Neurological

For patients with Huntington disease, which mental status change would the patient experience? Select all that apply. A. Dementia B. Dysphagia C. Poor judgment D. Decreased attention span E. Bowel and bladder incontinence

A, C, D

Which tool would the nurse use to test cognitive changes related to Alzheimer disease? A. Brudzinski test B. Mini-Mental State Examination C. Kernig test D. Huntington test

B

Which type of drug would the nurse expect to administer as part of the treatment plan for a patient with relapsing multiple sclerosis (MS)? A. Antispasmodic B. Immunomodulator C. Calcium channel blocker D. Penicillin-based antibiotic

B

Which type of multiple sclerosis (MS) involves steady and gradual neurological deterioration without remission of the symptoms? A. Relapsing-remitting multiple sclerosis (RRMS) B. Primary progressive multiple sclerosis (PPMS) C. Progressive relapsing multiple sclerosis (PRMS) D. Secondary progressive multiple sclerosis (SPMS)

B

When determining the onset and severity of the cognitive impairment of a patient with Alzheimer disease (AD), which test requires the patient to be able to read? A. Short Blessed Test B. Clock Drawing Test (CDT) C. Mini-Mental State Examination (MMSE) D. Brief Interview for Mental Status (BIMS)

C

Which characteristic would the nurse associate with the Alzheimer Association's Safe Return Program? A. The program receives funds from well-known private organizations. B. The association's program assists families of patients with dementia, worldwide. C. The group assists in identifying patients and returning them safely to their family. D. The program provides information through seminars and publications to nurses and health care workers.

C

Which communication technique would the nurse use when providing care for a patient with advanced Alzheimer disease? A. Write down instructions for the patient. B. Wait for the patient to express a need. C. Assume the patient is not completely confused. D. Provide the patient with several options from which to choose.

C

Which pathophysiologic event may be responsible for the nurse suspecting a patient has Alzheimer disease? A. Decrease in the amount of dopamine B. Increase in the amount of acetylcholine (ACh) C. Decrease in the amount of ACh D. Decrease in the amount of gamma aminobutyric acid (GABA)

C

When providing care for a patient in the last stage of Alzheimer disease, which strategy would the nurse implement to promote communication? A. Ask indirect questions. B. Use ambiguous gestures. C. Assume the patient is confused. D. Provide instruction with pictures.

D

Which clinical manifestation would a patient with Alzheimer disease exhibit when the disease impairs the patient's frontal lobe? A. Apraxia B. Aphasia C. Anomia D. Inability to make decisions

D

Which clinical manifestation would the nurse associate with a patient in the moderate stage of Parkinson disease (PD)? A. Akinesia and rigidity of the patient's limbs B. Bilateral limb movement and a masklike face C. Unilateral limb movement and minimal weakness D. Postural instability and increased gait disturbances

D

Which health care team member referral would the nurse recommend for a patient experiencing dysarthria? A. Urologist B. Physical therapist C. Occupational therapist D. Speech-language pathologist (SLP)

D

Which immunomodulator drug is used in the treatment of multiple sclerosis? A. Cyclosporine B. Methotrexate C. Methylprednisone D. Interferon beta-1b

D

Which information would the nurse relay to a stressed caregiver who provides care for an older-adult family member with Alzheimer disease? A. "Respite care should be used very sparingly." B. "You should spend time away resting once a month." C. "Do not try to use humor with an Alzheimer patient." D. "Consider attending local support group meetings conducted by the Alzheimer's Association."

D

Which instruction would the nurse provide a patient's spouse or caregiver when providing discharge instructions for home care of the patient with Parkinson disease? A. Speak loudly to the patient for better understanding. B. Begin completing ADLs for the patient. C. Provide high-calorie, high-carbohydrate foods to maintain the patient's weight. D. Administer medications promptly on schedule to maintain therapeutic drug levels.

D

Which medication for Parkinson disease (PD) is often the initial medication of choice and used by almost all patients with PD at some point in the progression of the disease? A. Rotigotine B. Pramipexole C. Apomorphine D. Carbidopa/levodopa

D

Which medication would the nurse anticipate the health care provider prescribing for a patient with Parkinson disease to aid the patient's sleep? A. Baclofen B. Venlafaxine C. Atropine sulfate D. Zolpidem tartrate

D

Which recommendation would the nurse make for decreasing fatigue in a patient with multiple sclerosis (MS)? A. Avoid aerobic exercise. B. Have group activities together. C. Take hot showers daily. D. Keep frequently used items accessible.

D

Which response would the nurse make when a friend expresses fears regarding his or her mother becoming older, extremely forgetful and disoriented, and beginning to wander? A. "I bet she has Alzheimer disease." B. "Those behaviors are a normal part of aging." C. "You should look into obtaining respite care." D. "Have you taken her for a checkup recently?"

D

Which statement about multiple sclerosis (MS) is accurate? A. MS affects more men than women. B. MS usually occurs in people older than 50 years. C. MS is seen more often in warmer climates. D. MS occurs more frequently among whites than other races.

D

Which statement reflects a understanding of Huntington disease (HD)? A. HD is an autosomal dominant disorder. B. HD causes both neurologic and behavioral symptoms. C. HD is associated with dementia and choreiform movements. D. HD is associated with an increased amount of dopamine levels.

D

Which type of prescribed medication would the nurse anticipate when a patient with Alzheimer disease begins to exhibit clinical manifestations of depression for the first time? A. Neuroleptic B. Antipsychotic C. Cholinesterase inhibitor D. Selective serotonin reuptake inhibitor

D

Which prescribed medication would the nurse anticipate administering to a patient whose caregiver reports loss of memory and thinking skills? A. Sertraline B. Paroxetine C. Memantine D. Amitriptyline

C

Which stage of Alzheimer disease would the nurse document in the electronic medical record when the patient is completely bedridden, has lost all motor and verbal skills, and is unable to recognize family members? A. I B. II C. III D. IV

C

A patient with multiple sclerosis will begin therapy with fingolimod. Which instruction would the nurse give the patient about this drug? A. Monitor the pulse daily. B. Report symptoms of vertigo. C. Report symptoms of flushing. D. Monitor daily fingerstick blood sugar.

A

For a patient beginning the discharge home process with progressive stage I Alzheimer disease, which priority action would the nurse implement to ensure continuity of care when the family expresses concern about providing care for the parent? A. Provide the name of the assigned case manager. B. Provide a safe home environment for the patient. C. Refer the family to the Alzheimer's Association. D. Answer all family questions before discharge.

A

To diagnose Alzheimer disease, the health care provider would order which test to detect apolipoprotein E4 (APOE 4)? A. Genetic testing B. Folate level testing C. Serum electrolyte test D. Complete blood count (CBC) test

A

Which finding would the nurse expect when assessing a 30-year-old patient diagnosed with multiple sclerosis (MS)? A. Vision changes B. Flaccid muscles C. Tremors at rest D. Absent deep tendon reflexes

A

Which intervention would the nurse plan for a patient diagnosed with multiple sclerosis who is experiencing cognitive impairment? A. Encourage the use of written lists. B. Teach the use of a monthly calendar. C. Teach about the use of antidepressants. D. Discourage the use of electronic devices.

A

Which medication may be prescribed for a patient with multiple sclerosis who is experiencing erectile dysfunction? A. Sildenafil B. Methotrexate C. Magnesium oxide D. Methylprednisone

A

Which stage of Alzheimer disease would the nurse document when the patient demonstrates independent ADLs, has no social or employment difficulties, forgets names and misplaces items, and experiences short-term memory loss? A. I B. II C. III D. IV

A

Which medication would the nurse anticipate administering to older-adult patients with Alzheimer disease (AD)? Select all that apply. A. Donepezil B. Paroxetine C. Memantine D. Amitriptyline

A, B, C

Which clinical manifestation would the nurse associate with a patient experiencing meningitis? Select all that apply. A. Vertigo B. Fatigue C. Photophobia D. Red macular rash E. Symptoms of decreased intracranial pressure (ICP)

A, B, C, D

Which finding is consistent with a diagnosis of multiple sclerosis? Select all that apply. A. Vertigo B. Tinnitus C. Dysmetria D. Intention tremor E. Dysarthria

A, B, C, D, E

Which intervention would the nurse implement to manage patients with Alzheimer disease? Select all that apply. A. Cognitive stimulation B. Reminiscence therapy C. Environmental relaxation D. Promoting communication E. Avoiding self-management

A, B, D

Which ocular or vision-related finding is a complication of multiple sclerosis (MS)? Select all that apply. A. Diplopia B. Scotomas C. Glaucoma D. Nystagmus E. Dry eye

A, B, D

For a hospitalized patient diagnosed with Parkinson disease (PD), which prescribed medication would the nurse administer via a continuous transdermal patch to maintain a consistent level of dopamine? A. Carbidopa/levodopa B. Rotigotine C. Amantadine D. Rivastigmine

B

For a patient diagnosed with Parkinson disease (PD), which stage of PD would the nurse associate with the patient's bilateral limb involvement, masklike face, and slow, shuffling gait? A. Stage 1 B. Stage 2 C. Stage 3 D. Stage 4

B

For a patient with advanced Alzheimer disease, which term reflects the behavior of increased confusion, belligerence, and wandering toward the end of the day, rather than any other time? A. Psychosis B. Sundowning C. Drug toxicity D. Prosopagnosia

B

The nurse is caring for a patient admitted with an exacerbation of multiple sclerosis (MS). The patient reports urinary incontinence. Which primary urinary bladder alteration related to MS is the likely cause? A. Flaccid bladder B. Spastic bladder C. Interstitial cystitis D. Vesicoureteral reflux

B

When providing care for a patient newly diagnosed with Huntington disease (HD), the nurse would include which statement when teaching the specifics of the disease? A. "Use the medications regularly." B. "It may be passed to your biologic child." C. "Do not share a bathroom with your family." D. "Do not depend on others for ADLs."

B

Which clinical manifestation would the nurse associate with the patient in stage I of Alzheimer disease? A. Loss of facial recognition B. Decreased sense of smell C. Motor and verbal skills lost D. General and focal neurologic deficits

B

Which disease is characterized by remissions and exacerbations of symptoms causing neurological disability? A. Spinal shock B. Multiple sclerosis C. Spinal cord tumor D. Amyotrophic lateral sclerosis (ALS)

B

Which intervention would the nurse implement to protect a patient with Parkinson disease (PD) from injury? A. Decrease the patient's level of activity. B. Monitor the patient's sleep patterns. C. Encourage the patient to watch the feet when walking. D. Suggest the patient obtain assistance in performing ADLs.

B

Which prescribed medication would the nurse associate with reducing the depression experienced by a patient with Alzheimer disease? A. Donepezil B. Paroxetine C. Memantine D. Amitriptyline

B

Which statement reflects an understanding about the federal regulations regarding use of restraints in long-term care facilities? Select all that apply. A. "Patients do not have the right to refuse physical and chemical restraints." B. "Before using a physical or chemical restraint, use the restraint alternatives." C. "Restraints should not be too tight as they may result in skin tears and irritation." D. "Avoid using restraint without written consent from the primary health care provider."

B, C, D

For the patient with Alzheimer disease (AD), which aspect would the nurse include with the primary focus of identifying abnormalities in cognition? Select all that apply. A. Posture B. Behavior C. Language D. Alertness E. Personality

B, C, E

A patient diagnosed with multiple sclerosis has slurred speech. Which term would the nurse use for this speech pattern? A. Scanning B. Dysmetria C. Dysarthria D. Scotomas

C

For patients with dementia, which prescribed medication would the nurse administer to treat those patients who also experience hallucinations? A. Donepezil B. Paroxetine C. Haloperidol D. Amitriptyline

C

The nurse is teaching a patient about multiple sclerosis. Which statement by the patient indicates a need for further teaching? A. "There's a good chance multiple sclerosis is related to viruses." B. "People in colder climates are more prone to developing multiple sclerosis." C. "People with Asian ancestry are more likely to get multiple sclerosis." D. "I am at higher risk for developing multiple sclerosis if my mother had it."

C

The nurse reviews the health history of a patient diagnosed with multiple sclerosis. Which assessment finding would be consistent with the report of the patient developing scotomas? A. Double vision B. Intention tremors C. Decreased peripheral vision D. Involuntary eye movements

C

Which antineoplastic drug has been shown to effectively reduce neurologic disability in patients with multiple sclerosis? A. Fingolimod B. Cyclosporine C. Mitoxantrone D. Methotrexate

C

As part of the discharging home process for a patient with Parkinson disease and his or her spouse, which action would the nurse implement to ensure successful plan management? A. Tell the spouse what the patient needs. B. Establish visitations by a home health nurse. C. Write up a detailed plan of care according to the standards. D. Involve the patient and spouse in developing a plan of care.

D

For a patient with Parkinson disease (PD), which prescribed intervention would the nurse anticipate when the patient develops a medication tolerance? A. Increase the prescribed medication dosage. B. Change the route of medication administration. C. Provide a medication holiday that lasts up to 20 days. D. Change the medication or its frequency of administration

D

The daughter of a patient diagnosed with multiple sclerosis expresses concern over the patient's inappropriate behavior in social situations. Which response would the nurse provide? A. "It may be important to avoid taking your parent into social situations." B. "We can talk about medication to help with the behavior." C. "Unfortunately, this is part of the disease process and will likely get worse." D. "You can develop a cue to alert your parent to modify actions."

D

When a patient with Parkinson disease is to begin taking rasagiline mesylate to relieve freezing episodes, which instruction would the nurse provide the patient and caregiver? A. "Strictly avoid grapefruit juice." B. "Strictly avoid coffee and tea." C. "Strictly avoid green, leafy vegetables." D. "Strictly avoid foods with cheese or cheese products."

D

When preparing to administer donepezil to a patient with Alzheimer disease, the nurse would associate which action with the prescribed medication? A. Dopamine levels are increased by this medication. B. The medication blocks the reuptake of serotonin. C. Donepezil prevents an increase in the protein beta amyloid. D. It delays the destruction of acetylcholine by acetylcholinesterase.

D