Lewis, Ch. 58 (Select All That Apply)

When performing a physical assessment of a patient with myasthenia gravis, what clinical manifestations is the nurse likely to find? Select all that apply.

Impaired facial mobility Difficulty in swallowing food Voice fading after a long conversation

A patient with head trauma is admitted to the emergency department with continuous muscle contractions and loss of consciousness. Which drugs would be effective for treating this patient? Select all that apply.

Phenytoin. Carbamazepine.

The nurse is educating a student nurse about how metabolic disturbances cause seizures. Which statements made by the student nurse indicate effective learning? Select all that apply.

"Seizures can be caused by a decrease in oxygen levels." "Seizures can be caused by a decrease in pH of the blood." "Seizures can be caused by a decrease in blood glucose levels."

A patient with multiple sclerosis has been advised to use dalfampridine to improve walking speed. What questions should the nurse ask the patient before administering the medication? Select all that apply.

"Do you have kidney disease?" "Do you have a history of any seizure disorder?"

Which suggestions given by the nurse to a patient with frequent headaches will be beneficial in determining the type of headache? Select all that apply.

"Note the time of the onset of the headache." "Jot down the dates in a diary when you experience headache." "List the foods that you have consumed before the onset of headache."

A patient with a history of headaches asks the nurse what cluster headaches are. What response(s) by the nurse are most appropriate? Select all that apply.

Alcohol is the only known dietary trigger for cluster headaches. Cluster headaches occur regularly and frequently at the same time each day. Cluster headaches can occur for weeks to months at a time, followed by remission periods.

A patient is advised to use diazepam for multiple sclerosis. What patient teaching is important for those taking this drug? Select all that apply.

Avoid driving while on the drug. Do not stop the drug abruptly. Do not stop the drug abruptly.

The nurse is caring for a patient with a spastic bladder secondary to multiple sclerosis. What manifestations of spastic bladder should the nurse expect to find in the patient? Select all that apply.

Bladder contractions are unchecked. The bladder has a small capacity for urine. The patient experiences incontinence and dribbling.

The nurse is caring for a patient with Parkinson's disease. What adjustments should the nurse make in the dietary habits of the patient to prevent malnutrition and constipation? Select all that apply.

Cut food into bite-size pieces. Serve hot foods on a warmed plate. Include whole grains and fruits in the diet.

A patient with Parkinson's disease is prescribed sinemet. Which side effects of the drug would the nurse monitor for in this patient? Select all that apply.

Dyskinesia. Involuntary eyelid movements. Severe nausea and vomiting

A patient with a history of angina is diagnosed with migraines. Which medications does the nurse anticipate to be excluded from the patient's prescription? Select all that apply.

Eletriptan Zolmitriptan

Which interventions would the nurse include in the care plan of a patient with chronic tension headaches? Select all that apply.

Encouraging the patient to perform yoga in the morning. Massaging the patient's shoulders with warm coconut oil. Encouraging the patient to practice deep breathing exercises.

A patient is experiencing generalized tonic-clonic seizures due to hypoxia. What should be the immediate nursing interventions provided to the patient? Select all that apply.

Ensure patent airway. Remove restrictive clothes

A patient complains of difficulty with eye and eyelid movement, chewing, swallowing, speaking, and breathing. Which findings in the patient's diagnostic results would indicate the presence of myasthenia gravis? Select all that apply.

Improved muscle contractibility during the Tensilon test. Decreased response to repeated stimulation of hand muscles during EMG test.

An elderly patient with impaired liver function is suspected of having sustained a seizure. Which antiseizure drugs are safe for this patient? Select all that apply.

Lamotrigine. Gabapentin.

When performing a physical assessment on a patient with amyotrophic lateral sclerosis, which manifestations is the nurse likely to find? Select all that apply.

Limb weakness. Difficulty articulating words. Difficulty swallowing.

On a follow-up visit, a patient with migraines reveals that she has had fewer headaches. Which actions of the patient would be responsible for this improvement? Select all that apply.

Meditating in the evening. Taking sumatriptan once a day. Performing yoga in the morning.

A patient is advised to use teriflunomide for multiple sclerosis. What nursing interventions are important for this patient? Select all that apply.

Monitor liver function tests. Instruct the patient to avoid pregnancy.

A patient with Willis-Ekbom disease is admitted to the hospital. What are the signs and symptoms that the nurse is likely to find during data collection and assessment? Select all that apply.

Numbness Tingling in the legs

The nurse is planning discharge teaching for a patient with myasthenia gravis. What instructions should the nurse include in the plan? Select all that apply.

Plan activities with periods of rest. Eat a balanced diet that can be easily chewed and swallowed. Schedule drugs so that the peak effect of the drug is at mealtime.

Which criterion is included to establish that a patient has Parkinson's disease? Select all that apply.

Positive response to antiparkinsonian medications. Presence of two of the three classic features: rigidity, bradykinesia, and tremor.

The nurse is assessing a client who is experiencing seizure activity. The nurse understands that it is necessary to determine information about which items as part of routine assessment of seizures? Select all that apply.

Postictal status. Duration of the seizure. Changes in pupil size or eye deviation. Seizure progression and type of movements.

The nurse is caring for a patient with multiple sclerosis in remission. What information should the nurse include when teaching the patient about advantages of exercise for multiple sclerosis? Select all that apply.

Decreases spasticity. Increases coordination. Retrains unaffected muscles to substitute for impaired ones.

A patient with Parkinson's disease is unresponsive to drug therapy and is being considered for surgery. After the physician discusses surgical options, about which options does the nurse anticipate educating the patient? Select all that apply.

Ablation. Transplantation. Deep brain stimulation.

A patient suspected of having myasthenia gravis suffers injury and has related pain, infection, and inflammation. Which drugs must be used with caution? Select all that apply.

Diuretics Antibiotics Opioid analgesics

What instructions should the nurse give to a patient being treated with carbamazepine for seizures? Select all that apply.

Do not stop using the drug abruptly. Do not take the drug with grapefruit juice. Notify the health care provider about any vision problems.

The nurse is performing a physical examination on a patient with Parkinson's disease. What manifestations of Parkinson's disease is the nurse likely to find? Select all that apply.

Drooling of saliva Shuffling, propulsive gait. Decreased arm swing.

A patient with Willis-Ekbom disease is admitted to the hospital. What are the signs and symptoms that the nurse is likely to find during data collection and assessment? Select all that apply.

Numbness and tingling in the legs. Leg pain localized to the calf muscles. Sensation like bugs creeping on the legs.

A patient with myasthenia gravis is admitted to the hospital in respiratory failure and diagnosed with myasthenic crisis. Which of the factors in the patient's current life situation led to the development of this myasthenic crisis? Select all that apply.

Omitted pyridostigmine previous day. Attended funeral of family member earlier in week. Took antibiotic prescribed for urinary tract infection. Diagnosed with urinary tract infection previous week.

A patient with myasthenia gravis is concerned whether he or she will need a thymectomy. For which patients is thymectomy performed? Select all that apply.

Patients with thymoma. Patients with purely ocular myasthenia gravis. Patients between the ages of puberty and about 65 year.

What instructions should a nurse give to a patient who has focal seizures well controlled with phenytoin and who has mild gingival hyperplasia? Select all that apply.

Regular tooth brushing can limit hyperplasia. Regular flossing can control gingival tissue growth.

A patient with multiple sclerosis is under treatment with β-interferon. What patient teaching would be appropriate for this patient? Select all that apply.

Rotate injection sites with each dose. Know that flu-like symptoms are common. Wear sunscreen while exposed to sunlight.

When taking the history of a patient with a migraine headache, what features of a migraine headache is the patient likely to report? Select all that apply.

The headache is usually unilateral. The headache is preceded by an aura. The headache is usually triggered by certain foods, such as chocolate.

A patient's caregiver asks the nurse how the patient could have developed a tonic-clonic seizure, having no prior history of epilepsy. What would be the nurse's best responses about the precipitating intracranial causes of the tonic-clonic seizure? Select all that apply.

"Stroke is an intracranial cause of tonic-clonic seizure." "Brain tumor is an intracranial cause of tonic-clonic seizure." "Hypertensive crisis is an intracranial cause of tonic-clonic seizure."

A patient asks the nurse what causes migraine headaches. What responses by the nurse are correct? Select all that apply.

These headaches generally last from 4 to 72 hours. The pain is a continuous, throbbing, and pulsating pain. Some risk factors of migraines include low level of education and socioeconomic status.

The parent of a child newly diagnosed with a typical absence seizure is concerned. What information should the nurse provide to the parent regarding typical absence seizures? Select all that apply.

The occurrence of seizures usually subsides during adolescence. The seizures are characterized by brief staring spells. The seizures are usually precipitated by flashing lights.

The caregivers of a patient with acute seizures ask the nurse what they should do if another episode of seizure occurs at home after discharge. What should the nurse tell them? Select all that apply.

Ease the patient to the floor. Loosen constrictive clothes.

The nurse is caring for an elderly patient with a brain tumor. The family reports symptoms of headaches, confusion, and altered level of consciousness. Which drugs would be best for this patient? Select all that apply.

Gabapentin. Levetiracetam. Oxcarbazepine.

A patient diagnosed with seizures is advised to take phenytoin. About which common side effects of phenytoin should the nurse inform the patient? Select all that apply.

Hirsutism Gingival hyperplasia.

A patient with a history of severe migraines reports a throbbing headache. After further inquiry, the nurse finds that the patient experiences migraines after eating. Which foods may be causing the headache? Select all that apply.

Hotdog. Ice cream. Orange juice.

A patient with a family history of Huntington's disease (HD) who underwent genetic testing has positive results. What can the nurse infer from this finding? Select all that apply.

There is no cure for this disease. The patient will develop a progressive, degenerative brain disorder. The onset of disease usually occurs between 30 and 50 years of age.

The nurse is managing the care of a patient with a seizure disorder who was admitted for status epilepticus. Which long-acting antiseizure medications would be effective for a patient with status epilepticus? Select all that apply.

Phenytoin. Lamotrigine. Phenobarbital

A patient with migraines asks the nurse about complementary therapies to use alongside her prescription medication. What suggestions should the nurse provide to the patient? Select all that apply.

Practice yoga to possibly enhance the benefits of your prescription medication. Visit an acupuncturist to treat migraine pain, along with your usual prescription.

A patient diagnosed with myasthenia gravis reports difficulty in swallowing, chewing, eye movement, and facial mobility. Which drugs are most suitable for the patient? Select all that apply.

Prednisone Azathioprine Pyridostigmine

A patient with a suspected neurologic disorder has weakness of the limbs, blurred vision, patchy blindness, and bowel and bladder dysfunction. Which clinical findings would support the diagnosis of multiple sclerosis? Select all that apply.

Presence of visual and auditory evoked potential. Presence of increased IgG antibodies in the cerebrospinal fluid. Presence of inflammation, tissue breakdown, an atrophy of the spinal cord in the MRI.

What nursing interventions would be applied first for the patient with acute exacerbation of multiple sclerosis? Select all that apply.

Preventing the complication of pressure ulcers. Preventing the complication of urinary tract infections.

What suggestion should the nurse give to the family members of a patient with Parkinson's disease to promote self-care and independence of the patient? Select all that apply.

Use slip-on shoes. Use an elevated toilet seat. Elevate the legs on an ottoman when sitting