PUCH64 PARTI
A client is diagnosed with meningococcal meningitis. The 22-year-old client shares an apartment with one other person. What would the nurse expect as appropriate care for the client's roommate? A. Treatment with antimicrobial prophylaxis as soon as possible B. Admission to the nearest hospital for observation C. No treatment unless the roommate begins to show symptoms D. Bedrest at home for 72 hours
A
A patient has been diagnosed with meningococcal meningitis at a community living home. When should prophylactic therapy begin for those who have had close contact with the patient? A. Within 24 hours after exposure B. Within 48 hours after exposure C. Within 72 hours after exposure D. Therapy is not necessary prophylactically and should only be used if the person develops symptoms.
A
A patient with Bell's palsy says to the nurse, "It doesn't hurt anymore to touch my face. How am I going to get muscle tone back so I don't look like this anymore?" What interventions can the nurse suggest to the patient? A. Suggest massaging the face several times daily, using a gentle upward motion, to maintain muscle tone. B. Suggest applying cool compresses on the face several times a day to tighten the muscles. C. Inform the patient that the muscle function will return as soon as the virus dissipates. D. Tell the patient to smile every 4 hours.
A
Guillain-Barré syndrome is an autoimmune attack on the peripheral myelin sheath. Which of the following is an action of myelin? A. Speeds nerve impulse transmission B. Carries message to the next nerve cell C. Represents building block of nervous system D. Acts as chemical messenger
A
A client has been diagnosed with a frontal lobe brain abscess. Which nursing intervention is appropriate? A. Assess for facial weakness. B. Initiate seizure precautions. C. Assess visual acuity. D. Ensure that client takes nothing by E. mouth.
B
A client with possible bacterial meningitis is admitted to the ICU. What assessment finding would the nurse expect for a client with this diagnosis? A. Pain upon ankle dorsiflexion of the foot B. Neck flexion produces flexion of knees and hips C. Inability to stand with eyes closed and arms extended without swaying D. Numbness and tingling in the lower extremities
B
Which condition is a rare, transmissible, progressive fatal disease of the central nervous system characterized by spongiform degeneration of the gray matter of the brain? A. Multiple sclerosis B. Creutzfeldt-Jakob disease C. Parkinson disease D. Huntington disease
B
A client arrives at the emergency department complaining of extreme muscle weakness after minimal effort. The physician suspects myasthenia gravis. Which drug will be used to test for this disease? A. Ambenonium (Mytelase) B. Pyridostigmine (Mestinon) C. Edrophonium (Tensilon) D. Carbachol (Carboptic)
C
During assessment, a patient reports that she sometimes "wets herself" when sneezing. The nurse documents this as which of the following? A. Urge incontinence B. Functional incontinence C. Stress incontinence D. Reflex incontinence
C
A client spends most of his time in a wheelchair. The nurse would be especially alert for the development of pressure ulcers in which area? A. Greater trochanter B. Lateral malleolus C. Scapula D. Ischial tuberosity
D
An adult client's current goals of rehabilitation focus primarily on self-care. What is a priority when teaching a client who has self-care deficits in ADLs? A. To provide an optimal learning environment with minimal distractions B. To describe the evidence base for any chosen interventions C. To help the client become aware of the requirements of assisted-living centers D. To ensure that the client is able to perform self-care without any aid from caregivers
A
Which of the following is considered a central nervous system (CNS) disorder? A. Multiple sclerosis B. Guillain-Barré C. Myasthenia gravis D. Bell's palsy
A
The nurse is planning care of a client admitted to the neurologic rehabilitation unit following a cerebrovascular accident. Which nursing intervention would be of highest priority? A. Provide instruction on blood-thinning medication. B. Praise client when using adaptive equipment. C. Include client in planning of care and setting of goals. D. Assess client for ability to ambulate independently.
C
Which is the primary vector of arthropod-borne viral encephalitis in North America? A. Birds B. Spiders C. Mosquitoes D. Ticks
C
The nurse is assessing a client newly diagnosed with myasthenia gravis. Which of the following signs would the nurse most likely observe? A. Diplopia and ptosis B. Numbness C. Patchy blindness D. Loss of proprioception
A
The nurse is performing an initial assessment on a client with suspected Bell's palsy. Which of the following findings would the nurse be most focused on related to this medical diagnosis? A. Facial distortion and pain B. Hyporeflexia and weakness of the lower extremities C. Ptosis and diplopia D. Fatigue and depression
A
Which is a component of the nursing management of the client with new variant Creutzfeldt-Jakob disease (vCJD)? A. Providing supportive care B. Initiating isolation procedures C. Preparing for organ donation D. Administering amphotericin B
A
Which is a component of the nursing management of the client with variant Creutzfeldt-Jakob disease (vCJD)? A. Providing palliative care B. Initiating isolation procedures C. Preparing for organ donation D. Administering amphotericin B
A
A college student goes to the infirmary with a fever, headache, and a stiff neck. The nurse suspects the student may have meningitis and has the student transferred to the hospital. If the diagnosis is confirmed, what should the nurse institute for those who have been in contact with this student? Select all that apply. A. Administration of rifampin B. Administration of ciprofloxacin hydrochloride C. Administration of ceftriaxone sodium D. Amoxicillin E. Rofecoxib
A B C
A nurse is completing an assessment of a client who has just been transferred to the rehabilitation facility. During the health history, the nurse asks about the client's activities of daily living (ADLs). About which areas would the nurse gather information? Select all that apply. A. Bathing B. Cleaning C. Cooking D. Toileting E. Eating
A D E
A nurse is assisting with a neurological examination of a client who reports a headache in the occipital area and shows signs of ataxia and nystagmus. Which of the following conditions is the most likely reason for the client's problems? A. Frontal lobe abscess B. Temporal lobe abscess C. Cerebellar abscess D. Wernicke's abscess
C
A nurse has taught a client how to perform quadriceps-setting exercises. The nurse determines that the client has understood the instructions when he demonstrates which of the following? A. Contracts the buttocks together for a count of five B. Pushes the popliteal area against the mattress while raising the heel C. Raises the body by pushing the hands against the chair seat D. Lifting the body off the bed while holding on to a trapeze
B
A nurse is reviewing the medical record of an immobilized patient who has developed a pressure ulcer. Which nutritional deficiency would the nurse identify as placing the patient at risk for delayed wound healing? A. Vitamin D B. Vitamin C C. Vitamin E D. Calcium
B
The diagnosis of multiple sclerosis is based on which test? A. CSF electrophoresis B. Magnetic resonance imaging C. Evoked potential studies D. Neuropsychological testing
B
The nurse is preparing the client for an acetylcholinesterase inhibitor test to rule out myasthenia gravis. Which is the priority nursing action? A. Assess facial weakness 5 minutes after injection. B. Ensure atropine is readily available. C. Administer edrophonium chloride per orders. D. Document the results.
B
A provider prescribes a disease-modifying drug for a patient with relapsing-remitting MS. The nurse advises the patient that the drug has to be taken subcutaneously on a daily basis, and it may take 6 months for evidence of any response. Which of the following is the medication most likely prescribed in this scenario? A. Avonex B. Betaseron C. Copaxone D. Novantrone
C
The nurse has been educating a client newly diagnosed with MS. Which statement by the client indicates an understanding of the education? A. "I will take hot tub baths to decrease spasms." B. "I should participate in non-weight-bearing exercises." C. "I will stretch daily as directed by the physical therapist." D. "The exercises should be completed quickly to reduce fatigue."
C
A nurse is performing a baseline assessment of a client's skin integrity. What are the priority assessments? Select all that apply. A. indwelling catheter output B. family history of pressure ulcers C. presence of pressure ulcers on the client D. overall risk of developing pressure ulcers E. potential areas of pressure ulcer development
C D E
