neuro quiz

18. A client with myasthenia gravis becomes increasingly weak. The health care provider prepares to identify whether the client is reacting to an overdose of the medication (cholinergic crisis) or increasing severity of the disease (myasthenic crisis). An injection of edrophonium (Enlon) is administered. Which of the following indicates that the client is in cholinergic crisis? a. No change in the condition b. Complaints of muscle spasms c. An improvement of the weakness d. A temporary worsening of the condition

d

19. Carbidopa-levodopa (Sinemet) is prescribed for a client with Parkinson's disease, and the nurse monitors the client for adverse reactions to the medication. Which of the following indicates that the client is experiencing an adverse reaction? a. Pruritus b. Tachycardia c. Hypertension d. Impaired voluntary movements

d

14. A client with spinal cord injury suddenly experiences an episode of autonomic dysreflexia. After checking vital signs, the nurse immediately: a. Raises the head of the bed and removes the noxious stimulus b. Lowers the head of the bed and removes the noxious stimulus c. Lowers the head of the bed and administers an anti hypertensive agent d. Removes the noxious stimulus and administers an antihypertensive agent

a

2. A client has just undergone computed tomography (CT) scanning with a contrast medium. The nurse determines that the client understands postprocedure care if the client verbalizes that he or she will: a. drink extra fluids for the day b. Hold medications for at least 4 hours. c. Eat lightly for the remainder of the day. d. Rest quietly for the remainder of the day.

a

5. A client recovering from a head injury is arousable and participating in care. The nurse determines that the client understands measures to prevent elevations in intracranial pressure (ICP) if the nurse observes the client doing which of the following activities? a. Blowing the nose b. Isometric exercises c. Coughing vigorously d. Exhaling during repositioning

d

20. Phenytoin (Dilantin), 100 mg orally three times daily, has been prescribed for a client for seizure control. The nurse reinforces instructions regarding the medication to the client. Which statement by the client indicates an understanding of the instructions? a. "I will use a soft toothbrush to brush my teeth." b. "It's all right to break the capsules to make it easier for me to swallow them." c. If I forget to take my medication, I can wait until the next dose and eliminate that dose." d. "If my throat becomes sore, it's a normal effect of the medication and it's nothing to be concerned about."

a

22. Ibuprofen (Advil) is prescribed for a client. The nurse tells the client to take the medication: a. With 8 oz of milk b. In the morning after arising c. 60 minutes before breakfast d. At bedtime on an empty stomach

a

3. A nurse is caring for a client with increased intracranial pressure (ICP). The nurse should monitor for which of the following trends in vital signs that would occur if ICP is rising? a. increasing temperature, decreasing pulse, decreasing respirations, increasing blood pressure (BP) b. Decreasing temperature, decreasing pulse, increasing respirations, decreasing BP c. Decreasing temperature, increasing pulse, decreasing respirations, increasing BP d. Increasing temperature, increasing pulse, increasing respirations, decreasing BP

a

10. A client with a cervical spine injury has Crutchfield tongs applied in the emergency department. The nurse should avoid which of the following when planning care for this client? a. Using a Stryker frame bed b. Removing the weights to reposition the client c. Assessing the integrity of the weights and pulleys d. Comparing the amount of prescribed traction with the amount in use

b

11. A nurse has provided discharge instructions to a client with an application of a halo device. The nurse determines that the client needs further clarification of the instructions if the client states that he or she will: a. Use a straw for drinking. b. Drive only during the daytime. c. Use caution, because the device alters balance. d. Wash the skin daily under the lamb's wool liner of the vest.

b

17. A client with myasthenia gravis is receiving pyridostigmine (Mestinon). The nurse monitors for signs and symptoms of cholinergic crisis caused by overdose of the medication. The nurse checks the medication supply to ensure that which medication is available for administration if a cholinergic crisis occurs? a. Vitamin K b. Atropine sulfate c. Protamine sulfate d. Acetylcysteine (Mucomyst)

b

21. A client is taking phenytoin (Dilantin) for seizure control and a sample for a serum drug level is drawn. Which of the following indicates a therapeutic serum drug range? a. 5 to 10 mcg/ml b. 10 to 20 mcg/ml c. 20 to 30 mcg/ml d. 30 to 40 mcg/ml

b

4. A nurse is positioning the client with increased intracranial pressure (ICP). Which position should the nurse avoid? a. Head midline b. head turned to the side c. neck in neutral position d. head of bed elevated 30 to 45 degrees

b

8. A client was seen and treated in the emergency department for treatment of a concussion. The nurse determines that the family needs further discharge instructions if they say to bring the client back to the emergency department if which of the following occurs? a. Vomiting b. Minor headache c. Difficulty speaking d. Difficulty awakening

b

25. A client is receiving meperidine hydrochloride (Demerol) for pain. Which of the following are side effects of this medication. Select all that apply. a. Diarrhea b. Tremors c. Drowsiness d. Hypotension e. Urinary frequency f. Increased respiratory rate

bcd

12. A nurse is caring for the client who has suffered spinal cord injury. The nurse further monitors the client for signs of autonomic dysreflexia and suspects this complication if which of the following is noted? a. Sudden tachycardia b. Pallor of the face and neck c. Severe, throbbing headache d. Severe, and sudden hypotension

c

23. A nurse is caring for a client who is taking phenytoin (Dilantin) for control of seizures. During data collection, the nurse notes that the client is taking birth control pills. Which of the following information should the nurse provide to the client? a. Pregnancy should be avoided while taking phenytoin (Dilantin). b. The client may stop taking the phenytoin (Dilantin) if it is causing severe gastrointestinal effects. c. The potential for decreased effectiveness of the birth control pills exists while taking phenytoin (Dilantin). d. The increased risk of thrombophlebitis exists while taking phenytoin (Dilantin) and birth control pills together.

c

24. A client with trigeminal neuralgia is being treated with carbamazepine (Tegretol}. Which laboratory result would indicate that the client is experiencing an adverse reaction to the medication? a. Sodium level, 140 mEq/L b. Uric acid level, 5.0 mg/dl c. White blood cell count, 3000 cells/mm3 d. Blood urea nitrogen (BUN) level, 15 mg/dl

c

7. A client is admitted to the hospital for observation with a probable minor head injury after an automobile crash. The nurse would plan on leaving the cervical collar in place until: a. The family comes to visit. b. The nurse needs to do physical care. c. The result of spinal x-rays is known. d. The health care provider makes rounds

c

9. A nurse is caring for a client who has undergone craniotomy with a supratentorial incision. The nurse should plan to place the client in which position postoperatively? a. Head of bed flat, head and neck midline b. Head of bed flat, head turned to the nonoperative side c. Head of bed elevated 30 to 45 degrees, head and neck midline d. Head of bed elevated 30 to 45 degrees, head turned to the operative side

c

1. A client is having a lumbar puncture (LP) performed. The nurse would place the client in which position for the procedure? a. Supine, in semi-Fowler's b. Prone, in slight Trendelenburg's c. Prone, with a pillow under the abdomen d. side - lying, with legs pulled up and head bent down onto the chest

d

13. A client with spinal cord injury is prone to experiencing autonomic dysreflexia. The nurse should avoid which measure to minimize the risk of recurrence? a. Strict adherence to a bowel retraining program b. Keeping the linen wrinkle-free under the client c. Avoiding unnecessary pressure on the lower limbs d. limiting bladder catheterization to once every 12 hours

d

16. A client with myasthenia gravis is suspected of having cholinergic crisis. Which of the following indicate that this crisis exists? a. Ataxia b. Mouth sores c. Hypotension d. Hypertension

d

6. A client has clear fluid leaking from the nose after a basilar skull fracture. The nurse determines that this is cerebrospinal fluid (CSF) if the fluid: a. Is grossly bloody in appearance and has a pH of 6 b. Clumps together on the dressing and has a pH of 7 c. Is clear in appearance and tests negative for glucose d. Separates into concentric rings and tests positive for glucose

d

15. The client with a spinal cord injury suddenly experiences an episode of autonomic dysreflexia. After checking the client's vital signs, number the nurse's actions in order of priority, with the first selected action being of highest priority and the last selected action of lowest priority. (Number 1 is the first priority action and number 6 is the last priority action.) a. Contact the health care provider (HCP). b. Raise the head of the bed. c. Check for bladder distention. d. Loosen tight clothing on the client. e. Administer an antihypertensive medication . f. Document the occurrence, treatment, and response.

dacbef