that."

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

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 patient is diagnosed with an intracerebral tumor. The nurse knows that the diagnosis may include which of the following? Select all that apply. Acoustic neuroma Meningioma Astrocytoma Ependymoma Medulloblastoma

Astrocytoma Ependymoma Medulloblastoma

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? Offering family support groups Explaining hospice care and services Managing muscle weakness Optimizing nutrition

Explaining hospice care and services

A client is admitted reporting low back pain. How will the nurse best determine if the pain is related to a herniated lumbar disc? 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. Ask if the client can walk.

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

A client with a cervical disc herniation in the acute phase reports of numbness and tingling in the arms. What are the priority interventions for the nurse to perform? Select all that apply. Provide NSAID therapy Have the client wear a cervical collar daily Encourage weight lifting to strengthen arms Assist the client in isometric exercises of the arms Encourage exercises to strengthen the legs

Have the client wear a cervical collar daily Provide NSAID therapy

A male client who has undergone a cervical discectomy is being discharged with a cervical collar. Which of the following would be most appropriate to include the client's discharge plan? Removing the entire collar when shaving Keeping the head in a neutral position Moving the neck from side to side when the collar is off Wearing the cervical collar when sleeping

Keeping the head in a neutral position

A patient is diagnosed with an aggressive, primary malignant brain tumor. The nurse is aware that the glioma: Originated within the brain tissue. Originated from the coverings of the brain. Developed on the cranial nerves. Metastasized from a cancer in another part of the body.

Originated within the brain tissue

Which of the following is a late symptom of spinal cord compression? Urinary incontinence Urinary retention Paralysis Fecal incontinence

Paralysis

A client has just returned from surgery after undergoing a lumbar laminectomy. Which of the following would be most important to do when positioning the client in bed? Keeping the knees flat with the head on a pillow Allowing the client to sit up at the edge of the bed Using a logrolling motion to change positions Maintaining full knee flexion when lying on the side

Using a logrolling motion to change positions

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 resting When the client is preparing his or her meal tray to eat When the client is ambulating When the client is participating in occupational therapy

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: Doppler ultrasonography. electromyography (EMG). Doppler scanning. quantitative spectral phonoangiography.

electromyography (EMG)

Bone density testing in clients with post-polio syndrome has demonstrated osteoarthritis. low bone mass and osteoporosis. no significant findings. calcification of long bones.

low bone mass and osteoporosis

The nurse teaches the client that corticosteroids will be used to treat his brain tumor to facilitate regeneration of neurons. prevent extension of the tumor. identify the precise location of the tumor. reduce cerebral edema.

reduce cerebral edema.

The nurse is caring for a patient with Huntington's disease in the long-term care facility. What does the nurse recognize as the most prominent symptom of the disease that the patient exhibits? Rapid, jerky, involuntary movements Slow, shuffling gait Dementia Dysphagia and dysphonia

Rapid, jerky, involuntary movements

A client with a cerebellar brain tumor is admitted to an acute care facility. The nurse formulates a nursing diagnosis of Risk for injury. Which "related-to" phrase should the nurse add to complete the nursing diagnosis statement? Related to psychomotor seizures Related to difficulty swallowing Related to impaired balance Related to visual field deficits

Related to impaired balance

A patient with amyotrophic lateral sclerosis (ALS) asks if the nurse has heard of a drug that will prolong the patient's life. The nurse knows that there is a medication that may prolong the life by 3 to 6 months. To which medication is the patient referring? Riluzole Diazepam Baclofen Dantrolene sodium

Riluzole

The nurse is providing postoperative care for a client who just underwent surgery to remove a metastatic intramedullary tumor. On postoperative day 3, the client states, "I am really looking forward to going running again, it had become too difficult because of the loss of feeling in my feet." Which should the nurse address in the client's care plan? Impaired cognition Body image disturbance Knowledge deficit Anxiety

Knowledge deficit

Bone density testing will be completed for the client with post-polio syndrome. The nurse teaches the client bone density testing is used to identify what potential complication? Low bone mass and osteoporosis Pathologic fractures Calcification of long bones Osteoarthritis

Low bone mass and osteoporosis

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? "The disease is not hereditary and therefore there is no risk to you." "The disease is inherited and all offspring of a parent will develop the disease." "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 an 75% 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? "There will be less cancer left that might be resistant to chemotherapy." "Any tissue that was dead will be removed." "My headache and nausea should be lessened somewhat." "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 cerebral metastasis suddenly experiences a seizure for which phenytoin 10 mg/kg intravenously is ordered as an initial loading dose. The client weighs 132 pounds. How many milligrams of phenytoin should the client receive? Enter the number ONLY. - unit of entry

600

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

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? Palpate the surgical site. Call the surgeon to report the client's pain. Administer a dose of an NSAID. Remove the dressing to assess the surgical site.

Call the surgeon to report the client's pain

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

The nurse is caring for a client who has been hospitalized for investigation of a sudden change in gait due to loss of balance and coordination. A magnetic resonance imaging scan reveals the client has a brain tumor. On or close to which brain structure is the tumor most likely situated? Brain stem Pituitary gland Cerebellum Temporal lobe

Cerebellum

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

Cerebral angiography

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? Infection at the surgical site Growth of a secondary tumor Cerebrospinal fluid leakage Impaired tissue healing

Cerebrospinal fluid leakage

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? Clients generally do not adhere to the drug regimen. Drugs administered may not cause the requisite therapeutic effect. Drugs administered may cause a wide variety of adverse effects. Clients take an assortment of different drugs.

Drugs administered may cause a wide variety of adverse effects

A client is admitted to the hospital with pneumonia. He has a history of Parkinson disease, which his family says is worsening. Which assessment should the nurse expect? Pleasant and smiling demeanor Muscle flaccidity Impaired speech Tremors in the fingers that increase with purposeful movement

Impaired speech

A patient with a brain tumor is complaining of headaches that are worse in the morning. What does the nurse know could be the reason for the morning headaches? Increased intracranial pressure Dehydration The tumor is shrinking. Migraines

Increased intracranial pressure

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 administer? Bevacizumab Temozolomide Everolimus Mannitol

Mannitol

A client with muscle weakness and an abnormal gait is being evaluated for muscular dystrophy. What is the supportive goal for the client diagnosed with muscular dystrophy? Client will be free of respiratory complications. Minimized functional deterioration in the client. Client will complete end-of-life decisions. Genetic testing will identify specific gene mutations.

Minimized functional deterioration in the client

Which client should the nurse assess for degenerative neurologic symptoms? The client with Paget disease. The client with osteomyelitis. The client with Huntington disease. The client with glioma.

The client with Huntington disease.

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. They do not require surgical removal. The prognosis is very poor. They can affect vital functioning.

They can affect vital functioning