neuro

Which statement(s) about aqueous humor is/are true? (Select all that apply.)

* Bathes and feeds the lens, posterior surface of the cornea, and iris * Drains out of the eye through drainage channels located near the junction of the cornea and sclera * Flows out of the canal of Schlemm into the venous system of the eye

The nurse is providing education to a patient recently prescribed pregabalin (Lyrica).

1. perform baseline assesment of pt speech, alertness orientation 2. obtain pt creatnine 3.review pt record to document frequency of seizure activity 4. review substance abuse 5 when used as analgesic perform pain assesment

2. The health care provider orders diazepam (Valium) 10 mg IV stat for a patient who was admitted with status epilepticus. What important nursing interventions(s) associated with administration of this medication IV should the nurse perform? (Select all that apply.) a. Apply a cardiac monitor to the patient to assess for continuous heart rate, if not already done. b. Administer the prescribed dosage over 1 minute. c. Mix diazepam in a primary IV solution to avoid overdosing. d. Continuously assess the patient's airway. e. Obtain the correct dose (10 mg) and administer over slow IV push.

A,D,E

The nurse is assessing an older patient with Parkinson's disease who was started on entacapone 1 week ago. The patient has a history of coronary artery disease and takes an antihypertensive and aspirin. Which information would support the need for a reduction in medication dosage by the health care provider? a. Constipation b. Brownish orange urine c. Drowsiness d. Dizziness

D )dizziness these effects disspate as tolerence to the drug develops orthostatic hypotension

Which response by the nurse is accurate when a patient who has been on lamotrigine (Lamictal) for seizure control reports a skin rash and urticaria? a. Reassure the patient that this is a common adverse effect of the medication and not to worry. b. Instruct the patient to discontinue use of the drug immediately. c. Instruct the patient to decrease the dosage of the medication until the rash disappears. d. Advise the patient that this adverse effect usually resolves but should be reported to the health care provider.

D) Advise the patient that this adverse effect usually resolves but should be reported to the health care provider.

Which is a potential serious adverse effect associated with mannitol (Osmitrol)?

FLUID OVERLOAD

Indications for use for anticholinergic agents

GI Disorders (peptic ulcer dz, gastritis, diverticulitis) GU Disorders (drug of choice for their antispasmodic effects on smooth muscle to relieve the symptoms of urinary incontinence and frequency that accompany an overactive bladder) Ophthalmology Respiratory Disorders charac. by bronchoconstriction Cardiac Disorders (atropine may be given to increase HR in bradycardia and heart block charac. by hypotension and shock Parkinson's Dz (decreases salivation, spasticity, and tremors) Preoperative Use (to prevent vagal stimulation and potential bradycardia, hypotension, and cardiac arrest) Toxicity and Poisoning **bradycardia, b4 surgery,parkinson

Which medication is used to control seizures or prevent migraine headaches? a. Topiramate (Topamax) b. Zonisamide (Zonegran) c. Valproic acid (Depakene) d. Tiagabine (Gabitril)

Topiramate (Topamax)

mportant nursing assessment for a patient with a chemical splash to eyes who used an eyewash after being splashed

Visual acuity • Presence of pain, blurred or halo vision, or lack of vision • Type of chemical • Presence of contacts or use of eyeglasses

Which body function(s) is/are controlled by the autonomic nervous system? (Select all that apply.) a. Blood pressure b. Skeletal muscle contraction c. GI secretion d. Body temperature e. Urination

a. Blood pressure c. GI secretion d. Body temperature e. Urination

What is the rationale for administering levodopa instead of dopamine for treatment of Parkinson's disease? a. Dopamine does not cross the blood-brain barrier when administered orally. b. Levodopa is much less expensive. c. The half-life of dopamine is too short. d. Dopamine has too many reactions with other medications.

a. Dopamine does not cross the blood-brain barrier when

Parkinson's disease has which characteristic symptom(s)? (Select all that apply.) a. Muscle tremors b. Posture alterations c. Muscle flaccidity d. Tachycardia e. Slow body movement

a. Muscle tremors b. Posture alterations e. Slow body movement

Which adverse effect(s) is/are common when a patient is receiving a cholinergic agent? (Select all that apply.) a. Nausea b. Hypertension c. Dizziness d. Bradycardia e. Constipation

a. Nausea c. Dizziness d. Bradycardia

What information would be most important for the nurse to provide to a patient when teaching about the adverse effects of succinimide therapy? a. Nausea, vomiting, and indigestion are common during the initiation of therapy. b. Avoid taking the medication with food or milk to minimize adverse effects. c. Sedation, drowsiness, and dizziness tend to worsen with continued therapy. d. Reducing the dosage of medication will relieve symptoms of nausea.

a. Nausea, vomiting, and indigestion are common during the initiation of therapy.

When a patient taking a monoamine oxidase B inhibitor receives his dietary tray, the nurse knows to remove the a. cheese. b. eggs. c. bread. d. coffee.

a. cheese.

Neurotransmitter(s) include: (Select all that apply.) a. gamma aminobutyric acid. b. acetylcholine. c. serotonin. d. glucose. e. histamine. f. epinephrine.

a. gamma aminobutyric acid. b. acetylcholine. c. serotonin. e. histamine. f. epinephrine.

. The nurse is preparing to begin administration of apomorphine to a patient. Before administering, the nurse will perform a baseline assessment of the patient's (Select all that apply.) a. mobility. b. orientation. c. intellectual ability. d. alertness. e. vital signs. The nurse is assessing a patient who is going to begin therapy with apomorphine for Parkinson's disease. Which condition would be a concern if identified in the patient? (Select all that apply.) A) Severe cardio vascular disease B) Inability to swallow C) Advanced stage of Parkinson's Disease D) Glaucoma E) Allergy to sulfa drugs

abde (Premedication assessment prior to apomorphine therapy should include baseline vital signs, patient's degree of mobility, alertness, and orientation to name, place, and time. It is not necessary to assess intellectual ability prior to apomorphine therapy.) A) Severe cardio vascular disease E) Allergy to sulfa drugs Drug allergies The most important nursing assessment in a patient who is to take apomorphine is a history of drug allergies, specifically allergies to sulfa drugs and sulfite preservatives, because an allergy to these substances

Patients taking phenytoin (Dilantin) for control of seizures must be aware of the risk for which adverse effect(s)? (Select all that apply.) a. Blood dyscrasias b. Hyperglycemia c. Urinary retention d. Gingival hyperplasia e. Insomnia f. Sedation

abdf (Phenytoin may cause blood dyscrasias, gingival hyperplasia, and sedation and may elevate blood glucose levels, especially if higher doses are used. Urinary retention and insomnia are not adverse effects of phenytoin.)

A patient on anticonvulsant therapy confides to the nurse at an outpatient clinic that she suspects she may be pregnant. The nurse should encourage the patient to take which action(s)? (Select all that apply.) a. Consult an obstetrician. b. Discontinue medications. c. Carry an identification card. d. Provide a list of seizure medications. e. Consider oral contraception.

acd (Pregnancy considerations include encouraging the patient to consult with an obstetrician, provide a list of seizure medications, and carry an identification card. Medications should not be discontinued unless told to do so by the health care provider. If pregnancy is suspected, oral contraceptives should not be encouraged.)

The nurse is preparing to administer zonisamide (Zonegran) to a newly admitted patient with the diagnosis of adult partial seizures. The nurse should hold this medication if the patient has which sign(s) or symptom(s)? (Select all that apply.) a. Skin rash b. Urinary frequency c. Drowsiness d. Allergy to Bactrim e. Pruritus

ade (Zonisamide should not be administered without specific approval if the patient has an allergy to Bactrim or a dermatologic reaction such as a skin rash and/or pruritus. Urinary frequency is not associated with zonisamide. Drowsiness is a common adverse effect of zonisamide.)

Which vitamin will reduce the therapeutic effects of levodopa? a. A b. B6 c. C d. D

b (Pyridoxine (vitamin B6) will reduce the therapeutic effects of levodopa in oral doses of 5 to 10 mg or more. Generally, diets typically have less than 1 mg of vitamin B6 and therefore are not restricted. The ingredients in multivitamins, however, must be assessed. Vitamins A, C, and D do not affect therapy with levodopa.

The nurse is providing education to a patient recently placed on selegiline disintegrating tablets. Which statement by the patient indicates a need for further teaching? a. "This medication will help slow the development of symptoms." b. "I will place the tablet on my tongue before breakfast." c. "I may need to use a stool softener for constipation." d. "I should not push the tablet through the foil."

b (Selegiline orally disintegrating tablets should be taken in the morning before breakfast, without liquid. This medication is used to slow the development of symptoms and progression of disease.

Which adverse effects associated with levodopa therapy would support the nursing diagnosis risk for injury? a. Nausea and vomiting b. Orthostatic hypotension c. Anorexia and depression d. Tachycardia and palpitations

b (When initiating levodopa therapy, orthostatic hypotension may occur. Although generally mild, patients may experience dizziness and weakness. Symptoms usually resolve within 1 or 2 weeks once tolerance is developed to the levodopa therapy. Orthostatic hypotension increases the risk for injury in Parkinson's patients because they are also experiencing alterations in gait patterns. Although nausea, vomiting, anorexia, and depression are adverse effects of levodopa, they do not contribute to a risk for falling. Tachycardia and palpitations are not common adverse effects of levodopa.

Which nerve endings liberate norepinephrine? a. Cholinergic b. Adrenergic c. Anticholinergic d. Muscarinic

b) adrenergic

What dose is within the acceptable range for administering IV phenytoin (Dilantin) to a patient with a seizure disorder? a. 5 mg/min b. 30 mg/min c. 60 mg/min d. 100 mg/min

b. 30 mg/min slowly at rate of 25-50 mg/min

The nurse is providing information to a patient recently prescribed entacapone. Which statement is correct? a. This medication is not to be taken with carbidopa levodopa. b. Dosage is adjusted according to the patient's response. c. There will be fewer incidences of dopaminergic effects, such as confusion. d. This medication increases the production of dopamine in the brain

b. Dosage is adjusted according to the patient's response.

The nurse is preparing discharge instructions for a patient with a history of diabetes who has just been diagnosed with seizure disorder. The patient has been prescribed hydantoin therapy. What will the patient most likely experience? a. Hunger b. Hyperglycemia c. Diarrhea d. Pupil dilation

b. Hyperglycemia blood dyscrasias

Which condition would indicate to the nurse that a patient has phenytoin (Dilantin) toxicity? a. Oculogyric crisis b. Nystagmus c. Strabismus d. Amblyopia

b. Nystagmus

Which statement(s) is/are true about efferent nerves? (Select all that apply.) a. They transmit signals to the spinal cord and brain. b. They leave the CNS to carry impulses to other body parts. c. They are part of the peripheral nervous system. d. They transmit signals that control contractions of smooth and skeletal muscle. e. They transmit signals that control contractions of some glandular secretions.

b. They leave the CNS to carry impulses to other body parts. c. They are part of the peripheral nervous system. d. They transmit signals that control contractions of smooth and skeletal muscle. e. They transmit signals that control contractions of some glandular secretions.

. What is included in the nursing management of the patient with generalized tonic-clonic seizure activity? (Select all that apply.) a. Restraining the patient's arms to avoid further injury b. Placing padding around or under the patient's head c. Attempting to insert a tongue depressor into the patient's mouth d. Positioning the patient on the side once the relaxation stage is entered to allow oral secretions to drain e. Requesting additional assistance and/or necessary equipment in case the patient does not begin breathing spontaneously when the seizure is over

bde (Managing a patient during a seizure includes protecting the patient from further injury, (placing padding around or under the head to help prevent head injury), positioning the patient in the recovery position to facilitate respiratory effort, clearing the airway, and initiating ventilations should the patient lack spontaneous respirations after seizure. Restraining a patient who is having a seizure can cause, rather than prevent, injury. Inserting anything into the mouth of someone who is having a seizure can cause injury.)

Which cholinergic symptoms of Parkinson's disease are reduced with anticholinergic drugs? a. Cognitive impairments b. Rigidity c. Tremors and drooling d. Postural abnormalities

c (Anticholinergic drugs will reduce the severity of tremors and drooling in patients with Parkinson's disease. Anticholinergics are most useful when used in combination with levodopa. Anticholinergic drugs do not affect cognitive impairments. Anticholinergics have little effect on rigidity or on postural abnormalities.)

A patient taking rasagiline is assessed by the nurse to have a lasting significant increase in blood pressure. When reviewing the patient's current list of medications, the nurse decides to hold the next dose of a. dextromethorphan. b. levodopa. c. ciprofloxacin. d. Valium.

c (Ciprofloxacin is an antibiotic that inhibits the metabolism of rasagiline, significantly raising rasagiline serum levels and potentially causing significant hypertension. Dextromethorphan, levodopa, and Valium are not related to significant hypertensive changes when used in conjunction with rasagiline.)

action of entacapone, a potent catechol O methyl transferase (COMT) inhibitor? a. Slows the deterioration of dopaminergic nerve cells b. Inhibits the relative excess of dopaminergic activity c. Reduces the destruction of dopamine in peripheral tissues d. Enhances the cholinergic symptoms of Parkinson's disease

c (Entacapone, a COMT inhibitor, reduces dopamine destruction in peripheral tissues. This significantly increases the amount of dopamine available to reach the brain. Entacapone, when used with carbidopa levodopa therapy, results in more constant dopaminergic stimulation. Entacapone is not effective when used alone. Entacapone does not affect the nerve cells but blocks enzymes that break down levodopa. Parkinson's disease is characterized by a relative deficit of dopaminergic activity. Entacapone does not affect cholinergic symptoms of Parkinson's disease.)

The autonomic nervous system can be subdivided into which types of adrenergic receptors? a. Nicotinic and muscarinic b. Afferent and efferent c. Alpha and beta d. Agonists and antagonists

c ) alpha and better

The nurse is providing discharge teaching to a patient prescribed phenytoin (Dilantin) for management of a seizure disorder. Which patient statement indicates a need for further teaching? a. "I need to avoid or limit caffeine intake." b. "I will check with the pharmacist before taking over-the-counter medication." c. "If I develop enlarged gums, I will stop taking the medication." d. "It is important for me to take my medicine at the same time daily."

c. "If I develop enlarged gums, I will stop taking the medication." Sensory : caution patient blurred vision may occur hyperglycemia: blood dyscrasias report a rash or pruritus immediately and withhould additional doses

What point(s) should be included when teaching a patient about the use of apomorphine for treatment of Parkinson's disease? (Select all that apply.) a. The restoration of function resulting from stimulation of dopamine receptors is permanent. b. Apomorphine may be administered intravenously for rapid relief. c. Apomorphine does not have any opioid activity. d. A multidose injector pen is commonly used to administer apomorphine. e. You may experience nausea and vomiting, which can be treated with trimethobenzamide (Tigan). f. You may experience sleep attacks or episodes of daytime sleepiness.

c. Apomorphine does not have any opioid activity. d. A multidose injector pen is commonly used to administer apomorphine. e. You may experience nausea and vomiting, which can be treated with trimethobenzamide (Tigan). f. You may experience sleep attacks or episodes of daytime sleepiness. 1. assess pt's on apomorphine therapy for orthostatic hypotension 2. do not administer apomorphine intravenously 3. asses pt's receiving apomorphine therapy for sudden sleep attacks

Dopamine agonists have been linked with which adverse effects in patients with Parkinson's disease? a. Oculogyric crisis b. Tardive dyskinesia c. Sudden sleep events d. Akathisia

c. Sudden sleep events

For which condition may carbamazepine (Tegretol) be used? a. Tardive dyskinesia b. Psychotic episodes c. Trigeminal neuralgia pain d. Sedation

c. Trigeminal neuralgia pain

What is the drug of choice when treating a generalized tonic-clonic seizure? a. Diazepam (Valium) b. Haloperidol (Haldol) c. Valproic acid (Depakene) d. Risperidone (Risperdal)

c. Valproic acid (Depakene)

The pediatric nurse is caring for a patient diagnosed with refractory seizures. The physician orders a ketogenic diet. When the child receives his food tray, the nurse should remove any food containing high levels of a. fat. b. salt. c. carbohydrates. d. vitamin K.

c. carbohydrates.

A long-term care resident is taking an anticholinergic agent. The nurse observes the resident to be disoriented and hallucinating. The priority nursing action is to a. report development of alterations to the charge nurse. b. assess blood glucose. c. provide for resident's safety. d. medicate with antianxiety medication.

c. provide for resident's safety.

The nurse is teaching a patient with Parkinson's disease about levodopa. Which statement by the nurse is accurate regarding drug administration? a. "Take this medication in between meals." b. "Take this medication at bedtime to prevent dizziness." c. "Take this medication when your tremors get worse." d. "Take this medication with food or antacids to reduce GI upset."

d. "Take this medication with food or antacids to reduce GI upset."

What is a guideline for the nurse when administering phenytoin (Dilantin) intravenously? a. Deliver rapidly. b. Monitor for signs of tachycardia. c. Assess for hypertensive crisis. d. Administer without mixing with other medications.

d. Administer without mixing with other medications.

Before the initiation of anticholinergic medications, it is important for the nurse to screen patients for which condition? a. Hypertension b. Infectious diseases c. Diabetes d. Closed-angle glaucoma

d. Closed-angle glaucoma

Which condition is associated with hydantoin therapy? a. Postictal state b. Atonia c. Seizure threshold reduction d. Gingival hyperplasia

d. Gingival hyperplasia Hydantoins may elevate blood sugar levels.

The nurse is caring for a patient taking a cholinergic agent. When auscultating lung sounds, the nurse notes inspiratory and expiratory wheezing bilaterally. The best action for the nurse to take would be to a. provide the next dose of the cholinergic agent immediately. b. assess heart rate and blood pressure. c. reposition the patient. d. withhold the next dose and notify the physician.

d. withhold the next dose and notify the physician.

1. Why are anticholinergics used for Parkinson's?

deficiency of dopamine which results in excess of the cholinergineic neurotransmitter acetycholine .used to reduce the hyperstimulation that is caused by excessive acetychloline

Instructions to help patients manage adverse effects of anticholinergic medications

dryness of mucosa be be relieved by candy, ice chips chewing gum, encourage adequate fluids intake, food that provide sufficient bulk and excersise

What is the mechanism of action of osmotic agents when used to decrease IOP?

• Increasing plasma osmolarity and drawing extracellular fluid into the blood

Pain scale most appropriate for a nonverbal adult patient

• The Face, Legs, Activity, Cry, Consolability (FLACC) scale would be used to assess pain in the nonverbal patient.