Question 1

A client is actively experiencing status epilepticus.Which prescribed medication does the nurse prepare to administer?

Accepted Answer

Initially,intravenous lorazepam is administered to stop motor movements.This is followed by the administration of phenytoin.Atropine and morphine are not administered for seizure activity.

Question 2

The nurse is reviewing a client's prescription for sumatriptan succinate (Imitrex).Which condition in this client's medical history does the nurse report to the health care provider?

Accepted Answer

Sumatriptan succinate effectively reduces pain and other associated symptoms of migraine by binding to serotonin receptors and triggering cranial vasoconstriction.Vasoconstrictive effects are not confined to the cranium and can cause coronary vasospasm in clients with Prinzmetal's angina.The other conditions would not affect the client's treatment.

Question 3

The nurse is assessing a client with a history of migraines.Which clinical manifestation is an early sign of a migraine with aura?

Accepted Answer

Early warning of impending migraine with aura usually consists of visual changes,flashing lights,or diplopia.The other manifestations are not associated with an impending migraine with aura.

Question 4

A client with epilepsy develops stiffening of the muscles of the arms and legs,followed by an immediate loss of consciousness and jerking of all extremities.How does the nurse document this seizure activity?

Accepted Answer

Seizure activity that begins with stiffening of the arms and legs,followed by loss of consciousness and jerking of all extremities,is characteristic of a tonic-clonic seizure.The other seizures do not manifest in this manner.

Question 5

The nurse is caring for a hospitalized client with Alzheimer's disease who has a history of agitation.Which intervention does the nurse implement to help prevent agitation and aggressive behavior in this client?

Accepted Answer

Fatigue from disturbed sleep increases confusion and behavioral manifestations,such as aggression and agitation.Reality orientation is inappropriate for clients in a later stage of the disease.Constant noise from the TV most likely would agitate the client.Sedation should be used as a last resort.

Question 6

The nurse is assessing a client with a cluster headache.Which clinical manifestation does the nurse expect to find?

Accepted Answer

Cluster headache is usually accompanied by ipsilateral tearing,rhinorrhea or nasal congestion,ptosis,eyelid edema,facial sweating,and miosis.The other manifestations are not associated with cluster headaches.

Question 7

The caregiver of a client with advanced Alzheimer's disease states,"She is always wandering off.What can I do to manage this restless behavior?" How does the nurse respond?

Accepted Answer

Several strategies may be used to cope with restlessness and wandering.Taking the client for frequent walks may decrease restless behavior.Another strategy is to engage the client in structured activities.The other options would not be as helpful.

Question 8

A hospitalized client with late-stage Alzheimer's disease says that breakfast has not been served.The nurse witnessed the client eating breakfast earlier.Which statement made to this client is an example of validation therapy?

Accepted Answer

Use of validation therapy involves acknowledgment of the client's feelings and concerns.This technique has proved more effective in later stages of the disease,when using reality orientation only increases agitation.Telling the client that he or she already ate breakfast may agitate the client.The other statements do not validate the client's concerns.

Question 9

The nurse is caring for a client with Parkinson's disease.Which intervention does the nurse implement to prevent respiratory complications in the client?

Accepted Answer

Elevation of the back rest will help prevent aspiration.The other options will not prevent aspiration,which is the greatest respiratory complication of Parkinson's disease.

Question 10

A client with new-onset status epilepticus is prescribed phenytoin (Dilantin).After teaching the client about this treatment regimen,the nurse assesses the client's understanding.Which statement indicates that the client understands the teaching?

Accepted Answer

Discontinuing antiepileptic drugs can lead to the recurrence of seizures or status epilepticus.The client does not need to drink more water and can continue to work while taking this medication.The medication will not stop an aura before a seizure.

Question 11

A client with Alzheimer's disease is admitted to the hospital.Which psychosocial assessment is most important for the nurse to complete?

Accepted Answer

As the disease progresses,the client experiences changes in emotional and behavioral affect.The nurse should be alert to the client's reaction to a change in environment,such as being hospitalized,because the client may exhibit an exaggerated response,such as aggression,to the event.The other assessments should be completed but are not as important for a client with Alzheimer's disease.

Question 12

A client is prescribed levetiracetam (Keppra).Which laboratory tests does the nurse monitor for potential adverse effects of this medication?

Accepted Answer

Adverse effects of levetiracetam (Keppra)include coordination problems and renal toxicity.The other laboratory tests are not affected by levetiracetam.

Question 13

The daughter of a client with Alzheimer's disease asks,"Will the medication my mother is taking improve her dementia?" How does the nurse respond?

Accepted Answer

Drug therapy is not effective for treating dementia or halting the advancement of Alzheimer's disease.However,certain drugs may help suppress emotional disturbances and psychiatric manifestations.

Question 14

The nurse is caring for a client with a history of epilepsy who suddenly begins to experience a tonic-clonic seizure and loses consciousness.What is the nurse's priority action?

Accepted Answer

The nurse should turn the client's head to the side to prevent aspiration and allow drainage of secretions.The client should not be restrained nor an airway placed in his or her mouth during the seizure because these actions increase seizure activity and can harm the client.Vital signs are measured in the postictal phase of the seizure.

Question 15

The nurse is taking the health history of a client suspected of having bacterial meningitis.Which question is most important for the nurse to ask?

Accepted Answer

Meningococcal meningitis tends to occur in outbreaks.It is most likely to occur in areas of high-density population,such as college dormitories,prisons,and military barracks.The other questions do not identify risk factors for bacterial meningitis.

Question 16

The nurse assesses for which clinical manifestations in the client with suspected encephalitis?

Accepted Answer

Nuchal rigidity is associated with meningeal irritation and is frequently present in clients with encephalitis.The other manifestations are not associated with encephalitis.

Question 17

The nurse is teaching a client who is newly diagnosed with epilepsy.Which statement by the client indicates a need for further teaching concerning the drug regimen?

Accepted Answer

The nurse must emphasize that antiepileptic drugs must be taken even if seizure activity has stopped.Discontinuing the medication can predispose the client to seizure activity and status epilepticus.The client should not drink alcohol while taking seizure medications.The client should wear a medical alert bracelet and should make the doctor aware of all medications to prevent complications of polypharmacy.

Question 18

The nurse is talking to the family of a client who has Parkinson's disease.Which statement indicates that the family has a good understanding of the changes in motor movement associated with this disease?

Accepted Answer

A masklike face,drooling,and excess perspiration are common in clients with Parkinson's disease.Changes in facial expression or a masklike facies in a Parkinson's disease client can be misinterpreted.Because chewing and swallowing can be problematic,small frequent meals and a supplement are better for meeting the client's nutritional needs.The other statements indicate poor understanding of the disease process.

Question 19

The nurse is caring for a client experiencing migraine headaches who is receiving a beta blocker to help manage this disorder.When preparing a teaching plan,which instruction does the nurse plan to provide?

Accepted Answer

Beta blockers are prescribed as prophylactic treatment to prevent the vascular changes that initiate migraine headaches.Heart rate and blood pressure will also be affected,and the client should monitor these side effects.The other responses do not discuss an appropriate use of the medication.

Question 20

The nurse is assessing a client with a history of absence seizures.Which clinical manifestation does the nurse assess for?

Accepted Answer

Automatisms are characteristic of absence seizures.These behaviors consist of lip smacking,patting,and picking at clothing.The other manifestations do not correlate with absence seizures.

Quiz 44: Care of Patients With Problems of the Central Nervous System: the Brain