Neurological Disorders

A client who has undergone a Tensilon test for the detection of myasthenia gravis (MG) has developed bradycardia. Which drug will be most beneficial for the client? 1. Atropine 2. Neostigmine 3. Pyridostigmine 4. Mycophenolate mofetil

1. Atropine

The RN is teaching a client about seizure management. Which statement made by the client indicates effective teaching? Select all that apply. 1. "I should wear a medic alert bracelet." 2. "I should refrain from driving." 3. "I should monitor my blood glucose levels daily." 4. "I should take short and deliberate steps while walking." 5. "I should apply sunscreen and skin emollients while going out in sunlight."

1. "I should wear a medic alert bracelet." 2. "I should refrain from driving."

Which intervention should the nurse implement for the client with increased intracranial pressure following a brain tumor resection? 1. Administer stool softeners. 2. Position the client in a supine position at all times. 3. Apply sequential compression devices. 4. Encourage the client to use a non-alcohol containing mouth wash.

1. Administer stool softeners.

The RN is providing postsurgical care for a client with a brain tumor. Which nursing action helps to prevent cerebral edema? 1. Administering glucocorticoids to the client 2. Positioning the client's head at a 15° angle 3. Applying a sequential compression device to the client 4. Administrating benzodiazepines to the client

1. Administering glucocorticoids to the client

The nurse notes a client with Parkinson's disease has uncoordinated body movements. Which brain system coordination failure is responsible for the client's condition? 1. Basal ganglia and cerebellum 2. Thalamus and cerebral cortex 3. Limbic system and aversion center 4. Hypothalamus and anterior pituitary gland

1. Basal ganglia and cerebellum

The nurse is caring for a client with a glioma. Which part of the brain is affected in this client? 1. Cerebrum 2. Meninges 3. Pituitary lobe 4. Cranial Nerve XIII

1. Cerebrum

The nurse is assessing a client who reports severe, unrelenting pain in and around the eye. The pain occurs around the same time for several weeks, more often at night. Which kind of headache is the client most likely experiencing? 1. Cluster headaches 2. Migraine headaches 3. Episodic tension headaches 4. Chronic tension headaches

1. Cluster headaches

Which cranial nerve, when affected because of Guillain-Barré syndrome (GBS), affects expressions such as smiling or frowning? 1. Cranial nerve VII (facial nerve) 2. Cranial nerve X (vagus) 3. Cranial nerve XI (spinal accessory) 4. Cranial nerve XII (hypoglossal)

1. Cranial nerve VII (facial nerve)

Which lifestyle changes are most appropriate for the nurse to teach to the client in order to prevent headaches? Select all that apply. 1. Drink an adequate amount of fluids. 2. Perform gentle exercises of the neck. 3. Eliminate triggers from the diet. 4. Establish consistent sleep habits. 5. Eat as little as possible on the days you have headaches.

1. Drink an adequate amount of fluids. 2. Perform gentle exercises of the neck. 3. Eliminate triggers from the diet. 4. Establish consistent sleep habits.

Which interventions should the nurse implement for the client with Parkinson's disease (PD)? Select all that apply. 1. Elevate head of bed when eating and drinking. 2. Arrange speech therapy for the client. 3. Teach the client to take long steps while walking. 4. Teach the client to call the healthcare provider for medical compliance. 5. Discuss and evaluate the client's ability to drive.

1. Elevate head of bed when eating and drinking. 2. Arrange speech therapy for the client. 4. Teach the client to call the healthcare provider for medical compliance. 5. Discuss and evaluate the client's ability to drive.

Which are symptoms of meningitis? Select all that apply. 1. Fever and headache 2. Flashing lights 3. Nuchal rigidity 4. Opisthotonos 5. Uncontrolled yawning

1. Fever and headache 3. Nuchal rigidity 4. Opisthotonos

Which cranial nerve controls sensory functions from the tongue, such as taste, touch, and temperature? 1. IX (glossopharyngeal) 2. X (vagus) 3. XI (spinal accessory) 4. XII (hypoglossal)

1. IX (glossopharyngeal)

Which is true regarding percutaneous rhizotomy to treat trigeminal neuralgia? Select all that apply. 1. In this process, a needle is inserted through the cheek into the foramen ovale. 2. In this process, a lesion forms, which interrupts pain transmission to the brain. 3. In this process, nerve fibers are damaged or destroyed. 4. In this process, a shredded fluorocarbon resin pad is placed between the vessels and the nerve. 5. In this process, clients may experience permanent facial numbness.

1. In this process, a needle is inserted through the cheek into the foramen ovale. 3. In this process, nerve fibers are damaged or destroyed. 5. In this process, clients may experience permanent facial numbness.

Which best describes psychogenic non-epileptic attack disorder (PNES)? 1. It does not involve abnormal electrical discharges. 2. It is provoked by other disorders and conditions. 3. It is a chronic disorder. 4. It is an uncontrolled, sudden, excessive discharge of electrical activity.

1. It does not involve abnormal electrical discharges.

Which is true regarding the parasympathetic nervous system? 1. It is referred to as the "rest and digest" portion of the nervous system. 2. It is referred to as the "flight or fight" system. 3. It regulates involuntary functions of the body. 4. It elevates heart rate and blood pressure, and respiratory rate.

1. It is referred to as the "rest and digest" portion of the nervous system.

The pain in a client with trigeminal neuralgia is not relieved by the use of antiepileptics. Which nondrug treatment is most appropriate for the client? 1. Microvascular decompression 2. IV immunoglobulin 3. Plasmapheresis 4. Thymectomy

1. Microvascular decompression

A client is diagnosed with myasthenia gravis (MG). The client also has paralytic ileus and is unable to take oral medication. Which drug is most likely to benefit the client? 1. Neostigmine 2. Azathioprine 3. Cyclosporine 4. Mycophenolate mofetil

1. Neostigmine

Which is a clinical features of a myasthenic crisis? Select all that apply. 1. Tachycardia 2. Sweating and excessive secretions 3. Pale, cool skin 4. Bradycardia 5. Flaccid muscles

1. Tachycardia 3. Pale, cool skin 5. Flaccid muscles

Which is a likely cause of recurrent headaches? Select all that apply. 1. Taking ibuprofen on a near-daily basis 2. Maintaining an incorrect posture 3. Maintaining irregular eating habits 4. Using ill-fitting dentures 5. Sleeping in a dark, quiet room

1. Taking ibuprofen on a near-daily basis 2. Maintaining an incorrect posture 3. Maintaining irregular eating habits 4. Using ill-fitting dentures

Which is true regarding the stages of Guillain-Barré syndrome? (GBS) 1. The acute stage usually lasts 4 weeks. 2. The first stage is the plateau stage, and it lasts from a few days to several weeks. 3. Remyelination and axonal regeneration begins after the first stage has completed. 4. The acute stage starts when demyelination ceases.

1. The acute stage usually lasts 4 weeks.

Which assessment finding corresponds with the first stage of Parkinson's Disease (PD)? 1. Upper extremity tremors 2. Muscle rigidity 3. Shuffling gait 4. Postural instability

1. Upper extremity tremors

The nurse is caring for a client who is prescribed carbamazepine for complex partial seizures. Which is the most appropriate information for the nurse to teach the client? 1. "The medication must be chewed." 2. "The medication may cause blurred vision." 3. "Weight gain is a side effect of the medication." 4. "The medication may cause sedation."

2. "The medication may cause blurred vision."

An RN is teaching student nurses about nursing actions for caring for clients with Guillain-Barré syndrome (GBS). Which statement made by the student nurse indicates a need for further teaching? 1. "Do not keep the client in a single position." 2. "Do not offer any kind of diversions to the client." 3. "Establish methods of communication, and provide a method to call the nurse." 4. "Discuss the use of analgesics or nonopioids with the health-care provider."

2. "Do not offer any kind of diversions to the client."

The RN is teaching a group of nursing student about how to care for clients with Kernig's sign, rhinorrhea, and disturbed sensory perception. Which action mentioned by a nursing student indicates a need for further teaching? 1. "I should administer IV fluids to the client." 2. "I should expose the client to sunlight from the windows." 3. "I should maintain standard precautions and implementing transmission precautions while caring for the client." 4. "I should provide cooling baths and cooling blankets to the client."

2. "I should expose the client to sunlight from the windows."

The RN is discussing treatment with a client who has a brain tumor and is receiving chemotherapy. Which statement made by the client indicates a need for further teaching? 1. "I should wear a hat while going out." 2. "I should stop taking glucocorticoids when I feel normal." 3. "I should rinse my mouth with alcohol-free mouthwash." 4. "I should consult the primary health-care provider when a dose of anti-epileptic medication is missed."

2. "I should stop taking glucocorticoids when I feel normal."

An RN is teaching nursing students about Guillain-Barré syndrome (GBS). Which statement of a nursing student indicates a need for further teaching? 1. "It leads to flaccid paralysis." 2. "It is not an autoimmune disease." 3. "It leads to the destruction of the myelin between the nodes of Ranvier." 4. "It is acute inflammatory demyelinating polyneuropathy."

2. "It is not an autoimmune disease."

The RN is discussing myasthenia gravis (MG) with a nursing student. Which statement by the nursing student indicates a need for further teaching? 1. "The symptoms include localized skeletal muscle weakness, ptosis, diplopia, and fatigue." 2. "Penicillamine is used in the treatment of MG." 3. "Serological tests and electromyography are used in the diagnosis of MG." 4. "Plasmapheresis is an additional therapy used in the treatment of MG."

2. "Penicillamine is used in the treatment of MG."

Which precautionary measure should a nurse take when administering pyridostigmine to a client when treating myasthenia gravis (MG)? 1. Monitoring the blood glucose level, which may fluctuate 2. Administering the medication 30 to 60 minutes before a meal 3. Checking if calcium and vitamin D supplements have been ordered 4. Educating the client about side effects of steroids

2. Administering the medication 30 to 60 minutes before a meal

The clinical manifestations of encephalitis are the same as those of meningitis. Which characteristic feature helps identify encephalitis? 1. It involves pathogens that invade the central nervous system. 2. It involves the cerebrum, brainstem, and cerebellum. 3. It can be a life-threatening emergency leading to increased cranial pressure, coma, and death. 4. It is diagnosed by examining the cerebrospinal fluid.

2. It involves the cerebrum, brainstem, and cerebellum.

The RN is caring for a client with tonic-clonic seizures. Which action of the RN is most likely to benefit the client? 1. Encouraging the client to eat finger foods 2. Placing the client in a left recumbent position 3. Placing a clock and calendar in the client's room 4. Encouraging the client to participate in self-care activities

2. Placing the client in a left recumbent position

Which diagnostic test is useful in distinguishing a myasthenic crisis from a cholinergic crisis? 1. Repetitive nerve stimulation (RNS) 2. Tensilon test 3. Chest computed tomography (CT) scan 4. Serological test

2. Tensilon test

Which type of surgery is usually performed for a client with myasthenia gravis (MG)? 1. Microvascular decompression 2. Thymectomy 3. Percutaneous rhizotomy 4. Sterotactic radiosurgery

2. Thymectomy

Which describes the role of the speech therapist in terms of care provided for a client with Parkinson's disease? 1. To maximize independence in activities of daily living (ADLs) 2. To evaluate the client's ability to swallow 3. To provide exercises that increase strength 4. To promote home safety

2. To evaluate the client's ability to swallow

Which statements noted by the nurse indicate a need for further discussion on the autonomic nervous system (ANS)? Select all that apply. 1. "It elevates the heart rate." 2. "It dilates the pupils." 3. "It speeds the process of digestion." 4. "It shunts blood from the periphery of the body to the internal organs." 5. "It decreases the respiratory rate."

3. "It speeds the process of digestion." 4. "It shunts blood from the periphery of the body to the internal organs." 5. "It decreases the respiratory rate."

The nurse is caring for a client who has recurrent tension headaches. Which is the most appropriate instruction for the nurse to give the client about a headache diary? 1. "Document activities performed throughout the day." 2. "Document lifestyle and food habits." 3. "Record the date and time when the headache occurs." 4. "Record the medications taken for pain relief."

3. "Record the date and time when the headache occurs."

Which is true regarding acetylcholine? Select all that apply. 1. The activity of acetylcholine is triggered by acetylcholinesterase. 2. Acetylcholine diffuses across the synapse and binds to muscarinic acetylcholine receptors on the parasympathetic end organ. 3. Acetylcholine crosses the synapse to bind to nicotinic receptors of the membrane of the postganglionic neurons. 4. Acetylcholine is the substance released into the synapse when an action potential is conducted down the axon of the preganglionic autonomic neuron. 5. Acetylcholine is a neurotransmitter synthesized by sympathetic neurons.

3. Acetylcholine crosses the synapse to bind to nicotinic receptors of the membrane of the postganglionic neurons. 4. Acetylcholine is the substance released into the synapse when an action potential is conducted down the axon of the preganglionic autonomic neuron.

A client diagnosed with myasthenia gravis is prescribed neostigmine. Which side effects are likely to be observed? Select all that apply. 1. Anemia 2. Leucopenia 3. Bradycardia 4. Muscle twitches 5. Stomach cramps

3. Bradycardia 4. Muscle twitches 5. Stomach cramps

A client reports a sharp, throbbing, and shock-like pain after brushing the teeth, smiling, or talking. Which drug is the most appropriate as first-line therapy? 1. Baclofen 2. Gabapentin 3. Carbamazepine 4. Oxcarbazepine

3. Carbamazepine

A client has undergone a thymectomy after detection of myasthenia gravis (MG). The symptoms did not subside after the surgery. Which drug will be most beneficial for the client? 1. Neostigmine 2. Azathioprine 3. Cyclosporine 4. Cyclophosphamide

3. Cyclosporine

Which clinical manifestation should a nurse look for in a client with myasthenia gravis (MG)? 1. Facial pain 2. Areflexia 3. Diplopia 4. Paralysis

3. Diplopia

In which state of a seizure is a client most likely to have compromised airway and decreased level of consciousness? 1. After a seizure episode 2. During the preictal state 3. During the postictal state 4. Between seizure episodes

3. During the postictal state

Which nursing intervention is essential while caring for a client with myasthenia gravis (MG)? 1. Keeping the head of the bed in a lowered position 2. Providing meals when medications are at trough levels 3. Offering soft foods and thickened liquids per the order of the speech therapist 4. Encouraging the client to refrain from taking breaks by keeping him/her involved in activities of daily living (ADLs)

3. Offering soft foods and thickened liquids per the order of the speech therapist

The nurse observes a client experiencing a partial seizure. Which behavior does the nurse document as automatism? 1. Unilateral, rhythmic muscle movements 2. Rhythmic jerkiness of all extremities 3. Repetitive unconscious movements 4. Visualizations or hallucinations

3. Repetitive unconscious movements

Which intervention should the nurse implement for a client who experienced a seizure? 1. Restrain the client's movements. 2. Assist the client to a supine position. 3. Suction the oral airway. 4. Encourage the client to drink water.

3. Suction the oral airway.

The nurse is caring for a client undergoing chemotherapy for a brain tumor. Which is the most important nursing intervention for this client? 1. Encourage use of sunscreen lotion. 2. Provide nutritional supplements. 3. Teach importance of frequent handwashing. 4. Encourage use of skin emollients.

3. Teach importance of frequent handwashing.

A client is exhibiting autonomic dysfunction with cardiac dysrhythmia. Which cranial nerve damage is responsible for the client's condition? 1. VII 2. IX 3. X 4. XII

3. X

Which cranial nerve controls movement of the head, neck, and shoulders? 1. X (vagus) 2. IX (glossopharyngeal) 3. XI (spinal accessory) 4. XII (hypoglossal)

3. XI (spinal accessory)

Which intervention should the nurse implement for the client admitted to the intensive care unit with encephalitis? 1. Restrict the client's water intake. 2. Position the client's bed next to a window. 3. Allow the family to visit and talk to the client. 4. Turn and reposition the client every two hours.

4. Turn and reposition the client every two hours.

Which should the nurse do to assess for Kernig's sign in the client with meningitis? 1. Assess the client's ability to move the head sideways. 2. Assess the client for involuntary flexion of the hips. 3. Assess the movement of the eyes on the affected side. 4. Assess the client for pain behind the knee.

4. Assess the client for pain behind the knee.

A client with Parkinson's disease is on medication. During the follow-up visit, the client reports blurred vision, confusion, and urinary retention. Which medication is most likely to be responsible for the client's condition? 1. Ropinirole 2. Carbidopa 3. Pramipexole 4. Benztropine

4. Benztropine

A client is diagnosed with a tumor in the left inferior frontal lobe (Broca's Area). Which symptom is the client likely to exhibit? 1. Loss of vision in one eye 2. Loss of upward gaze 3. Motor weakness 4. Difficulty with speech

4. Difficulty with speech

In which phase of migraine headache does the client experience confusion and exhaustion? 1. During the premonitory phase 2. Prior to the migraine 3. After the client experiences auras 4. During the postdromal phase

4. During the postdromal phase

Which is true regarding a cholinergic crisis? 1. It is caused by lack of anticholinesterase medication. 2. It is an exacerbation of myasthenic gravis weakness that provokes an acute episode of respiratory failure. 3. It is characterized by a clinical feature such as tachycardia. 4. It is caused by an excessive intake of anticholinesterase medication.

4. It is caused by an excessive intake of anticholinesterase medication.

What is a likely cause of viral meningitis? 1. Lumbar puncture 2. Intraventricular catheter 3. Traumatic injury 4. Lack of immunization against mumps

4. Lack of immunization against mumps

Which is most likely responsible for headache that has been going for a prolonged period of time? 1. Meningitis 2. Brain tumor 3. Cerebral aneurysm 4. Opiate dependence and withdrawal

4. Opiate dependence and withdrawal

Which finding is used to diagnose the presence of Parkinson's disease (PD)? 1. Electroencephalogram (EEG) 2. Magnetic resonance imaging (MRI) 3. Cerebrospinal fluid (CSF) testing 4. Presence of tremors and muscular rigidity

4. Presence of tremors and muscular rigidity

Which is true regarding the pathophysiology of myasthenia gravis (MG)? 1. An inadequate amount of acetylcholine (Ach) is released. 2. Acetylcholine (Ach) crosses the synaptic clefts and attaches to Ach receptors (AchR). 3. T cells or T lymphocytes are produced by the thymus gland. 4. Sensitivity to normal amounts of acetylcholine is diminished.

4. Sensitivity to normal amounts of acetylcholine is diminished.

The home health-care nurse is caring for an elderly client with Alzheimer's disease (AD). Which intervention should the nurse implement for the client? 1. Provide the client with semi-soft diet. 2. Encourage the client to take an afternoon nap. 3. Provide the client with a different schedule every day. 4. Speak calmly using positive statements.

4. Speak calmly using positive statements.

Which medication is most likely to benefit a client with bradykinesia, tremor, drooling, and postural instability? 1. Rivastigmine 2. Phenytoin 3. Dexamethasone 4. Trihexyphenidyl

4. Trihexyphenidyl