PrepU chapter 65

The nurse is caring for a client with mid-to-late stage of an inoperable brain tumor. What teaching is important for the nurse to do with this client?

Explaining hospice care and services

The greatest risk of seizures for clients with brain tumors occurs in those who have tumors in which regions of the brain? Select all that apply.

Frontal Parietal Temporal

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

Excessive levels of which neurotransmitter has been implicated in amyotrophic lateral sclerosis (ALS)?

Glutamate

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:

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

A client is admitted reporting low back pain. How will the nurse best determine if the pain is related to a herniated lumbar disc?

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

A nurse is providing care to a client who has been diagnosed with metastatic brain cancer. When developing the client's plan of care, which outcome would the nurse most likely identify?

Improved quality of life

A patient with a brain tumor is complaining of headaches that are worse in the morning. What does the nurse know could be the reason for the morning headaches?

Increased intracranial pressure

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

What is the only known risk factor for brain tumors?

Ionizing radiation

A client has undergone a cervical discectomy. The nurse determines which interventions are essential to teach the client? Select all that apply.

Keep staples or sutures clean and dry Cover incision with dry dressing Call health care provider if the area is red or irritated Avoid twisting or flexing the neck Do not remove dressing until the next visit

A nurse helps a patient recently diagnosed with a pituitary adenoma understand that:

Most tumors produce too much of one or more hormones.

Which of the following is a late symptom of spinal cord compression?

Paralysis

Which disease is associated with decreased levels of dopamine due to destruction of pigmented neuronal cells?

Parkinson disease

A client newly diagnosed with Huntington diease asks for information concerning management of symptoms. Which action would the nurse first take to address this request?

Perform a focused assessment on the client's needs and capabilities.

The nurse educator is teaching nursing students about various types of brain tumors. The instructor recognizes that teaching has been effective when students correctly identify a client whose lab work indicates excessively high levels of thyroid stimulating hormone would most likely be diagnosed with which type of tumor?

Pituitary adenoma

The nurse cares for a client with Huntington disease. What intervention is a priority for safe care?

Protecting the client from falls

Which statement indicates appropriate nursing intervention for a client with post-polio syndrome?

Provide care aimed at slowing the loss of strength and maintaining overall well-being.

The nurse is caring for a client with metastatic brain cancer. The client will be receiving palliative treatment. The nurse should anticipate what type of medical management will be included in the client's care? Select all that apply

Radiosurgery Craniotomy with debulking Radiation

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?

Riluzole

A nurse is assessing a client with Parkinson's disease. Which of the following would the nurse expect to find?

Slowing of activity

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

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:

Surgery can improve survival time but the results are not guaranteed.

Which client should the nurse assess for degenerative neurologic symptoms?

The client with Huntington disease.

The nurse is seeing the mother of a client who states, "I'm so relieved because my son's doctor told me his brain tumor is benign." The nurse knows what is true about benign brain tumors?

They can affect vital functioning.

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

A nurse is caring for a client who underwent a lumbar laminectomy 2 days ago. Which finding requires immediate intervention?

Urine retention or incontinence

A client has just returned from surgery after undergoing a lumbar laminectomy. Which of the following would be most important to do when positioning the client in bed?

Using a logrolling motion to change positions

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

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).

A nurse is working on a surgical floor. The nurse must logroll a client following a:

laminectomy

Bone density testing in clients with post-polio syndrome has demonstrated

low bone mass and osteoporosis.

The nurse is providing discharge teaching for a client who was admitted to hospital after having complex partial seizures secondary to a glioma. The client has been prescribed levetiracetam to manage the seizures. What should the nurse include in the discharge teaching for this medication?

"Driving a car should be avoided until the you know how this medication effects you."

The community health nurse is conducting a home visit with a client who was discharged from hospital 3 days ago after surgical resection of a brain tumor and radiation therapy. The client is accompanied by his partner during the nurse's visit. During the visit, the client's partner becomes tearful. How should the nurse respond?

"Going through this experience with your partner has been very difficult for you, I'm sure. Can you tell me about your experience so far?"

The nurse is seeing a client who has just been diagnosed with a grade I meningioma. The nurse is correct when stating what information about the client's diagnosis?

"Grade 1 is the most common type of this tumor."

The daughter of a patient with Huntington's disease asks the nurse what the risk is of her inheriting the disease. What is the best response by the nurse?

"If one parent has the disorder, there is a 50% chance that you will inherit the disease."

A client with post-polio syndrome displays fatigue and decreased muscle strength. How should the nurse best respond to the client?

"Intravenous immunoglobulin infusion may help you."

The nurse and a nursing student are admitting a client with a malignant glioma brain tumor preoperatively for resection of the tumor. The nursing student asks the nurse, " I was told these types of tumors have a very poor prognosis. Why is the tumor being resected?" Which rationale for this intervention is true?

"Surgical resection of the tumor will decrease intracranial pressure."

A client with Parkinson's disease is prescribed amantadine hydrochloride 100 mg twice a day. The pharmacy supplies amantadine syrup, because the client has a history of difficulty swallowing tablets. The label reads 50 mg/5 mL. How many milliliters would the nurse administer to the client for each dose? Enter the correct number ONLY.

10

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 165 pounds. How many milligrams of phenytoin should the client receive? Enter the number ONLY.

750

A nurse knows that a patient exhibiting seizure-like movements localized to one side of the body most likely has what type of tumor?

A motor cortex tumor

Which medication classification should be avoided in the treatment of brain tumors?

Anticoagulants

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 = 175/45 mm Hg; HR = 42 bpm

A client who was diagnosed with Parkinson's disease several months ago recently began treatment with levodopa-carbidopa. The client and his family are excited that he has experienced significant symptom relief. The nurse should be aware of what implication of the client's medication regimen?

Benefits of levodopa-carbidopa often diminish after 1 or 2 years of treatment.

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?

Call the surgeon to report the client's pain.

In which location are most brain angiomas located?

Cerebellum

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.

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?

Dysphonia

An acoustic neuroma is a benign tumor of which cranial nerve?

Eighth

Which disease includes loss of motor neurons in the anterior horns of the spinal cord and motor nuclei of the lower brain stem?

Amyotrophic lateral sclerosis

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

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.

A client is diagnosed with a brain angioma. When providing care to this client, the nurse would be especially vigilant in monitoring for signs and symptoms of which of the following?

Hemorrhagic stroke

Which nursing diagnosis takes the highest priority for a client with parkinsonian crisis?

Ineffective airway clearance

A client with a brain tumor experiences projectile vomiting. The nurse integrates understanding of this occurrence as resulting from which of the following?

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?

Magnetic resonance imaging

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

The nurse is conducting a preoperative assessment of a client who is scheduled for surgical removal of a primary spinal tumor. What should the nurse include in the preoperative session? Select all that apply.

Methods of pain control after surgery Adjusting to changes in daily activities Question about current bowel and bladder control

The nurse is providing discharge instructions for a client who was admitted to the oncology unit due to dehydration and anorexia after chemotherapy treatment. What information should the nurse provide to the client to promote improve the client's nutritional intake at home?

Take prescribed pain medication prior to commencing a meal