Deck 34: Chronic and Degenerative Neurologic Disorders

Question 1

Which neurotransmitter is depleted in clients with Parkinson's disease?
1) Acetylcholine
2) Serotonin
3) Dopamine
4) Glutamate

Answer 1

3

Question 2

Which instruction should the nurse provide to a client who is prescribed an anticholinergic drug for symptomatic relief of Parkinson's disease?
1) "You should watch out for side effects such as dry mouth and double vision after taking the medication."
2) "You will be able to perform daily activities at a normal pace after taking the medication."
3) "You should stay away from exercise therapy during the course of medication."
4) "You should remember that the medication may precipitate tremors during initiation of therapy."

Answer 2

1

Question 3

The nurse is discussing the interictal period with a group of student nurses. Which statement made by the student nurse indicates effective learning?
1) "It is the episode of the seizure."
2) "It is the time after the completion of the seizure."
3) "It is measured when the brain activity is abnormal."
4) "It is the phase between seizures when multiple seizures occur in a short time frame."

Answer 3

4

Question 4

A client suffering from myasthenia gravis is admitted to the intensive care unit after being diagnosed with respiratory failure. Which factor could have precipitated this condition in the client?
1) A tapered dose of immunosuppressants
2) Microbial infection
3) Surgery
4) All the above

Question 5

A client is diagnosed with narrowing of the spinal cord. Based on which test did the primary health-care provider confirm this diagnosis?
1) Angiography
2) Evoked potentials
3) Computed tomography
4) Electronystagmography

Question 6

Which neurotransmitter dysfunction has been implicated in Tourette's syndrome?
1) Serotonin
2) Dopamine
3) Acetylcholine
4) None of the above

Question 7

Which client is expected to have status epilepticus?
1) A client who is experiencing a series of three tonic-clonic seizures
2) A client who is experiencing rapid alternate contraction and relaxation of muscles
3) A client who is experiencing seizure or appears to be staring into space for a few moments
4) A conscious client with rhythmic jerking movements of the arms and legs

Question 8

Which diagnostic test is used to measure the brain and body activity during sleep?
1) Myelography
2) Thermography
3) Polysomnogram
4) Evoked potentials

Question 9

Which pathophysiological condition particularly activates the trigeminovascular system?
1) Epilepsy
2) Cluster headache
3) Parkinson's disease
4) Tension headache

Question 10

The nursing instructor is teaching a group of student nurses about the preventive therapy for migraine. Which client requires preventive therapy to be prioritized first?
1) A client who experiences one or two migraine attacks per month.
2) A young female client who stopped the use of oral contraceptives.
3) A female client who is on therapy with vasodilators.
4) A client who withdrew from consuming alcohol.

Question 11

In a client with Guillain-Barré syndrome, the health-care provider has found that the possibility of performing plasmapheresis is low. Which other alternative treatment can be recommended to this client to produce the same effect as that of plasmapheresis?
1) Corticosteroids
2) Cerebrospinal fluid filtration
3) Intravenous immunoglobulin
4) None of the above

Question 12

The nursing instructor is teaching a group of student nurses about the most important intervention for clients with myasthenic crisis. Which statement made by a student nurse indicates effective learning?
1) "The most important intervention by the nurse in clients with myasthenia gravis is to constantly monitor the arterial blood gases."
2) "The forced vital capacity and negative inspiratory force of the client should be monitored every 2 to 4 hours."
3) "The client must be closely monitored in an intensive care unit for decreased heart rate."
4) "Immunosuppressant agents should be completely withdrawn in clients who experienced a myasthenic crisis."

Question 13

Which statement by the student nurse indicates the need for further teaching about cerebrospinal fluid (CSF) analysis?
1) "The CSF from the client is obtained by performing the lumbar puncture technique."
2) "While taking the CSF, the client is asked to lie on one side, in a ball position with knees close to the chest."
3) "An anesthetic injection is given on the lower back of the client between the two vertebras."
4) "To lessen the after-effect of lumbar puncture, the client is asked to stand still."

Question 14

A nursing instructor is teaching a group of student nurses about athetosis movements in clients with Huntington's disease. Which statement made by the student nurse indicates effective learning?
1) "Athetosis refers to twisting and writhing movements."
2) "Athetosis refers to brief, irregular dancing-like movements."
3) "When athetosis is severe, there are thrashing motions referred to as ballismus."
4) "Antipsychotic medications, such as haloperidol, may be symptomatically beneficial to treat athetosis."

Question 15

The nurse is caring for a client who had a head injury in a motor vehicle accident. The client complains of lack of coordination and imbalance since the accident. Which part of the cerebrum would the nurse suspect to have been damaged?
1) Cerebrum
2) Brain stem
3) Cerebellum
4) Diencephalon

Question 16

The student nurse is performing a Babinski reflex test in a client to assess his or her neurologic system. Which is the correct interpretation by the student nurse?
1) A negative Babinski reflex indicates an upper motor neuron disorder.
2) A positive Babinski reflex, where the client has flaring of the toes in response to stimulation of the sole of the foot, indicates an upper motor neuron disorder.
3) A positive Babinski reflex occurs when the toes of the client flex inward upon stimulation of the sole of the foot.
4) A negative Babinski reflex occurs when there is flaring of the toes in response to stimulation of the sole of the foot.

Question 17

Which type of epileptic seizure is characterized by a sudden lapse of consciousness for 5 to 30 seconds?
1) Tonic seizure
2) Clonic seizure
3) Petit mal seizure
4) Tonic-clonic seizure

Question 18

While reviewing the medication chart of a client, the nurse finds that the client is on a therapy to decrease the release of the excitatory neurotransmitter glutamate. Which disorder will the nurse suspect in the client?
1) Myasthenia gravis
2) Huntington's disease
3) Guillain-Barré syndrome
4) Amyotrophic lateral sclerosis

Question 19

Which statement relates to multiple sclerosis?
1) "It is a demyelinating disorder."
2) "It is an autosomal dominant neurological disorder."
3) "It is the progressive loss of dopamine-producing cells."
4) "It is a progressive neurodegenerative disorder with the loss of upper and lower motor neurons."

Question 20

After a theoretical session about edrophonium (Tensilon) testing, the nursing instructor asks a student nurse to perform the test in a group of clients with different neurological disorders. Which client should the student nurse choose to perform the test?
1) A client with multiple sclerosis
2) A client with myasthenia gravis
3) A client with Huntington's disease
4) A client with Guillain-Barré syndrome

Question 21

A client with cluster headaches is prescribed dihydroergotamine. What signs in the client indicate the effectiveness of the therapy?
1) Decreased nasal discharge
2) Reduced tearing from the eye
3) Relaxed cervicothoracic muscle
4) Reduced bradykinesia
5) Normalized deep tendon reflexes

Question 22

The primary health-care provider is assessing a client who lost consciousness. Which assessment techniques would the nurse expect the primary health-care provider to order?
1) Hearing
2) Vital signs
3) Orientation
4) Pupil response
5) Glasgow Coma Scale

Question 23

Which function is associated with the frontal lobe of the cerebral cortex?
1) Orientation
2) Planning
3) Reasoning
4) Problem solving
5) Visual processing
Other

Question 24

The student nurse is taught about lumbar puncture. Prioritize the steps performed by the student nurse to indicate effective learning.(Enter the letter of each step in the proper sequence, do not use commas or spaces.)
A. Clean the area and inject local anesthetic.
B. Locate the site for puncture in the lower back.
C. Instruct the client to lean forward while sitting on a table or bed.
D. Insert a special needle into the spinal sac and remove a small amount of fluid.

Question 25

What supportive care should be provided to a client diagnosed with Guillain-Barré syndrome?
1) Provide mechanical ventilation.
2) Monitor hemodynamics continuously.
3) Provide physical and occupational therapy.
4) Administer antipsychotic medications as prescribed.
5) Provide speech therapy and swallowing interventions.