chapter 70 - management of patients with oncologic or degenerative neurologic disorders

In which location are most brain angiomas located? Cerebellum Hypothalamus Thalamus Brainstem

cerebellum-

The nurse is caring for a client who was diagnosed with a glioma 5 months ago. Today, the client was brought to the emergency department by his caregiver because he collapsed at home. The nurse suspects late signs of rising intracranial pressure (ICP) when which blood pressure and pulse readings are noted? BP = 90/50 mm Hg; HR = 75 bpm BP =130/80 mm Hg; HR = 55 bpm BP = 150/90 mm Hg; HR = 90 bpm BP = 175/45 mm Hg; HR = 42 bpm

BP = 175/45 mm Hg; HR = 42 bpm

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

Cerebrospinal fluid leakage

The nurse identifies a nursing diagnosis of self-care deficit, bathing related to motor impairment and decreased cognitive function for a client with cerebral metastasis. Which outcome would the nurse most likely identify on this client's plan of care? Client demonstrates positive coping strategies. Client participates in daily hygiene activities with assistive devices. Client expresses feelings related to self-care ability. Client consumes adequate calories to meet energy needs.

Client participates in daily hygiene activities with assistive devices.

A client is admitted to undergo lumbar laminectomy for treatment of a herniated disk. Which action should the nurse take first to promote comfort preoperatively? Help the client assume a more comfortable position. Administer hydrocodone (Vicodin) as ordered. Provide teaching on nonpharmacologic measures to control pain. Notify the physician of the client's pain.

Help the client assume a more comfortable position.

The nurse is caring for a patient with Huntington's disease in the long-term care facility. What does the nurse recognize as the most prominent symptom of the disease that the patient exhibits? Rapid, jerky, involuntary movements Slow, shuffling gait Dysphagia and dysphonia Dementia

Rapid, jerky, involuntary movements

The nurse educator is providing information to a group of nurses regarding different types of brain tumors. The nurse is correct in explaining that total surgical resection of a glioblastoma multiforme (GBM) is not possible for which reason? The presence of finger-like tentacles produced by the tumor. There is a capsule surrounding the tumor. The tumor is surrounded by blood vessels. The tumor covers the meninges of the brain.

The presence of finger-like tentacles produced by the tumor.

The nurse is providing postoperative care for a client who just underwent surgery to remove a metastatic intramedullary tumor. On postoperative day 3, the client states, "I am really looking forward to going running again, it had become too difficult because of the loss of feeling in my feet." Which should the nurse address in the client's care plan? Body image disturbance Anxiety Impaired cognition Knowledge deficit

knowledge deficit

The nurse is seeing a client who is suspected of having a glioblastoma multiforme tumor. The nurse anticipates the client will require which diagnostic test to confirm the client has this form of brain tumor? Tissue biopsy Weber and Rinne test Audible bruit over the skull An increase in prolactin

tissue biopsy

Which medication classification should be avoided in the treatment of brain tumors? Anticoagulants Osmotic diuretics Corticosteroids Anticonvulsants

anticoagulants- are not prescribed because of the risk for central nervous system (CNS) hemorrhage

The nurse is performing an assessment for a patient in the clinic with Parkinson's disease. The nurse determines that the patient's voice has changed since the last visit and is now more difficult to understand. How should the nurse document this finding? Dysphagia Dysphonia Hypokinesia Micrographia

dysphonia- voice impairment or altered voice production

A nurse is providing care to a client recently diagnosed with a brain tumor. When planning this client's care, the nurse anticipates which therapy as providing the best outcome for the client? Surgery Radiation therapy Chemotherapy Immunotherapy

surgery

A patient has been diagnosed with a brain tumor, a glioblastoma multiforme. The nurse met with the family after the diagnosis to help them understand that: The tumor rarely spreads to other parts of the body. Chemotherapy, following surgery, has recently been shown to be a highly effective treatment. Radiation is not an option because of the tumor's location near the brainstem. Surgery can improve survival time but the results are not guaranteed.

Surgery can improve survival time but the results are not guaranteed

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

eighth- hearing and balance

The nurse is assessing a client who was brought to the emergency department due to a severe headache with sudden onset, lowered level of consciousness and slurred, non-sensical speech. The client completed chemotherapy and radiation treatment for a glioma-type brain tumor 6 months ago. The client has been taking low molecular weight heparin since completing treatment. The nurse should be prepared to provide care for which possible problem? Intracerebral hemorrhage Deep vein thrombosis Pulmonary embolism Spinal metastasis TAKE ANOTHER QUIZ

intracerebral hemorrhage- due to receiving anticoagulants

Bone density testing in clients with post-polio syndrome has demonstrated osteoarthritis. calcification of long bones. no significant findings. low bone mass and osteoporosis.

low bone mass and osteoporosis.

Which disease includes loss of motor neurons in the anterior horns of the spinal cord and motor nuclei of the lower brain stem? Parkinson disease Amyotrophic lateral sclerosis Alzheimer disease Huntington disease

Amyotrophic lateral sclerosis- is a disease of unknown cause in which there is a loss of motor neurons in the anterior horns of the spinal cord and the motor nuclei of the lower brain stem.

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

Autosomal dominant

A 37-year-old mother of three has just been diagnosed with a grade I meningioma. As part of patient education, the nurse tells the patient that: The tumor is malignant and aggressive. The tumor will cause pressure on the eighth cranial nerve. Growth is slow and symptoms are caused by compression rather than tissue invasion. Surgery, which can result in complete removal of the possible tumor, should be done as soon as possible.

Growth is slow and symptoms are caused by compression rather than tissue invasion.

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? Hemorrhagic stroke Thyroid disorders Hearing loss Visual loss

Hemorrhagic stroke

A client is admitted reporting low back pain. How will the nurse best determine if the pain is related to a herniated lumbar disc? Ask the client if there is pain on ambulation. Ask if the client can walk. Have the client lie on the back and lift the leg, keeping it straight. Ask if the client has had a bowel movement.

Have the client lie on the back and lift the leg, keeping it straight.

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

The client should ensure no one else handles the medication. The client should seek emergency care if he or she develops a fever. Hair loss should be expected when taking the medication.

Which term is used to describe edema of the optic nerve?

papilledema

The nurse is providing health education to a client recently diagnosed with a brain tumor. During the appointment, the client states, "I'm really worried that I will have a seizure while I am at work or with my kids. Should I be concerned about this?" How should the nurse respond? "There is a risk for seizures in people who have this diagnosis. What have you already discussed with your primary health care provider regarding management of seizures?" "60% of people with brain tumors have seizures. There is a strong chance you will have a seizure at some point and should keep a seizure kit close by." "Seizures are genetic neurological conditions. Do you have anyone in your family with a seizure disorder? If so, this increases the likelihood you will have one." "It is not within my scope to discuss this aspect of your care with you. You should talk to your treating primary health care provider about this and discuss options."

"There is a risk for seizures in people who have this diagnosis. What have you already discussed with your primary health care provider regarding management of seizures?"

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? Mannitol Temozolomide Bevacizumab Everolimus

mannitol- osmotic diuretic

A client seeks care for lower back pain of 2 weeks' duration. Which assessment finding suggests a herniated intervertebral disk? Pain radiating down the posterior thigh Back pain when the knees are flexed Atrophy of the lower leg muscles Homans' sign

pain radiating down the posterior thigh- a herniated intervertebral disk can compress the spinal nerve roots

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

pain-

A male client who has undergone a cervical discectomy is being discharged with a cervical collar. Which of the following would be most appropriate to include the client's discharge plan? Keeping the head in a neutral position Wearing the cervical collar when sleeping Removing the entire collar when shaving Moving the neck from side to side when the collar is off

Keeping the head in a neutral position

The nurse is caring for a client hospitalized after a motor vehicle accident. The client has a comorbidity of Parkinson's disease. Why should the nurse closely monitor the condition and the drug regimen of a client with Parkinson's disease? Drugs administered may not cause the requisite therapeutic effect. Clients take an assortment of different drugs. Clients generally do not adhere to the drug regimen. Drugs administered may cause a wide variety of adverse effects.

Drugs administered may cause a wide variety of adverse effects.

A client has a herniated disk in the region of the third and fourth lumbar vertebrae. Which nursing assessment finding most supports this diagnosis? Hypoactive bowel sounds Severe lower back pain Sensory deficits in one arm Weakness and atrophy of the arm muscles

severe lower back pain

A nurse is reading a journal article about spinal cord tumors and metastasis from other primary sites. The nurse demonstrates understanding of the article when identifying which primary sites as commonly metastasizing to the spinal cord? Select all that apply. Lung Breast Gastrointestinal tract Prostate Bladder

Lung Breast Gastrointestinal tract

The nurse is seeing a client who is being investigated for a possible spinal tumor. The nurse knows that a tumor in this region of the body is more likely if the client reports increased pain when: sleeping on the stomach. lying flat on the back. lying on the side. standing.

sleeping on the stomach- prone position

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? Hemorrhagic stroke Thyroid disorders Hearing loss Visual loss TAKE ANOTHER QUIZ

hemorrhagic stroke- brain angioma is a mass composed of abnormal blood vessels are found either in the brain or on its surface and have thin walls

The nursing is assessing a client who has been diagnosed with a pituitary adenoma, but has not yet started treatment. The client reports having increased heart rate, hand tremors, difficulty sleeping, weight loss and hyperthermia. The nurse anticipates the client will require blood work to assess for overproduction of which hormone? Thyroid-stimulating hormone Adrenocorticotropic hormone Prolactin Growth hormone

Thyroid-stimulating hormone

The nurse educator is providing orientation to a new group of staff nurses on an oncology unit. Part of the orientation is to help nurses understand the differences between various types of brain tumors. The nurse educator correctly identifies that glioma tumors are classified based on the fact that they originate where in the brain? Within the brain tissue From the coverings of the brain In the cranial nerves From metastasis of a primary tumor

Within the brain tissue

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

chorea-prominent clinical features of Huntington disease include chorea, intellectual decline, and often emotional disturbance. As the disease progresses, speech becomes slurred, gait becomes disorganized, and cognitive function is altered with dementia.

The nurse reviews the patient's drug regimen for treatment of a brain tumor. She explains to the patient why one of the following drugs would not be prescribed, even though it might have therapeutic benefits. Which drug would not be prescribed for this patient? Paclitaxel Coumadin Decadron Dilantin

coumadin

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? Gliomas Meningiomas Acoustic neuromas Pituitary adenomas

gliomas-

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

Most tumors produce too much of one or more hormones.

A client with cerebral metastasis suddenly experiences a seizure for which phenytoin 10 mg/kg intravenously is ordered as an initial loading dose. The client weighs 132 pounds. How many milligrams of phenytoin should the client receive? Enter the number ONLY.

First, change the client's weight in pounds to kilograms by dividing the weight by 2.2 (2.2 pounds = 1 kg). The client's weight is 60 kg. Next, set up a proportion: 10/1 = x/60; cross multiply and solve for x, which is 600.

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

Irritation of the medullary vagal centers

A client with spinal cord compression from a tumor must undergo diagnostic testing. Which of the following is the most likely procedure for this client? Core needle biopsy Ultrasonography Computed tomography Magnetic resonance imaging

Magnetic resonance imaging- helpful in detecting epidural spinal cord compression and vertebral bone metastases.

A client is scheduled for a laminectomy to repair a herniated intervertebral disk. When developing the postoperative care plan, the nurse should include which action? Keeping a pillow under the client's knees at all times Placing the client in semi-Fowler's position Maintaining bed rest for 72 hours after the laminectomy Turning the client from side to side, using the logroll technique

Turning the client from side to side, using the logroll technique

A client was undergoing conservative treatment for a herniated nucleus pulposus, at L5 - S1, which was diagnosed by magnetic resonance imaging. Because of increasing neurologic symptoms, the client undergoes lumbar laminectomy. The nurse should take which step during the immediate postoperative period? Discourage the client from doing any range-of-motion (ROM) exercises. Have the client sit up in a chair as much as possible. Logroll the client from side to side. Elevate the head of the bed to 90 degrees.

logroll the client from side to side

A client with a cerebellar brain tumor is admitted to an acute care facility. The nurse formulates a nursing diagnosis of Risk for injury. Which "related-to" phrase should the nurse add to complete the nursing diagnosis statement? Related to visual field deficits Related to difficulty swallowing Related to impaired balance Related to psychomotor seizures

related to impaired balance

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? Baclofen Riluzole Dantrolene sodium Diazepam

riluzole- glutamate antagonist

Which of the following outcomes would be most appropriate to include in the plan of care for a client diagnosed with a muscular dystrophy? Client participates in activities of daily living using adaptive devices. Client demonstrates understanding of the need to adhere to medication therapy. Client verbalizes understanding of the chronic nature of the disorder. Client describes the importance of diagnostic follow-up to evaluate the disorder.

Client participates in activities of daily living using adaptive devices- muscular dystrophies are a group of incurable muscle disorders characterized by progressive weakening and wasting of the skeletal or voluntary muscles. Nursing care focuses on maintaining the client at his or her optimal level of functioning and enhancing the quality of life