Study Guide 3 & 4 (Exam 2)

The nurse is caring for a pt with a brain tumor who is experiencing symptoms due to compression and infiltration of normal tissue. The pathophysiologic changes that result can cause what manifestations? (select all that apply) a. intracranial hemorrhage b. infections of CSF c. increased ICP d. focal neurologic signs e. altered pituitary function

c. increased ICP d. focal neurologic signs e. altered pituitary function

Which nursing technique best allows the pt with slight expressive aphasia to communicate his feelings about using adaptive equipment in public? a. Use a communication board to express thoughts b. enlist a close family member to interpret words c. sit beside pt and patiently assist in interpreting communication d. allow the pt time to process the words to express and return later for the conversation.

c. sit beside pt and patiently assist in interpreting communication

When taking cholinergic blocking drug for Parkinson like symptoms, the pt most likely would experience which of the following adverse reactions? a. Constipation, urinary frequency b. Muscle spasm, convulsions c. Diarrhea, HTN d. Dry mouth, dizziness

d. Dry mouth, dizziness

The nurse reports which of the following as a diminished response to antiparkinson drug tx rather than an adverse reaction? a. Dry mouth and difficulty in swallowing b. Anorexia, nausea, and vomiting c. Abdominal pain and constipation d. Increased hand tremor

d. Increased hand tremor

The nurse initiates a teaching plan for the family and pt with neurologic deficits because of parkinson's disease. What nursing instruction is the highest priority? a. encourage adequate sleep b. reduce home safety hazards. c. use measures to improve self-esteem d. maintain social relationships

b. Reduce home safety hazards.

A home care nurse is helping a pt and family cope with a recent neurologic deficit. What intervention is most important for the nurse to perform first? a. Identify solutions for the pt and family's health problems b. encourage outside assistance from community agencies and resources c. assist the pt and family to identify possible needs and solutions d. call the physician and ask for suggestions for meeting the pt's needs.

c. assist the pt and family to identify possible needs and solutions.

A 25 y.o. pt takes ethosuximide for the tx of absence seizures calls the clinic to report that she has developed a sore throat and a slight fever. The nurse will explain that she should come to the clinic to have what checked? a. Ethosuximide serum level b. bleeding tendencies c. blood cell count d. pulse and blood pressure

c. blood cell count

When administering diazepam to an older pt, the nurse should monitor the pt for unusual effects of the drug such as? a. marked excitement b. excessive sweating c. heart arrhythmias d. agitation

c. heart arrhythmias

The nurse understands that a pt receiving which anticonvulsant will need close observation for possible toxicity after the initiation of a protease inhibitor such as lopinavir/ritonavir (Kaletra) for the tx of HIV? a. Carbamazepine b. phenobarbital c. phenytoin d. Valporic acid

a. Carbamazepine

Which of the following adverse reactions, if observed in a pt prescribed phenytoin, would indicate that the pt may be developing phenytoin toxicity? a. severe occipital headache b. ataxia c. hyperactivity d. somnolence

b. Ataxia

The pt who has Parkinson's disease is experiencing dysphagia. Which drug should the nurse have available for parenteral administration? a. apomorphine b. bromocroptine c. levodopa d. ropinirole

a. apomorphine

The nurse is conducting a pre-administration assessment of a pt prescribed entacapone. The nurse determines caution is warranted after discovering which disorders listed in the pt's past hx? (Select all that apply) a. hypotension b. renal dysfunction c. hepatic dysfunction d. prostatic hypertrophy e. HTN

a. hypotension b. renal dysfunction c. hepatic dysfunction e. HTN

The nurse is explaining the therapeutic effects of medication to a pt with Parkinson's disease. What characteristics of levodopa and dopamine should the nurse describe? (select all that apply) a. Levodopa is a precursor of dopamine b. Levodopa crosses the blood-brain barrier c. Levodopa is converted to dopamine d. Levodopa stimulates the brain to synthesize dopamine e. Dopamine reverts levodopa for metabolism

a. Levodopa is a precursor of dopamine b. Levodopa crosses the blood-brain barrier c. Levodopa is converted to dopamine

A nurse is reading a journal article about spinal cord tumors and metastasis from other primary sites. The nurse demonstrates understanding of the article when identifying which primary sites as commonly metastasizing to the spinal cord. (Select all that apply) a. lung b. breast c. GI tract d. prostate e. bladder

a. lung b. breast c. GI tract

A pt has been prescribed benztropine as a drug therapy for Parkinson's disease. What assessment finding would suggest a therapeutic effect to the nurse? a. Decreased rigidity and tremors b. increased LOC c. increased motivation and muscle strength d. absence of seizure activity

a. Decreased rigidity and tremors

The pt has been diagnosed with Parkinson's disease and has been prescribed levodopa. What should the nurse in the care plan? (select all that apply) a. Monitor the pt's v/s Q shift b. Monitor the pt's urine output Q shift c. Auscultate the pt's bowel sounds once per shift d. Monitor the pt's creatinine clearance whenever available e. Auscultate the pt's lung sounds q4hrs

a. Monitor the pt's v/s Q shift b. Monitor the pt's urine output Q shift c. Auscultate the pt's bowel sounds once per shift d. Monitor the pt's creatinine clearance whenever available

The nurse is preparing to administer carbidopa/levodopa to a pt recently diagnosed with Parkinson's disease. The nurse should question this order if which disorder is noted in the pt's record? (Select all that apply) a. Narrow-angle glaucoma b. renal disease c. hepatic disease d. psychosis e. use of MAOI antidepressants

a. Narrow-angle glaucoma e. use of MAOI antidepressants

Which of the following occupations are anticipated to improve the functioning of a pt with a neurologic deficit? (Select all that apply) a. Occupational Therapist b. Speech therapist c. Neurologist d. Electrocardiography technician e.Electroencephalogram technician f. Physical therapist

a. Occupational Therapist b. Speech therapist c. Neurologist f. Physical therapist

A pt with a hx of a brain tumor is undergoing diagnostic testing to evaluate whether current symptoms are the result of the tumor or scar tissue. The nurse would prepare the pt for which test? a. PET b. MRI c. three-dimensional biopsy d. cerebral aniography

a. PET scan

simple seizures, motor seizures, and somatosensory seizures are classified as what type of seizure? a. Partial seizures b. generalized seizures c. tonic-clonic seizures d. myoclonic seizures

a. Partial seizures

The nurse is preparing to administer phenytoin to a pt. The nurse should question this order if which disorder is noted in the pt's past hx. (Select all that apply) a. Pregnancy b. Sinus Bradycardia c. Hepatic disease d. Diabetes e. AFIB

a. Pregnancy b. Sinus Bradycardia

A pt is prescribed phenytoin for a recurrent convulsive disorder. The nurse teaches the pt that the most common adverse reactions are? a. Related to the GI system b. Associated with the reproductive system c. Associated with kidney functions d. Related to the CNS

a. Related to the GI system

An older adult pt experiencing seizures is prescribed diazepam. Which assessment should the nurse prioritize? a. Respiratory rate and depth b. blood glucose levels c. swallowing ability d. speech quality

a. Respiratory rate and depth

The nurse is educating the pt who has been started on Dilantin and its side effects. Which symptom would indicate a life-threatening condition and should be reported to the healthcare provider immediately? a. SOB b. Rash with itching c. any change in bowel elimination d. a change in the sense of taste

a. SOB (shortness of breath)

The nurse is caring for a pt diagnosed with generalized seizures. What classification of medications will the nurse administer to the pt? (Select all that apply) a. Succinimides b. Acetazolamide c. Valporic Acid d. Hydantoins e. Benzodiazepines

a. Succinimides d. Hydantoins e. Benzodiazepines

A nurse is providing care to a pt recently diagnosed with a brain tumor. When planning this pt's care, the nurse anticipates which therapy as providing the best outcome for the pt? a. Surgery b. Radiation therapy c. Chemotherapy d. Immunotherapy

a. Surgery

Identify the interventions to use to help promote sleep for the pt with RLS. Select ALL that apply a. Take a hot bath b. watch a fast paces show c. Do a crossword puzzle d. Take a brisk walk e. Take vitamin B6

a. Take a hot bath c. Do a crossword puzzle

A college student goes to the infirmary with a fever, headache, and 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 ceftiaxone sodiam (Rocephin) d. amoxicillin (Amoxil) e. Rofecoxib (Vioxx)

a. administration of rifampin b. administration of ciprofloxacin hydrochloride c. administration of ceftiaxone sodiam (Rocephin)

An older adult pt exhibiting clinical manifestations of a brain tumor is admitted to the hospital for testing. What tumor types does the nurse know are commonly seen in the older adult? (select all that apply) a. anaplastic astrosytoma b. cerebral metastasis from other sites c. glioblastoma d. medulloblastoma e. ependymoma

a. anaplastic astrosytoma b. cerebral metastasis from other sites c. glioblastoma

While administering phenytoin, the nurse should observe the pt what adverse reaction? (select all that apply) a. ataxia b. nausea c. lethargy d. gingival hyperplasia e. increased seizure activity

a. ataxia b. nausea c. lethargy d. gingival hyperplasia

The nurse is teaching a pt and caregivers about the prescribed phenytoin. The nurse determines the session is successful when they correctly choose which adverse reaction to report to the health care provider immediately? (Select all that apply) a. ataxia b. nystagmus c. slurred speech d. lethargy e. diplopia

a. ataxia c. slurred speech d. lethargy

Some antiepileptic medication may cause birth defects. The nurse should instruct the female pt regarding? a. Birth control methods b. prenatal vitamins and supplements c. alternative therapy for seizure control d. how to stop taking the drugs to get pregnant.

a. birth control methods

A nurse is caring for a pt diagnosed with Guillain - Barre syndrome. The pt states, "It's getting harder to take a deep breath." Which action by the nurse is most appropriate? a. call the MD and prepare for intubation b. explain the progression of the syndrome c. assess lung sounds d. encourage the pt to cough

a. call the MD and prepare for intubation

The most serious adverse reactions seen with levodopa include which of the following. a. choreiform and dystonic movements b. depression c. suicidal tendencies d. paranoia

a. choreiform and dystonic movements

The nurse has administered carbidople/levodopa to a pt. Which findings should the nurse prioritize on the ongoing assessment? (select all that apply) a. choreiform movements b. hyperglycemia c. hypotension d. dry mouth e. anorexia

a. choreiform movements d. dry mouth e. anorexia

The nurse is preparing to administer a new drug to a pt currently prescribed carbidopa/levodopa which can decrease its effects. Which medication will require the nurse to monitor for decreased carbidopa/levodopa effectiveness? (select all that apply ) a. phenytoin b. amitriptyline c. zonisamide d. IBU e. meperidine

a. phenytoin c. zonisamide

Which basic of pt care, occurring during the acute phase, is most helpful in promoting the rehabilitation of a pt following debilitating CVA? a. prevention of joint contractures b. promoting ability to critically think c. creating a positive environment d. use of adaptive equipment

a. prevention of joint contractures

The nurse caring for a pt diagnosed with Parkinson's disease has prepared a plan of care that would include what goal? a. promoting effective communication b. controlling diarrhea c. preventing cognitive decline d. managing choreiform movements

a. promoting effective communication

The pt with a brain tumor is experiencing changes in cognition that require the nurse to reorient the pt frequently. When performing this task, which devices would be appropriate for the nurse to use? (Select all that apply) a. pts clothing b. picture of the pts family c. clock d. calendar e. common words

a. pts clothing b. picture of the pts family c. clock d. calendar

The nurse is caring for a pt postoperatively from a soinal tumor resection. The nurse assesses that the pt has partial paralysis. What anticipated problems should the nurse include in the pt's care plan? (select all that apply) a. risk for impaired physical mobility b. risk for injury c. risk for powerlessness d. risk for sexual dysfunction e. risk for knowledge deficit

a. risk for impaired physical mobility b. risk for injury c. risk for powerlessness e. risk for knowledge deficit

A pt with a malignant brain tumor comes to the clinic for a follow up. During the visit, the pt asks the nurse, "Why am I so tired all the time?" When responding to the pt, which information would the nurse include as possible causes? (select all that apply) a. tumor b. tx being used c. stress d. metastasis e. effects of increase ICP

a. tumor b. tx being used c. stress

Parkinson disease occurs because of the lack of which neurotransmitter? a. Acetycholine b. Dopamine c. Serotonin d. GABA

b. Dopamine

The pt taking Tolcapone for Parkinsons disease is monitored closely for which of the following? a. Kidney dysfunction b. Liver dysfunction c. Agranulocytosis d. The development of autoimmune disease

b. Liver dysfunction

A 69 y.o. pt is brought to the ED by ambulance because a family member found him lying on the flood disorientated and lethargic. The health care provider suspects bacterial meningitis and admits the pt to the ICU. What interventions should the nurse perform? (select all that apply) a. obtain a blood type and cross-match b. administer antipyrectics as prescribed c. perform frequent neurologic assessments d. monitor pain levels and administer analgesics e. place the pt in positive pressure isolation

b. administer antipyrectics as prescribed c. perform frequent neurologic assessments d. monitor pain levels and administer analgesics

A pt with a brain tumor is exhibiting papilledema. When reviewing the pt's hx, which information would the nurse correlate with this finding? (Select all that apply) a. enhanced visual acuity b. double vision c. visual field deficit d. swaying gait e. aphasia

b. double vision c. visual field deficit

When planning strategies for managing bowel elimination for the pt with a neurologic deficit, what nursing intervention is most appropriate to include? a. administer a tap water enema just before bedtime. b. encourage a high fiber diet to increase stool bulk c. change disposable absorbent undergarments when soiled d. pad the rim of the bedpan to prevent skin breakdown

b. encourage a high fiber diet to increase stool bulk

Older pts prescribed one of the dopamine receptor agonists are monitored closely for which of the following adverse reactions? a. occipital headache b. hallucinations c. paralytic ileus d. cardiac arrhythmias

b. hallucinations

The recovery phase begins when the pt is a. unstable b. stable c. recovered d. dead

b. stable

A family member asks the nurse which exercise is best to help a pt with Parkinson's disease maintain balance, Which is the best response? a. swimming b. tai chi c. jogging d. mind puzzles

b. tai chi

A pt is in the skilled rehab setting during the chronic phase of care. When developing the pt's nursing plan of care, what long-term goal is most appropriate. a. the pt will consume dietary carbohydrates for energy b. the pt will be free of skin breakdown or contractures c. the pt will be emotionally stable, with no signs of clinical depression d. the pt will regain use of all extremeties

b. the pt will be free of skin breakdown or contractures

Which pt goal is established by the nurse, is most important as the nurse plans care for a seizure pt in the home setting? a. the pt will take the seizure meds at the same time daily b. the pt will remain free of injury if a seizure does occur c. the pt will verbalize an understanding of feelings that preempt seizure activity. d. the pt will post emergency numbers on the fridge for ease of obtaining.

b. the pt will remain free of injury if a seizure does occur

The nurse is caring for pt's on a neurologic floor. Which pt goal is most appropriate for the acute phase of a neurologic injury? a. the pt will use the adaptive devices to assist with feeding b. the pt's vital signs will stabilize returning to baseline c. the pt's skin will remain clean, dry, and intact d. the pt will return to optimal level of functioning

b. the pt's vital signs will stabilize returning to baseline

A pt has been prescribed an anticholinergic agent for tx of Parkinson-related symptoms. What pt education should be provided? a. do not take any OTC sleep aids b. void before taking the medication c. move to a warm climate to decrease symptoms d. enroll in an exercise class at the senior center.

b. void before taking the medication

Which statement would be included when educating the pt taking trimethadione for seizures? a. take this drug with milk to enhance absorption b. wear sunscreen and protective clothing when exposed to sunlight c. to minimize adverse reaction, take this drug once daily at bedtime d. visit a dentist frequently because this drug increases the risk of gum disease.

b. wear sunscreen and protective clothing when exposed to sunlight

A physician orders oral levodope 0.75g to be given. The only dosage available on hand is 100mg, 250mg, and 500mg tablets. What would the nurse administer to this pt? a. 3 tabs of 250mg b. 1 1/2 tabs of 500mg c. 1 250mg tab and 1 500mg tab d. 2 250mg tabs 2 1/2 100 mg tabs

c. 1 250mg tab and 1 500mg tab

Focal seizures make up what percentage of total seizures? a. 20% b. 40% c. 60% d. 100%

c. 60%

In which of the following disease processes is the nurse most likely to care for a pt in the chronic phase of a neurologic disease? a. TIA b. Malignant brain tumor c. Alzheimer's disease d. Pneumonia

c. Alzheimer's disease

Pts should be monitored closely for EPS when taking antiparkinson drugs with which class of drugs? a. anticoagulants b. Vitamins c. Antidepressants d. Antihypertensives

c. Antidepressants

The nurse practitioner prescribes the medication of choice for an MS pt who is experiencing disabling episodes of muscle spasms, especially at night. Which of the following is the drug most likely prescribed in this scenario? a. Valium b. Zanaflex c. Lioresal d. Dantrium

c. Lioresal

A pt with Parkinson's disease is prescribed carbidopa/ levodopa. The nurse will exercise caution when administering this drug if which disorder is noted in the pt's medical hx? (select all that apply) a. Hyperthyroidism b. Seizure disorder c. Renal disease d. Asthma e. Peptic ulcer disease

c. Renal disease d. Asthma e. Peptic ulcer disease

A pt with a neurologic deficit has been admitted to the nursing unit. The nurse caring for the pt is assessing the pt and observes significant changes in the pt's status. Which of the following action should the nurse perform immediately? a. Use the Glasgow coma scale b. use the Mini-mental status exam c. report the change to the MD d. Monitor the blood pressure

c. Report the change to the MD

Which of the following best describes convulsions? a. loss of consciousness b. disturbances in brain electrical activity c. sudden, involuntary contractions d. disrupted CNS neurologic impulses

c. Sudden, involuntary contractions

A pt with parkinson's disease asks the nurse what can be done to prevent problems with bowel elimination. What would be an intervention that would assist the pt with a regular stool pattern? a. take psyllium (metamucil) daily b. take a laxative whenever bloating is experienced c. adopt a diet with moderate fiber intake d. adopt a high-fiber diet

c. adopt a diet with moderate fiber intake

A nurse is caring for a pt who has been prescribed miscellaneous anticonvulsants containing valporic acid. What method of drug administration should the nurse inform the pt about? a. take the drug in small and frequent doses b. dissolve the tablet in a glass of water to take the drug c. do not chew but swallow the whole tab to avoid irritation d. take the drug orally with meals to avoid an adverse reaction

c. do not chew but swallow the whole tab to avoid irritation

Which nursing intervention is most helpful when addressing the priority nursing diagnosis of impaired Physical Mobility related to damage of brain tissue as evidenced by visual deficits and absence of portions of the visual field? a. place pt in a room near the nursing station b. announce yourself when approaching the pt c. ensure a clutter-free walkway d. instruct on adaptive plate with rims.

c. ensure a clutter-free walkway

The nurse is planning care of a pt admitted to the neurologic rehabilitation unit following a CVA. Which nursing intervention would be of highest priority? a. provide instruction on blood-thinning medications b. praise pt when using adaptive equipment c. include pt in planning of care and setting of goals d. assess pt for ability to ambulate independently.

c. include pt in planning of care and setting of goals

when caring for a pt with a neurologic deficit, what nursing intervention is most important for preventing the formation of a pressure ulcer? a. promote a balanced nutritional intake b. massage reddened areas frequently c. relieve pressure over bony prominences

c. relieve pressure over bony prominences

When caring for a pt taking a succinimide for seizure control, the nurse monitors the pt for blood dyscrasias. Which of the following symptoms would indicate that the pt may be devloping a blood dyscrasia? a. constipation, blood in the stool b. diarrhea, lethargy c. sore throat, general malaise d. Hyperthermia, excitement

c. sore throat, general malaise.

The pt is diagnosed with a tumor of the temporal lobe. When developing the pt's plan of care the nurse would plan interventions to address problems with which areas of functioning? (Select all that apply) a. reading b. writing c. understanding language d. emotions e. memory

c. understanding language d. emotions e. memory

A 70 y.o. pt with Parkinson's disease is receiving pramipexole. Which potential adverse reaction should the nurse monitor the pt for? a. blurred vision b. memory loss c. visual hallucinations d. muscular rigidity

c. visual hallucinations

Neurologic deficits are divided into three phases a. Intermediate, Acute, Chronic b. Acute, Cutaneous, Recovery c. Slow, Fast, Gradual d. Acute, Recovery, Chronic

d. acute, recovery, chronic

The nurse is volunteering for a Red Cross blood drive and is taking the hx of potential donors. Which volunteer would the nurse know will not be allowed to donate blood? a. donor with a hx of HTN with a blood pressure for 140/90 mm Hg b. donor who is taking medication for benign prostatic hyperplasia c. donor who moved to the US from Canada d. donor who was in college in England for 1 year

d. donor who was in college in England for 1 year

The nurse caring for a pt in the chronic phase of a neurologic deficit knows that nursing management focuses on what? a. working with team members to plan a rehabilitation program b. retraining the pt's bowel and bladder c. supporting the pt during recovery d. preventing physical and psychological complications

d. preventing physical and psychological complications

The nurse is caring for an 82 y.o. pt who needs bladder training. The nurse knows that bladder training is difficult for older adult pts with neurologic deficits because of what? a. urinary incontinence b. urinary retention c. decreased energy expenditure d. relaxation of the internal bladder sphincter

d. relaxation of the internal bladder sphincter

A pt diagnosed with Bell Palsy is having decreased sensitivity to touch of the involved nerve. What should the nurse recommend to prevent atrophy of the muscles? a. Blowing up balloons b. deliberately frowning c. smiling repeatedly d. whistling

d. whistling