neuro/ms

The patient with Parkinson disease has a pulse oximetry reading of 72% but the patient is not displaying any other signs of decreased oxygenation. What most likely is contributing to the patient's low SpO 2 level? 1 Motion 2 Anemia 3 Dark skin color 4 Thick acrylic nails

a

The patient with a history of tension headaches complains of head pain. The nurse determines the patient has normal vital signs and a normal brief neurological assessment. Which next action by the nurse would be most appropriate? 1 Obtain a detailed past medical history 2 Anticipate a prescription for a computed axial tomography (CAT; computed tomography [CT]) scan of the head 3 Obtain a neurological consult 4 Call the stroke team

a

A patient with multiple sclerosis is under treatment with β-interferon. What patient teaching would be appropriate for this patient? Select all that apply. 1 Wear sunscreen while exposed to sunlight. 2 Rotate injection sites with each dose. 3 Know that flu-like symptoms are common. 4 Do not drink grape juice. 5 Monitor vital signs regularly

a,b,c

To reduce the incidence of pain for a patient with low back pain, the nurse includes which interventions? Select all that apply. 1 Placing a pillow between the patient's legs and turning the body as a unit. 2 Administering prescribed nonsteroidal antiinflammatory drugs (NSAIDs). 3 Maintaining the patient on strict bed rest. 4 Applying heat or ice to the area of most pain. 5 Preventing the patient from lifting anything at the bedside

a,b,d

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. 1 Eat a balanced diet that can be easily chewed and swallowed. 2 IncFlude liquid rather than solid foods in the diet. 3 Plan activities with periods of rest. 4 Practice hobbies such as playing golf. 5 Schedule drugs so that the peak effect of the drug is at mealtime

a,c,e

1. A client diagnosed with Parkinson's disease is being discharged. Which statement made by the client indicates an understanding of discharge instructions? a. "My medications will help cure the disease." b. "I need to eat 3 large meals a day to have adequate nutrition." **c. "I should cut my food in bite sized pieces." d. "I should see immediate results when taking Levodopa." 2. The nurse is admitting a client with the diagnosis of Parkinson's disease. Which assessment finding supports this diagnosis? a. Crackles in the upper lung fields. **b. Reduction in facial expressions and shuffling gait. c. Muscle weakness in upper extremities. d. A decrease in appetite. 3. The patient with migraine headaches has a seizure. After the seizure, which action can you delegate to the nursing assistant? a. Restrain the patient for protection. b. Perform a neurologic check c. Document the seizure. **d. Take the patient's vital signs. 4. You are creating a teaching plan for a patient with newly diagnosed migraine headaches. Which key items should be included in the teaching plan? (Choose all that apply). **a. Abortive therapy is aimed at eliminating the pain during the aura. b. Continue taking estrogen as prescribed by your physician. ***c. A potential side effect of medications is rebound headache. ***d. Complementary therapies such as relaxation may be helpful. ***e. Avoid drugs such as Tagamet, nitroglycerin and Nifedipine. 5. Which intervention should the nurse take with the client recently diagnosed with ALS? A. Discuss percutaneous gastrostomy tube. B. Explain how a fistula is accessed. **C. Provide an advanced directive. D. Call for a Physical Therapist consult for leg braces. Which assessment data would make the nurse suspect that the client has ALS? A. History of a cold or GI upset in the last month B. Complaints of double vision and drooping eyelids **C. Fatigue, progressive muscle weakness, and twitching. D. Loss of sensation below the level of the umbilicus. Which care should the nurse prioritize when providing care to a patient with a diagnosis of Multiple Sclerosis? **a. Vigilant infection control and adherence to standard precautions. b. Careful monitoring of neurological assessment and frequent reorientation c. Maintenance of calorie count and hourly assessment of intake and output d. Assessment of blood pressure and monitoring for signs/symptoms of orthostatic hypotension Your patient has been diagnosed with Multiple Sclerosis. You are teaching them about how to reduce muscle spasticity. Which of the following statement, if made by the patient, would indicate a need for further teaching? e. "Daily exercise, including weight bearing can help reduce spasticity." f. "My stretching routine can help with spasms." g. "Taking Baclofen can help relieve the spasms in my legs. " ***h. "At the end of the day taking a nice hot bath may help relieve spasms in my legs. " Huntington's disease affects primarily which body system? i. Lymphatic **j. Neurological k. Cardiovascular l. Respiratory 7. Huntington's disease is an inherited illness, passed on from one generation to another. If a parent has this disease, what's the likelihood of a child developing it also? a. 100% b. 75% **c. 50% d. 10% 8. A young woman is asking the nurse about her grandfather, who just received a diagnosis of Huntington's disease. She wants to know if she will have the disease, too. What should the nurse tell her? Select all that apply. a. "Huntington's disease affects men more than women." **b. "Huntington's disease is an autosomal dominant disease." c. "Huntington's disease can be cured, so there's no reason to worry." **d. "There is a 50% chance you will have the disease." 9. A chronic, progressive neurodegenerative disorder characterized by slowness in the initiation and execution of movement, increased muscle tone, tremor at rest, and gait disturbance. a. Creutzfeldt - Jakob Disease b. Multiple Sclerosis ***c. Parkinson's Disease d. All the above 10. During shift change a nurse receives a report she will be caring for a patient with Parkinson's disease. They recall from NP 2 class with Mrs. Stiefvater many years ago, that a lack of this neurotransmitter plays a role in this disease: a. Lewy Bodies b. Myelin **c. Dopamine d. Levodopa 11. The client with ALS is admitted to the medical unit with SOB. dyspnea, and respiratory complications. Which intervention should the nurse implement first? a. Elevated the HOB 30 degrees **b. Administer oxygen via nasal cannula c. Assess lung sounds d. Obtain a pulse ox reading 12. MS is characterized by a. Buildup of acids in the brain that causes inflammation b. Lack of calcium that causes neuron flaring **c. Disseminated demyelination of nerve fibers d. Unilateral (sometime bilateral ) throbbing pain, a triggering event or factor, and manifestations associated with neurologic and autonomic nervous system dysfunction 13. Which 30 year old will be more likely to get MS? a. A man relocating from Cuba to Brazil b. A man relocating from Florida to Canada c. A woman relocating from New York to Texas **d. A woman relocating from Mexico to Northern Europe 14. Which statement is false about MS? a. MS doesn't affect unemployment b. Pregnant women with MS can see an improvement in symptom's **c. MS is a deadly disease d. After the myelin sheath around the axon encounters some damage due to MS, it can still regenerate. 15. Which statement is true about MS? a. Anger is not associated with MS **b. A person with MS can experience feelings of extreme happiness c. If MS is caught early enough it can be cured. d. Luckily, the bladder isn't affected in MS 16. A patient with MS might have to (select all that apply) **a. Self-catheterize their bladder **b. Be confined to bed during an acute exacerbation c. Wake up early during times of remission d. Use a hot Jacuzzi or hot dry sauna to sweat during remission **e. Decrease their caffeine intake 17. True or False: HD is not hereditary: false 18. What is the most important thing to ask about when trying to diagnose HD? Family history 19. HD's most common age of onset is 30-50 (but it can happen anytime.) 20. Abnormal and excessive involuntary movements are define as? Chorea 21. What are the three characteristics of HD? Chorea, dementia, and psychological issues 22. What are the main medications used to treat HD? Medications for symptom relief 23. What are the two main causes of death in HD? Aspiration pneumonia and suicide 24. List possible intervention for HD patients. Numerous 25. Which antibody causes most cases of myasthenia gravis? a. Anti-MuSK b. CBC **c. Anti-AChR d. CRP e. ANA 26. Which statement by the client supports the diagnosis of myasthenia gravis (MG)? a. "I have weakness and fatigue in my feet and legs." **b. "My eyelids droop, and I see double everything." c. "I get chest pain and faint after I walk in the hall." d. "I gained 3 pounds this week, and I am spitting up pink frothy sputum." 27. Which response to the Tensilon (edrophonium chloride) injection indicates the client has myasthenia gravis? a. The client has no apparent change in the assessment data. b. There is reduced amplitude of electrical stimulation in the muscle. c. The anti-acetylcholine receptor antibodies are present. **d. The client shows a marked improvement of muscle strength. 28. The diagnostic work-up of a client hospitalized with complaints of progressive weakness and fatigue confirms a diagnosis of myasthenia gravis. The medication used to treat myasthenia gravis is: **a. Prostigmine (neostigmine) b. Atropine (atropine sulfate) c. Didronel (etidronate) d. Tensilon (edrophonium)

b

A 50-year-old male patient has been diagnosed with amyotrophic lateral sclerosis (ALS). What nursing intervention is most important to help prevent a common cause of death for patients with ALS? 1 Reduce fat intake 2 Reduce the risk of aspiration 3 Decrease injury related to falls 4 Decrease pain secondary to muscle weakness

b

A patient has ptosis resulting from myasthenia gravis. Which assessment finding would the nurse expect to see in this patient? 1 Redness and swelling of the conjunctiva 2 Drooping of the upper lid margin in one or both eyes 3 Redness, swelling, and crusting along the lid margin 4 Small, superficial white nodules along the lid margin

b

A patient has been found to have amyotrophic lateral sclerosis. What classic symptom of the disorder does the nurse recognize? 1 Dysuria 2 Dyspnea 3 Dysphagia 4 Dysreflexia

c

The nurse is planning health promotion teaching for a patient with asthma, low back pain from a herniated lumbar disc, and hypertension. The nurse determines which exercise would be best to include in an individualized exercise plan for the patient? 1 Running 2 Weight-lifting 3 Walking 4 Tennis

c

The nurse is reinforcing general health teaching with a 48-year-old patient with osteoarthritis of the knees. Which statement by the patient demonstrates correct understanding of osteoarthritis? 1 "Joint degeneration with pain and disability occurs in the majority of people by the age of 60." 2 "Osteoarthritis can be prevented from progressing when well controlled with a regimen of exercise, diet, and medication." 3 "Osteoarthritis is more common with aging, but usually it remains confined to a few joints and does not cause crippling." 4 "Osteoarthritis is an inflammatory disease of the joints that may present symptoms at any age

c

The nurse is caring for a patient with a spinal bone fracture and osteoporosis. The patient asks the nurse for information on osteoporosis. The most appropriate response by the nurse is: 1 Tendons and ligaments become more flexible. 2 Almost 50% of a person's muscle mass is decreased by age 70. 3 An increase in motor neurons can lead to more problems with skeletal muscle movement. 4 For many people, diseases such as osteoarthritis and osteoporosis are not a normal part of growing older

d

The patient with osteoporosis and hypertension understands dietary teaching when the patient selects which meal for dinner? 1 Ham and Swiss-cheese sandwich on whole-wheat bread, steamed broccoli, and an apple 2 Baked chicken with one cup of yogurt and steamed rice 3 A two-egg omelet with 2 oz. of American cheese, one slice of whole-wheat toast, and half a grapefruit 4 Baked salmon with one cup of spinach and steamed carrots

d

When reinforcing health teaching about the management of osteoarthritis, the nurse determines that the patient needs additional instruction after making which statement? 1 "I should take the acetaminophen (Tylenol) as prescribed to help control the pain." 2 "I should continue my typical exercise and diet regimen." 3 "I can use a cane if I find it helpful in relieving the pressure on my back and hip." 4 "A cold shower in the morning will help relieve the stiffness I have when I get up

d

Which criterion is included to establish that a patient has Parkinson's disease? Select all that apply. 1 Decreased serum dopamine levels. 2 Tumor present in the thymus gland. 3 Magnetic resonance imaging (MRI) shows areas of plaque on cranial nerves. 4 Presence of two of the three classic features: rigidity, bradykinesia, and tremor. 5 Positive response to antiparkinsonian medications

d,e

he nurse understands that generalized tonic-clonic seizures are the most common type of generalized seizure and include various phases. Arrange the phases of generalized tonic-clonic seizures in the correct order. 1.The patient loses consciousness. 2.The patient falls to the ground 3.The patient feels tired and sleepy 4,The body stiffens for 10 to 20 seconds. .5.the extremities jerk for 30 to 40 seconds.

1,2,4,5,3

Which condition is caused by a refractive error in the eye? 1 Myopia 2 Cataract 3 Glaucoma 4 Conjunctivitis

a

The nurse is completing discharge teaching with a patient who has undergone total knee arthroplasty. Which statement would indicate the need for additional teaching? 1 "I should continue physical therapy as prescribed." 2 "I will increase intake of vitamins and minerals." 3 I will report pain or swelling to the health care provider." 4 "I should expect that my knee may change shape

d

A 48-year-old man was just diagnosed with Huntington's disease. His 20-year-old son is upset about his father's diagnosis. How can the nurse best help this young man? 1 Provide emotional and psychologic support 2 Encourage him to get diagnostic genetic testing done 3 Tell him the cognitive deterioration will be treated with counseling 4 Tell him the chorea and psychiatric disorders can be treated with haloperidol (Haldol)

a

A 57-year-old patient with osteoarthritis of the knees has been taking celecoxib (Celebrex) 200 mg every 12 hours. The patient states that the drug does not seem to work as well as it used to in controlling the pain. The nurse's response to the patient is based on the knowledge that: 1 This patient may respond better to an alternate nonsteroidal antiinflammatory drug (NSAID). 2 The patient is now tolerant of the medication and will need to double the dose. 3 If NSAIDs are not effective in controlling symptoms, the next line of therapy is systemic corticosteroids. 4 It may take several months for NSAIDs to reach maximal effectiveness.

a

A patient with Parkinson disease has lost 35 pounds over two months. A swallowing study shows that the patient is able to swallow and does not aspirate. What suggestion should the nurse discuss with the patient and spouse to improve nutrition? 1 Allow adequate time for the patient to eat meals. 2 Encourage the patient to eat at least every two hours while awake. 3 Administer prescribed carbidopa/levodopa (Sinemet) with a protein drink. 4 Include foods that are chewy so the patient builds up the jaw muscles.

a

The nurse asks the patient scheduled for a total hip replacement to sign the operative permit as directed in the health care provider's preoperative prescriptions. The patient states that the health care provider has not really explained what is involved in the surgical procedure. What is the most appropriate action by the nurse? 1 Notify the health care provider about the conversation with the patient and delay the signature 2 Ask family members to clarify the information for the patient 3 Have the patient sign the form and explain the procedure to the patient 4 Have the patient sign the consent form and ask the health care provider to discuss again before surgery

a

The nurse is caring for a 73-year-old male patient with osteoarthritis. The nurse concludes the patient has accurate knowledge when the patient describes the condition as: 1 Degeneration of cartilage in synovial joints 2 An under-production of synovial fluid 3 Breakdown of tissue caused by a sedentary lifestyle 4 An autoimmune disorder that is hereditary in nature

a

The nurse suspects that a patient is at a high risk of developing osteoporosis. The nurse made this conclusion based on which statement made by the patient? 1 "I do not perform any weight-bearing exercises." 2 "I take folic acid supplements on a regular basis." 3 "I take cod liver oil supplements on a regular basis." 4 "I refrain from following drastic diets for weight loss."

a

Which measure should the nurse prioritize when providing care for a patient with a diagnosis of multiple sclerosis (MS)? 1 Vigilant infection control and adherence to standard precautions 2 Careful monitoring of neurologic assessment and frequent reorientation 3 Maintenance of a calorie count and hourly assessment of intake and output 4 Assessment of blood pressure and monitoring for signs of orthostatic hypotension

a

The parent of a child newly diagnosed with a typical absence seizure is worried. What information should the nurse provide to the parent regarding typical absence seizures? Select all that apply. 1 The occurrence of seizures usually subsides during adolescence. 2 The seizures are characterized by brief staring spells. 3 The seizures are usually precipitated by flashing lights. 4 A seizure is associated with loss of postural tone. 5 The child will usually seem confused after a seizure

a,b,c

When performing a physical assessment on a patient with amyotrophic lateral sclerosis, which manifestations is the nurse likely to find? Select all that apply. 1 Limb weakness 2 Difficulty articulating words 3 Difficulty swallowing 4 Twisting movements of the face 5 Involuntary movements of the bod

a,b,c

A patient with a history of myasthenia gravis is admitted to the hospital in respiratory failure and diagnosed with a 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. 1 Diagnosed with urinary tract infection previous week. 2 Attended funeral of family member earlier in week. 3 Took antibiotic prescribed for urinary tract infection. 4 Omitted pyridostigmine (Mestinon) previous day. 5 Continued taking prescribed corticosteroid every other day

a,b,c,d

A patient in the clinic for a nasal fracture that occurred during a baseball game was controlled. During discharge teaching, the nurse instructs the patient to do which of these? Select all that apply. A Use aspirin for pain relief. B Encourage the patient not to smoke. C Avoid hot showers for the next 48 hours. D Apply ice to the face and nose for one-hour intervals. E Drink a glass of wine in the evening for relaxation

a,b,c,e

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. 1 Ease the patient to the floor. 2 Loosen constrictive clothes. 3 Restrain the patient to a bed. 4 Protect the patient from any injury. 5 Bring the patient to the hospital immediately

a,b,d

The nurse is caring for the patient with skeletal traction for an extremity fracture. What action(s) by the nurse are mostappropriate? Select all that apply. A Keep the weights off of the floor. B Elevate the end of the bed as needed. C Confirm that the forces are pulling in the same direction. D Apply the traction intermittently as prescribed by the health care provider (HCP). E Make sure that the traction ranges from 5 to 45 pounds (2.3 to 20.4 kg). F Ensure that the weights are secured to the pulleys

a,b,e

A patient diagnosed with seizures is advised to take phenytoin (Dilantin). Which common side effects of phenytoin (Dilantin) should the nurse inform the patient about? Select all that apply. 1 Gingival hyperplasia 2 Neuropathy 3 Memory loss 4 Hirsutism 5 Weight gain

a,d

A patient with myasthenia gravis is wondering about whether he will need thymectomy. For which patients is thymectomy performed? Select all that apply. 1 Patients with thymoma 2 Patients with cholinergic crisis 3 Patients with a positive Tensilon test 4 Patients with purely ocular myasthenia gravis 5 Patients between the ages of puberty and about 65 years

a,d,e

A patient is advised to use diazepam (Valium) for multiple sclerosis. What patient teaching is important for those taking this drug? Select all that apply. 1 Avoid driving while on the drug. 2 Do not stop the drug abruptly. 3 Avoid taking alcohol with the drug. 4 Monitor blood pressure regularly. 5 Avoid contact with large crowds

a.b,c

A 58-year-old male patient with a history of transient ischemic attacks (TIAs) is undergoing rehabilitation following an ischemic stroke. The patient's medical history is likely to be related to what health problems? 1 Inguinal hernia 2 Erectile dysfunction 3 Testosterone deficiency 4 Benign prostatic hyperplasia (BPH

b

A female patient has left-sided hemiplegia following an ischemic stroke that she experienced four days earlier. How should the nurse best promote the health of the patient's integumentary system? 1 Position the patient on her weak side the majority of the time. 2 Alternate the patient's positioning between supine and side-lying. 3 Avoid the use of pillows to promote independence in positioning. 4 Establish a schedule for the massage of areas where skin breakdown emerges

b

A patient aged 20, who developed seizures after a head injury, tells the nurse he or she feels like he or she has lost control over his or her life since the seizures. Initially, what is the most appropriate response by the nurse? 1 "With medications and your health care provider's assistance, I am sure you will be able to achieve your life goals." 2 "Tell me about what you would like to do and how the seizures affect you." 3 "New treatments come out every year, so don't give up." 4 "You are young and can still heal from the injury. It has only been a few months."

b

A patient who underwent spinal surgery reports a severe headache afterward. When changing the dressing to the incisional area, the nurse finds the drainage to be slightly yellow, and positive on a dipstick test. What is the best nursing intervention in this situation? 1 Send the drainage sample for culture. 2 Inform the primary health care provider. 3 Administer an analgesic for the headache. 4 Apply a new dressing on the incisional area

b

The daughters of a 78-year-old nonresponsive patient who had an ischemic stroke two weeks ago have asked the nurse if they can bring a Healing Touch (HT) practitioner to the bedside. How should the nurse best respond? 1 Review the literature on HT before granting permission. 2 Consult with the health care team and facilitate the practitioner's visit. 3 Encourage the family to defer their decision until physiotherapy has been shown to be ineffective. 4 Dialogue with the family members about whether they would prefer to change to a complementary and alternative plan of care.

b

The nurse teaches a patient with osteoporosis about dietary modifications to improve calcium intake. Which patient food choices indicate the need for additional teaching? 1 One glass of milk, cottage cheese, and one cup yogurt 2 Boiled egg, carrot and lettuce salad, and a fresh cut apple 3 Spinach soup and roasted salmon with cheddar cheese dip 4 Steamed broccoli salad, steamed oysters, and one cup ice cream

b

The primary health care provider prescribes glucosamine to a patient with osteoarthritis. Which associated complication does the nurse anticipate? 1 Increased risk of obesity 2 Increased risk of bleeding 3 Increase risk of diarrhea 4 Increased risk of hypertension

b

Which cytokine is used in the treatment of multiple sclerosis? 1 Interferon-alpha 2 Interferon-beta 3 Interleukin-2 4 Interleukin-11

b

Which drug is prescribed to stabilize vital signs and prevent seizures and delirium for a patient withdrawing from alcohol? 1 Thiamine 2 Diazepam 3 Folic acid 4 Magnesium sulfate

b

While completing an admission history for a 73-year-old man with osteoarthritis admitted for knee arthroplasty, the nurse asks him about his perception of the reason for admission. The nurse expects the patient to state: 1 Fractured patella 2 Chronic knee pain 3 Frequent and multiple falls 4 Total immobilization of his knee

b

The nurse is caring for the patient with a history of rheumatoid arthritis. The patient asks the nurse how is rheumatoid arthritis (RA) different from osteoarthritis (OA)? What statements by the nurse are most appropriate? Select all that apply. A RA usually occurs after age 40. B People with OA are often overweight. C Effusions are uncommon in people with RA. D Rheumatoid factor (RF) is negative in people with OA. E RA is a localized disease with a variable progressive course. F With OA, stiffness occurs upon arising but usually subsides after 30 minutes

b, d, f

A patient sustained a fall 1 week ago, but did not have a fracture. The patient reports pain in the right hip, which increases in intensity with activity. The patient has a fever and the site of injury is swollen and tender to the touch. Which diagnostic tests would help determine the cause of the patient's condition? Select all that apply. 1 X-ray of the hip 2 Bone tissue biopsy 3 White blood cell count 4 Radionuclide bone scans 5 Magnetic resonance imaging

b, d,e

When establishing a diagnosis of multiple sclerosis (MS), what diagnostic studies should the nurse teach the patient about? Select all that apply. 1 EEG 2 Computed tomography (CT) scan 3 Carotid duplex scan 4 Evoked response testing 5 Cerebrospinal fluid analysis

b, d,e

A nurse is caring for a patient admitted to the health care facility with acute ischemic stroke. The patient is receiving IV antihypertensive drugs. Which interventions should the nurse perform for this patient? Select all that apply. 1 Assess blood pressure (BP) and pulse every 30 minutes. 2 Titrate drug according to mean arterial pressure (MAP) or BP as prescribed. 3 Measure hourly urine output. 4 Provide assistance to get up as patient desires. 5 Perform frequent neurologic checks

b,c,e

The nurse is reinforcing health teaching about osteoporosis with a patient admitted to the hospital. The nurse discusses several risk factors for osteoporosis, including which of the following? Select all that apply. 1 Obesity 2 Asian descent 3 Smoking 4 Hyperlipidemia 5 Sedentary lifestyle

b,c,e

A 65-year-old patient who was admitted with Parkinson's disease fell down some stairs in the hospital. The nurse who was caring for him finds that he is conscious and is complaining of severe pain in the calf muscles. There are no apparent bone fractures. What should be the immediate course of action for the nurse? Select all that apply. 1 Apply hot compresses. 2 Apply ice to the painful area. 3 Encourage the patient to mobilize the limb. 4 Elevate the affected limb. 5 Restrain the patient to the bed

b,d

What instructions should a nurse give to a patient who has focal seizures well controlled with phenytoin (Dilantin) and who has mild gingival hyperplasia? Select all that apply. 1 The drug should be changed immediately. 2 Regular flossing can control gingival tissue growth. 3 Surgical repair of gingival tissue will be required. 4 Regular tooth brushing can limit hyperplasia. 5 Gingival hyperplasia is not related to phenytoin (Dilantin)

b,d

The patient is complaining of chronic low back pain. Which of the following are risk factors of chronic low back pain and risk factors that can directly cause this problem? Select all that apply. A Illegal drug abuse B Cigarette smoking C Lack of aerobic exercise D Prolonged periods of sitting E Jobs that require repetitive heavy lifting F Previous compression fractures of the spine

b,d,e,f

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. A Cluster headaches are quite common and occur in about 10% of the American population. B Cluster headaches can occur for weeks to months at a time, followed by remission periods. C At the onset of cluster headaches, imaging studies are always negative.D Alcohol is the only known dietary trigger for cluster headaches. E Cluster headaches have a pulsing type of pain like migraine headaches. F Cluster headaches occur regularly and frequently at the same time each day

b,d,f

A male patient with a diagnosis of Parkinson disease (PD) has been admitted recently to a long-term care facility. Which action should the health care team take to promote adequate nutrition for this patient? 1 Provide multivitamins with each meal. 2 Provide a diet that is low in complex carbohydrates and high in protein. 3 Provide small, frequent meals throughout the day that are easy to chew and swallow. 4 Provide the patient with a minced or pureed diet that is high in potassium and low in sodium

c

A patient is diagnosed with multiple sclerosis (MS) and is prescribed interferon (Betaseron). What should the nurse include in medication teaching? 1 The medication should be taken before meals on an empty stomach. 2 The medication is given during exacerbation of symptoms to promote remission. 3 The medication often causes patients to experience flu-like symptoms. 4 The medication alters carbohydrate metabolism and elevates serum glucose levels

c

A patient is receiving alendronate (Fosamax) for treatment of osteoporosis. The nurse would become concerned after noting which action by the patient? The patient: 1 Takes the medication with 8 ounces of water 2 Increases intake of calcium and vitamin D 3 Takes the medication immediately before bed 4 Continues to perform weight-bearing exercises

c

A patient with a brain tumor presents with symptoms of visual disturbances and seizures. When evaluating the patient, the nurse knows that this tumor is most likely located in which area of the brain? 1 Subcortical 2 Parietal lobe 3 Occipital lobe 4 Temporal lobe

c

A patient with a history of epilepsy is admitted to the hospital for treatment of fever and shortness of breath. The patient is diagnosed with pneumonia. On taking history, the nurse finds that the patient had an episode of seizures four days ago with profuse vomiting. What type of pneumonia does the patient have? 1 Hospital-associated pneumonia 2 Community-acquired pneumonia 3 Aspiration pneumonia 4 Opportunistic pneumonia

c

A patient with asthma who has undergone a total hip replacement complains on the third postoperative day of shortness of breath and slight chest pain and notes that "something is wrong." Temperature is 98.8°F, blood pressure 168/98 mm Hg, pulse 96, respirations 32, and oxygen saturation is 89% on room air. What is the prioritynursing action? 1 Administer the prescribed antihypertensive medication and reassess in 15 minutes 2 Obtain an electrocardiogram (ECG) and administer albuterol nebulizers 3 Apply oxygen and place the patient in a semi-Fowler position 4 Notify the health care provider and document the vital signs

c

A patient with osteoporosis is treated with analgesics and biphosphonates. The nurse teaches the patient about safe administration of the drug. Which patient action may interfere with the therapeutic action of the drug? 1 Taking the biphosphonates with a full glass of water 2 Taking the biphosphonates 30 minutes before a meal 3 Taking the analgesics and biphosphonates at the same time 4 Remaining upright for 30 minutes after taking bisphosphonates

c

An adult patient, whose parent died from Huntington's disease, is discussing the condition and genetic testing with a nurse. Which of the patient's statements needs to be corrected by the nurse? 1 Ospring of persons with Huntington's disease have a 50% risk to develop it. 2 Currently there is no eective treatment or cure for Huntington's disease. 3 Positive genetic testing indicates at what age the symptoms of the disease will occur 4 Positive genetic testing indicates the patient eventually will develop the disease

c

An asthmatic patient was prescribed theophylline (Theo-24). A nurse understands that the patient is at risk for tachycardia and seizures. In regards to safety, the nurse expects that what will be included on the patient's treatment plan? 1 Encourage the use of caffeine. 2 Monitor serum blood levels of adrenaline. 3 Monitor serum blood levels of theophylline. 4 Use diazepam (Valium) to prevent seizures

c

The nurse is assessing a patient who is taking alendronate (Fosamax) for osteoporosis. The nurse knows that this medication: 1 Helps replace low calcium levels 2 Can lead to uncontrolled weight gain 3 Must be taken with a full glass of water 4 Is always given after primary treatment with estrogen therapy

c

The nurse is assessing the recent health history of a 43-year-old patient with osteoarthritis. The nurse determines that the patient was managing the condition well when the patient states that his or her activity pattern has consisted of which of the following? 1 Minimal exercise with frequent rest periods 2 Bed rest and walking to the restroom 3 Walking and swimming regularly 4 Running three miles most days of the week

c

The nurse is caring for a patient who is scheduled to undergo surgery. The nurse advises the patient to refrain from eating his/her favorite food, garlic bread. What is the likely reason for the nurse's advice? 1 The patient may experience excessive sedation. 2 The patient may experience excessive nausea after the surgery. 3 The patient may experience excessive bleeding during the surgery. 4 The patient may experience an increase in blood pressure during the surgery

c

The nurse provides discharge instructions to a patient who has undergone total hip arthroplasty. Which statement by the patient indicates understanding of the instructions? 1 "I'll walk at least 2 miles a day after I get home." 2 "I may get back to work as soon as I feel that I'm able." 3 "I have to do the physical therapy exercises several times a day." 4 "I should take frequent bike rides to increase my activity and joint flexibility

c

Two sons of a father who has Huntington's disease cannot agree on whether or not to be tested for Huntington's disease because of the cost. What assistance should the nurse give when discussing presymptomatic genetic testing with these men? 1 "If one brother has the disease, the other brother will as well." 2 "A positive genetic mutation increases your risk of the disease." 3 "If there is a positive result, the patient will be diagnosed with the disease." 4 "You could use a direct-to-consumer genetic test for making future life decisions

c

Which nursing diagnosis is likely to be a priority in the care of a patient with myasthenia gravis (MG)? 1 Acute confusion 2 Bowel incontinence 3 Activity intolerance 4 Disturbed sleep pattern

c

Which refractive error of the eye results in loss of accommodation? 1 Myopia 2 Hyperopia 3 Presbyopia 4 Astigmatism

c

A patient recently diagnosed with osteoporosis is concerned about getting a bone fracture. On what preventive measures would the nurse educate the patient? Select all that apply. 1 Eat foods such as bananas, salmon, and broccoli 2 Increase calcium supplement intake to 300 to 600 mg/day 3 Increase exposure to sunlight to at least 20 minutes a day 4 Conduct weight-bearing exercises, such as tennis or walking 5 Participate in high-impact exercises, such as aerobics or running 6 Eat foods such as cottage cheese, sardines, and turnip greens

c,d,f

A 68-year-old patient has undergone a total hip replacement and has glaucoma. The nurse forms a nursing diagnosis of disturbed sensory perception related to increased intraocular pressure. The plan of care should focus on which main element? 1 Use of occupational and physical therapy for visual deficits 2 Managing the pain using oral antiinflammatories and opioids as needed 3 Restriction of driving privileges immediately 4 Encouraging medication compliance to reduce the risk of vision loss

d

A nurse is caring for a patient with Huntington's disease. This condition had been prevalent in the patient's family for the past five generations. The patient has two sons, both above the age of 40, and they do not show any signs or symptoms of Huntington's disease. Which term should be used to explain this genetic phenomenon? 1 X-linked disorder 2 Somatic mutation 3 Variable expression t4 Incomplete penetrance

d

A patient reports headache, fatigue, and a stiff neck after sustaining a tick bite. Borrelia burgdorferi is present in the patient's blood. The nurse anticipates that which medication will be prescribed? 1 Atropine (AtroPen) 2 Ceftriaxone (Rocephin) 3 Deferoxamine (Desferal) 4 Doxycycline (Vibramycin)

d

A patient status post right total knee arthroplasty has a prescription to get out of bed to the chair. Which action would the nurse take to protect the knee joint while carrying out the prescription? 1 Use a walker and two-person transfer technique. 2 Transfer the patient to the chair using a mechanical lift. 3 Ask the physical therapist to assist to limit weight bearing while the patient gets out of bed. 4 Ensure a knee immobilizer is in place and elevate the leg while sitting

d

A patient who had a total hip replacement less than one month ago comes into the clinic complaining of constant bone pain that is unrelieved by rest and seems to worsen with activity. The nurse would expect the health care provider to prescribe a laboratory test to rule out which organism? 1 Streptococcus viridans 2 Escherichia coli 3 Staphylococcus aureus 4 Staphylococcus epidermis

d

A patient with osteoarthritis is about to undergo total left-knee arthroplasty. The nurse assesses the patient carefully to be sure that there is no evidence of which sign in the preoperative period? 1 Immobility 2 Pain 3 Inflammation 4 Infection

d

A patient with severe osteoarthritis of the left knee has undergone left-knee arthroplasty with prosthetic replacement of the knee joint. After surgery, the nurse expects to include which intervention? 1 Active range of motion every hour 2 Strict bedrest for 24 hours 3 Total knee immobilization for 72 hours 4 Physical therapy to achieve full knee flexion

d

An 86-year-old patient has osteoarthritis of the knees. Which finding would the nurse expect upon examination of the patient's knees? 1 Stiffness that is worse in the morning 2 Positive anterior drawer test 3 Positive Phalen and Tinels signs 4 Pain with joint movement

d

The nurse completes a teaching session with factor workers on measures to prevent back pain. Which statement by one of the employees indicates the need for additional teaching? 1 "Maintaining a healthy weight will help prevent back pain." 2 "Sleeping in the side-lying position will help relax the back at night." 3 "Sleeping on a firm mattress will better support my back and reduce back strain." 4 "Standing straight and still during my shift will improve my posture and reduce back pain.

d

The nurse is caring for a 73-year-old patient who underwent a left total knee arthroplasty. On the third postoperative day, the patient complains of shortness of breath, slight chest pain, and that "something is wrong." Temperature is 98.4° F, blood pressure 130/88, respirations 36/minute, and oxygen saturation 91% on room air. What action should the nurse take first? 1 Notify the health care provider 2 Administer a nitroglycerin tablet sublingually 3 Conduct a thorough assessment of the chest pain 4 Sit the patient up in bed as tolerated and apply oxygen

d

he nurse is completing discharge teaching with an 80-year-old male patient who underwent right total hip arthroplasty. The nurse identifies a need for further instruction if the patient states the need to: 1 Avoid crossing his legs 2 Use a toilet elevator on toilet seat 3 notify future caregivers about the prosthesis 4 Maintain hip in adduction and internal rotation

d

Which measures reduce the risk of osteoarthritis in a patient? Select all that apply. A Avoiding intake of fish B Exercising on a hard surface C Increasing the intake of vitamin K D Avoiding bending the knee past 90 degrees E Avoiding forceful, repetitive movements

d,e