Deck 22: The Neurologic System

Question 1

An older patient newly diagnosed with Alzheimer's disease is prescribed galantamine (Razadyne). How will the nurse instruct the patient about this medication? Select all that apply.
1) Take at bedtime.
2) Take the medication with food.
3) The dosage may be changed every 4 weeks.
4) Side effects of this medication are minimal.
5) Do not take the medication with an NSAID.

Answer 1

2, 3, 5

Question 2

The family of an older patient with Alzheimer's disease does not want to discuss long-term care placement for at least "a few years." How should the nurse respond to the family?
1) "Long-term care placement is inevitable with this diagnosis."
2) "It often takes a year for an individual with Alzheimer's disease to be admitted."
3) "Talking about it now gives you time to think about locations and make a decision."
4) "By providing this information now, we will not need to address these concerns later."

Answer 2

3

Question 3

An older client is demonstrating signs of a brain attack. What will the nurse do to assess the degree of cerebral infarct?
1) Assess the client's ability to cry
2) Assess the client's motor strength
3) Assess the client's ability to sleep
4) Assess the client's ability to digest food

Answer 3

2

Question 4

An older client with advanced Alzheimer's disease is being treated for pneumonia. The daughter is not sure if resuscitation efforts should be a part of the plan of care. What information should the nurse provide to the daughter?
1) "Resuscitation is often effective for older adults."
2) "After resuscitation, the patient will return to the same level of functioning."
3) "As long as the resuscitation efforts are initiated quickly, the patient will survive."
4) "Resuscitation for cardiac or respiratory arrest can be effective for older adults."

Question 5

The nurse instructs an older client with Parkinson's disease about carbidopa-levodopa (Sinemet). Which of the following shows an accurate understanding of the medication?
1) The client takes medication with meals.
2) The client sits on the side of the bed before standing.
3) The client believes the medication will cure Parkinson's disease.
4) The client believes this medication will not affect her blood pressure medications.

Question 6

A care conference is being held with the family of an older patient in the late stages of Alzheimer's disease. The family wants to know if a feeding tube should be placed. How should this question be answered?
1) Tube feeding will aid the patient to gain weight.
2) Tube feeding is associated with a reduced risk of aspiration.
3) Tube feeding reduces the discomfort associated with dehydration.
4) The absence of tube feeding promotes dehydration which reduces pain sensitivity.

Question 7

An older client is diagnosed with dementia caused by Lewy bodies. What will the nurse most likely assess in this client? Select all that apply.
1) Tremor
2) Rigidity
3) Postural instability
4) Sleep apnea
5) Visual hallucinations

Question 8

An older client with Alzheimer's disease has wandered away from the home several times. What can the nurse suggest that the spouse do to reduce the client's risk for wandering? Select all that apply.
1) Use hospital-approved belt restraints.
2) Install motion detectors on the door of the client's room.
3) Disguise the door so it looks like a mirror.
4) Alert neighbors.
5) Place emergency telephone numbers on the refrigerator door.

Question 9

The nurse is preparing an educational session on stroke prevention for a group of senior citizens. What information would be important for the nurse to provide to these participants? Select all that apply.
1) Stop smoking.
2) Stop drinking alcohol.
3) Maintain a healthy body weight.
4) Follow a low-sodium diet as prescribed.
5) Take blood pressure medication as prescribed.

Question 10

An older patient begins to experience status epilepticus. Which action will the nurse take to help this patient?
1) Measure vital signs.
2) Orient the patient between seizures.
3) Prevent chilling with warmed bed linens.
4) Ensure an intravenous access line is available.

Question 11

An older patient is diagnosed with early-mild Alzheimer's disease. Which should be done at the time of diagnosis?
1) Discuss treatment options and wishes with the patient.
2) Identify a long-term care facility for immediate transfer.
3) Explain that this stage of the disorder can last up to 10 years.
4) Instruct family members to slowly improve the home environment for safety.

Question 12

What should the nurse teach the family of an older patient with Alzheimer's disease to help with spatial disorientation? Select all that apply.
1) Use color to contrast objects and items.
2) Keep furniture in the same familiar place.
3) Fill the patient's room with memorabilia.
4) Remove cues for exiting the home away from the doors.
5) Place family photos or recognizable familiar items in a prominent spot.

Question 13

An older patient is being evaluated for dementia. What manifestations need to be present to diagnose this disorder? Select all that apply.
1) Intermittent forgetfulness
2) Inability to manage finance
3) Misplacing personal belongings
4) Repetitive questions or conversations
5) Difficulty thinking of common words while speaking

Question 14

An older patient with Alzheimer's disease is demonstrating agnosia. Which intervention would be important to include in this patient's plan of care?
1) List choices for the patient to select.
2) Provide deadlines for self-care activities.
3) Refrain from providing verbal instructions.
4) Remove inedible items from the environment.

Question 15

An older patient with Alzheimer's disease has a feeding tube. The family wants to know if the patient will ever be able to eat solid food again. What information should the nurse include when responding to this family's question?
1) The dietitian will decide if this can be done.
2) It depends upon the patient's functional eating abilities.
3) This can be done but the feeding tube has to be removed first.
4) In the patient with dementia, the restoration of natural feeding is highly unlikely.

Question 16

An older client is being evaluated for delirium. Of the following, which is not a manifestation typically used to make a diagnosis of this disorder?
1) Unable to physically swallow when asked to
2) Unable to remember who visited earlier in the day
3) Unable to sleep at night, but able to sleep through the day
4) Unable to maintain attention

Question 17

The nurse suspects an older client is having a grand mal seizure. What is the nurse's highest priority?
1) To use the head-tilt/chin-lift method
2) To prevent the seizure from lasting more than five minutes
3) To document the progression of symptoms
4) To prevent the client from being injured

Question 18

The nurse suspects that an older client is experiencing Parkinson's disease. What did the nurse observe in this patient? Select all that apply.
1) Chorea
2) Tremor
3) Epileptic seizures
4) Restless leg syndrome
5) Dystonia

Question 19

After a neurologic assessment, the nurse determines that an older patient is exhibiting normal signs of aging. What did the nurse assess in this patient? Select all that apply.
1) Slow movements
2) Intermittent hand tremor
3) Ataxia with position changes
4) Decreased sensation in the feet
5) Slight impairment of coordination

Question 20

Which assessment finding places an older patient at the greatest risk factor for the development of Alzheimer's disease?
1) Age
2) Genetic predisposition
3) Environmental exposure
4) History of previous head injury

Question 21

The nurse is preparing an educational session on vascular dementia for a group of senior citizens. He wants to include information on factors that can potentially reduce the risk of this type of dementia. What information would be important for the nurse to provide to these participants? Select all that apply.
1) Control blood pressure
2) Discontinue alcohol consumption
3) Control weight
4) Take a daily, low-dose aspirin
5) Control blood sugar level

Question 22

An older client with moderate stage dementia frequently cannot remember which room he is assigned in a long-term care facility. Which nursing intervention would help this client?
1) Reorient the client when it happens again.
2) Establish landmarks.
3) Investigate placing the client in a private room.
4) Accompany the client on walks.

Question 23

An older client is being evaluated for frontotemporal dementia. Of the following, which manifestation would be present to make this diagnosis?
1) Abrupt onset of dementia
2) Loss of personal awareness
3) Lewy bodies in the midbrain
4) Cerebrovascular low-density areas

Question 24

An older client is prescribed gabapentin (Neurontin) for a seizure disorder. When instructing the client on this medication, which common side effects should the nurse include? Select all that apply.
1) Headache
2) Increased thirst
3) Irritability
4) Black, tarry stools
5) Weight gain

Question 25

An older client with mild Alzheimer's disease abruptly stops taking the prescribed medication donepezil (Aricept). When assessing the patient for withdrawal symptoms of the the sudden discontinuation of the medication, on which area should the nurse focus?
1) The client's reflexes
2) The client's rest and sleep pattern
3) The client's cognitive function
4) The client's cardiovascular function