Ch 69: Neuro

1. A college student goes to the infirmary with a fever, headache, and a stiff neck. The nurse suspects the student may have meningitis and has the student transferred to the hospital. If the diagnosis is confirmed, what should the nurse institute for those who have been in contact with this student? (Select all that apply.) a. Administration of rifampin b. Administration of ciprofloxacin hydrochloride c. Administration of ceftriaxone sodium d. Administration of amoxicillin e. Administration of rofecoxib

A, B, C

8. The nurse is caring for a patient with MS who is having spasticity in the lower extremities that decreases physical mobility. What interventions can the nurse provide to assist with relieving the spasms? (Select all that apply.) a. Have the patient take a hot tub bath to allow muscle relaxation b. Demonstrate daily muscle stretching exercises c. Apply warm compresses to the affected areas d. Allow the patient adequate time to perform exercises e. Assist with a rigorous exercise program to prevent contractures

B, C, D

10. During a Tensilon test to determine if a patient has myasthenia gravis, the patient reports cramping and becomes diaphoretic. Vital signs are BP 130/78, HR 42 and respiration 18. What is the priority action by the nurse? a. Place the patient in the supine position b. Give diphenhydramine for the allergic reaction c. Give atropine to control the side effects of edrophonium d. Call the rapid response team because the patient is preparing to Arrest

C

14. The nurse is caring for a patient in the emergency department with an onset of pain related to trigeminal neuralgia. What subjective data stated by the patient does the nurse determine triggered the paroxysms of pain? a. "I was sitting at home watching television" b. "I was putting my shoes on" c. "I was brushing my teeth" d. "I was taking a bath"

C

5. The nurse is giving the IV antiviral medication ganciclovir to the patient with herpes simplex virus (HSV)-1 encephalitis. What is the best way for the nurse to give the medication to avoid crystallization of the medication in the urine? a. Give the medication rapidly over 15 minutes with 100 mL of normal saline b. Dilute the medicine in 500 mL of lactated Ringer solution c. Give via slow IV over 1 hour d. Give in a drip over 4 hours

C

7. A patient diagnosed with MS 2 years ago has been admitted to the hospital with another relapse. The previous relapse followed a complete recovery with the exception of occasional vertigo. What type of MS does the nurse recognize this patient most likely has? a. Benign b. Primary progressive c. Relapsing-remitting (RR) d. Disabling

C

11. 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 give the medication until after breakfast. What outcome will the patient have related to this late dose? a. The muscles will become fatigued and the patient will not be able to chew food or swallow pills b. There should not be a problem, since the medication was only delayed by about 2 hours c. The patient will go into cardiac arrest d. The patient will require a double dose prior to lunch

A

15. A patient with Bell 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? a. Suggest massaging the face several times daily, using a gentle upward motion, to maintain muscle tone b. Suggest applying cool compresses on the face several times a day to tighten the muscles c. Inform the patient that the muscle function will return as soon as the virus dissipates d. Tell the patient to smile every 4 hours

A

2. 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? a. Within 24 hours after exposure b. Within 48 hours after exposure c. Within 72 hours after exposure d. Therapy is not necessary prophylactically and should only be used if the person develops symptoms

A

4. The nurse is caring for a patient admitted to the hospital with a brain abscess that developed from an untreated case of otitis media. What assessment data is a priority to alert the nurse to changes in intracranial pressure? a. Level of consciousness b. Peripheral pulses c. Sensory perception d. Crackles bilaterally

A

9. The nurse is assisting with giving a Tensilon test to a patient with ptosis. If the test is positive for myasthenia gravis, what outcome does the nurse observe? a. Thirty seconds after administration, the facial weakness and ptosis will be relieved for approximately 5 minutes b. After administration of the medication, there will be no change in the status of the ptosis or facial weakness c. The patient will have recovery of symptoms for at least 24 hours after the administration of the Tensilon d. Eight hours after administration, the acetylcholinesterase begins to regenerate the available acetylcholine and will relieve Symptoms

A

12. A patient suspected of having GBS has had a lumbar puncture for cerebrospinal fluid (CSF) evaluation. When reviewing the laboratory results, what does the nurse find that is diagnostic for this disease? a. Glucose in the CSF b. Elevated protein levels in the CSF c. Red blood cells present in the CSF d. White blood cells in the CSF

B

13. The nurse is caring for a patient with GBS in the intensive care unit and is assessing the patient for autonomic dysfunction. What interventions should be provided in order to determine the presence of autonomic dysfunction? a. Assess the respiratory rate and oxygen saturation b. Assess the blood pressure and heart rate c. Assess the peripheral pulses d. Listen to the bowel sounds

B

3. The nurse caring for a patient with bacterial meningitis is giving dexamethasone that has been prescribed as an adjunct to antibiotic therapy. When does the nurse determine is the appropriate time to give this medication? a. 1 hour after the antibiotic has been infused and daily for 7 days b. 15 to 20 minutes before the first dose of antibiotic and every 6 hours for the next 4 days c. 2 hours prior to the administration of antibiotics for 7 days d. It can be given every 6 hours for 10 days.

B

6. The nurse is volunteering for a Red Cross blood drive and is taking the history of potential donors. Which volunteer would the nurse know will not be allowed to donate blood? a. A donor with a history of hypertension with a blood pressure of 140/90 mm Hg b. A donor who is taking medication for benign prostatic hyperplasia c. A donor who moved to the United States from Canada d. A donor who was in college in England for 1 year

D