Chapter 64: Management of Patients With Neurologic Infections, Autoimmune Disorders, and Neuropathies

A client with suspected Creutzfeldt-Jakob disease (CJD) is being admitted to the unit. The nurse would expect what diagnostic test to be ordered for this client? A. Cerebral angiography B. ABG analysis C. CT D. EEG

EEG

The nurse is teaching a client with Guillain-Barré syndrome about the disease. The client asks how the client can ever recover if demyelination of the nerves is occurring. What would be the nurse's best response? A. "Guillain-Barré spares the Schwann cell, which allows for remyelination in the recovery phase of the disease." B. "In Guillain-Barré, Schwann cells replicate themselves before the disease destroys them, so remyelination is possible." C. "I know you understand that nerve cells do not remyelinate, so the health care provider is the best one to answer your question." D. "For some reason, in Guillain-Barré, Schwann cells become activated and take over the remyelination process."

"Guillain-Barré spares the Schwann cell, which allows for remyelination in the recovery phase of the disease."

The nurse is preparing to provide care for a client diagnosed with myasthenia gravis. The nurse should know that the signs and symptoms of the disease are the result of what issue? A. Genetic dysfunction B. Upper and lower motor neuron lesions C. Decreased conduction of impulses in an upper motor neuron lesion D. A lower motor neuron lesion

A lower motor neuron lesion

A client arrives at the emergency department complaining of extreme muscle weakness after minimal effort. The physician suspects myasthenia gravis. Which drug will be used to test for this disease? a) Edrophonium b) Carbachol c) Pyridostigmine d) Ambenonium

A) Edrophonium

Which intervention should the nurse suggest to help a client with multiple sclerosis avoid episodes of urinary incontinence? a) Establish a regular voiding schedule. b) Insert an indwelling urinary catheter. c) Limit fluid intake to 1,000 mL/day. d) Administer prophylactic antibiotics, as prescribed.

A) Establish a regular voiding schedule.

A 35-year-old woman is diagnosed with a peripheral neuropathy. When making her plan of care, the nurse knows to include what in patient teaching? Select all that apply. A) Inspect the lower extremities for skin breakdown. B) Footwear needs to be accurately sized. C) Immediate family members should be screened for the disease. D) Assistive devices may be needed to reduce the risk of falls. E) Dietary modifications are likely necessary.

A) Inspect the lower extremities for skin breakdown. B) Footwear needs to be accurately sized D) Assistive devices may be needed to reduce the risk of falls.

What assessment findings would the nurse expect to find with a client with progressive myasthenia gravis? a) Muscle weakness, difficulty swallowing, double vision, and difficulty speaking b) Muscle pain, difficulty speaking, headaches, and arthritic changes c) Muscle inflammation, choking when eating, nearsightedness, and painful joints d) Atrophy of the muscles, difficulty chewing, strabismus, and difficulty moving

A) Muscle weakness, difficulty swallowing, double vision, and difficulty speaking

The nurse assesses for euphoria in a client with multiple sclerosis, looking for what characteristic clinical manifestation? a) an exaggerated sense of well-being b) slurring of words when excited c) visual hallucinations d) inappropriate laughter

A) an exaggerated sense of well-being

A client with multiple sclerosis (MS) is experiencing bowel incontinence and is starting a bowel retraining program. Which strategy is not appropriate? a) limiting fluid intake to 1,000 mL/day b) setting a regular time for elimination c) using an elevated toilet seat d) eating a diet high in fiber

A) imiting fluid intake to 1,000 mL/day

Which is an initial sign of Parkinson's disease? a) tremor b) bradykinesia c) rigidity d) akinesia

A) tremor

The nurse is caring for a 77-year-old client with MS. The client is very concerned about the progress of the disease and what the future holds. The nurse should know that older adult clients with MS are known to be particularly concerned about what variables? Select all that apply. A. Possible nursing home placement B. Pain associated with physical therapy C. Increasing disability D. Becoming a burden on the family E. Loss of appetite

A. Possible nursing home placement C. Increasing disability D. Becoming a burden on the family

An expected nursing intervention for a patient diagnosed with Bell's palsy would be which of the following? A) Applying a protective eye shield at night B) Encouraging the patient to eat on the affected side C) Avoiding analgesics D) Avoiding brushing of the teeth

Applying a protective eye shield at night

A client with herpes simplex virus encephalitis (HSV) has been admitted to the ICU. What medication would the nurse expect the health care provider to order for the treatment of this disease process? A. Cyclosporine B. Acyclovir C. Cyclobenzaprine D. Ampicillin

Acyclovir

7. The physician has ordered a Tensilon test to rule out myasthenia gravis. The nurse knows that which of the following medications would be used to counteract the side effects of the Tensilon? A) Baclofen (Lioresal) B) Atropine (AtroPen) C) Epinephrine (Adrenalin) D) Narcan (Naloxone)

Atropine (AtroPen)

The nurse caring for a client in ICU diagnosed with Guillain-Barré syndrome should prioritize monitoring for what potential complication? A. Impaired skin integrity B. Cognitive deficits C. Hemorrhage D. Autonomic dysfunction

Autonomic dysfunction

The nurse is discharging a client home after surgery for trigeminal neuralgia. What advice should the nurse provide to this client in order to reduce the risk of injury? A. Avoid watching television or using a computer for more than 1 hour at a time. B. Use over-the-counter antibiotic eye drops for at least 14 days. C. Avoid rubbing the eye on the affected side of the face. D. Rinse the eye on the affected side with normal saline daily for 1 week.

Avoid rubbing the eye on the affected side of the face.

When teaching a client about levodopa-carbidopa therapy for Parkinson's disease, a nurse should include which instruction? a) "Report any eye spasms." b) "Be aware that your urine may appear darker than usual." c) "Stop taking this drug when your symptoms disappear." d) "Take this medication at bedtime."

B) "Be aware that your urine may appear darker than usual."

A nurse is caring for an older adult client with advanced Parkinson's disease. Which client statement about advance directives indicates a need for further instruction? a) "My family will take care of me. I've given my daughter durable power of attorney for health care." b) "I don't really need to sign anything. I'm depending on my physician to tell my family what to do if something bad happens." c) "I've signed the advance directive papers and will fight to maintain the highest quality of life until my time comes." d) "I know that I'll eventually be unable to make decisions. Signing an advance directive now will save my family grief."

B) "I don't really need to sign anything. I'm depending on my physician to tell my family what to do if something bad happens."

A 69-year-old patient is brought to the ED by ambulance because a family member found him lying on the floor disoriented and lethargic. The physician suspects bacterial meningitis and admits the patient to the ICU. The nurse knows that risk factors for an unfavorable outcome include what? Select all that apply. A) Blood pressure greater than 140/90 mm Hg B) Heart rate greater than 120 bpm C) Older age D) Low Glasgow Coma Scale E) Lack of previous immunizations

B) Heart rate greater than 120 bpm C) Older age D) Low Glasgow Coma Scale

When developing a long term care plan for the client with multiple sclerosis, the nurse should teach the client to prevent: a) fluid overload. b) contractures. c) dry mouth. d) ascites.

B) contractures.

Which is an expected outcome for a client with Parkinson's disease who has had a pallidotomy? a) reduced emotional stress b) improved functional ability c) better appetite d) increased alertness

B) improved functional ability

A client with multiple sclerosis (MS) lives with her daughter and 3-year-old granddaughter. The daughter asks the nurse what she can do at home to help her mother. Which measure would be most beneficial? a) weekly visits by another person with MS b) regular exercise c) psychotherapy d) day care for the granddaughter

B) regular exercise

A 69-year-old client is brought to the ED by ambulance because a family member found the client lying on the floor disoriented and lethargic. The health care provider suspects bacterial meningitis and admits the client to the ICU. What interventions should the nurse perform? Select all that apply. A. Obtain a blood type and cross-match. B. Administer antipyretics as prescribed. C. Perform frequent neurologic assessments. D. Monitor pain levels and administer analgesics. E. Place the client in positive pressure isolation.

B. Administer antipyretics as prescribed. C. Perform frequent neurologic assessments. D. Monitor pain levels and administer analgesics.

To alleviate pain associated with trigeminal neuralgia, a client is taking carbamazepine. What health education should the nurse provide to the client before initiating this treatment? A. Concurrent use of calcium supplements is contraindicated. B. Blood levels of the drug must be monitored. C. The drug is likely to cause hyperactivity and agitation. D. Carbamazepine can cause tinnitus during the first few days of treatment.

Blood levels of the drug must be monitored.

A 33-year-old client presents at the clinic with reports of weakness, incoordination, dizziness, and loss of balance. The client is hospitalized and diagnosed with MS. What sign or symptom, revealed during the initial assessment, is typical of MS? A. Diplopia, history of increased fatigue, and decreased or absent deep tendon reflexes B. Flexor spasm, clonus, and negative Babinski reflex C. Blurred vision, intention tremor, and urinary hesitancy D. Hyperactive abdominal reflexes and history of unsteady gait and episodic paresthesia in both legs

Blurred vision, intention tremor, and urinary hesitancy

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

C) Ineffective airway clearance

A nurse is teaching a client with multiple sclerosis (MS). When teaching the client how to reduce fatigue, the nurse should tell the client to: a) increase the dose of muscle relaxants. b) take a hot bath. c) rest in an air-conditioned room. d) avoid naps during the day.

C) rest in an air-conditioned room.

A client is admitted through the ED with suspected St. Louis encephalitis. The unique clinical feature of St. Louis encephalitis will make what nursing action a priority? A. Serial assessments of hemoglobin levels B. Blood glucose monitoring C. Close monitoring of fluid balance D. Assessment of pain along dermatomes

Close monitoring of fluid balance

When caring for a client with myasthenia gravis who is receiving anticholinesterase drug therapy, the nurse must be able to distinguish cholinergic crisis from myasthenic crisis. Which of the following symptoms is not present in cholinergic crisis? a) Increased weakness. b) Diaphoresis. c) Increased salivation. d) Improved muscle strength after I.V. administration of edrophonium chloride.

D) Improved muscle strength after I.V. administration of edrophonium chloride.

A nurse is caring for a client admitted with a diagnosis of exacerbation of myasthenia gravis. Upon assessment of the client, the nurse notes the client has severely depressed respirations. The nurse would expect to identify which acid-base disturbance? a) Metabolic acidosis b) Metabolic alkalosis c) Respiratory alkalosis d) Respiratory acidosis

D) Respiratory acidosis

The nurse has asked the unlicensed assistive personnel (UAP) to ambulate a client with Parkinson's disease. The nurse observes the UAP pulling on the client's arms to get the client to walk forward. The nurse should: a) give the client a muscle relaxant. b) have the UAP keep a steady pull on the client to promote forward ambulation. c) assist the UAP with getting the client back in bed. d) explain how to overcome a freezing gait by telling the client to march in place.

D) explain how to overcome a freezing gait by telling the client to march in place.

The primary nursing goal for a client with myasthenia gravis is to: a) provide psychological support and reassurance. b) promote comfort and relieve pain. c) ensure a safe environment. d) maintain respiratory function.

D) maintain respiratory function.

A client with Parkinson's disease is prescribed levodopa (L-dopa) therapy. Improvement in which area indicates effective therapy? a) alertness b) appetite c) mood d) muscle rigidity

D) muscle rigidity

Which goal is the most realistic for a client diagnosed with Parkinson's disease? a) to cure the disease b) to begin preparations for terminal care c) to stop progression of the disease d) to maintain optimal body function

D) to maintain optimal body function

11. The nurse knows that plasmapheresis is being utilized in the treatment of the patient with Guillain-Barre' syndrome for which of the following reasons? A) Removal of anti-acetylcholine receptor antibodies B) Reduction in the number of bacteria in the bloodstream C) Decrease in antibodies attacking peripheral nerve myelin D) Removal of potassium and fluid

Decrease in antibodies attacking peripheral nerve myelin

6. Upon admission, the physician orders baclofen (Lioresal) for a patient diagnosed with multiple sclerosis. The nurse knows that which of the following is an expected outcome of this medication? A) Reduction in the appearance of new lesions on the MRI B) Decreased muscle spasms in the lower extremities C) Increased muscle strength in the upper extremities D) Limited severity and duration of exacerbations

Decreased muscle spasms in the lower extremities

A client diagnosed with MS has been admitted to the medical unit for treatment of an MS exacerbation. Included in the admission orders is baclofen. What should the nurse identify as an expected outcome of this treatment? A. Reduction in the appearance of new lesions on the MRI B. Decreased muscle spasms in the lower extremities C. Increased muscle strength in the upper extremities D. Decreased severity and duration of exacerbations

Decreased muscle spasms in the lower extremities

A patient diagnosed with myasthenia gravis has been hospitalized to receive plasmapheresis for a myasthenic exacerbation. The nurse knows that the course of treatment for plasmapheresis in a patient with myasthenia gravis is what? A) Every day for 1 week B) Determined by the patients response C) Alternate days for 10 days D) Determined by the patients weight

Determined by the patients response

A middle-aged client has sought care from the primary provider and undergone diagnostic testing that has resulted in a diagnosis of MS. What sign or symptom is most likely to have prompted the client to seek care? A. Cognitive declines B. Personality changes C. Contractures D. Difficulty in coordination

Difficulty in coordination

A client is being admitted to the neurologic ICU with suspected herpes simplex virus encephalitis. What nursing action best addresses the client's reported headache? A. Initiating a client-controlled analgesia (PCA) of morphine sulfate B. Administering hydromorphone IV as needed C. Dimming the lights and reducing stimulation D. Distracting the client with activity

Dimming the lights and reducing stimulation

18. A patient with trigeminal neuralgia is taking Tegretol (carbamazepine) to alleviate pain associated with this disorder. It is important to teach the patient that which of the following side effects may occur from taking this medication? A) Skin discoloration B) Drowsiness C) Insomnia D) Tinnitus

Drowsiness

The nurse is caring for a patient who is hospitalized with an exacerbation of MS. To ensure the patients safety, what nursing action should be performed? A) Ensure that suction apparatus is set up at the bedside. B) Pad the patients bed rails. C) Maintain bed rest whenever possible. D) Provide several small meals each day

Ensure that suction apparatus is set up at the bedside.

A patient with MS has been admitted to the hospital following an acute exacerbation. When planning the patients care, the nurse addresses the need to enhance the patients bladder control. What aspect of nursing care is most likely to meet this goal? A) Establish a timed voiding schedule. B) Avoid foods that change the pH of urine. C) Perform intermittent catheterization q6h. D) Administer anticholinergic drugs as ordered.

Establish a timed voiding schedule.

Bell's palsy is a disorder of cranial nerve VII. What are the clinical manifestations of the disorder? A) Tinnitus B) Facial paralysis C) Pain at the base of the tongue D) Diplopia

Facial paralysis

The nurse is developing a plan of care for a client newly diagnosed with Bell palsy. The nurse's plan of care should address what characteristic manifestation of this disease? A. Tinnitus B. Facial paralysis C. Pain at the base of the tongue D. Diplopia

Facial paralysis

8. The nurse is caring for a patient recently diagnosed with myasthenia gravis whose CT scan reveals an enlarged thymus gland. Which additional assessment data would be consistent with the diagnosis of myasthenia gravis? A) Decreased sensation in the hands and feet B) Incoordination of gait C) Facial numbness causing slurred speech D) Generalized weakness of the extremities

Generalized weakness of the extremities

The nurse is teaching a patient with Guillain-Barr syndrome about the disease. The patient asks how he can ever recover if demyelination of his nerves is occurring. What would be the nurses best response? A) Guillain-Barr spares the Schwann cell, which allows for remyelination in the recovery phase of the disease. B) In Guillain-Barr, Schwann cells replicate themselves before the disease destroys them, so remyelination is possible. C) I know you understand that nerve cells do not remyelinate, so the physician is the best one to answer your question. D) For some reason, in Guillain-Barr, Schwann cells become activated and take over the remyelination process.

Guillain-Barr spares the Schwann cell, which allows for remyelination in the recovery phase of the disease.

A nurse is planning the care of a 28-year-old client hospitalized with a diagnosis of myasthenia gravis. What approach would be most appropriate for the care and scheduling of diagnostic procedures for this client? A. All at one time, to provide a longer rest period B. Before meals, to stimulate the client's appetite C. In the morning, with frequent rest periods D. Before bedtime, to promote rest

In the morning, with frequent rest periods

10. It is important to frequently monitor the patient with Guillain-Barre' syndrome when ascending paralysis is occurring. When assessing the patient for bulbar muscle weakness, the nurse should be alert to which of the following clinical manifestations? A) Decreased level of consciousness B) Inability to clear secretions C) Hypersensitivity of hands and feet D) Increased intracranial pressure

Inability to clear secretions

The clinic nurse is caring for a client with a recent diagnosis of myasthenia gravis. The client has begun treatment with pyridostigmine bromide. What change in status would most clearly suggest a therapeutic benefit of this medication? A. Increased muscle strength B. Decreased pain C. Improved GI function D. Improved cognition

Increased muscle strength

Which of the following nursing interventions would be included in the care plan for a patient admitted with MS? A) Encourage the patient to void 1 hour after drinking. B) Order a low-residue diet. C) Provide total assistance as needed with all activities of daily living. D) Instruct the patient on daily muscle stretching.

Instruct the patient on daily muscle stretching.

What basic information will the nurse caring for a patient recently diagnosed with multiple sclerosis (MS) provide to him? A) It is a degenerative disease of the nervous system. B) It usually occurs more frequently in men. C) It has an acute onset. D) It is caused by a bacterial infection.

It is a degenerative disease of the nervous system

The nurse is working with a client who is newly diagnosed with MS. What basic information should the nurse provide to the client? A. MS is a progressive demyelinating disease of the nervous system. B. MS usually occurs more frequently in men. C. MS typically has an acute onset. D. MS is sometimes caused by a bacterial infection

MS is a progressive demyelinating disease of the nervous system.

A 73-year-old client comes to the clinic reporting weakness and loss of sensation in the feet and legs. Assessment of the client shows decreased reflexes bilaterally. Why would it be a challenge to diagnose a peripheral neuropathy in this client? A. Older adults are often vague historians. B. Older adults have fewer peripheral nerves than younger adults. C. Many older adults are hesitant to admit that their body is changing. D. Many symptoms can be the result of normal aging process.

Many symptoms can be the result of normal aging process.

The critical care nurse is caring for 25-year-old admitted to the ICU with a brain abscess. What is a priority nursing responsibility in the care of this client? A. Maintaining the client's functional independence B. Providing health education C. Monitoring neurologic status closely D. Promoting mobility

Monitoring neurologic status closely

1. A nurse caring for a patient with possible bacterial meningitis in the ICU knows that which of the following assessment findings would be expected for a patient with bacterial meningitis? A) Pain upon ankle dorsiflexion of the foot B) Neck flexion produces flexion of knees and hips C) Inability to stand with eyes closed and arms extended without swaying D) Numbness and tingling in the lower extremities

Neck flexion produces flexion of knees and hips

17. A patient with Guillain-Barre' has had arterial blood gases (ABGs) drawn. Which of the following ABG values indicates that the patient's status is deteriorating? A) pH 7.37 B) PaCO2 60 C) HCO3 24 D) Oxygen saturation of 94%

PaCO2 60

16. When examining a patient with Guillain-Barre' syndrome, the nurse would expect to assess which of the following clinical manifestations? A) Paresthesias of the hands and feet B) Hyperactive deep tendon reflexes C) Hypotension D) Descending weakness

Paresthesias of the hands and feet

A client presents at the clinic with pain and weakness in the hands. On assessment, the nurse notes diminished reflexes in the upper extremities bilaterally and bilateral loss of sensation. The nurse knows that these findings are indicative of what condition? A. Guillain-Barré syndrome B. Myasthenia gravis C. Trigeminal neuralgia D. Peripheral nerve disorder

Peripheral nerve disorder

A client with MS has developed dysphagia as a result of cranial nerve dysfunction. What nursing action should the nurse consequently perform? A. Arrange for the client to receive a low residue diet. B. Position the client upright during feeding. C. Suction the client following each meal. D. Withhold liquids until the client has finished eating

Position the client upright during feeding.

A client presents to the clinic reporting a headache. The nurse notes that the client is guarding the neck and tells the nurse about stiffness in the neck area. The nurse suspects the client may have meningitis. What is another well-recognized sign of this infection? A. Negative Brudzinski sign B. Positive Kernig sign C. Hyperpatellar reflex D. Sluggish pupil reaction

Positive Kernig sign

14. The nurse would expect to document which of the following in a patient with myasthenia gravis undergoing a Tensilon test? A) Positive Tensilon test B) Negative Tensilon test C) Positive sweat test D) Negative sweat test

Positive Tensilon test

A client with Guillain-Barré syndrome has experienced a sharp decline in vital capacity. What is the nurse's most appropriate action? A. Administer bronchodilators as ordered. B. Remind the client of the importance of deep breathing and coughing exercises. C. Prepare to assist with intubation. D. Administer supplementary oxygen by nasal cannula

Prepare to assist with intubation.

15. The nurse assessing a patient with multiple sclerosis understands that due to the pathophysiology of this disease process which of the following is the expected primary finding on the MRI? A) Subarachnoid hemorrhage B) Presence of multiple plaques C) Atrophy of the caudate nuclei D) Presence of a tumor

Presence of multiple plaques

A client with diabetes presents to the clinic and is diagnosed with a mononeuropathy. This client's nursing care should involve which of the following? A. Protection of the affected limb from injury B. Passive and active ROM exercises for the affected limb C. Education about improvements to glycemic control D. Interventions to prevent contractures

Protection of the affected limb from injury

The critical care nurse is admitting a client in myasthenic crisis to the ICU. The nurse should prioritize what nursing action in the immediate care of this client? A. Suctioning secretions B. Facilitating ABG analysis C. Providing ventilatory assistance D. Administering tube feedings

Providing ventilatory assistance

When teaching the patient with multiple sclerosis how to reduce fatigue, the nurse should tell him 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.

Rest in an air-conditioned room.

13. The nurse recognizes that corticosteroid therapy, when used in the treatment of Guillain-Barre' syndrome, reduces the inflammation and edema associated with this neuromuscular disorder. It is most important for the nurse to monitor which of the following lab values for the patient on corticosteroid therapy? A) pH of urine B) Hemoglobin C) Serum potassium D) Serum glucose

Serum glucose

A client diagnosed with myasthenia gravis has been hospitalized to receive therapeutic plasma exchange (TPE) for a myasthenic exacerbation. The nurse should anticipate what therapeutic response? A. Permanent improvement after 4 to 6 months of treatment B. Symptom improvement that lasts a few weeks after TPE ceases C. Permanent improvement after 60 to 90 treatments D. Gradual improvement over several months

Symptom improvement that lasts a few weeks after TPE ceases

A 48-year-old client has been diagnosed with trigeminal neuralgia following recent episodes of unilateral face pain. The nurse should recognize what implication of this diagnosis? A. The client will likely require lifelong treatment with anticholinergic medications. B. The client has a disproportionate risk of developing myasthenia gravis later in life. C. The client needs to be assessed for MS. D. The disease is self-limiting and the client will achieve pain relief over time.

The client needs to be assessed for MS.

12. When assessing a patient with myasthenia gravis, the nurse would be correct in questioning the patient regarding which of the following clinical manifestations? A) Weakness associated with fatigue B) Headache that worsens at night C) Projectile vomiting without nausea D) Diaphoresis

Weakness associated with fatigue

A 42-year-old woman diagnosed with metastatic cancer has developed trigeminal neuralgia. She is taking carbamazepine (Tegretol) for pain relief. Which of the following applies to this medication? A) The medication should be taken on an empty stomach. B) Thee patient should be monitored for bone marrow depression.. C) Side effects include renal dysfunction. D) The medication should be taken in maximum dosage form to be effective.

Thee patient should be monitored for bone marrow depression

5. When developing a plan of care for a patient with Guillain-Barre' syndrome, the nurse knows that which of the following nursing interventions would receive priority? A) Using the incentive spirometer as prescribed B) Maintaining the patient on bed rest C) Assisting the patient with activities of daily living D) Determining abnormalities of cognitive function

Using the incentive spirometer as prescribed

The nurse would expect to find which of the following symptoms when assessing a 38-year-old patient diagnosed with multiple sclerosis? A) Vision changes B) Absent deep tendon reflexes C) Tremors at rest D) Flaccid muscles

Vision changes

9. The nurse is caring for a recently diagnosed patient with myasthenia gravis whose CT scan reveals an enlarged thymus gland. Which additional assessment parameter should the nurse complete to confirm the diagnosis of myasthenia gravis? A) Passive range of motion of the neck B) Check of deep tendon reflexes C) Application of painful stimuli to legs D) Visual screening using the Snellen chart

Visual screening using the Snellen chart

3. Which of the following clinical manifestations would alert the nurse caring for a patient with Guillain-Barré syndrome that his status is deteriorating? A) Tidal volume of 500 mL B) Residual lung volume of 1200 mL C) Vital capacity of 11 mL/kg D) Oxygen saturation of 97%

Vital capacity of 11 mL/kg

The nurse planning caring for a client diagnosed with Guillain-Barré syndrome. The nurse's communication with the client should reflect the possibility of which sign or symptom of the disease? A. Intermittent hearing loss B. Tinnitus C. Tongue enlargement D. Vocal paralysis

Vocal paralysis

Which of the following is a clinical manifestation associated with Guillain-Barré syndrome? A) Vertigo B) Ptosis of the eyelid C) Diminished taste for food D) Vocal paralysis

Vocal paralysis

2. The nurse teaching a patient with trigeminal neuralgia about factors that precipitate an attack would be correct in teaching him to avoid: A) Washing his face B) Exposing his skin to sunlight C) Using artificial tears D) Drinking liquids at room temperature

Washing his face

A client diagnosed with Bell palsy is having decreased sensitivity to touch of the involved nerve. What should the nurse recommend to prevent atrophy of the muscles? A. Blowing up balloons B. Deliberately frowning C. Smiling repeatedly D. Whistling

Whistling

A client has an exacerbation of multiple sclerosis. The physician orders dantrolene, 25 mg P.O. daily. Which assessment finding indicates the medication is effective? a) Increased ability to sleep b) Relief from pain c) Relief from constipation d) Reduced muscle spasticity

d) Reduced muscle spasticity