ATI : Neurological Disorders

A nurse in the CCU is completing an admission assessment of a client who has a gunshot wound to the head. Which of the following assessment findings are indicative of increased ICP? Select all that apply a. headache b. dilated pupils c. tachycardia d. decoritcate posturing e. hypotension

a, b, d - bradycardia and hypertensions are a sign

A nurse is caring for a client who is having surgery for the removal of an encapsulated acoustic tumor. Which of the following potential complications should the nurse monitor for postoperatively? Select all that apply. a. increased ICP b. hemorrhagic shock c. hydrocephalus d. hypoglycemia e. seizures

a, c, e

A nurse is reviewing a prescription for dexamethasone with a client who has an expanding brain tumor. Which of the following are appropriate statements by the nurse? Select all that apply. a. "It is given to reduce swelling of the brain" b. "You will need to monitor for low blood sugar" c. "You might notice weight gain" d. "Tumor growth will be delayed" e. "It can cause you to retain fluids"

a, c, e - it can cause hyperglycemia and does not effect tumor growth

A nurse is caring for a client who is experiencing mild acute pain after spraining an ankle. Which of the following analgesics should the nurse expect to administer? a. ketorolac b. ketamine c. meperidine d. methadone

a. - this is an NSAID

A nurse if preparing to administer sumatriptan to a client for the first time. The nurse should instruct the client that sumatriptan is indicated for which of the following conditions? a. tonic-clonic seizures b. presence of a migraine headache c. exacerbation of multiple sclerosis d. Alzheimer's disease

b

A nurse is caring for a client who has a new prescription for pramipexole to treat Parkinson's disease. The nurse should recognize that which of the following lab tests requires monitoring? a. C-reactive protein b. Creatinine clearance c. Thyroid function d. CBC

b - direct-acting dopamine receptor agonist

A nurse is caring for a client who has a closed-head injury with ICP readings ranging from 16 to 22 mmHg. Which of the following actions should the nurse take to decrease the potential for raising the client's ICP? Select all that apply a. suction the endotracheal tube frequency b. decrease the noise level in the client's room c. elevate the client's head on two pillows d. administer a stool softener e. keep the client well hydrated

b, d - suctioning increases ICP - hyperflexion increases ICP - overhydration can increase ICP

A nurse is administering fentanyl to a client to reduce pain. Which of the following drugs should the nurse have available to reverse the effects of fentanyl? a. Neostigmine b. Succinylcholine c. Naloxone d. Dantrolene

c

A nurse is assessing a client. Which of the following findings indicates that the client has experienced a left-hemispheric stroke? a. impulse control difficulty b. poor judgement c. inability to recognize familiar objects d. loss of depth perception

c - this is called agnosia

A nurse is caring for a client who has a new diagnosis of cataracts. Which of the following manifestations should the nurse expect? Select all that apply a. eye pain b. floating spots c. blurred vision d. white pupils e. bilateral red reflexes

c, d - eye pain = open-angle glaucoma - floating spots = detached retina - bilateral red reflexes are absent in cataracts

A nurse is monitoring a client who is receiving opioid analgesia. Which of the following findings should the nurse identify as adverse effects of opioid analgesics. Select all that apply. a. urinary incontinence b. diarrhea c. bradypnea d. orthostatic hypotension e. nausea

c, d, e - urinary retention and constipation are adverse effects

A nurse is caring for a client who experienced a cervical spine injury 24 hours ago. Which of the following prescriptions should the nurse clarify with the provider? a. anticoagulant b. plasma expanders c. H2 antagonists d. muscle relaxants

d - unnecessary at this time

A nurse is completing discharge teaching to a client following middle ear surgery. Which of the following statements by the client indicates understanding of the teaching? a. "I should restrict rapid movements and avoid bending from the waist for several weeks" b. "I should wait until the day after surgery to wash my hair" c. "I will remove the dressing behind my ear in seven days" d. "My hearing should be back to normal right after my surgery"

a

A nurse is planning care for a client who has a spinal cord injury involving a T12 fracture 1 week ago. The client has no muscle control of the lower limbs, bowel, or bladder. Which of the following should be the nurse's highest priority? a. prevention of further damage to the spinal cord b. prevention of contractures of the lower extremities c. prevention of skin breakdown of areas that lack sensation d. prevention of postural hypotension when placing the client in a wheelchair

a

A nurse is reviewing the medical history of a client who has a new prescription for a reduced dosage of alprazolam for anxiety. Which of the following findings should indicate to the nurse the reason fro the prescription modification? a. renal function impairment b. cataracts c. recent weight loss d. smoking

a

A nurse is teaching a client who is taking levodopa/carbidopa to treat Parkinson's disease. Which of the following instructions should the nurse include? a. change position slowly to prevent orthostatic hypotension b. eat a high-protein snack to increase absorption c. take the drug at bedtime to avoid daytime drowsiness d. expect eye twitching to develop with long-term therapy

a

A nurse is caring for a client who just experienced a generalized seizure. Which of the following actions should the nurse perform first? a. keep the client in a side-lying position b. document the duration of the seizure c. reorient the client to the environment d. provide client hygiene

a - aspiration is the greatest risk

A nurse is caring for a client who has been taking amphetamine/dextroamphetamine sulfate for the treatment of attention deficit hyperactivity disorder (ADHD) for 2 weeks. The nurse should report which of the following findings to the provider? a. weight loss of 2.3 kg (5 lbs) b. BP 110/70 mm Hg c. apical pulse 8-/min d. respiratory rate 16/min

a - can cause a decreased appetite and weight loss; should weigh patient 2 times a week

A nurse is teaching a client about interferon beta-1a. Which of the following instructions should the nurse give to help the client avoid the adverse effects of this drug? a. premedicate with acetaminophen b. take the drug with food c. increase your fluid intake d. take the drug in the morning

a - can cause fever, chills, headaches, and muscle aches

A nurse is teaching a client who has a prescription for carbamazepine. Which of the following instructions should the nurse include to help the client avoid adverse effects of this drug? a. begin taking the drug at a low dosage b. discontinue the drug immediately if diarrhea occurs c. have serum glucose levels checked regularly d. take the drug on an empty stomach

a - can cause visual disturbances, vertigo, and ataxia

A nurse is providing teaching for a client who has a new diagnosis of dry macular degeneration. Which of the following instructions should the nurse include in the teaching? a. increase intake of deep yellow and orange vegetables b. administer eye drops twice daily c. avoid bending at the waste d. wear an eye patch at night

a - carotenoids and antioxidants decrease progression

A nurse is teaching a client who has a prescription for baclofen. Which of the following instructions should the nurse include? a. avoid driving until the drug's effects are evident b. stop taking the med immediately if headache occurs c. take the drug as needed for spasticity d. take the drug with antacids to reduce gastric effects

a - centrally-acting muscle relaxants cause CNS depression

A nurse is caring for a client who was recently admitted to the emergency department following a head-on motor vehicle crash. The client is unresponsive, has spontaneous respirations of 22/min, and has a laceration on the forehead that is bleeding. Which of the following is the priority nursing action at this time? a. keep neck stabilized b. insert NG tube c. monitor pulse and blood pressure frequently d. establish IV access and start fluid replacement

a - greatest risk is permanent damage to spinal cord

A nurse is teaching a client who has a prescription for modafinil to treat narcolepsy. Which of the following instructions should the nurse include? a. take the drug in the morning b. take the drug 30 min before bedtime c. anticipate daytime drowsiness d. expect urinary frequency

a - nonamphetamine stimulant; for those with narcolepsy

A nurse is teaching a client who is about to begin sumatriptan therapy to treat migraine headaches. The nurse should instruct the client to monitor for which of the following adverse effects? a. chest pain b. polyuria c. joint pain d. insomnia

a - serotonin agonist; can cause coronary vasospasm and chest pain

A nurse is caring for a client who has a prescription for fluoxetine and who reports self-administering St. John's wort daily for the past 2 weeks. Which of the following findings should the nurse report to the provider as an indication of serotonin syndrome? a. hallucinations b. decreased temperature c. hypersexual behavior d. constipation

a - serotonin syndrome

A nurse is caring for a client who experienced a cervical spine injury 3 months ago. The nurse should plan to implement which of the following types of bladder management methods? a. condom catheter b. intermittent urinary catheterization c. Crede's method d. indwelling urinary catheter

a - client has upper motor neuron injury so the bladder will empty on its own

A nurse is reinforcing teaching with a client who has Parkinson's disease and has a new prescription for bromocriptine. Which of the following instructions should the nurse include? a. rise slowly when standing b. expect urine to become dark-colored c. avoid foods containing tyramine d. report any skin discoloration

a - orthostatic hypotension is common adverse effect

A nurse is reviewing the health record of a client who has severe otitis media. Which of the following are expected findings? Select all that apply. a. enlarged adenoids b. report of recent cold c. client prescription for daily furosemide d. light reflex visible on otoscopic exam in the affected ear e. ear pain relieved by meclizine

a, b

A nurse is reviewing trigger factors that can cause seizures with a client who has a new diagnosis of generalized seizures. Which of the following information should the nurse include in the review? Select all that apply. a. avoid overwhelming fatigue b. remove caffeinated products from diet c. limit looking at flashing lights d. perform aerobic exercise e. limit episodes of hypoventilation f. use of aerosol hairspray is recommended

a, b, c - avoid vigorous physical activity, limit excess hyperventilation, and avoid aerosol cans

A nurse is assessing a client who has a seizure disorder. The client tells the nurse, "I am about to have a seizure." Which of the following actions should the nurse implement? Select all that apply. a. provide privacy b. ease the client to the floor if standing c. move furniture away from the client d. loosen the client's clothing e. protect the client's head with padding f. restrain the client

a, b, c, d, e

A nurse is planning care for a client who has dysphagia and a new dietary prescription. Which of the following should the nurse include in the plan of care? Select all that apply a. have suction equipment available for use b. feed the client thickened liquids c. place food on the unaffected side of the client's mouth d. assign an assistive personnel to feed the client slowly e. teach the client to swallow with the neck flexed

a, b, c, e - nurse should feed due to risk of aspiration

A nurse is caring for a client who has experienced a right-hemisphere stroke. The nurse should expect the client to have difficulty with which of the following? Select all that apply. a. impulse control b. moving the left side c. depth perception d. speaking e. situational awareness

a, b, c, e - aphasia is left-sided

A nurse is completing an assessment of a client who has increased ICP. Which of the following are expected findings? Select all that apply. a. disoriented to time and place b. restlessness and irritability c. unequal pupils d. ICP 15 mmHg e. headache

a, b, c, e, - 15 mmHg is within the reference range

A nurse in a clinic is caring for a client who has been experiencing mild to moderate vertigo due to benign paroysmal vertigo for several weeks. Which of the following actions should the nurse recommend to help control the vertigo? Select all that apply a. reduce exposure to bright lights b. move head slowly when changing positions c. do not eat fruit high in potassium d. plan evenly-spaced daily fluid intake e. avoid fluids containing caffeine

a, b, d - should avoid sodium

A nurse is developing a plan of care for a client who is scheduled for cerebral angiography with contrast media. Which of the following statements by the client should the nurse report to the provider? Select all that apply. a. "I think I might be pregnant" b. "I take Warfarin" c. "I take antihypertensive medication" d. "I am allergic to shrimp" e. "I ate a light breakfast this morning"

a, b, d, e

A nurse is providing teaching to a client who is about to begin amitriptyline therapy to treat major depressive disorder. Which of the following instructions should the nurse include? (Select all that apply.) a. change positions slowly from sitting or lying to standing b. do not stop taking the drug abruptly c. avoid crushing the tablet d. take the drug at bedtime to prevent daytime drowsiness e. increase fiber and fluid intake

a, b, d, e

A nurse is caring for a client who has global aphasia. Which of the following should the nurse include in the client's plan of care? Select all that apply a. speak to the client at a slower rate b. assist the client to use cards with pictures c. speak to the client in a loud voice d. complete sentences that client cannot finish e. give instructions one step at a time

a, b, e

A nurse is beginning a physical assessment of a client who has a new diagnosis of multiple sclerosis. Which of the following findings should the nurse suspect? Select all that apply a. areas of parasthesia b. involuntary eye movements c. alopecia d. increased salivation e. ataxia

a, b, e - hair loss is not expected - dysphagia is expected

A nurse is assessing for the presence of Brudzinski's sign in a client who has suspected meningitis. Which of the following actions should the nurse take when performing this technique? Select all that apply. a. place client in supine position b. flex client's hip and knee c. place hands behind the client's neck d. bend client's head toward chest e. straighten the client's flexed leg at the knee

a, c, d - b and d are for Kernig's sign

A nurse is making a home visit to a client who has AD. The client's partner states that the client is often disoriented to time and place, is unsteady, and has a history of wandering. Which of the following safety measures should the nurse review with the partner? Select all that apply. a. remove floor rugs b. have door locks that can be easily opened c. provide increased lighting in stairwells d. install handrails in the bathroom e. place the mattress on the floor

a, c, d, e

A nurse is caring for a client who has AD. A family member of the client asks the nurse about risk factors for the disease. Which of the following should be included in the nurse's response? Select all that apply. a. exposure to metal waste products b. long-term estrogen therapy c. sustained use of vitamin E d. previous head injury e. history of herpes infection

a, d, e - long-term estrogen therapy can prevent AD - Vit E is not a risk factor

A nurse is planning care for a client who has meningitis and is at risk for increased ICP. Which of the following actions should the nurse plan to take? Select all that apply. a. implement seizure precautions b. perform neurologic checks four times a day c. administer morphine for the report of neck and generalized pain d. turn off room lights and television e. monitor for impaired extra-ocular movements f. encourage the client to cough frequently

a, d, e - should perform checks every 2 with risk for ICP - opioids can mask changes in ICP - coughing can increase ICP

A nurse is assessing a client for changes in the level of consciousness using the GCS. The client opens his eyes when spoken to, speaks incoherently, and moves his extremities when pain is applied. Which of the following GCS scores should the nurse document? a. E2 + V3 + M5 = 10 b. E3 + V4 + M4 = 11 c. E4 + V5 + M6 = 15 d. E2 + V2 + M4 = 8

b

A nurse is caring for a client who experienced a traumatic head injury and has an intraventricular catheter for ICP monitoring. The nurse should monitor the client for which of the following complications related to the catheter? a. headache b. infection c. aphasia d. hypertension

b

A nurse is caring for a client who has AD and falls frequently. Which of the following actions should the nurse take first to keep the client safe? a. keep the call light near the client b. place the client in a room close to the nurses' station c. encourage the client to ask for assistance d. remind the patient to walk with someone for support

b

A nurse is caring for a client who has a new prescription for dantrolene to treat skeletal muscle spasms. The nurse should identify that which of the following lab tests requires monitoring? a. serum potassium b. liver function c. serum sodium d. thyroid function

b

A nurse is caring for a client who has diabetes mellitus and reports gradual loss of peripheral vision. The nurse should recognize this as a manifestation of which of the following diseases? a. cataracts b. open-angle glaucoma c. macular degeneration d. angle-closure glaucoma

b

A nurse is caring for a client who has multiple sclerosis. Which of the following findings should the nurse expect? a. fluctuations in blood pressure b. loss of cognitive function c. ineffective cough d. drooping eye lids

b

A nurse is providing education to a client who is to undergo an EEG the next day. Which of the following information should the nurse include in the teaching? a. "Do not wash your hair the morning of the procedure" b. Try to stay awake most of the night prior to the procedure" c. "The procedure will take approximately 15 minutes" d. "You will need to lie flat for 4 hours after the procedure"

b

A nurse is reviewing the medical record of a client who has a newly diagnosed seizure disorder and a new prescription for valproic acid and phenytoin. The nurse should identify that which of the following can occur as a result of an interaction between these drugs? a. Hyperammonemia b. Phenytoin toxicity c. Hypertension d. Peptic ulcer disease

b

A nurse is teaching a client who is receiving methohexital sodium. The nurse should monitor the client for which of the following adverse effects? a. cardiac excitability b. respiratory depression c. hyperthermia d. hypertension

b

A nurse is caring for a client who has spinal cord injury who reports a severe headache and is sweating profusely. Vital signs include blood pressure 220/110 mmHg and apical heart rate of 54/min. Which of the following actions should the nurse take first? a. examine skin for irritation or pressure b. sit the client upright in bed c. check the urinary catheter for blockage d. administer antihypertensive medication

b - stroke can be secondary caused by autonomic dysrexflexia

A nurse is assessing a client who reports severe headache and a stiff neck. The nurse's assessment reveals positive Kernig's and Brudzinski's signs. Which of the following actions should the nurse perform first? a. administer antibiotics b. implement droplet precautions c. initiate IV access d. decrease bright lights

b - urgent vs nonurgent; prevents spread to others

A nurse is caring for a client who has increased ICP and a new prescription for mannitol. For which of the following adverse effects should the nurse monitor? a. hyperglycemia b. hyponatremia c. hypervolemia d. oliguria

b - mannitol is a diuretic

A nurse is caring for a client who has just undergone a craniotomy for a supratentorial tumor and has a respiratory rate of 12. Which of the following postoperative prescriptions should the nurse clarify with the provider? a. Dexamethasone 30 mg IV bolus BID b. Morphine sulfate 2 mg IV bolus Q2 PRN for pain c. Ondansetron 4 mg IV bolus Q4 PRN for nausea d. Phenytoin 100 mg IV bolus TID

b - morphine can cause CNS depression and respiratory depression

A nurse in a clinic is caring for a client who has frequent migraine headaches. The client asks about foods that can cause headaches. The nurse should recommend that the client avoid which of the following foods? a. baked salmon b. salted cashews c. frozen strawberries d. fresh asparagus

b - nuts contain tyramine

A nurse is caring for a client who has left homonymous hemianopsia. Which of the following is an appropriate nursing intervention? a. teach the client to scan to the right to see objects on the right side of the body b. place the bedside table on the right side of the bed c. orient the client to the food on the plate using the clock method d. place the wheelchair on the client's left side

b - unable to see to the left

A nurse is caring for a client who is postprocedure following lumbar puncture and reports a throbbing headache when sitting upright. Which of the following actions should the nurse take? Select all that apply. a. use the Glascow Coma Scale when assessing the client b. assist the client to a supine position c. encourage the client to increase fluid intake d. instruct the client to perform deep breathing and coughing exercises

b, c, d - GSC is used for all patients, not just lumbar puncture - coughing can increase ICP following a lumbar puncture

A nurse is planning care for a client who has bacterial meningitis. Which of the following actions should the nurse include in the plan of care? Select all that apply. a. monitor for bradycardia b. provide an emesis basin at the bedside c. administer antipyretic medication d. perform a skin assessment e. keep the head of the bed flat

b, c, d - should monitor for tachycardia and should elevate HOB to 30 degrees to promote venous drainage from the head and prevent increased ICP

A nurse is caring for a male older adult client who has a new diagnosis of glaucoma. Which of the following should the nurse recognize as risk factors associated with this disease? Select all that apply. a. sex b. genetic predisposition c. hypertension d. age e. diabetes mellitus

b, c, d, e

A nurse is assessing a client for manifestations of Parkinson's disease. Which of the following are expected findings? Select all that apply. a. decreased vision b. pill-rolling tremor of the fingers c. shuffling gait d. drooling e. bilateral ankle edema f. lack of facial expression

b, c, d, f

A nurse is teaching a client who has a new prescription for valproic acid to treat a seizure disorder. The nurse should instruct the client to monitor for which of the following adverse effects. (select all that apply) a. hirsutism b. drowsiness c. headache d. ataxia e. rash

b, c, e

A nurse in a provider's office is obtaining a health history from a client who has cluster headaches. Which of the following are expected findings" Select all that apply. a. pain is bilateral across the posterior occipital area b. client experiences altered sleep-wake cycles c. headache occurs approximately 1 to 8 times daily d. client describes headache pain as dull and throbbing e. nasal congestion and drainage occur

b, c, e - cluster headaches typically occur on one side and described as unilateral, sharp, and non throbbing

A nurse is developing a plan of care for the nutritional needs of a client who has stage IV Parkinson's disease. Which of the following actions should the nurse include? Select all that apply. a. provide three large balanced meals daily b. record diet and fluid intake daily c. document weight every other week d. offer cool fluids such as milkshakes e. offer nutritional supplements between meals

b, d, e - small, frequent meals to maintain nutrition - document weight weekly

A nurse is caring for a client who has a benign brain tumor. The client asks the nurse if this same type of tumor can occur in other areas of the body. Which of the following responses should the nurse make? a. "It can spread to breasts and kidneys" b. "It can develop in you GI tract" c. "It is limited to brain tissue" d. "It probably started in another area of your body and spread to your brain"

c

A nurse is caring for a client who is receiving morphine via a patent-controlled analgesia (PCA) infusion device after abdominal surgery. Which of the following client statements indicates that the client understands how to use the device? a. "I'll wait to use the device until it's absolutely necessary" b. "I'll be careful about pushing the button so I don't get an overdose" c. "I should tell the nurse if the pain doesn't stop after I use the device" d. :I will ask my son to push the dose button when I am sleeping"

c

A nurse is preparing to administer memantine to a client who has Alzheimer's disease. Which of the following findings in the client's medical history indicates a need to withhold the drug and notify the provider? a. pancreatic cancer b. hypotension c. cirrhosis d. osteoporosis

c

A nurse is providing teaching for a client who has a new prescription for valproic acid to treat a seizure disorder. The nurse should instruct the client to monitor for which of the following adverse effects? a. hirsutism b. depression c. jaundice d. gum irritation

c

A nurse is reviewing the use of the meningococcal vaccine (MCV4) for the prevention of meningitis with a newly licensed nurse. Which of the following information should the nurse include? a. the vaccine is indicated to reduce the risk of respiratory infection b. the vaccine is administered in a series of four doses c. the vaccine is recommended for adolescents before starting college d. the vaccine is initially given at 2 months of age

c

A nurse is teaching a client who has a history of migraine headaches about a new prescription for zolmitriptan. Which of the following statements by the client indicates understanding of the teaching? a. "This medication will relieve my symptoms by causing my blood vessels to dilate" b. "I should take this medication daily to prevent the headache from occurring" c. "I should expect facial flushing when I take this medication" d. "This medication will lower my sensitivity to food triggers"

c

A nurse at a clinic is talking with a client who has cancer and takes extended-release opioids twice daily. The client reports an increase in localized, achy pain over the last few days. How should the nurse document this increase in pain? a. phantom limb pain b. mixed pain c. breakthrough pain d. neuropathic pain

c - acute pain that is beyond the level the client normally experiences

A nurse is caring for a client who has just been admitted following surgical evacuation of a subdural hematoma. Which of the following is the priority assessment? a. Glascow Coma Scale b. cranial nerve function c. oxygen saturation d. pupillary response

c - airway is the most important

A nurse is caring for a client who has a new prescription for dantrolene to treat skeletal muscle spasms. The nurse should instruct the client to report which of the following adverse effects? a. slow heart rate b. cough c. diarrhea d. hearing loss

c - can cause dehydration and other serious effects

A nurse is caring for a client who is taking donepezil to treat Alzheimer's disease. For which of the following adverse effects should the nurse monitor? a. confusion b. dry mouth c. nausea d. double vision

c - food can help minimize adverse effects; it is a cholinesterase inhibitor

A nurse is providing teaching to a client who has a prescription for lithium carbonate about reducing the risk for lithium toxicity. Which of the following instructions should the nurse include? a. consume a low-sodium diet b. reduce fluid intake c. avoid taking NSAIDs d. take the drug with food

c - increase renal reabsorption of lithium and sodium

A nurse is caring for a client who has a new prescription for amphetamine sulfate. The nurse should monitor the client for which of the following adverse effects? a. hypotension b. tinnitus c. tachycardia d. bronchospasm

c - it is a stimulant; notify the development of palpitations or chest pain

A nurse is caring for a client who displays manifestations of stage III Parkinson's disease. Which of the following actions should the nurse include? a. recommend a community support group b. integrate a daily exercise routine c. provide a walker for ambulation d. perform ADLs for the client

c - movement slows

A nurse is providing teaching to the partner of a client who has Alzheimer's disease and has a new prescription for donepezil. Which of the following statements by the partner indicates the teaching is effective? a. "This medication should increase my husband's appetite" b. "This medication should help my husband sleep better" c. "This medication should help my husband's daily function" d. "This medication should increase my husband's energy level"

c - slows progression of Alzheimer's

A nurse is completing discharge teaching to a client who has seizures and received a vagal stimulator to decrease seizure activity. Which of the following statements should the nurse include in the teaching? a. "It is safe to use microwaves that are 1200 watts or less" b. "You should avoid the use of CT scans with contrast" c. "You should place a magnet over the implantable device when you feel an aura occurring" d. "It is recommended that you use ultrasound diathermy for pain management"

c - this decreases seizure activity

A nurse is providing discharge instructions to a client who has a prescription for phenytoin. Which of the following information should the nurse include? a. consider taking an antacid when on this medication b. watch for receding gums when taking the medication c. take the medication at the same time every day d. provide a urine sample to determine therapeutic levels of the medication

c - enhances effectiveness

A nurse is caring for a client who has a C4 spinal cord injury. The nurse should recognize the client is at greatest risk for which of the following complications? a. neurogenic shock b. paralytic ileus c. stress ulcer d. respiratory compromise

d

A nurse is caring for a client who has been taking selegiline to treat Parkinson's disease. The provider is considering the use of analgesics for the client but should be aware that a drug interaction between selegiline and meperidine can result in which of the following? a. frequent urination b. jaundice c. cellulitis d. muscle rigidity

d

A nurse is caring for a client who has suspected Meniere's disease. Which of the following is an expected finding? a. presence of a purulent lesion in the external ear canal b. feeling of pressure in the ear c. bulging, red bilateral tympanic membranes d. unilateral hearing loss

d

A nurse is discussing pain assessment with a newly licensed nurse. Which of the following information should the nurse include? a. most clients exaggerate their level of pain b. pain must have an identifiable source to justify the use of opioids c. objective data are essential in assessing pain d. pain is whatever the client says it is

d

A nurse is obtaining a health history from a client who is being evaluated for the cause of frequent headaches. Which of the following questions should the nurse ask to identify the aura type of migraine headache? a. "Do the headaches occur multiple times each day" b. "Is our headache accompanied by profuse facial sweating" c. "Does your headache occur on one side of your head" d. "Do you have the same manifestations each time the headache occurs"

d

A nurse is providing discharge instructions to a client who has a new diagnosis of migraine headaches. Which of the following instructions should the nurse include? a. use music therapy for relaxation with onset of the headache b. increase physical activity when a headache is present c. drink beverages that contain artificial sweeteners to prevent headaches d. apply a cool cloth to the face during a headache

d

A nurse is reviewing the health record of a client who has a malignant brain tumor and notes the client has a positive Romberg sign. Which of the following actions should the nurse take to assess for this finding? a. stroke the lateral aspect of the sole of the foot b. ask the client to blink both eyes c. observe for facial drooping d. have the client stand erect with eyes closed

d

A nurse is working in a long-term care facility is planning care for a client who has moderate Alzheimer's. Which of the following interventions should be included in the plan of care? a. use a gait belt for ambulation b. thicken all liquids c. provide protective undergarments d. reorient the client to self and current events

d

A nurse is caring for a client who is taking interferon beta-1b. The nurse should identify that which of the following findings indicates a potential serious adverse effect of this drug? a. tinnitus b. twitching eyelids c. blue-green skin discoloration d. fatigue

d - adverse effects include unexplained bruising, bleeding, and fatigue; can indicate bone marrow suppression and decreased platelet count

A nurse is teaching a client who has multiple sclerosis and a new prescription for baclofen. Which of the following statements should the nurse include in the teaching? a. "This medication will help you with your tremors" b. "This medication will help you with your bladder infection" c. "This medication can cause your skin to bruise easily" d. "This medication can cause you to experience dizziness"

d - baclofen is a antispasmodic for muscle spasms and can cause drowsiness

A nurse is providing teaching for a client who has a new prescription for betaxolol eye drops. Which of the following adverse effects should the nurse include in the teaching? a. constricted pupils b. discoloration of the iris c. hypertension d. bradycardia

d - blocks cardiac beta 1 receptors

A nurse is caring for a client who has Parkinson's disease and is starting to display bradykinesia. Which of the following is an appropriate action by the nurse? a. teach the client to walk more quickly when ambulating b. complete passive ROM exercises daily c. place the client on a low-protein, low-calorie diet d. give the client extra time to perform activities

d - bradykinsia = slow movement; this provides encouragement to complete activities

A nurse is providing postoperative teaching to a client following cataract surgery. Which of the following statements should the nurse include in the teaching? a. "You can resume playing golf in 2 days" b. "You need to tilt your head back when washing your hair" c. "You can get water in your eyes in 1 day" d. "You need to limit your housekeeping activities"

d - can cause an increase in IOP

A nurse is teaching a client who received a prescription for interferon beta-1a for the treatment of multiple sclerosis. Which of the following information should the nurse include? a. have kidney function tests done every month for a year b. take an extra dose in muscle aches occur c. store the drug at a room temperature after mixing it d. administer the drug in your thigh or upper arm

d - it is a SQ

A nurse is caring for a client who has been taking alprazolam for an extended period of time to treat anxiety. The nurse should identify that abruptly stopping alprazolam therapy can result in which of the following adverse effects? a. anterograde amnesia b. respiratory depression c. paradoxical reaction d. withdrawal symptoms

d - it is a benzo; taper dose

A nurse is teaching a client who has a new diagnosis of Parkinson's disease about how levodopa/carbidopa can help control symptoms. The nurse should identify that the drug has which of the following pharmacologic effects? a. increases available acetylcholine in the brain b. inhibits norepinephrine metabolism in the brain c. inhibits serotonin metabolism in the brain d. increases available dopamine in the brain

d - it is a dopaminergic agent

A nurse is performing an otoscopic examination of a client. Which of the following is an unexpected finding? a. pearly grey tympanic membrane b. malleus visible behind the TM c. presence of soft cerumen in the external canal d. fluid or bubbles seen behind the TM

d - sign of otitis media

A nurse is teaching a client who has Alzheimer's disease and their caregiver about memantine. Which of the following instructions should the nurse include? a. increase fluid intake to improve renal excretion b. report memory loss or confusion c. watch for signs of liver impairment, such as jaundice & abdominal pain d. avoid taking OTC antiacids

d - sodium bicarbonate can increase urine alkalinity and decrease drug excretion

A nurse is teaching the family of a client who has a new diagnosis of Alzheimer's disease about donepezil. Which of the following information should the nurse include? a. monitor for constipation b. the dosage will be increased weekly to provide optimum therapeutic effect c. administering the drug first thing in the morning promotes effectiveness d. avoid the use of NSAIDs for pain

d - this can cause GI bleeding