PUCh65 PART II

A client is diagnosed with amyotrophic lateral sclerosis (ALS) in the early stages. Which medication would the nurse most likely expect to be prescribed as treatment? a. Riluzole b. Benztropine mesylate c. Amantadine d. Bromocriptine

a

A health care provider needs help in identifying the precise location of a brain tumor. To measure brain activity, as well as to determine structure, the nurse expects the health care provider to order which of the following tests? a. MRI b. Computed tomography (CT) c. Positron-emission tomography (PET) d. Computer-assisted stereotactic biopsy

c

A nurse is caring for a client with a pituitary adenoma. Which laboratory test result suggests that a client has a corticotropin-secreting pituitary adenoma? a. High corticotropin and low cortisol levels b. Low corticotropin and high cortisol levels c. High corticotropin and high cortisol levels d. Low corticotropin and low cortisol levels

c

A nurse begins an assessment interview of a patient with a brain tumor. The patient describes her headaches. The nurse expects to hear specific terms that describe her symptoms. Which of the following best describe the symptoms of her headache? Select all that apply. a. Occurs most frequently in the early morning b. Is intermittent and diminishes with rest c. Is unrelenting d. Is made worse with coughing and sudden movement e. May improve with vomiting

a c d e

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. a. The client should ensure no one else handles the medication. b. If a dose is missed, the client should take double the amount at the regular time the following day. c. The client should seek emergency help if nausea or vomiting occur. d. The client should seek emergency care if he or she develops a fever. e. Hair loss should be expected when taking the medication.

a d e

A nurse is reviewing a client's medical record and finds that the client has a spinal cord tumor that involves the vertebral bodies. The nurse identifies this as which type of spinal tumor? a. Intramedullary b. Intradural-extramedullary c. Extradural d. Metastatic

c

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

a

What is the most common type of brain neoplasm? a. Glioma b. Angioma c. Meningioma d. Neuroma

a

The nurse is caring for a client who is experiencing increased intracranial pressure (ICP), resulting from a pituitary adenoma. The nurse should anticipate which intervention will likely be prescribed to help decrease this client's ICP? a. Transsphenoidal surgery b. Salvage therapy c. Anticonvulsant agents d. Remaining in a side-lying position

a

What nursing intervention will best assist the client with chorea? a. Monitor the client on bed rest b. Assist the client with walking hourly c. Keep an oral airway at the bedside d. Administer pain medications every 4 hours

a

The nurse is caring for a client who is currently under medical investigation for a pituitary adenoma. The nurse anticipates the client will likely report which symptoms that are consistent with this type of brain tumor? Select all that apply. a. Polydipsia b. Polyuria c. Disturbed sleep d. Impairment of visual field e. Seizures

a b c d

Which of the following are clinical manifestations associated with increased intracranial pressure (ICP)? Select all that apply. a. Seizures b. Nausea with or without vomiting c. Papilledema d. Headache e. Angina

a b c d

A patient is diagnosed with amyotrophic lateral sclerosis, also known as ALS or Lou Gehrig's disease. The nurse understands that the symptoms of the disease will begin in what way? a. Ascending paralysis b. Numbness and tingling in the lower extremities c. Weakness starting in the muscles supplied by the cranial nerves d. Jerky, uncontrolled movements in the extremities

c

A client diagnosed with a brain tumor is exhibiting focal symptoms. Which assessment findings are the nurse likely to note? Select all that apply. a. Muscle weakness b. Sensory loss c. Aphasia d. Visual changes e. Vomiting

a b c d

A client with an incurable brain tumor is experiencing nausea and vomiting and has little interest in eating. His family states, "We don't know how to help him." Which of the following would be appropriate for the nurse to suggest to help improve the client's nutritional intake? Select all that apply. a. Ensure that the client is free of pain for meals. b. Place the client near the sounds and smells of meals being prepared. c. Plan meals for times when the client is rested. d. Provide the client with foods that he likes. e. Prepare the client for the insertion of a feeding tube.

a c d

A patient has been diagnosed with a lipoma. The nurse explains to the patient that this tumor is located in the part of the brain known as the: a. Optic chiasm. b. Brainstem. c. Corpus callosum. d. Cerebrum.

c

A patient with Parkinson's disease asks the nurse what can be done to prevent problems with bowel elimination. What would be an intervention that would assist this patient with a regular stool pattern? a. Take psyllium (Metamucil) daily. b. Take a laxative whenever bloating is experienced. c. Adopt a diet with moderate fiber intake. d. Adopt a high-fiber diet.

c

The nurse educator knows which statement about pituitary adenomas is true? a. They are most prevalent in the pediatric population. b. Most of these types of tumors are malignant. c. Cushing disease can result from a functioning tumor. d. Men are more likely to be diagnosed with this type of tumor.

c

A client is diagnosed with a brain angioma. When teaching the client about the risks associated with this type of brain tumor, the nurse would educate about signs and symptoms associated with which condition? a. Hemorrhagic stroke b. Thyroid disorders c. Hearing loss d. Visual loss

a

A client with Huntington disease has just been admitted to a long-term care facility. The charge nurse is creating a care plan for this client. Nutritional management for a client with Huntington disease should be informed by what principle? a. The client is likely to have an increased appetite. b. The client is likely to require enzyme supplements. c. The client will likely require a clear liquid diet. d. The client will benefit from a low-protein diet.

a

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? a. Dyskinesia b. Bradykinesia c. Micrographia d. Dysphonia

a

A new ancillary staff member is assisting the nurse with a client diagnosed with Parkinson's disease. The client needs assistance with eating but doesn't require thickened liquids to aid swallowing. Which instruction should the nurse give the ancillary staff member about eating assistance? a. Make sure the client is sitting with the head of bed elevated to 90 degrees. b. Assist the client into a comfortable position and stay alert for coughing, which signifies aspiration. c. Clients with Parkinson's disease shouldn't have liquids; remove them from the dinner tray before serving food to the client. d. There are no special precautions for the client with Parkinson's disease.

a

A nurse is reviewing the medical record of a client diagnosed with a primary brain tumor. The nurse identifies the type of tumor as one that is most commonly found in adults. Which type of tumor would the nurse most likely identify? a. meningioma b. acoustic neuroma c. pituitary adenoma d. angioma

a

How should the nurse best teach the client admitted with post-polio syndrome about causative pathophysiology? a. The exact cause is unknown, but aging or muscle overuse is suspected. b. The exact cause is unknown, but latent poliovirus is suspected. c. Post-polio syndrome is caused by an autoimmune response. d. Post-polio syndrome is caused by long-term intake of a low-protein, high-fat diet in polio survivors.

a

Nursing students are reviewing the various types of brain tumors. The students demonstrate understanding of the material when they identify which of the following as the most common type? a. Gliomas b. Meningiomas c. Acoustic neuromas d. Pituitary adenomas

a

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? a. Mannitol b. Temozolomide c. Bevacizumab d. Everolimus

a

The nurse is assessing a client with a confirmed spinal cord tumor. The client states, "I've been too embarrassed to tell anyone but, I have been awakened at night because I've wet the bed." It would be a priority for the nurse to further assess the client for which complication? a. Spinal cord compression b. Urinary tract infection c. Knowledge deficit d. Impaired skin integrity

a

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

a

The nurse is providing discharge instructions for a client who was admitted to the oncology unit due to dehydration and anorexia after chemotherapy treatment. What information should the nurse provide to the client to promote improve the client's nutritional intake at home? a. Take prescribed pain medication prior to commencing a meal b. Avoid any oral care prior to eating c. Eat uninterrupted by others to eliminate distractions d. Prepare the eating area with a pleasant room spray

a

The nurse is seeing a client who has just been diagnosed with a meningioma. The client states he is confused because the provider stated, "If you have to be diagnosed with a brain tumor, this is the least harmful." The client asks the nurse for clarification. How should the nurse respond? a. "I am unable to interpret what your provider meant by making that statement; however, it is true that meningiomas are slow growing tumors that are not typically fatal." b. "I am assuming your provider was trying to explain to you that meningiomas have a high cure rate if treated with surgery, chemotherapy and radiation aggressively." c. "It is likely that your provider was trying to be as supportive as possible with those positive words. You need a lot of support during this challenging time." d. "It would have been important for you to clarify your provider's statement during your appointment. It is not within my scope to discuss the details of your diagnosis."

a

Which medication classification should be avoided in the treatment of brain tumors? a. Anticoagulants b. Osmotic diuretics c. Corticosteroids d. Anticonvulsants

a

Which of the following is a brain tumor arising from the supporting structures? a. Meningiomas b. Astrocytomas c. Medulloblastoma d. Glioblastoma multiforme

a

The nurse educator is facilitating a class on neurological function with a group of nursing students. When discussing problems that can result from growing brain tumors, the nurse educator should include that clients can experience which neurologic deficits even after surgical resection? Select all that apply. a. Paralysis b. Incontinence c. Aphasia d. Fever e. Respiratory infection

a b c

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

b

Which nursing diagnosis takes the highest priority for a client with parkinsonian crisis? a. Imbalanced nutrition: Less than body requirements b. Ineffective airway clearance c. Impaired urinary elimination d. Risk for injury

b

A nurse knows that a patient exhibiting seizure-like movements localized to one side of the body most likely has what type of tumor? a. A cerebellar tumor b. A frontal lobe tumor c. A motor cortex tumor d. An occipital lobe tumor

c

A nurse suspects that a client has Huntington disease based on which assessment finding? a. Slurred speech b. Disorganized gait c. Chorea d. Dementia

c

The nurse teaches the client diagnosed with Huntington disease that it is transmitted as which type of genetic disorder? a. X-linked b. Autosomal recessive c. Autosomal dominant d. Non -repeated HTT gene

c

A client diagnosed with Parkinson's disease has developed slurred speech and drooling. The nurse knows that these symptoms indicate which of the following? a. The client is having an exacerbation. b. Medication needs to be adjusted to higher doses. c. The client is exhibiting signs of medication overdose. d. The disease has entered the late stages.

d

A nurse assesses a patient who has been diagnosed with having a pituitary adenoma that is pressing on the third ventricle. The nurse looks for the associated sign/symptom. What is that sign/symptom? a. Disruption in sleep patterns b. Unusual sensitivity to heat and cold c. Visual disturbances d. Increased intracranial pressure

d

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

d

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? a. Lumbar sacral strain b. The development of a skin ulcer from the radiation c. Hematoma formation d. Spinal metastasis

d

The nurse in the oncology outpatient clinic receives a phone call from a family member of a client who was diagnosed with a metastatic spinal cord tumor. The family member informs the nurse that the client has been reporting increased back pain in the region of the tumor and dizziness. How should the nurse respond? a. Provide education regarding adequate pain medication throughout the day b. Share information about expected symptoms related to growing tumors c. Instruct the family member to encourage the client to avoid lying in a prone position d. Tell the family member to get the client to hospital for emergency assessment

d

The nurse is caring for a client with increased intracranial pressure (ICP) after surgical resection of a brain tumor. The nurse recognizes the client is demonstrating late signs of ICP when which sign is observed? a. Hypotension b. Low pulse pressure c. Tachycardia d. Irregular respirations

d

The nurse is providing discharge teaching to a client who has had surgery for partial removal of a spinal tumor to decompress the spinal cord. Preoperatively, the client had lost sensation to the lower legs. When instructing the client regarding pain management strategies, the nurse should include which information? a. Use heat to decrease back pain b. Sleep in the recumbent position c. Perform moderate exercise d. Use assistive devices

d

The nurse is seeing a client who has just been diagnosed with a grade I meningioma. The nurse is correct when stating what information about the client's diagnosis? a. "Surgical intervention is not very effective for this type of tumor." b. "This type of tumor has a poor prognosis." c. "This type of tumor invades brain tissue quickly." d. "Grade 1 is the most common type of this tumor."

d

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

d

Which of the following is a hallmark of spinal metastases? a. Pain b. Nausea c. Fatigue d. Change in level of consciousness (LOC)

a

The nurse is conducting a neurological assessment with a client who has increased intracranial pressure secondary to growth of brain tumor mass. What assessment tools can the nurse use to determine the client's neurological status? Select all that apply. a. Glasgow coma scale (GCS) b. Mini mental status examination (MMSE) c. Urinalysis d. Chest auscultation e. Beck Depression Inventory (BDI)

a b

Which of the following is a common cancer that metastasizes to the spinal cord? Select all that apply. a. Breast b. Prostate c. Lung d. Colon e. Brain

a b 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? a. Frontal lobe b. Cerebellum c. Motor cortex d. Occipital lobe

b

A client with a brain tumor experiences projectile vomiting. The nurse integrates understanding of this occurrence as resulting from which of the following? a. Edema associated with the tumor b. Irritation of the medullary vagal centers c. Compression of surrounding structures d. Distortion of pain-sensitive structures

b

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? a. Baclofen b. Riluzole c. Dantrolene sodium d. Diazepam

b

Which disease is a chronic, progressive, hereditary disease of the nervous system that results in progressive, involuntary dancelike movements and dementia? a. Multiple sclerosis b. Huntington disease c. Parkinson disease d. Creutzfeldt-Jakob disease

b