Deck 50: Nursing Care of Patients With Peripheral Nervous System Disorders

Question 1

A patient with Bell's palsy has lost 10 pounds since being diagnosed. Why is this patient at risk for nutrition problems?

A)The patient may have difficulty preparing foods.
B)Nutrients are not absorbed efficiently.
C)Appetite is diminished.
D)Taste and chewing are affected.

Answer 1

Taste and chewing are affected.

Question 2

What nursing diagnosis takes priority when planning care for a patient with trigeminal neuralgia?

A)Pain related to inflammation of cranial nerve V
B)Imbalanced nutrition: less than body requirements
C)Self care deficit: hygiene
D)Ineffective coping

Answer 2

Pain related to inflammation of cranial nerve V

Question 3

The nurse is caring for a patient admitted with an exacerbation of multiple sclerosis (MS). Which of the following assessment findings should the nurse include when teaching the patient about risk factors for exacerbation?

A)Exposure to sun
B)Urinary tract infection
C)Sedentary lifestyle
D)Vegetarian diet

Answer 3

Urinary tract infection

Question 4

The nurse is preparing a patient with myasthenia gravis to undergo plasmapheresis. Which laboratory tests should the nurse verify and place on the medical record before the procedure?

A)Creatinine phosphokinase, blood type, and electrolytes
B)Electrolytes, blood urea nitrogen (BUN), creatinine, and albumin
C)Complete blood count, platelets, and clotting studies
D)Urine analysis, urine protein, BUN, and creatinine

Question 5

The nurse is caring for a mother of three young children who has a 3-year history of myasthenia gravis. She says to the nurse, "I just wish I could keep helping in my children's classrooms in the mornings. I get so fatigued, I have had to stop going." Which statement by the nurse can help this mother best cope with her problem?

A)"You need to realize that you may not be able to do the things you used to do."
B)"Getting plenty of sleep the night before you are scheduled to help will give you the stamina you need."
C)"If you wait to take your medication after you finish helping in the classroom, you may find that your energy level is better."
D)"Time your medication so that its action is peaking during the time you need the most energy."

Question 6

A patient with trigeminal neuralgia is admitted to the hospital for diagnostic testing and possible surgery. What intervention would be most appropriate for this patient?

A)Provide a fan in the room to keep the room well ventilated.
B)Provide soft foods at body temperature at mealtimes.
C)Provide frequent mouth care with a firm toothbrush.
D)Provide tissues for the patient to deal with drooling.

Question 7

The nurse is providing care for a patient who has Guillain-Barré syndrome. Which of the following laboratory results should the nurse evaluate first?

A)Complete blood count (CBC)
B)Arterial blood gases (ABGs)
C)Hemoglobin (Hgb) and hematocrit (Hct)
D)Electrolytes

Question 8

The nurse is assisting with teaching a patient who is beginning therapy with neostigmine (Prostigmin) for newly diagnosed myasthenia gravis (MG). The patient asks, "How does that work?" What is the best response by the nurse?

A)"It provides potassium to your muscles so that they will contract better."
B)"It reduces the inflammation in your nerves so that they transmit signals better."
C)"It makes more neurotransmitter available so that your muscles can contract."
D)"It is a muscle relaxant that prevents the cramping in your muscles."

Question 9

The nurse is caring for a patient who is being tested for possible myasthenia gravis (MG). What are the most common early symptoms of myasthenia gravis that the nurse should document in the medical record? (Select all that apply.?

A)Weakness
B)Nausea
C)Numbness of the extremities
D)Confusion
E)Tremor
F)Ptosis

Question 10

A thymectomy is sometimes used to treat which peripheral nervous system disorder?

A)Multiple sclerosis (MS)
B)Guillain-Barré syndrome (GBS)
C)Amyotrophic lateral sclerosis (ALS)
D)Myasthenia gravis (MG)
Multiple Response
Identify one or more choices that best complete the statement or answer the question.

Question 11

The nurse is caring for a patient experiencing an acute exacerbation of multiple sclerosis (MS). The nurse recognizes that symptoms of MS are caused by which of the following pathophysiological changes?

A)Myelin buildup in the central nervous system
B)Gamma aminobutyric acid (GABA) deficiency
C)Reduced acetylcholine receptors with impaired nerve impulse transmission
D)Demyelination and destruction of nerve fibers

Question 12

The nurse is helping a patient with trigeminal neuralgia with bathing. Which of the following nursing actions is most important when washing the patient's face?

A)Use a washcloth to stimulate circulation.
B)Use cold water to reduce inflammation.
C)Use hot water and antibacterial soap.
D)Use lukewarm water and cotton balls.

Question 13

A patient diagnosed with Bell's palsy has all of the following symptoms. Which symptom should the nurse attend to first?

A)Inability to close the affected eye
B)Drooping of one side of the face
C)Changes in taste
D)Speech difficulty

Question 14

The nurse is assisting with discharging a patient with myasthenia gravis after hospitalization for severe respiratory distress. Which statement by the patient indicates that the nurse's discharge teaching has been effective?

A)"I will take my anticholinergic medication to prevent developing respiratory distress again."
B)"If I develop muscle cramping, I can take quinine as needed."
C)"I know I should take my Prostigmin as needed, whenever I feel short of breath."
D)"I have to take my Prostigmin exactly as prescribed without skipping a dose."

Question 15

The nurse is caring for a patient who has amyotrophic lateral sclerosis. The patient has difficulty swallowing and has copious pulmonary secretions. What equipment is most important to have at the bedside at all times?

A)Suction
B)Oxygen
C)Tissues
D)Tongue blade

Question 16

A patient has been extremely fatigued for the past 2 months and is having difficulty lifting even light objects at work. The physician suspects myasthenia gravis (MG) and asks the nurse to assist with a Tensilon test. What patient response to the Tensilon test leads the nurse to suspect myasthenia gravis?

A)The patient's ptosis is temporarily improved.
B)The patient becomes dyspneic.
C)The patient's muscles become very weak.
D)The patient develops muscle cramps.

Question 17

The nurse is assisting with admission of a patient with Guillain-Barré syndrome (GBS) to a medical unit. The patient's legs are weak, making it impossible to walk without assistance. The patient says, "How did I get this? I'm not usually sick." Which response by the nurse is most accurate?

A)"No one knows what causes it."
B)"It is usually hereditary. Does anyone in your family have it?"
C)"It most often occurs as a result of a bacterial infection."
D)"It may be an autoimmune reaction to a virus."

Question 18

Which drug therapy does the nurse anticipate administering to help resolve an exacerbation of multiple sclerosis?

A)Pyridostigmine (Mestinon)
B)Adrenocorticotropic hormone (ACTH)
C)Thyrotropin
D)Diphenhydramine (Benadryl)

Question 19

The nurse is assisting with care of a resident diagnosed with amyotrophic lateral sclerosis (ALS). Which assessment findings does the nurse anticipate? (Select all that apply.?

A)Progressive weakness
B)Pill-rolling tremor
C)Ascending paralysis
D)Hemiparesis
E)Decreased coordination of extremities
F)Bradykinesia

Question 20

The nurse is providing eye care for a patient with Bell's palsy. Which of the following nursing actions is most appropriate to help protect the affected eye?

A)Request an order for ointment and a patch.
B)Apply a warm moist compress to the eye three times a day.
C)Keep the room lights dim at all times.
D)Check for pupil response twice a day.

Question 21

A patient with multiple sclerosis has been prescribed baclofen (Lioresal) to relax muscles. What should be included in the nurse's teaching about taking this drug? (Select all that apply.?

A)"Do not drive or operate machinery until the effects of the drug on you are known."
B)"Avoid crowds while on this medication."
C)"Try to prevent constipation by adequate fluid intake, eating fiber-rich foods, and using suppositories occasionally if necessary."
D)"Take a calcium supplement while on this medication."
E)"Report any shortness of breath or other respiratory problems."
F)"Do not eat grapefruit, drink grapefruit juice, or consume other products containing grapefruit."

Question 22

Which of the following are characteristics of Bell's palsy that differentiate it from trigeminal neuralgia (TN)? (Select all that apply.?

A)Sudden onset
B)Facial droop
C)Loss of taste over anterior part of tongue
D)Sensitivity to temperature
E)Drooling
F)Airflow sensitivity

Question 23

The nurse is teaching a patient with myasthenia gravis how to recognize a cholinergic crisis. The nurse should include which of the following signs and symptoms? (Select all that apply.?

A)Abdominal cramping
B)Diarrhea
C)Difficulty speaking
D)Salivation
E)Increased bronchial secretions
F)Vomiting