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

Question 1

A patient with MS has been prescribed baclofen to relax muscles. Which information is included in the nurse's teaching about this drug? (Select all that apply.)

A)"Avoid crowds while on this medication."
B)"Take a calcium supplement while on this medication."
C)"Report any shortness of breath or other respiratory problems."
D)"Avoid driving or operating machinery until the effects of the drug are known."
E)"Prevent constipation by increasing fluids and fiber-rich foods; use suppositories when necessary."

Answer 1

"Report any shortness of breath or other respiratory problems."
"Avoid driving or operating machinery until the effects of the drug are known."
"Prevent constipation by increasing fluids and fiber-rich foods; use suppositories when necessary."

Question 2

A mother of three young children has a 3-year history of MG and recently stopped helping in the children's classrooms because of fatigue. Which advice does the nurse give to help the patient best cope with the problem?

A)"You need to realize that you may not be able to do the things you used to do."
B)"Time your medication so its action peaks during the time you need the most energy."
C)"Get plenty of sleep the night before you help to give you the stamina you need."
D)"Take your medication after you finish helping, and you may have a better energy level."

Answer 2

"Time your medication so its action peaks during the time you need the most energy."

Question 3

The nurse is providing care for a patient being treated for trigeminal neuropathy. The nurse is concerned about the patient's nutritional status because of an inability to eat without experiencing severe pain. Which patient behavior indicates the nurse's interventions are successful?

A)The patient can sip cool or warm beverages through a straw.
B)The patient can eat multiple small, soft, lukewarm meals daily.
C)The patient's weight remains 10 pounds below the target weight.
D)The patient's pain is managed with postprandial pain medication.

Answer 3

The patient can eat multiple small, soft, lukewarm meals daily.

Question 4

The nurse is providing care for a patient after surgery for treatment of trigeminal neuropathy. Which nursing intervention will the nurse initiate for this patient?

A)Protect the patient's face from any movement of air.
B)Place eye patches bilaterally while the patient sleeps.
C)Check the eye on the surgery side for corneal sensation.
D)Provide a soft diet with food served at room temperature.

Question 5

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

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

Question 6

A patient is scheduled for a thymectomy. For which peripheral nervous system disorder does the nurse plan care for this patient?

A)MS
B)MG
C)GBS
D)ALS

Question 7

A patient who is prescribed neostigmine for newly diagnosed MG asks how the medication works. Which response does the nurse provide to the patient?

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

Question 8

The nurse is collecting information from a patient in the HCP's office. The patient is exhibiting symptoms associated with Bell palsy. Which population group does the nurse recognize as being at greatest risk for the condition?

A)Women in the third trimester of pregnancy
B)Patients who have experienced a stroke
C)Patients who have a history of sun exposure
D)Men with history of excessive alcohol abuse

Question 9

A patient reports to the nurse an inability to rest or sleep due to a long-term condition causing a constant urge to move the legs called restless legs syndrome (RLS). The patient expresses a need for some type of relief. Which suggestion by the nurse is most likely to help the patient?

A)Elimination of alcohol, tobacco, and caffeine
B)Pramipexole or ropinrole medication therapy
C)Using a vibrating pad (Relaxis) approved by the Food and Drug Administration (FDA)
D)Routine sleep habits and regular exercise program

Question 10

A patient diagnosed with Guillain-Barré syndrome (GBS) asks how the disease developed since the patient rarely has an illness. Which nursing response is the most accurate?

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

Question 11

The nurse is caring for a patient experiencing an acute exacerbation of multiple sclerosis (MS). Which pathophysiological change does the nurse recognize as causing the manifestations of MS?

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

Question 12

The nurse is collecting data from a patient who is diagnosed with MG. Which data is most important for the nurse to obtain?

A)Ascertain if the patient's needs are being met by an adequate support system.
B)Ask what amount of activity causes fatigue and muscle weakness to occur.
C)Determine baseline muscle strength through the use of appropriate techniques.
D)Monitor the patient's respiratory function and the ability to swallow effectively.

Question 13

The nurse is teaching a patient with MG how to recognize a cholinergic crisis. Which manifestations does the nurse include in this teaching? (Select all that apply.)

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

Question 14

The nurse is assisting with the care of a patient diagnosed with postpolio syndrome. The nurse asks the registered nurse (RN) to explain the source of the disease. Which answer by the RN is correct?

A)The syndrome begins with the contraction of polio.
B)The disease is common among third-world travelers.
C)The patient must first have had a poliovirus infection.
D)The syndrome leads to development of great debilitation.

Question 15

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

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

Question 16

A patient in the plateau stage of GBS is frustrated because there has been no improvement in manifestations for 5 days. Which explanation does the nurse provide to the patient?

A)The manifestations can last up to 2 weeks.
B)The manifestations can last up to 3 weeks.
C)The manifestations can last up to 6 months.
D)The manifestations can last up to 24 months.

Question 17

The nurse is visiting the home of a patient who is being treated for Bell palsy. Which statement by the patient indicates that care instructions need to be reviewed by the nurse?

A)"I find that I can eat better with a facial sling in place."
B)"Gentle massage of the effected muscles reduces discomfort."
C)"I follow the physical therapy exercises exactly as prescribed."
D)"Alternating heat and cold therapy is helping the swelling."

Question 18

The nurse reviews information with a patient and family members about the patient's recent diagnosis of amyotrophic lateral sclerosis (ALS). Which comment by a family member indicates a need for clarification?

A)"When the heart muscle is affected, death will occur shortly."
B)"We need to remember that mental functioning is intact."
C)"A feeding tube and ventilator may need to be considered later."
D)"We need to do some research to see if this is a familial risk."

Question 19

The nurse is collecting up-to-date data from a patient who was diagnosed with MS 15 years ago. The patient has a good understanding of the disease and manages to maintain a relatively high level of functioning. Which statement by the patient prompts the nurse to seek additional information?

A)"I am very careful to avoid sick people and crowds in the winter."
B)"I have been attending a special yoga class for people with MS."
C)"I love to work in my flower beds during the summer months."
D)"I find that I do much better if I let other people run errands for me."

Question 20

The nurse is assisting with care of patients diagnosed with neuromuscular disorders. Which complication does the nurse recognize as a medical emergency?

A)Evidence of severe muscle wasting
B)Indications of the development of pneumonia
C)Interruption of skin integrity over bony prominences
D)Difficulty maintaining weight due to difficulty swallowing