ATI neuro

A nurse is assessing a client who has a suspected diagnosis of Guillain-Barré syndrome (GBS). Which of the following questions should the nurse ask the client? "Do have a history of chronic alcohol abuse?" "Have you had a recent influenza infection?" "Have traveled overseas recently?" "Are you taking a multivitamin?"

"Have you had a recent influenza infection?" The nurse should ask the client about a recent Haemophilus influenzae infection. The cause of GBS is unknown, but it usually follows a viral infection.

A nurse is assisting with care of a client immediately following a lumbar puncture. Which of the following actions should the nurse take? (SATA) 1. encourage fluid intake 2. monitor puncture site for hematoma 3. insert urinary catheter 4. elevate head of bed 5. apply cervical collar

1 2

The nurse is assessing a patient admitted for a work-up to rule out ALS. Which symptoms are typically exhibited in a patient with ALS? (Select all that apply.) A Muscle pain B Slurred speech C Muscle spasticity D Decreased sensation E Difficulty swallowing

ABCE

Patient taking levodopa/carbidopa [Sinemet] for Parkinson disease experiences frequent "on-off" episodes (ie abrupt loss of effect). Which action by nurse is best? A. Administer med when patient has an empty stomach B. Instruct patient to avoid high-protein foods C. Have patient increase intake Vit B6 D. Discontinue drug for 10 days ("drug holiday")

B. Instruct patient to avoid high-protein foods Protein can decrease effectiveness of levodopa/carbidopa. Don't avoid protein altogether, but disperse is throughout day and avoid high protein meals.

A nurse is caring for a client who has myasthenia gravis (MG). Which of the following is a complication of MG for which the nurse should monitor? 1. respiratory difficulty 2. confusion 3. increased ICP 4. joint pain

1

Carbidopa-levodopa is prescribed for a client with Parkinson's disease, and the nurse monitors the client for adverse effects of the medication. Which sign/symptom indicates the client is experiencing an adverse effects? 1. pruritus 2. tachycardia 3. hypertension 4. impaired voluntary movements

4

A nurse is caring for a client who has Parkinson's disease and is taking diphenhydramine 25 mg PO TID. Which of the following therapeutic outcomes should the nurse expect to see? 1 Delay in disease progression 2 Improved bladder function 3 Relief of depression 4 Decreased tremors

4 Clients who have Parkinson's disease often experience trembling, muscle rigidity, difficulty walking, and problems with balance and coordination. Antihistamines, like diphenhydramine, have a mild anticholinergic effect and may be helpful in controlling tremors in the early stage of the disease. This medication does not delay disease progression.

A nurse is caring for a client who is scheduled to have a magnetic resonance imaging (MRI) scan. The client asks the nurse what to expect during the procedure. Which of the following statements should the nurse make? "An MRI scan is not distorted by movement, so you do not have to lie still." "An MRI scan is a short procedure and should take no longer than 30 minutes." "The MRI contrast dye contains iodine and can cause your skin to itch." "An MRI scan is very noisy, and you will be allowed to wear earplugs while in the scanner."

An MRI scan is very noisy, and you will be allowed to wear earplugs while in the scanner." The nurse should instruct the client that many clients report being disconcerted by the loud thumping and humming noises produced by the scanner, and for that reason, earplugs are offered to reduce the discomfort.

A patient diagnosed with multiple sclerosis (MS) is admitted to the medical unit. When assessing the patient, which of the following will the healthcare expect to identify? A. Seizures B. Scanning speech C. Resting tremors D. Flaccid paralysis E. Nystagmus

B E

Nurse is modifying diet of client who has Parkinson's disease and is prescribed selegiline, an MAOI. Which of the following foods should the nurse eliminate? A. Fresh fish B. Cheddar cheese C. Cherries D. Chicken

B. Cheddar cheeseThe nurse should eliminate aged cheeses from the diet of a client who is prescribed selegiline. Cheddar cheese contains tyramine, which can cause a hypertensive crisis.

A nurse is assessing a client who has Parkinson's disease. Which of the following manifestations should the nurse expect? Pruritus Hypertension Bradykinesia Xerostomia

Bradykinesia The nurse should expect to find bradykinesia or difficulty moving in a client who has Parkinson's disease.

Which of these assessment findings should the healthcare provider expect to identify as an early clinical characteristic of multiple sclerosis (MS)? A. Muscle atrophy B. Dementia C. Vision loss D. Clonus

C

A nurse is caring for a client who is undergoing a lumbar puncture. Which of the following is the priority action for the nurse take to maintain privacy for the client? Close the door to the client's room. Pull the curtains around the client's bed. Ask family members to leave the room. Use sterile drapes to cover the client.

Pull the curtains around the client's bed. Pulling the curtains around the client's bed assures privacy for the client should someone open the door or enter the room.

A nurse is assessing a client who has a score of 6 on the Glasgow Coma Scale. The nurse should expect which of the following outcomes based on this score? 1 The client needs total nursing care 2 The client is alert and oriented 3 The client is in a deep coma 4 Indicates stable neurologic status

1 A client who has a score of 6 on the Glasgow Coma Scale is in a comatose state and will require total nursing care.

A nurse is teaching a client who has MS about a new prescription for baclofen. Which of the following instructions should the nurse include in the teaching? 1 "Do not take antihistamines with this medication." 2 "Take the medication on an empty stomach." 3 "Stop taking the medication immediately for a headache." 4 "Expect to develop diarrhea initially."

1 Antihistamines will intensify the depressant effects of baclofen

A nurse is providing teaching to the family of a client who has Parkinson's disease. Which of the following information should the nurse include in the teaching? 1 Provide client supervision 2 Limit the client physical activity 3 Speak loudly to the client 4 Leave the television on continuously

1 Because the client's voluntary motor control is affected by the disease, the nurse should recommend that the family provide client supervision to create a safe and respectful environment. The nurse should recommend decreasing excess environmental stimuli to increase the client's ability to concentrate on listening

A nurse is caring for a client who is going to have a bone marrow biopsy under conscious sedation. The client expresses fear about the procedure and asks the nurse if the biopsy will hurt. Which of the following responses should the nurse make? 1 "The biopsy can be uncomfortable, but I will try to keep you as comfortable as possible." 2 "Relax, you'll be asleep for most of the procedure and you won't remember a thing." 3 "I will call your doctor and tell him you still have questions about the procedure." 4 "I can understand because you must be very worried about what the biopsy will show."

1 The client is seeking information. This open-ended therapeutic response gives the client the information that the client needs to cope, reassures the client of the nurse's presence, and encourages further communication.

A nurse is teaching a client who has MS and a new prescription for dantrolene. Which of the following statements by the client indicates an understanding of the teaching? 1 "I need to apply a sunscreen when I go outside," 2 "I can take OTC antihistamine for allergies when I am taking this drug." 3 "I should take this medication when my spasms are bad." 4 "My muscle strength should improve a lot in 2 to 3 days."

1 This medication can cause photosensitivity; therefore, the client should protect her skin by wearing a hat and using sunscreen while in sunlight

A nurse is reinforcing teaching with a client who is diagnosed with myasthenia gravis and is to start taking neostigmine. Which of the following instructions should the nurse include in the teaching? 1. take medication 45min before eating 2. expect diaphoresis as side effect 3. if dose is missed, wait until next scheduled dose to take medication 4. treat nasal rhinitis with OTC antihistamine

1 allows medication to work and limit difficulty chewing and swallowing. Diapheresis is a cholinergic crisis and is an emergency. Should have strict medication schedule. Contact provider before taking any OTC medication. Antihistamines may worsen symptoms.

A nurse is assisting with the care of a client who has myasthenia gravis and is in crisis. The nurse should identify that which of the following factors can cause a myasthenic crisis? 1. developing a respiratory infection 2. taking too much prescribed medication 3. insufficient sleep 4. insufficient exercise

1 r/t not taking or taking too little of the prescribed medication. Surgery and pregnancy are also triggers.

A nurse is caring for a client following a lumbar puncture. Which of the following actions should the nurse take? (SATA) 1. provide oral fluids 2. monitor for nausea 3. maintain fetal position 4. check LOC 5. check sensation in the toes

1 2 4 5 The nurse should also monitor for photophobia, headache, or drainage or redness from the puncture site.

The nurse is reviewing the medical record of a client diagnosed with amyotrophic lateral sclerosis (ALS). Which initial sign/symptom of this disorder supports this diagnosis? 1.Muscle wasting 2.Mild clumsiness 3.Altered mentation 4.Diminished gag reflex

2 The initial manifestation of ALS is a mild clumsiness usually in the distal portion of one extremity. The client may complain of tripping and may drag one leg when the lower extremities are involved.

A nurse is providing discharge teaching to a female client who has neuropathy and a new prescription for gabapentin. Which of the following statements should the nurse include in the teaching? 1 "Take this medication with an antacid to reduce gastric irritation." 2 "You may experience drowsiness while taking this medication." 3 "You should take this medication with meals." 4 "You may continue to breastfeed while taking this medication."

2 The nurse should instruct the client that drowsiness can occur while taking this medication and to exercise caution while performing activities that require alertness.

A nurse is teaching a client who is taking benztropine to treat Parkinson's disease. The nurse should instruct the client to report which of the following adverse effects? 1. Excess salivation 2 Difficulty voiding 3 Diarrhea 4 Slow pulse

2 The nurse should instruct the client to report difficulty voiding, which may indicate urinary retention, as an adverse effect of benztropine. Benztropine is an anticholinergic medication that helps decrease the rigidity and tremors of Parkinson's disease.

A nurse is assessing a client who has Parkinson's disease. Which of the following manifestations should the nurse expect? 1 Pruritus 2 Hypertension 3 Bradykinesia 4 Xerostomia

3

A nurse is caring for a client who has Parkinson's disease and is taking selegiline 5 mg. Which of the following therapeutic outcomes should the nurse monitor for? 1. improved speech patterns 2. increased bladder function 3. decreased tremors 4. diminished drooling

3

A nurse is providing teaching to a client who has a new diagnosis of Parkinson's disease. On which of the following medications should the nurse prepare to instruct the client? 1 Piperacillin/tazobactam 2 Levothyroxine 3 Levodopa/carbidopa 4 Carbamazepine

3

A nurse is presenting discharge instructions to a client who has MS. The client reports symptoms of diplopia, dysmetria, and sensory change. Which of the following nursing statements are appropriate? 1 "Wear an eye patch on the right side at all times." 2 "Plan to relax in a hot tub spa each day." 3 "Engage in a vigorous exercise program." 4 "Implement a schedule to include periods of rest."

4 The nurse should assist the client in developing a schedule that includes periods of exercise followed by periods of rest to maintain muscle strength and coordination.

A client with Parkinson's disease is experiencing a parkinsonian crisis. The nurse should immediately place the client where? 1.In a bed with padded side rails, with limb restraints nearby 2.In a room near the nurses' station that is near the code cart 3.In a high-Fowler's position, with a nasogastric tube at the bedside 4.In a quiet, dim room with respiratory and cardiac support available

4 Parkinsonian crisis can occur with emotional trauma or sudden withdrawal of medications. The client exhibits severe tremors, rigidity, and bradykinesia. The client also displays anxiety, is diaphoretic, and has tachycardia and hyperpnea (tachypnea). The client should be placed in a quiet, dim room, and respiratory and cardiac support should be available.

The healthcare provider is assessing a patient with a diagnosis of Parkinson disease (PD). Which of the following findings would the healthcare provider anticipate? Select all that apply. A. Kyphosis B. Depression C. insomnia D. Bradykinesia E. Exophthalamos F. Receptive aphasia

A B D Rationale: Kyphosis is humpback due to the stooped posture, depression as this effects mood, slow rigid movements will be noted. Sleepiness is common not insomnia, bulging eyes is common in thyroid disorders and aphasia is common in stroke.

When teaching the patient with multiple sclerosis (MS) about how to best manage his disease, the nurse determines the patient requires further instruction when making which statement? A. "It is important that I attend all of my physical therapy sessions." B. "I should eat adequate fiber to prevent constipation." C. "It is a good idea for me to take a hot shower in the morning to relax my muscles." D. "The injections of interferon beta-1b (Betaseron) will help manage my symptoms."

C Heat often exacerbates the symptoms of MS, so a hot shower in the morning is not advisable. Physical therapy and exercise are important for maintaining muscle strength. Constipation can be prevented by eating adequate fiber. Biologic response modifier drugs help treat the symptoms of MS; there is currently no cure for the disease.

A nurse is caring for a client who has a new diagnosis of myasthenia gravis. For which of the following manifestations should the nurse monitor?Confusion Weakness Increased intracranial pressure Increased urinary output

weakness