MIDTERM Questions

A client who has coronary artery disease tells the nurse he is afraid of dying from a heart attack. Which of the following responses should the nurse make?

"Tell me more about these fears of dying from a heart attack."

11) A nurse is providing discharge instructions for a client who has congestive heart failure. Which of the following client statements indicates to the nurse that the teaching was effective?

- "I plan to slow down if i am tired the day after exercising"

7) A nurse is presenting discharge instructions to a client who has multiple sclerosis (MS). The client reports symptoms of diplopia, dysmetria, and sensory change. Which of the following nursing statements are appropriate?

- "Implement a schedule to include periods of rest"

2) A nurse is caring for a 30 year old client with myasthenia gravis who is prescribed medications to alleviate the major symptoms of this disease. Which drug classification would the nurse most expect to be used to treat MG?

- Anticholinesterase

55) A patient with amyotrophic lateral sclerosis (ALS ) is hospitalized with pneumonia. Which nursing action will be included in the plan of care ?

- Assisting the patient with active range of motion

8) When teaching the patient with newly diagnosed multiple sclerosis (MS) about the disease, the nurse explains that

- Autoimmune processes cause gradual destruction of the myelin

31) The nurse encourages the ventilated client with advanced Guillain-Barre syndrome (GBS) to communicate by which simple technique?

- Blinking for "yes" or "no"

43)What is assessing the respiratory pattern of an older adult client who is receiving end-of-life care. Which of the following assessment findings should the nurse identify as cheyne- stokes respirations?

- Breathing ranging from very deep to very shallow with periods of apnea

16)When teaching patients who are at risk for Bell's Palsy because of a previous herpes simplex infection, which information should the nurse include?

- Call the doctor if pain or herpes lesions occur near the ear

15)A nurse is teaching a client who has chronic obstructive pulmonary disease and is to start using fluticasone by MDI twice daily. Which of the following instructions should the nurse include?

- Check your heart rate before each dose

47)The nurse is modifying the diet of a client who has Parkinson's disease and is prescribed selegiline and MAOI. Which of the following foods should the nurse eliminate?

- Cheddar cheese

22)The client's spouse expresses concern that the client, who has Guillain-Barre syndrome, is becoming very depressed and will not leave the house. What is the nurse's best response?

- Contact the Guillain-Barre foundation international for resources

57)A nurse is caring for a client who has Parkinson's disease and is to start taking diphenhydramine (Benadryl) 25 mg PO TID. Which of the following therapeutic outcomes should the nurse expect to see when evaluating the client's response to diphenhydramine?

- Decrease tremors

17) A nurse in the emergency department is caring for a client who has myasthenia gravis and is in crisis. The nurse knows which of the following factors can cause a myasthenic crisis?

- Developing a respiratory infection

20)A nurse is teaching a client who has multiple sclerosis about a new prescription for baclofen. Which of the following instructions should the nurse include in the teaching?

- Do not take antihistamines with this medication

50)A client has been diagnosed with ALS. The nurse caring for the client recognizes that a classic symptom of this disorder is which of the following

- Dysphasia

44)A nurse in a Cardiac Care Unit is caring for a client with acute right sided heart failure. Which of the following findings should the nurse expect?

- Elevated CVP.

30)A patient in the intensive care unit who has acute decompensated heart failure (ADHF) reports severe dyspnea and is anxious, tachypneic, and tachycardic. Several drugs have been prescribed for the patient. Which action should the nurse take first?

- Give PRN morphine sulfate 4 mg

52)A nurse is assessing a client who has a possible medical diagnosis of Guillain-Barre syndrome (GBS). Which of the following is an appropriate question for the nurse to ask?

- Have you had a recent upper respiratory infection?

56)The client newly diagnosed with myasthenia gravis (MG) is being discharged and the nurse is teaching about proper medication administration. Which statement by the client demonstrates a need for further teaching?

- I can continue to take over the counter drugs

14)The client with myasthenia gravis (MG) is receiving cholinesterase inhibitor drugs to improve muscle strength. The nurse is educating the family about this therapy. Which statement by a family member indicates the correct understanding of the nurse's instructions?

- I should call 911 if a sudden increase in weakness occurs

27)A nurse is instructing a client how to decrease the nausea associated with chemotherapy and radiation. Which of the following statements indicates an understanding of the teaching?

- I will increase the amount of unsaturated fats in my diet

48)Just providing medication instructions to a client diagnosed with amyotrophic lateral sclerosis (ALS ) who has been prescribed riluzole (rilutek). Which statement indicates to the nurse that the client understands the instructions?

- I will need frequent checks on my liver enzymes?

10) A patient who has numbness and weakness of both feet is hospitalized with Guillain - Barre syndrome. The nurse will anticipate the needs to teach the patient about?

- IV infusion of immunoglobulin (Sandoglobulin)

54) The client with Guillain- Barre syndrome is no longer able to perform ADLs Independently. Which priority Problem best identifies measures to prevent pressure ulcers?

- Impaired physical Mobility related to weakness paralysis and ataxia

29) While assessing an older adult patient, the nurse notes jugular vein distention (JVD) with the head of the patient's bed elevated 45 degrees. What does this finding indicate?

- Increased right atrial pressure.

23)When obtaining a health history and physical assessment for a patient with possible multiple sclerosis (MS), the nurse should

- Inquire about any urinary tract infection

12)When obtaining a health history and physical assessment for a 36-year-old female patient with possible multiple sclerosis (MS), the nurse should:

- Inquire about urinary tract problems

3) A nurse is assisting with obtaining an electrocardiogram (ECG) for a client who has atrial fibrillation. Which of the following actions should the nurse take? SATA

- Inspect the electrode pads - Instruct the client not talk during the test - Wash the skin with plain water before placing the electrodes.

45)A patient with Guillain-Barre Syndrome asks the nurse what has caused his disease. In responding to the patient the nurse explains that the Guillain- Barre syndrome

- Is due to an immune reaction that attacks the covering of the peripheral nerves

34) A nurse is assessing a client who has Bell's palsy. Which of the following manifestations are expected findings for Bell's Palsy? (Select all that apply) SATA

- MUSCLE DISTORTION - PAIN BEHIND THE EAR - IMPAIRED TASTE

36) The client has Parkinson disease (PD). Which nursing intervention best protects the client from injury?

- Monitoring the clients sleep pattern

24)A patient with guillain-barre syndrome asks whether he is going to die as the paralysis spreads toward his chest. In responding to the patient, what should the nurse know to be able to answer this question?

- Most patients with guillain-barre syndrome make a complete recovery

33) A nurse is caring for a client who has asthma and developed viral pharyngitis. Which of the following findings should the nurse expect?

- Negative throat culture

49)A client is receiving treatment for stage 4 ovarian cancer and asks the nurse to discuss her prognosis. The client plans to have aggressive surgical radiation and chemotherapy treatments. Which of the following prognosis should the nurse discuss with the client?

- Poor

51) Which body system is the major Focus for nursing care of the client with GuillainBarre syndrome

- Respiratory

25)To assess the functioning of the trigeminal and facial nerve (CN V & VII), the nurse should

- Shine a bright light into the patient's pupil

18) Which of the following is an important modifiable risk for COPD?

- Smoking

35) A nurse is providing teaching to a client who has unstable angina and a new prescription for nitroglycerin oral, sustained-release capsules. Which of the following instructions should the nurse include?

- Swallow the capsule whole

19) A 31-year-old woman who has multiple sclerosis (MS) asks the nurse about risks associated with pregnancy. Which response by the nurse is accurate?

- Symptoms of MS are likely to become worse during pregnancy

46)Which should be the nurse's first intervention with the client diagnosed with Bell's palsy?

- The client to protect the affected eye for injury

26)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?

- Weakness

21)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 to the client

- levodopa/carbidopa

5) A nurse is teaching a client about the side effects of chemotherapy medication. Which of the following nursing statements should the nurse include in the teaching?

-"Hair loss is common and includes eyebrows and eyelashes."

41)when planning care for a patient with MS who has a nursing diagnosis of risk for activity intolerance related to extremity weakness secondary to stress, the most appropriate patient goal is

-"The patient will complete ADLs without fatigue"

42)The client with Amyotrophic Lateral Sclerosis (ALS) is degenerating rapidly and will soon need respiratory support. What will the nurse plan to review with this client?

-Advance directives

4) A nurse is assessing a client who has Parkinson's disease. Which of the following manifestations should the nurse expect?

-Bradykinesia

28)A nurse is caring for a client who has a suspected diagnosis of myasthenia gravis. The provider prescribes a Tensilon test. Which of the following findings indicates a positive test?

-Muscle contractions become progressively stronger

38)The nurse is caring for a patient with chronic obstructive pulmonary disease (COPD). Which information would prompt the nurse to consult with the health care provider before administering the prescribed theophylline?

-The patient takes cimetidine (Tagamet HB) daily.

37) A patient has a new prescription for bromocriptine (Parlodel) to control symptoms of Parkinson's disease. Which information obtained by the nurse may indicate a need for a decrease in the dose?

-The patient's blood pressure is 90/46 mm Hg

39)Which information will the nurse include in the teaching plan for a patient newly diagnosed with asthma?

-Tremors are an expected side effect of rapidly

9) The client newly diagnosed with Parkinson's disease is being discharged. Which instructions are best for the nurse to provide to the client's spouse?

Administer medications promptly on schedule to maintain therapeutic drug levels.

6) A patient with chronic heart failure who is taking a diuretic and an angiotensin converting enzyme (ACE) inhibitor and who is on a low-sodium diet tells the home health nurse about a 5-lb weight gain in the past 3 days. What is the nurse's priority action?

Assess the patient for manifestations of acute heart failure

13)The client has Guillain-Barre syndrome. Which interdisciplinary health care team members will the nurse plan to collaborate with to help prevent pressure ulcers related to immobility in the client with Guillain-Barre syndrome? SATa

DIETICIAN OCCUPATIONAL THERAPIST SOCIAL WORKER FAMILY

53) After the nurse gives IV atropine to a patient with symptomatic type 1 second degree atrioventricular (AV) block which finding indicates that the drug has been effective?

Increase in patients heart rate

32)A nurse is monitoring a client who is on telemetry. Which of the following findings on the ECG strip should the nurse recognize as normal sinus rhythm?

The P wave falls before the QRS complex.

40)A nurse suspects a client who has myasthenia gravis is experiencing a myasthenic crisis. Which of the following interventions should the nurse take?

The increased dose of anticholinesterase meds