Neuro Muscular
A patient is taking Rasagiline "Azilect" for treatment of Parkinson's Disease. What foods do the patient want to limit in their diet? Select all that apply: A. Liver B. Aged Cheese C. Sweetbread D. Beer E. Fermented foods F. Shellfish
B. Aged Cheese D. Beer E. Fermented foods
During your discharge teaching to a patient with multiple sclerosis, you educate the patient on how to avoid increasing symptoms and relapses. You tell the patient to avoid: A. Cold temperatures B. Infection C. Overexertion D. Salt F. Stress
B. Infection C. Overexertion F. Stress
The patient's lumbar puncture results are back. Which finding below correlates with Guillain-Barré Syndrome? A. high glucose with normal white blood cells B. high protein with normal white blood cells C. high protein with low white blood cells D. low protein with high white blood cells
B. high protein with normal white blood cells
A patient is prescribed to take Carbidopa/Levodopa (Sinemet). As the nurse you know that which statement is incorrect about this medication: A. It can take up to 3 weeks for the patient to notice a decrease in signs and symptoms when beginning treatment with this medication. B. Body fluids can turn a dark color and stain clothes. C. This medication is most commonly prescribed with a vitamin B6 supplement. D. Carbidopa helps to prevent Levodopa from being broken down in the blood before it enters the brain. Hence, levodopa is able to enter the brain.
C. This medication is most commonly prescribed with a vitamin B6 supplement.
Your patient is recovering from a myasthenic crisis and you are providing education to the patient about the causes of this condition. Which statement by the patient demonstrates they understood the teaching about how to prevent this condition? A. "I will make sure I don't take too much of my anticholinesterase medication because it can lead to this condition." B. "I will avoid milk products while taking Pyridostigmine because it increases the chances of toxicity." C. "I will avoid taking over-the-counter supplements that contain aconite." D. "I will avoid people who are sick with respiratory infections and be sure not to miss my scheduled doses of Pyridostigmine."
D. "I will avoid people who are sick with respiratory infections and be sure not to miss my scheduled doses of Pyridostigmine."
True or False: Multiple Sclerosis tends to affect men more than women and occurs during the ages of 50-70 years. True False
False MS affects WOMEN more than men and shows up during the ages of 20-40 years.
When planning care for a patient diagnosed with Parkinson disease (PD), which of these patient outcomes should receive priority in the patient's plan of care? A, Taking a vitamin supplement each day B, Taking a daily walk around the neighborhood C, Toileting and bathing independently D, Working on a favorite hobby
Toileting and bathing independently
A client is taking long-term corticosteroids for myasthenia gravis. What teaching is most important? a.Avoid large crowds and people who are ill. b.Check blood sugars four times a day. c.Use two forms of contraception. d.Wear properly fitting socks and shoes.
a.Avoid large crowds and people who are ill. Corticosteroids reduce immune function.
Myasthenia gravis is considered an autoimmune disease in which antibodies are directed against ______________________.
acetylcholine receptors
The most effective drug currently used to control the tremor of parkinsonism is: a. Requip. b. Levodopa. c. Symmetrel. d. Permax.
b. Levodopa
A nurse assesses a client with Huntington disease. Which motor changes should the nurse monitor for in this client? a.Shuffling gait b.Jerky hand movements c.Continuous chewing motions d.Tremors of the hands
b.Jerky hand movements An imbalance between excitatory and inhibitory neurotransmitters leads to uninhibited motor movements, such as brisk, jerky, purposeless movements of the hands, face, tongue, and legs. Shuffling gait, continuous chewing motions, and tremors are associated with Parkinson disease.
A patient with Parkinson's disease has bradykinesia. Which action will the nurse include in the plan of care? a.Instruct the patient in activities that can be done while lying or sitting. b.Suggest that the patient rock from side to side to initiate leg movement. c.Have the patient take small steps in a straight line directly in front of the feet. d.Teach the patient to keep the feet in contact with the floor and slide them forward.
b.Suggest that the patient rock from side to side to initiate leg movement. Rocking the body from side to side stimulates balance and improves mobility. The patient will be encouraged to continue exercising because this will maintain functional abilities. Maintaining a wide base of support will help with balance. The patient should lift the feet and avoid a shuffling gait.
A client is receiving plasmapheresis. What action by the nurse best prevents infection in this client? a.Giving antibiotics prior to treatments b.Monitoring the client's vital signs c.Performing appropriate hand hygiene d.Placing the client in protective isolation
c.Performing appropriate hand hygiene
A 40-yr-old patient is diagnosed with early Huntington's disease (HD). When teaching the patient, spouse, and adult children about this disorder, the nurse will provide information about the a.use of levodopa-carbidopa (Sinemet) to help reduce HD symptoms. b.prophylactic antibiotics to decrease the risk for aspiration pneumonia. c.option of genetic testing for the patient's children to determine their own HD risks. d.lifestyle changes of improved nutrition and exercise that delay disease progression.
c.option of genetic testing for the patient's children to determine their own HD risks.
Clinical manifestations of Huntington's disease include: a. abnormal involuntary movements (chorea). b. emotional disturbances. c. intellectual decline. d. all of the above.
d. all of the above.
The nurse knows that Parkinson's disease, a progressive neurologic disorder, is characterized by: a. bradykinesia. c. tremor.b. muscle rigidity. d. all of the above.
d. all of the above.
After teaching the wife of a client who has Parkinson disease, the nurse assesses the wife's understanding. Which statement by the client's wife indicates she correctly understands changes associated with this disease? a."His masklike face makes it difficult to communicate, so I will use a white board." b."He should not socialize outside of the house due to uncontrollable drooling." c."This disease is associated with anxiety causing increased perspiration." d."He may have trouble chewing, so I will offer bite-sized portions."
d."He may have trouble chewing, so I will offer bite-sized portions."
Which of these nursing actions for a patient with Guillain-Barré syndrome is appropriate for the nurse to delegate to experienced unlicensed assistive personnel (UAP)? a.Nasogastric tube feeding q4hr b.Artificial tear administration q2hr c.Assessment for bladder distention q2hr d.Passive range of motion to extremities q4hr
d.Passive range of motion to extremities q4hr
The majority of patients with myasthenia gravis exhibit these two clinical signs: ___________ and ____________.
double vision, and drooping of the eyelids
List the five chief symptoms of amyotrophic lateral sclerosis
fatigue, progressive muscle weakness, cramps, fasciculations (twitching), and incoordination
Identify the four cardinal signs of Parkinson's disease:_____________________, ______________________, _____________________, and ______________________.
tremor, rigidity, bradykinesia, and postural instability
A patient with a diagnosis of Parkinson disease (PD) has been prescribed levodopa. Which of the following statements will the healthcare provider include when teaching the patient about this medication? Select all that apply. A "Let us know if you notice if the medication begins to lose its effectiveness." B "Call our office if you notice the development of a tic or facial grimace." C "If you experience nausea, you may take your medication with a high protein meal." D "This medication will reverse the disease process and give you a normal life." E "It may take a few months for you to experience the full effects of the medication."
A "Let us know if you notice if the medication begins to lose its effectiveness." B "Call our office if you notice the development of a tic or facial grimace." E "It may take a few months for you to experience the full effects of the medication."
The nurse is assessing a 37-year-old client diagnosed with multiple sclerosis. Which of the following symptoms would the nurse expect to find? A Vision changes B Absent deep tendon reflexes C Tremors at rest D Flaccid muscles
A Vision changes Vision changes, such as diplopia, nystagmus, and blurred vision, are symptoms of multiple sclerosis. Deep tendon reflexes may be increased or hyperactive — not absent. Babinski's sign may be positive. Tremors at rest aren't characteristic of multiple sclerosis; however, intentional tremors, or those occurring with purposeful voluntary movement, are common in clients with multiple sclerosis. Affected muscles are spastic, rather than flaccid.
You're teaching a group of nursing students about Guillain-Barré Syndrome and how it can affect the autonomic nervous system. Which signs and symptoms verbalized by the students demonstrate they understood the autonomic involvement of this syndrome? Select all that apply: A. Altered body temperature regulation B. Inability to move facial muscles C. Cardiac dysrhythmias D. Orthostatic hypotension E. Bladder distension
A. Altered body temperature regulation C. Cardiac dysrhythmias D. Orthostatic hypotension E. Bladder distension
A patient is suspected of having multiple sclerosis. The neurologist orders various test. The patient's MRI results are back and show lesions on the cerebellum and optic nerve. What signs and symptoms below would correlate with this MRI finding in a patient with multiple sclerosis? A. Blurry vision B. Pain when moving eyes C. Dysarthria D. Balance and coordination issues E. "Pill rolling" of fingers and hands G. Heat intolerance H. Dark spots in vision I. Ptosis
A. Blurry vision B. Pain when moving eyes C. Dysarthria D. Balance and coordination issues H. Dark spots in vision The answers are A, B C, D, and H. If lesions are present on the optic nerves, optic neuritis can occurs which can lead to blurry vision, pain when moving the eyes, and dark spots in the vision. If cerebellar lesions are found, this can affect movement, speech, and some cognitive abilities. This would present as dysarthria (issues articulating words), and balance/coordination issues. "Pill rolling" of the fingers and hands is found in Parkinson's disease. Ptosis is common in myasthenia gravis, and heat intolerance in thyroid issues.
A patient who has been prescribed the antiparkinsonian medication carbidopa/levodopa, asks the healthcare provider, "Why am I getting these two medications?" How should the healthcare provider respond? A "You will experience fewer side effects when you take both medications together." B "The carbidopa prevents the breakdown of the levodopa." C "This drug combination is composed of two types of the same medication." D "The levodopa turns the carbidopa into dopamine when it reaches the brain."
B "The carbidopa prevents the breakdown of the levodopa."
The nurse is teaching a female client with multiple sclerosis. When teaching the client how to reduce fatigue, the nurse should tell the client to: A take a hot bath. B rest in an air-conditioned room. C increase the dose of muscle relaxants. D avoid naps during the day.
B rest in an air-conditioned room. Fatigue is a common symptom in clients with multiple sclerosis. Lowering the body temperature by resting in an air-conditioned room may relieve fatigue; however, extreme cold should be avoided. A hot bath or shower can increase body temperature, producing fatigue. Muscle relaxants, prescribed to reduce spasticity, can cause drowsiness and fatigue. Planning for frequent rest periods and naps can relieve fatigue. Other measures to reduce fatigue in the client with multiple sclerosis include treating depression, using occupational therapy to learn energy conservation techniques, and reducing spasticity.
During a Tensilon test the patient has worsening of muscle weakness. The nurse anticipates that the physician will give the following order? A. Administer Atropine along with an anticholinesterase medication. B. Administer Atropine and hold any further doses of Pyridostigmine. C. Administer Pyridostigmine and hold Atropine. D. Administer Edrophonium along with Atropine.
B. Administer Atropine and hold any further doses of Pyridostigmine. If a patient experiences worsening of muscle weakness during a Tensilon test the patient has cholinergic crisis. Therefore, the nurse could anticipate that the physician will order Atropine (to reverse the signs and symptoms...because remember this drug is the antidote for Edrophonium which is given during the test) and to HOLD any further doses of Pyridostigmine (this is an anticholinesterase drug).
The healthcare provider is teaching a patient with a new diagnosis of Parkinson disease (PD) about lifestyle changes to make the disease more manageable. Which of the following will the healthcare provider include in the teaching? Select all that apply. A Maintain a low calorie diet, low fat diet B Wear shoes with rubber soles C Perform range of motion exercises daily D Choose clothing that does not require buttons E Eat small, frequent meals
C Perform range of motion exercises daily D Choose clothing that does not require buttons E Eat small, frequent meals
A patient is receiving Interferon Beta for treatment of multiple sclerosis. As the nurse you will stress the importance of? A. Physical exercise to improve fatigue B. Low fat diet C. Hand hygiene and avoiding infection D. Reporting ideation of suicide
C. Hand hygiene and avoiding infection Interferon Beta decreases the number of relapses of symptoms in MS patients by decreasing the immune system response, but it lowers the white blood cells count. Hence, there is a risk of infection. It is very important the nurse stresses the importance of hand hygiene and avoiding infection.
Female client is admitted to the hospital with a diagnosis of Guillain-Barre syndrome. The nurse inquires during the nursing admission interview if the client has history of: A Seizures or trauma to the brain B Meningitis during the last 5 years C Back injury or trauma to the spinal cord D Respiratory or gastrointestinal infection during the previous month.
D Respiratory or gastrointestinal infection during the previous month. Guillain-Barré syndrome is a clinical syndrome of unknown origin that involves cranial and peripheral nerves. Many clients report a history of respiratory or gastrointestinal infection in the 1 to 4 weeks before the onset of neurological deficits. Occasionally, the syndrome can be triggered by vaccination or surgery.
During an interview with a patient with a diagnosis of Parkinson disease (PD), which of the following speech patterns will the healthcare provider anticipate? A Pressured and hurried B Clear and rhythmic C Bubbly and spirited D Slow, slurred, and monotone
D Slow, slurred, and monotone
During nursing report you learn that the patient you will be caring for has Guillain-Barré Syndrome. As the nurse you know that this disease tends to present with: A. signs and symptoms that are unilateral and descending that start in the lower extremities B. signs and symptoms that are symmetrical and ascending that start in the upper extremities C. signs and symptoms that are asymmetrical and ascending that start in the lower extremities D. signs and symptoms that are symmetrical and ascending that start in the lower extremities
D. signs and symptoms that are symmetrical and ascending that start in the lower extremities
True or False: Patients with multiple sclerosis have different signs and symptoms because this disease can affect various areas of the peripheral nervous system. True False
False MS affects the CNS, not the PNS
You're caring for a patient with Parkinson's Disease that has tremors. Select the option that is INCORRECT about tremors experienced in this disease: A. The tremors are most likely to occur with purposeful movements. B. A common term used to describe the tremors in the hands and fingers is called "pill-rolling". C. Tremors are one of the most common signs and symptoms in Parkinson's Disease. D. Tremors in this disease can occur in the hands, fingers, arms, legs and even the lips and tongue.
A. The tremors are most likely to occur with purposeful movements. The tremors usually occur at rest.
The average time from onset to death for patients diagnosed with amyotrophic lateral sclerosis (ALS) is: a. 3 to 5 years. c. 10 years. b. 6to8years. d. 15to20years.
a. 3 to 5 years.
A positive diagnosis of myasthenia gravis can be reached using the following test: a. anticholinesterase levels. c. computed tomography (CT) scan. b. magnetic resonance imaging. d. electromyography.
a. anticholinesterase levels.
A client with myasthenia gravis (MG) asks the nurse to explain the disease. What response by the nurse is best? a."MG is an autoimmune problem in which nerves do not cause muscles to contract." b."MG is an inherited destruction of peripheral nerve endings and junctions." c."MG consists of trauma-induced paralysis of specific cranial nerves." d."MG is a viral infection of the dorsal root of sensory nerve fibers."
a."MG is an autoimmune problem in which nerves do not cause muscles to contract."
A woman who has multiple sclerosis (MS) asks the nurse about risks associated with pregnancy. Which response by the nurse is accurate? a."MS symptoms may be worse after the pregnancy." b."Women with MS frequently have premature labor." c."MS is associated with an increased risk for congenital defects." d."Symptoms of MS are likely to become worse during pregnancy."
a."MS symptoms may be worse after the pregnancy." During the postpartum period, women with MS are at greater risk for exacerbation of symptoms. There is no increased risk for congenital defects in infants born of mothers with MS. Symptoms of MS may improve during pregnancy. Onset of labor is not affected by MS.
After change-of-shift report, which patient should the nurse assess first? a.Patient with myasthenia gravis who is reporting increased muscle weakness b.Patient with a bilateral headache described as "like a band around my head" c.Patient with seizures who is scheduled to receive a dose of phenytoin (Dilantin) d.Patient with Parkinson's disease who has developed cogwheel rigidity of the arms
a.Patient with myasthenia gravis who is reporting increased muscle weakness Because increased muscle weakness may indicate the onset of a myasthenic crisis, the nurse should assess this patient first. The other patients should also be assessed but do not appear to need immediate nursing assessments or actions to prevent life-threatening complications.
A patient who has amyotrophic lateral sclerosis (ALS) is hospitalized with pneumonia. Which nursing action will be included in the plan of care? a.Observe for agitation and paranoia. b.Assist with active range of motion (ROM). c.Give muscle relaxants as needed to reduce spasms. d.Use simple words and phrases to explain procedures.
b.Assist with active range of motion (ROM). ALS causes progressive muscle weakness, but assisting the patient to perform active ROM will help maintain strength as long as possible. Psychotic manifestations such as agitation and paranoia are not associated with ALS. Cognitive function is not affected by ALS, and the patient's ability to understand procedures will not be impaired. Muscle relaxants will further increase muscle weakness and depress respirations.
After a thymectomy, a 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? a.Auscultate the patient's bowel sounds. b.Notify the patient's health care provider. c.Administer the prescribed PRN antiemetic drug. d.Give the scheduled dose of prednisone (Deltasone).
b.Notify the patient's health care provider May indicate cholinergic crisis
Which assessment data for a patient who has Guillain-Barré syndrome will require the nurse's most immediate action? a.The patient's sacral area skin is reddened. b.The patient is continuously drooling saliva. c.The patient complains of severe pain in the feet. d.The patient's blood pressure (BP) is 150/82 mm Hg.
b.The patient is continuously drooling saliva. Indicates decreased ability to swallow which places patient at risk for aspiration.
The expected outcome for a patient taking levodopa as a drug therapy for Parkinson's disease would be a: A) Decrease in rigidity B) Decrease in sweating C) Decrease in diarrhea D) Decrease in muscle twitching
A) Decrease in rigidity
The healthcare provider is assessing a patient with a diagnosis of Parkinson disease (PD). Which of the following findings would the healthcare provider anticipate? Select all that apply. A Bradykinesia B Daytime sleepiness C Kyphosis D Depression E Receptive aphasia F Exophthalamos
A Bradykinesia B Daytime sleepiness C Kyphosis D Depression The problems experienced by patients with PD are not limited to the motor system. PD often causes sleep pattern disruption, excessive daytime sleepiness, and "sleep attacks" where the patient experiences a sudden onset of sleep. The negative impact on motor disability and decreased quality of life associated with PD can result in the onset of depression. Bradykinesia (moving slow) is a classic motor symptom of PD. Increased muscle rigidity and stiffness promotes the posture typical of PD, including a forward position of the head, rounded shoulders, thoracic kyphosis, and bent knees.
A patient is newly diagnosed with Parkinson's disease. Levodopa (Dopar) has been prescribed. Which of the following patient teaching information should be high priority? A)Avoid vitamin B6 intake because a combination with levodopa may lead to decreased efficacy. B)Avoid hot environments because this could cause increased sweating, which is a normal response. C)Headache and difficulty sleeping are expected adverse effects. They will subside when the body adjusts to the drug. D)Allow rest periods to avoid adverse effects of fatigue, weakness, and drowsiness
A) Avoid vitamin B6 intake because a combination with levodopa may lead to decreased efficacy.
Select all the signs and symptoms associated with a myasthenic crisis: A. Pupil dilation B. Muscle fasciculation C. Miosis D. Bowel and bladder incontinence E. Negative gag or cough reflex F. Respiratory failure G. Bradycardia
A. Pupil dilation D. Bowel and bladder incontinence E. Negative gag or cough reflex F. Respiratory failure
Select all the signs and symptoms below that can present in myasthenia gravis:* A. Respiratory failure B. Increased salivation C. Diplopia D. Ptosis E. Slurred speech F. Restlessness G. Mask-like appearance of looking sleepy H. Difficulty swallowing
A. Respiratory failure C. Diplopia D. Ptosis E. Slurred speech F. Restlessness G. Mask-like appearance of looking sleepy H. Difficulty swallowing
Which nursing diagnosis takes highest priority for a client with Parkinson's crisis? A. Imbalanced nutrition: Less than body requirements B. Ineffective airway clearance C. Impaired urinary elimination D. Risk for injury
B. Ineffective airway clearance In Parkinson's crisis, dopamine-related symptoms are severely exacerbated, virtually immobilizing the client. A client confined to bed during such a crisis is at risk for aspiration and pneumonia. Also, excessive droolingincreases the risk of airway obstruction. Because of these concerns, the nursing diagnosis of Ineffective airway clearance takes highest priority. Although the other options also are appropriate, they aren't immediately life-threatening.
A 25 year-old presents to the ER with unexplained paralysis from the hips downward. The patient explains that a few days ago her feet were feeling weird and she had trouble walking and now she is unable to move her lower extremities. The patient reports suffering an illness about 2 weeks ago, but has no other health history. The physician suspects Guillain-Barré Syndrome and orders some diagnostic tests. Which finding below during your assessment requires immediate nursing action? A. The patient reports a headache. B. The patient has a weak cough. C. The patient has absent reflexes in the lower extremities. D. The patient reports paresthesia in the upper extremities.
B. The patient has a weak cough The patient's signs and symptoms in this scenario are typical with Guillain-Barré Syndrome. The syndrome tends to start in the lower extremities (with paresthesia that will progress to paralysis) and migrate upward. The respiratory system can be affected leading to respiratory failure. Therefore, the nurse should assess for any signs and symptoms that the respiratory system may be compromised (ex: weak cough, shortness of breath, dyspnea...patient says it is hard to breath etc.). The nurse should immediately report this to the MD because the patient may need mechanical ventilation. Absent reflexes is common in GBS and paresthesia can extend to the upper extremities as the syndrome progresses. A headache is not common.
Which of the following statements by a patient with Parkinson's disease would indicate to the nurse that the patient has a good understanding of levodopa as a drug therapy? A)"I will take the medication for about a year and then stop." B)"I should avoid exercising while taking this drug." C)"I should take this drug with meals to avoid gastrointestinal upset." D)"I will take megavitamins to ensure that I have good nutrition."
C)"I should take this drug with meals to avoid gastrointestinal upset."
The nurse is teaching the female client with myasthenia gravis about the prevention of myasthenic and cholinergic crises. The nurse tells the client that this is most effectively done by: A Eating large, well-balanced meals B Doing muscle-strengthening exercises C Doing all chores early in the day while less fatigued D Taking medications on time to maintain therapeutic blood levels
D Taking medications on time to maintain therapeutic blood levels Clients with myasthenia gravis are taught to space out activities over the day to conserve energy and restore muscle strength. Taking medications correctly to maintain blood levels that are not too low or too high is important. Muscle-strengthening exercises are not helpful and can fatigue the client. Overeating is a cause of exacerbation of symptoms, as is exposure to heat, crowds, erratic sleep habits, and emotional stress.
A patient with Parkinson's disease is admitted to the hospital for treatment of pneumonia. Which nursing interventions will be included in the plan of care (select all that apply)? a.Provide an elevated toilet seat. b.Cut patient's food into small pieces. c.Serve high-protein foods at each meal. d.Place an armchair at the patient's bedside. e.Observe for sudden exacerbation of symptoms.
a.Provide an elevated toilet seat. b.Cut patient's food into small pieces. d.Place an armchair at the patient's bedside. Because the patient with Parkinson's disease has difficulty chewing, food should be cut into small pieces. An armchair should be used when the patient is seated so that the patient can use the arms to assist with getting up from the chair. An elevated toilet seat will facilitate getting on and off the toilet. High-protein foods will decrease the effectiveness of L-dopa. Parkinson's disease is a steadily progressive disease without acute exacerbations.
The nurse advises a patient with myasthenia gravis (MG) to a. perform physically demanding activities early in the day. b. anticipate the need for weekly plasmapheresis treatments. c. do frequent weight-bearing exercise to prevent muscle atrophy. d. protect the extremities from injury due to poor sensory perception.
a.perform physically demanding activities early in the day. Muscles are generally strongest in the morning, and activities involving muscle activity should be scheduled then. Plasmapheresis is not routinely scheduled but is used for myasthenia crisis or for situations in which corticosteroid therapy must be avoided. There is no decrease in sensation with MG, and muscle atrophy does not occur because although there is muscle weakness, they are still used.
The nurse is aware that multiple sclerosis is a progressive disease of the central nervous system characterized by: a. axon degeneration. c. sclerosed patches of neural tissue. b. demyelination of the brain and the spinal cord. d. all of the above.
b. demyelination of the brain and the spinal cord.
When a 74-yr-old patient is seen in the health clinic with new development of a stooped posture, shuffling gait, and pill rolling-type tremor, the nurse will anticipate teaching the patient about a.oral corticosteroids. b.antiparkinsonian drugs. c.magnetic resonance imaging (MRI). d.electroencephalogram (EEG) testing.
b.antiparkinsonian drugs.
When obtaining a health history and physical assessment for a 36-yr-old female patient with possible multiple sclerosis (MS), the nurse should a.assess for the presence of chest pain. b.inquire about urinary tract problems. c.inspect the skin for rashes or discoloration. d.ask the patient about any increase in libido.
b.inquire about urinary tract problems. Urinary tract problems with incontinence or retention are common symptoms of MS. Chest pain and skin rashes are not symptoms of MS. A decrease in libido is common with MS.
During assessment, the nurse knows that the most frequently reported disabling symptom found in multiple sclerosis is: a. depression. b. double vision. c. fatigue. d. pain.
c. fatigue.
The initial neurologic symptom of Guillain-Barré syndrome is: a. absent tendon reflexes. c. paresthesia of the legs. b. dysrhythmias. d. transient hypertension.
c. paresthesia of the legs.
A surgical intervention that can cause substantial remission of myasthenia gravis is: a. esophagostomy. b. myomectomy. c. thymectomy. d. splenectomy.
c. thymectomy.
Which assessment is most important for the nurse to make regarding a patient with myasthenia gravis? a.Pupil size c.Respiratory effort b.Grip strength d.Level of consciousness
c.Respiratory effort Because respiratory insufficiency may be life threatening, it will be most important to monitor respiratory function. The other data also will be assessed but are not as critical.
Which patient below is MOST at risk for developing a cholinergic crisis? A. A patient with myasthenia gravis is who is not receiving sufficient amounts of their anticholinesterase medication. B. A patient with myasthenia gravis who reports not taking the medication Pyridostigmine for 2 weeks. C. A patient with myasthenia gravis who is experiencing a respiratory infection and recently had left hip surgery. D. A patient with myasthenia gravis who reports taking too much of their anticholinesterase medication.
D. A patient with myasthenia gravis who reports taking too much of their anticholinesterase medication. patients who experience a cholinergic crisis are most likely to because they've received too much of their anticholinesterase medications (example Pyridostigmine). However, on the other hand, patients who have received insufficient amount of their anticholinesterase medication or have experienced an illness/stress/surgery are most likely to experience a myasthenia crisis. Both conditions will lead to muscle weakness and respiratory failure but from different causes, which is why a Tensilon test is used to help differentiate between the two conditions.
The clinical manifestations of Parkinson's disease (bradykinesia, rigidity, and tremors) are directly related to a decreased level of: a. acetylcholine. c. serotonin. b. dopamine. d. phenylalanine.
b. dopamine.
A nurse plans care for a client with Parkinson disease. Which intervention should the nurse include in this client's plan of care? a.Ambulate the client in the hallway twice a day. b.Ensure a fluid intake of at least 3 liters per day. c.Teach the client pursed-lip breathing techniques. d.Keep the head of the bed at 30 degrees or greater.
d.Keep the head of the bed at 30 degrees or greater. Elevation of the head of the bed will help prevent aspiration. The other options will not prevent aspiration, which is the greatest respiratory complication of Parkinson disease, nor do these interventions address any of the complications of Parkinson disease. Ambulation in the hallway is usually implemented to prevent venous thrombosis. Increased fluid intake flushes out toxins from the client's blood. Pursed-lip breathing increases exhalation of carbon dioxide.
A 68-year-old patient hospitalized with a new diagnosis of Guillain-Barré syndrome has numbness and weakness of both feet. The nurse will anticipate teaching the patient about a.intubation and mechanical ventilation. b.administration of corticosteroid drugs. c.insertion of a nasogastric (NG) feeding tube. d.infusion of immunoglobulin (Sandoglobulin).
d.infusion of immunoglobulin (Sandoglobulin). Because the Guillain-Barré syndrome is in the earliest stages (as evidenced by the symptoms), use of high-dose immunoglobulin is appropriate to reduce the extent and length of symptoms. Mechanical ventilation and tube feedings may be used later in the progression of the syndrome but are not needed now. Corticosteroid use is not helpful in reducing the duration or symptoms of the syndrome.
