MS1 CH 45 Neurological Disorders PrepU
A client is suspected of having amyotrophic lateral sclerosis (ALS). To help confirm this disorder, the nurse prepares the client for various diagnostic tests. The nurse expects the physician to order: electromyography (EMG). Doppler scanning. Doppler ultrasonography. quantitative spectral phonoangiography.
electromyography (EMG).
A nurse is working on a surgical floor. The nurse must logroll a client following a: laminectomy. thoracotomy. hemorrhoidectomy. cystectomy.
laminectomy.
A female patient has presented to the emergency department (ED) with complaints of a high fever and severe headache. The patient states that acetaminophen has had no appreciable effect on either symptom. The triage nurse recognizes the need to perform a rapid assessment for possible meningitis and should ask which of the following questions: "Have you had a nosebleed since this problem started?" "Have you noticed any tremors in your hands or arms?" "Have you done any travelling in the last few weeks?" "Are you having stiffness or pain in your neck?"
"Are you having stiffness or pain in your neck?"
The nurse is taking health history from a client admitted to rule out Guillain-Barre syndrome. An important question to ask related to the diagnosis is which of the following? "Have you experienced any viral infections in the last month?" "Have you experienced any ptosis in the last few weeks?" "Have you had difficulty with urination in the last 6 weeks?" "Have you developed any new allergies in the last year?"
"Have you experienced any viral infections in the last month?"
Myasthenia gravis occurs when antibodies attack which receptor sites? Serotonin Dopamine Acetylcholine Gamma-aminobutyric acid
Acetylcholine
A 34-year-old patient is diagnosed with relapsing-remitting MS. The nurse explains to the patient's family that they should expect: Acute attacks with full recovery or residual deficit upon recovery. Progressive disability from onset. Acute attacks followed by progression at a variable rate. Progression with clear relapses with or without recovery.
Acute attacks with full recovery or residual deficit upon recovery.
A client is suspected to have bacterial meningitis. What is the priority nursing intervention? Administer prescribed antibiotics. Assess the CSF fluid laboratory test results. Prepare the client for a CT scan. Encourage oral fluid intake.
Administer prescribed antibiotics.
A client with myasthenia gravis is admitted with an exacerbation. The nurse is educating the client about plasmapheresis and explains this in which of the following statements? Antibodies are removed from the plasma. The thymus gland is removed. Immune globulin is given intravenously. Mestinon therapy is initiated.
Antibodies are removed from the plasma.
Which nursing intervention is the priority for a client in myasthenic crisis? Assessing respiratory effort Administering intravenous immunoglobin (IVIG) per orders Preparing for plasmapheresis Ensuring adequate nutritional support
Assessing respiratory effort
A client who is diagnosed with meningitis has a history of seizure activity. Which action(s) should the nurse implement to decrease the client's risk for injury during seizure activity? Select all that apply. Assist the client to the floor. Move objects away from the client. Inspect the client's oral cavity and teeth. Loosen clothing around the client's neck. Physically restrain the client's movements.
Assist the client to the floor. Move objects away from the client. Loosen clothing around the client's neck.
A client is admitted to an acute care facility after an episode of status epilepticus. After the client is stabilized, which factor is most beneficial in determining the potential cause of the episode? The type of anticonvulsant prescribed to manage the epileptic condition Recent stress level Recent weight gain and loss Compliance with the prescribed medication regimen
Compliance with the prescribed medication regimen
A patient with generalized seizure disorder has just had a seizure. The nurse would assess for what characteristic associated with the postictal state? Epileptic cry Confusion Urinary incontinence Body rigidity
Confusion
Which is the primary medical management of arthropod-borne virus (arboviral) encephalitis? Preventing renal insufficiency Controlling seizures and increased intracranial pressure Maintaining hemodynamic stability and adequate cardiac output Preventing muscular atrophy
Controlling seizures and increased intracranial pressure
A client was running along an ocean pier, tripped on an elevated area of the decking, and struck his head on the pier railing. According to his friends, "He was unconscious briefly and then became alert and behaved as though nothing had happened." Shortly afterward, he began complaining of a headache and asked to be taken to the emergency department. If the client's intracranial pressure (ICP) is increasing, the nurse should expect to observe which sign first? Pupillary asymmetry Irregular breathing pattern Involuntary posturing Declining level of consciousness (LOC)
Declining level of consciousness (LOC)
A patient diagnosed with multiple sclerosis (MS) has been admitted to the medical unit for treatment of an MS exacerbation. Included in the admission orders is baclofen (Lioresal). What would be the expected outcome of this medication? Reduction in the appearance of new lesions on magnetic resonance imaging (MRI) Decreased muscle spasms in the lower extremities Increased muscle strength in the upper extremities Promotion of urinary continence
Decreased muscle spasms in the lower extremities
The nurse is assessing a client newly diagnosed with myasthenia gravis. Which of the following signs would the nurse most likely observe? Diplopia and ptosis Numbness Patchy blindness Loss of proprioception
Diplopia and ptosis
The nurse is caring for a client who has developed SIADH. What intervention is most appropriate? Fluid restriction Transfusion of platelets Transfusion of fresh frozen plasma (FFP) Electrolyte restriction
Fluid restriction
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 performing an initial assessment on a client admitted with a possible brain abscess. Which of the following would the nurse most likely find? Headache that is worse in the morning Ptosis that is more pronounced at the end of the day Diplopia that is constant Nuchal rigidity
Headache that is worse in the morning
The nurse is caring for a client who is scheduled for a cervical discectomy the following day. During health education, the client should be made aware of what potential complications? Vertebral fracture Hematoma at the surgical site Scoliosis Renal trauma
Hematoma at the surgical site
A client has been brought to the ED with altered LOC, high fever, and a purpura rash on the lower extremities. The family states the client was reporting neck stiffness earlier in the day. What action should the nurse do first? Initiate isolation precautions. Ensure the family receives prophylaxis antibiotic treatment. Administer prescribed antibiotics. Apply a cooling blanket.
Initiate isolation precautions.
Which is a chronic, degenerative, progressive disease of the central nervous system characterized by the occurrence of demyelination in the brain and spinal cord? Parkinson disease Huntington disease Creutzfeldt-Jakob disease Multiple sclerosis
Multiple sclerosis
Which of the following is considered a central nervous system (CNS) disorder? Multiple sclerosis Guillain-Barré Myasthenia gravis Bell's palsy
Multiple sclerosis
During assessment of a hospitalized client who is recovering from a cervical discectomy, the client reports sudden and severe pain. Which of the following interventions is the nurse's priority? Give the client something to help induce sleep. Change the client's bandages. Notify the client's surgeon. Increase the client's pain medication.
Notify the client's surgeon.
A patient 3 days postoperative from a craniotomy informs the nurse, "I feel something trickling down the back of my throat and I taste something salty." What priority intervention does the nurse initiate? Give the patient some mouthwash to gargle with. Request an antihistamine for the postnasal drip. Ask the patient to cough to observe the sputum color and consistency. Notify the physician of a possible cerebrospinal fluid leak.
Notify the physician of a possible cerebrospinal fluid leak.
A client with herpes simplex virus (HSV) encephalitis is receiving acyclovir. To ensure early intervention, the nurse monitors laboratory values and urine output for which type of adverse reactions? Musculoskeletal Integumentary Hepatic Renal
Renal
A community health nurse is performing a home visit to a patient with amyotrophic lateral sclerosis (ALS). The nurse should prioritize assessments related to which of the following? Respiratory function Potential skin breakdown Cardiac function Cognition
Respiratory function
A client is diagnosed with amyotrophic lateral sclerosis (ALS) in the early stages. Which medication would the nurse most likely expect to be prescribed as treatment? Riluzole Benztropine mesylate Amantadine Bromocriptine
Riluzole
Following a generalized seizure in a client, which nursing assessment is a priority for detailing the event? Seizure began at 1300 hours. The client cried out before the seizure began. Seizure was 1 minute in duration including tonic-clonic activity. Sleeping quietly after the seizure
Seizure was 1 minute in duration including tonic-clonic activity.
A client with Parkinson disease is undergoing a swallowing assessment because the client has recently developed adventitious lung sounds. The client's nutritional needs should be met by what method? Total parenteral nutrition (TPN) Provision of a low-residue diet Semisolid food with thick liquids Minced foods and a fluid restriction
Semisolid food with thick liquids
A patient with Parkinson's disease is undergoing a swallowing assessment because she is experiencing difficulties when swallowing. What consistency is most appropriate for this patient, to reduce the risk of aspiration? Solid food with thin liquids Pureed food with water Semisolid food with thick liquids Thin liquids only
Semisolid food with thick liquids
A client diagnosed with Parkinson's disease has developed slurred speech and drooling. The nurse knows that these symptoms indicate which of the following? The client is having an exacerbation. Medication needs to be adjusted to higher doses. The client is exhibiting signs of medication overdose. The disease has entered the late stages.
The disease has entered the late stages.
A patient with myasthenia gravis is in the hospital for treatment of pneumonia. The patient informs the nurse that it is very important to take pyridostigmine bromide on time. The nurse gets busy and does not administer the medication until after breakfast. What outcome will the patient have related to this late dose? The muscles will become fatigued and the patient will not be able to chew food or swallow pills. There should not be a problem, since the medication was only delayed by about 2 hours. The patient will go into cardiac arrest. The patient will require a double dose prior to lunch.
The muscles will become fatigued and the patient will not be able to chew food or swallow pills.
A client is hospitalized with Guillain-Barré syndrome. Which nursing assessment finding is most significant? Warm, dry skin Urine output of 40 ml/hour Soft, nondistended abdomen Uneven, labored respirations
Uneven, labored respirations
A client diagnosed with Huntington disease is on a disease-modifying drug regimen and has a urinary catheter in place. Which potential complication is the highest priority for the nurse while monitoring the client? Severe depression Choreiform movements Urinary tract infection Emotional apathy
Urinary tract infection
A nurse is caring for a client who underwent a lumbar laminectomy 2 days ago. Which finding requires immediate intervention? More back pain than the first postoperative day Paresthesia in the dermatomes near the wounds Urine retention or incontinence Temperature of 99.2° F (37.3° C)
Urine retention or incontinence
The nurse is caring for a client with Bell's palsy. Which of the following teaching points is a priority in the management of symptoms for this client? Avoid stimuli that trigger pain. Use ophthalmic lubricant and protect the eye. Encourage semiannual dental exams. Complete the course of antibiotics as prescribed.
Use ophthalmic lubricant and protect the eye.
A patient had a small pituitary adenoma removed by the transsphenoidal approach and has developed diabetes insipidus. What pharmacologic therapy will the nurse be administering to this patient to control symptoms? Mannitol Furosemide (Lasix) Vasopressin Phenobarbital
Vasopressin
A nurse is assessing a client diagnosed with multiple sclerosis (MS). Which symptom does the nurse expect to find? Vision changes Absent deep tendon reflexes Tremors at rest Flaccid muscles
Vision changes
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: take a hot bath. rest in an air-conditioned room. increase the dose of muscle relaxants. avoid naps during the day.
rest in an air-conditioned room.
A client with newly diagnosed seizures asks about stigma associated with epilepsy. The nurse will respond with which of the following statements? "In most people, epilepsy is usually synonymous with intellectual disability." "For many people with epilepsy, the disorder is synonymous with mental illness." "Many people with developmental disabilities resulting from neurologic damage also have epilepsy." "Cases of epilepsy are often associated with intellectual level."
"Many people with developmental disabilities resulting from neurologic damage also have epilepsy."
A client with Guillain-Barré syndrome has paralysis affecting the respiratory muscles and requires mechanical ventilation. When the client asks the nurse about the paralysis, how should the nurse respond? "The paralysis caused by this disease is temporary." "You'll be permanently paralyzed; however, you won't have any sensory loss." "It must be hard to accept the permanency of your paralysis." "You'll first regain use of your legs and then your arms."
"The paralysis caused by this disease is temporary."
The parents of a client intubated due to the progression of Guillain-Barré syndrome ask whether their child will die. What is the best response by the nurse? "Don't worry; your child will be fine." "Once Guillain-Barré syndrome progresses to the diaphragm, survival decreases significantly." "There are no guarantees, but a large portion of people with Guillain-Barré syndrome survive." "It's too early to give a prognosis."
"There are no guarantees, but a large portion of people with Guillain-Barré syndrome survive."
A client is newly diagnosed with relapsing-remitting multiple sclerosis (RRMS). Which instruction should the nurse provide? "You will have a steady and gradual decline in function." "Your type of MS is the least common, making it difficult to manage." "You must avoid stress and extreme fatigue, because these can trigger a relapse." "You should take your medications only during times of relapse."
"You must avoid stress and extreme fatigue, because these can trigger a relapse."
The school nurse notes a 6-year-old running across the playground with his friends. The child stops in midstride, freezing for a few seconds. Then the child resumes his progress across the playground. The school nurse suspects what in this child? An absence seizure A myoclonic seizure A partial seizure A tonic-clonic seizure
An absence seizure
Which medication classification is used preoperatively to decrease the risk of postoperative seizures? Diuretics Corticosteroids Anticonvulsants Antianxiety
Anticonvulsants
A client with respiratory complications of multiple sclerosis (MS) is admitted to the medical-surgical unit. Which equipment is most important for the nurse to keep at the client's bedside? Sphygmomanometer Padded tongue blade Nasal cannula and oxygen Suction machine with catheters
Suction machine with catheters
A patient has been diagnosed with meningococcal meningitis at a community living home. When should prophylactic therapy begin for those who have had close contact with the patient? Within 24 hours after exposure Within 48 hours after exposure Within 72 hours after exposure Therapy is not necessary prophylactically and should only be used if the person develops symptoms.
Within 24 hours after exposure
During a Tensilon test to determine if a patient has myasthenia gravis, the patient complains of cramping and becomes diaphoretic. Vital signs are BP 130/78, HR 42, and respiration 18. What intervention should the nurse prepare to do? Place the patient in the supine position. Administer diphenhydramine (Benadryl) for the allergic reaction. Administer atropine to control the side effects of edrophonium. Call the rapid response team because the patient is preparing to arrest.
Administer atropine to control the side effects of edrophonium.
A nurse is caring for a client with a brain tumor and increased intracranial pressure (ICP). Which intervention should the nurse include in the care plan to reduce ICP? Encourage coughing and deep breathing. Position the client with the head turned toward the side of the brain tumor. Administer stool softeners. Provide sensory stimulation.
Administer stool softeners.
The nurse is administering the IV antiviral medication ganciclovir (Cytovene) to the patient with HSV-1 encephalitis. What is the best way for the nurse to administer the medication to avoid crystallization of the medication in the urine? Administer the medication rapidly over 15 minutes with 100 mL of normal saline. Dilute the medicine in 500 mL of lactated Ringer's solution. Administer via slow IV over 1 hour. Administer in a drip over 4 hours.
Administer via slow IV over 1 hour.
Which is a late sign of increased intracranial pressure (ICP)? Irritability Slow speech Altered respiratory patterns Headache
Altered respiratory patterns
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
The nurse caring for a patient with bacterial meningitis is administering dexamethasone (Decadron) that has been ordered as an adjunct to antibiotic therapy. When does the nurse know is the appropriate time to administer this medication? 1 hour after the antibiotic has infused and daily for 7 days 15 to 20 minutes before the first dose of antibiotic and every 6 hours for the next 4 days 2 hours prior to the administration of antibiotics for 7 days It can be administered every 6 hours for 10 days.
15 to 20 minutes before the first dose of antibiotic and every 6 hours for the next 4 days
Cerebral edema peaks at which time point after intracranial surgery? 12 hours 24 hours 48 hours 72 hours
24 hours
A patient is admitted to the hospital with an ICP reading of 20 mm Hg and a mean arterial pressure of 90 mm Hg. What would the nurse calculate the CPP to be? 50 mm Hg 60 mm Hg 70 mm Hg 80 mm Hg
70 mm Hg
Which positions is used to help reduce intracranial pressure (ICP)? Avoiding flexion of the neck with use of a cervical collar Keeping the head flat, avoiding the use of a pillow Rotating the neck to the far right with neck support Extreme hip flexion, with the hip supported by pillows
Avoiding flexion of the neck with use of a cervical collar
The nurse is caring for a client admitted with a diagnosis of septic meningitis. The nurse is aware that this infection is caused by which of the following? Bacteria Virus Lymphoma Leukemia
Bacteria
The nurse responds to the call light of a client who has had a cervical discectomy earlier in the day. The client states that she is having severe pain that had a sudden onset. What is the nurse's most appropriate action? Palpate the surgical site. Remove the dressing to assess the surgical site. Call the surgeon to report the client's pain. Administer a dose of an NSAID.
Call the surgeon to report the client's pain.
A nurse is planning discharge education for a client who underwent a cervical discectomy. What strategies would the nurse assess that would aid in planning discharge teaching? Care of the cervical collar Technique for performing neck ROM exercises Home assessment of ABGs Techniques for restoring nerve function
Care of the cervical collar
A nurse is assisting with a neurological examination of a client who reports a headache in the occipital area and shows signs of ataxia and nystagmus. Which of the following conditions is the most likely reason for the client's problems? Frontal lobe abscess Temporal lobe abscess Cerebellar abscess Wernicke's abscess
Cerebellar abscess
A patient has been diagnosed with myasthenia gravis. The nurse documents the initial and most common manifestation of: Dysphoria. Facial muscle weakness. Diplopia. Generalized fatigue.
Diplopia.
The nurse has created a plan of care for a client who is at risk for increased ICP. The client's care plan should specify monitoring for what early sign of increased ICP? Disorientation and restlessness Decreased pulse and respirations Projectile vomiting Loss of corneal reflex
Disorientation and restlessness
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.
The clinic nurse caring for a patient with Parkinson's disease notes that the patient has been taking levodopa and carbidopa (Sinemet) for 7 years. What common side effects of Sinemet would the nurse assess this patient for? Pruritus Dyskinesia Lactose intolerance Diarrhea
Dyskinesia
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
A client with a brain tumor is complaining of a headache upon awakening. Which nursing action would the nurse take first? Elevate the head of the bed. Complete a head-to-toe assessment. Administer morning dose of anticonvulsant. Administer Percocet as ordered.
Elevate the head of the bed.
A client undergoes a craniotomy with supratentorial surgery to remove a brain tumor. On the first postoperative day, the nurse notes the absence of a bone flap at the operative site. How should the nurse position the client's head? Flat Turned onto the operative side Elevated no more than 10 degrees Elevated 30 degrees
Elevated 30 degrees
The nurse is preparing the client for an acetylcholinesterase inhibitor test to rule out myasthenia gravis. Which is the priority nursing action? Assess facial weakness 5 minutes after injection. Ensure atropine is readily available. Administer edrophonium chloride per orders. Document the results.
Ensure atropine is readily available.
A patient is being treated in hospital for St. Louis encephalitis. When planning this patient's care, the nurse should be aware that this specific variant of encephalitis creates a potential for what nursing diagnosis? Excess fluid volume Risk for deficient fluid volume Imbalanced nutrition: less than body requirements Risk for unstable blood glucose
Excess fluid volume
The nurse is performing an initial assessment on a client with suspected Bell's palsy. Which of the following findings would the nurse be most focused on related to this medical diagnosis? Facial distortion and pain Hyporeflexia and weakness of the lower extremities Ptosis and diplopia Fatigue and depression
Facial distortion and pain
A client with Guillain-Barre syndrome cannot swallow and has a paralytic ileus; the nurse is administering parenteral nutrition intravenously. The nurse is careful to assess which of the following related to intake of nutrients? Gag reflex and bowel sounds Condition of skin Respiratory status Urinary output and capillary refill
Gag reflex and bowel sounds
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.
Which is the most common cause of acute encephalitis in the United States? Western equine bacteria Herpes simplex virus (HSV) Lyme Disease Human immunodeficiency virus (HIV)
Herpes simplex virus (HSV)
One defining characteristic of a complex partial seizure versus a simple partial seizure is the presence of which of the following? Sensory symptoms Motor symptoms Impaired consciousness Compound forms
Impaired consciousness
A 55-year-old male patient has been admitted to the hospital with a gastrointestinal bleed, and the patient has just experienced a generalized seizure that may be attributable to alcohol withdrawal. When providing immediate care during the patient's seizure, what nursing diagnosis should be prioritized? Impaired gas exchange Acute pain Acute confusion Risk for impaired skin integrity
Impaired gas exchange
A client with amyotrophic lateral sclerosis (ALS) is being visited by the home health nurse who is creating a care plan. Which of the following nursing diagnoses is most likely for a client with this condition? Chronic confusion Impaired urinary elimination Impaired verbal communication Bowel incontinence
Impaired verbal communication
A middle-aged woman has just received word that her recent diagnostic testing has resulted in a diagnosis of myasthenia gravis. The nurse who is contributing to this woman's care should be aware that she is experiencing signs and symptoms that are the result of what pathophysiological process? Inadequate action of acetylcholine Nerve demyelination Decreased levels of dopamine Loss of upper and lower motor neurons
Inadequate action of acetylcholine
The nurse is planning care of a client admitted to the neurologic rehabilitation unit following a cerebrovascular accident. Which nursing intervention would be of highest priority? Provide instruction on blood-thinning medication. Praise client when using adaptive equipment. Include client in planning of care and setting of goals. Assess client for ability to ambulate independently.
Include client in planning of care and setting of goals.
The nurse is caring for a patient postoperatively after intracranial surgery for the treatment of a subdural hematoma. The nurse observes an increase in the patient's blood pressure from the baseline and a decrease in the heart rate from 86 to 54. The patient has crackles in the bases of the lungs. What does the nurse suspect is occurring? Increased ICP Exacerbation of uncontrolled hypertension Infection Increase in cerebral perfusion pressure
Increased ICP
The nurse is caring for a client with Guillain-Barré syndrome. Which assessment finding would indicate the need for oral suctioning? Decreased pulse rate, respirations of 20 breaths/minute Increased pulse rate, adventitious breath sounds Increased pulse rate, respirations of 16 breaths/minute Decreased pulse rate, abdominal breathing
Increased pulse rate, adventitious breath sounds
Which of the following are disease-modifying agents used in the treatment of multiple sclerosis (MS)? Select all that apply. Interferon beta-1a (Rebif) Interferon beta-1b (Betaseron) Interferon beta-1a (Avonex) Glatiramer acetate (Copaxone) Tizanidine (Zanaflex)
Interferon beta-1a (Rebif) Interferon beta-1b (Betaseron) Interferon beta-1a (Avonex) Glatiramer acetate (Copaxone)
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
A nurse is preparing to administer an antiseizure medication to a client. Which of the following is an appropriate antiseizure medication? Lamictal Lamisil Labetalol Lomotil
Lamictal
Which medication is the most effective agent in the treatment of Parkinson disease? Benztropine Amantadine Levodopa Bromocriptine mesylate
Levodopa
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.
The nurse is called to attend to a patient having a seizure in the waiting area. What nursing care is provided for a patient who is experiencing a convulsive seizure? Select all that apply. Loosening constrictive clothing Opening the patient's jaw and inserting a mouth gag Positioning the patient on his or her side with head flexed forward Providing for privacy Restraining the patient to avoid self injury
Loosening constrictive clothing Positioning the patient on his or her side with head flexed forward Providing for privacy
A nurse is preparing a teaching plan for a client diagnosed with amyotrophic lateral sclerosis (ALS) and his family about the disorder and changes that may occur. Which of the following would the nurse least likely include in the discussion? Spasticity Difficulty swallowing Loss of bladder control Speech difficulties
Loss of bladder control
The diagnosis of multiple sclerosis is based on which test? Cerebrospinal fluid (CSF) electrophoresis Magnetic resonance imaging (MRI) Evoked potential studies Neuropsychological testing
Magnetic resonance imaging (MRI)
The neurologic ICU nurse is admitting a client with increased intracranial pressure. How should the nurse best position the client? Position the client supine. Maintain head of bed (HOB) elevated at 30 to 45 degrees. Position client in prone position. Maintain bed in Trendelenburg position.
Maintain head of bed (HOB) elevated at 30 to 45 degrees.
A new ancillary staff member is assisting the nurse with a client diagnosed with Parkinson's disease. The client needs assistance with eating but doesn't require thickened liquids to aid swallowing. Which instruction should the nurse give the ancillary staff member about eating assistance? Make sure the client is sitting with the head of bed elevated to 90 degrees. Assist the client into a comfortable position and stay alert for coughing, which signifies aspiration. Clients with Parkinson's disease shouldn't have liquids; remove them from the dinner tray before serving food to the client. There are no special precautions for the client with Parkinson's disease.
Make sure the client is sitting with the head of bed elevated to 90 degrees.
A client with increased intracranial pressure (ICP) has a ventriculostomy for monitoring ICP. The nurse's most recent assessment reveals that the client is now exhibiting nuchal rigidity and photophobia. The nurse would be correct in suspecting the presence of what complication? Encephalitis Cerebral spinal fluid leak Meningitis Catheter occlusion
Meningitis
Which is the primary vector of arthropod-borne viral encephalitis in North America? Birds Spiders Mosquitoes Ticks
Mosquitoes
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
Which well-recognized sign of meningitis is exhibited when the client's neck is flexed and flexion of the knees and hips is produced? Positive Kerning sign Photophobia Positive Brudzinski sign Nuchal rigidity
Positive Brudzinski sign
A client with a new diagnosis of amyotrophic lateral sclerosis (ALS) is overwhelmed by the diagnosis and the known complications of the disease. How can the client best make known their wishes for care as the disease progresses? Prepare an advance directive. Designate a most responsible health care provider (MRP) early in the course of the disease. Collaborate with representatives from the Amyotrophic Lateral Sclerosis Association. Ensure that witnesses are present when he provides instruction.
Prepare an advance directive.
A 35-year-old client with a history of traumatic brain injury has been admitted to the emergency department for a recent change in cognition. The client is steadily walking across the room, intermittently laughing loudly, and crying hysterically. What is the most likely condition associated with these signs? Dementia Status epilepticus Pseudobulbar affect Absence seizure
Pseudobulbar affect
A patient diagnosed with MS 2 years ago has been admitted to the hospital with another relapse. The previous relapse was followed by a complete recovery with the exception of occasional vertigo. What type of MS does the nurse recognize this patient most likely has? Benign Primary progressive Relapsing-remitting (RR) Disabling
Relapsing-remitting (RR)
The nurse is caring for a client with Bell's palsy. Which body system will the nurse identify as the priority for this client? Sensory Neurologic Integumentary Musculoskeletal
Sensory
Guillain-Barré syndrome is an autoimmune attack on the peripheral myelin sheath. Which of the following is an action of myelin? Speeds nerve impulse transmission Carries message to the next nerve cell Represents building block of nervous system Acts as chemical messenger
Speeds nerve impulse transmission
A patient with Bell's palsy says to the nurse, "It doesn't hurt anymore to touch my face. How am I going to get muscle tone back so I don't look like this anymore?" What interventions can the nurse suggest to the patient? Suggest massaging the face several times daily, using a gentle upward motion, to maintain muscle tone. Suggest applying cool compresses on the face several times a day to tighten the muscles. Inform the patient that the muscle function will return as soon as the virus dissipates. Tell the patient to smile every 4 hours.
Suggest massaging the face several times daily, using a gentle upward motion, to maintain muscle tone.
Which of the following tests confirms the diagnosis of myasthenia gravis (MG)? Tensilon test Computed tomography (CT) scan Electromyogram (EMG) Serum studies
Tensilon test
A client with increased intracranial pressure has a cerebral perfusion pressure (CPP) of 40 mm Hg. How should the nurse interpret the CPP value? The CPP is high. The CPP is low. The CPP is within normal limits. The CPP reading is inaccurate.
The CPP is low.
Which client goal, established by the nurse, is most important as the nurse plans care for a seizure client in the home setting? The client will take the seizure medication at the same time daily. The client will remain free of injury if a seizure does occur. The client will verbalize an understanding of feelings that preempt seizure activity. The client will post emergency numbers on the refrigerator for ease of obtaining.
The client will remain free of injury if a seizure does occur.
The nurse is liaising with the physical therapist and occupational therapist to create an activity management plan for a patient who has multiple sclerosis. What principle should be integrated into guidelines for exercise and activity that the team will provide to this patient in anticipation of discharge? The patient should perform frequent physical activity but avoid becoming fatigued. The patient should perform exercises that are brief but high-intensity. The patient should prioritize energy conservation and remain on bed rest if possible. The patient should attempt to maintain prediagnosis levels of activity and mobility.
The patient should perform frequent physical activity but avoid becoming fatigued.
A 70-year-old woman is being treated at home for Parkinson's disease (PD), a health problem that she was diagnosed with 18 months ago. The nurse who is participating in the woman's care should be aware that her initial symptoms most likely consisted of: Increasing forgetfulness and confusion Tremors and muscle rigidity Visual disturbances and muscle weakness Fatigue and respiratory difficulties
Tremors and muscle rigidity
A 45-year-old client is admitted to the facility with excruciating paroxysmal facial pain. He reports that the episodes occur most often after feeling cold drafts and drinking cold beverages. Based on these findings, the nurse determines that the client is most likely suffering from which neurologic disorder? Bell's palsy Trigeminal neuralgia Migraine headache Angina pectoris
Trigeminal neuralgia
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? Intermittent hearing loss Tinnitus Tongue enlargement Vocal paralysis
Vocal paralysis
