CHAPTER 53

What is the nurse assessing when asking the patient, "Who is the president of the United States?" during a level of consciousness assessment?

Fund of knowledge

Which is the drug of choice for status epilepticus

Valium/diazepam

The nurse assures an anxious family member of a 92-year-old patient who is demonstrating signs of dementia that many causes of dementia are reversible and preventable. What is one example?

Hypotension

A patient, age 45, is to have a myelogram to confirm the presence of a herniated intervertebral disk. Which nursing action should be planned with respect to this diagnostic test?

Obtain an allergy history before the test.

Why are the drugs neostigmine (Prostigmin) and pyridostigmine (Mestinon) helpful to the person with myasthenia gravis?

Promotes nerve impulse transmission

The nurse should include which instructions when teaching an adult patient about an antivertigo agent

Take 30-60 minutes before airplane or boat departure

What is the cardinal sign of increased intracranial pressure in a brain injured patient?

Decrease in the level of consciousness

Lithium is an antimanic drug that is used in the treatment of which condition

manic-depressive psychosis

Clonazepam (Klonopin), a benzodiazepine, is used on certain patients with which disorders of the central nervous system

myoclonic seizures

The nurse is aware that the characteristic gait of the person with Parkinson disease is a propulsive gait, which causes the patient to:

shuffle with arms flexed.

The physician has ordered phenobarbital (Luminal) 100 mg three times a day for a patient with seizures. To help the nurse develop an appropriate care plan for this patient, which best describes the action of this drug in the body

It has a long duration and a sedative effect on the brain

A frantic family member is distressed about the flaccid paralysis of her son following a spinal cord injury several hours ago. What does the nurse know about this condition?

It is possibly a temporary condition and will clear.

Which medication is classified as a benzodiazepine

Lorazepam(Ativan) Diazepam (Valium) Clonazepam (Klonopin)

The newly admitted patient to the emergency room 30 minutes ago after a fall off a ladder has gradually decreased in consciousness and has slowly reacting pupils, a widening pulse pressure, and verbal responses that are slow and unintelligible. What is the most appropriate position for the patient?

Neck placed in a neutral position

The nurse is instructing a patient about the use of her oral antimigrate agent. The instructor should include the best effective action of the drug which represents the best way to take this agent.

Take the medication at the onset of an of an attack

Long-term use of dopaminergic drugs (anti-psychotic) often leads to which condition

Tardive dyskinesia

What is the cranial nerve that supplies most of the organs in the thoracic and abdominal cavities and also carries motor fibers to glands that produce digestive juices and other secretions?

Vagus nerve

Which question is likely to elicit the most valid response from the patient who is being interviewed about a neurologic problem?

"Can you describe the sensations you are having?"

The nurse is aware that the drug t-PA (Activase), a tissue plasminogen activator, must be given in____hours of the onset of symptoms to have maximum benefit.

3 hours

A patient has recently suffered a stroke with left-sided weakness and has problems with choking, especially when drinking thin liquids. What nursing interventions would be most helpful in assisting this patient to swallow safely?

Tuck chin when swallowing

What are the two divisions of the nervous system?

central nervous system and peripheral nervous system

A patient comes into the emergency department with status epilepticus in progress. The nurse expects the physician to order which drug for this condition

diazepam (valium)

The nurse is caring for a home health patient who had a spinal cord injury at C5 three years ago. The nurse bases the plan of care on the knowledge that the patient will be able to:

feed self with setup and adaptive equipment.

Which is the main action of benzodiazepines

they depress the CNS

CNS depression, decreased respiratory rate, constricted pupils, tachycardia, and areflexia are symptoms of overdose with which drugs

Barbiturates

What is the nurse aware of when assessing a person with a craniocerebral injury?

Signs and symptoms may not occur until several days after the trauma

Diphenhydramine (Benadryl) is an antiemetic; it is also used for which other conditions

Rash,motion sickness, insomnia, allergies

The desired effect of an antidepressant drug will usually occur within which period

3-4 weeks

What are surgical navigational systems?

Computerized devices that guide the surgeon

What is the mechanism of action for antimigraine agents?

Constricting dilated cerebral arteries

Which symptom is specific to migraine headaches?

They are preceded by an aura

What should the nurse do when the child arrives on the floor with the diagnosis of bacterial meningitis?

Place the child in respiratory isolation

What Glasgow Coma Scale rating would a patient receive who opens the eyes spontaneously, but has incomprehensible speech and obeys commands for movement?

12

How would a nurse record the behavior when a patient with Alzheimer disease attempts to eat using a napkin rather than a fork?

Agnosia

The nurse is aware that when assessing a patient by the FOUR score coma scale, the patient is assessed in four categories: eye response, brainstem reflexes, motor response, and respiration. How are these results reported?

As individual scores in each category

What does the nurse know about the stroke patient who has expressive aphasia?

Can understand the spoken word, but cannot speak

A family member of a patient who has just suffered a tonic-clonic seizure is concerned about the patient's deep sleep. What is this behavior called?

Postictal period

A patient comes to the clinic and tells the nurse she might be pregnant. She has migraine headaches. The physician prescribes dihydroergotamine (DHE 45). The nurse explains to the patient that this drug is being used for which reason

This agent does not have oxytocic effects

The nurse gives a patient in the emergency department (ED) who has nausea and vomiting prochlorperazine (Compazine) IM, as ordered by the physician. The patient is discharged 2 hours after the administration of this medication. The nurse asks the friend of the patient to drive him home. This action is necessary for which reason

The patient should not operate a motor vehicle after receiving this medication *avoid exposure to sunlight

What is the basic problem that prompts most of the early signs of Alzheimer disease?

Memory loss that disrupts daily life

A patient is in which stage of Alzheimer disease when she demonstrates "sundowning"?

Second stage

As the result of a stroke, a patient has difficulty discerning the position of his body without looking at it. In the nurse's documentation, which would best describe the patient's inability to assess spatial position of his body?

Proprioception

The nurse instructs a patient about monoamine oxidase (MAO) inhibitors before discharge. The nurse tells the patient to avoid certain foods and beverages while she is on the MAO inhibitors because they could cause which problems?

sudden and severe hypertension *avoid tyramine rich foods cheese sour cream yogurt soy sauce etoh chocolate smoked meats or fish