Question 1

Which test involving injection of a drug would the nurse anticipate being ordered to diagnose myasthenia gravis MG)?

Accepted Answer

The Tensilon test involves the injection of edrophonium chloride, which temporarily blocks the breakdown of acetylcholine at the neuromuscular junction, leading to improved muscle contraction in individuals with myasthenia gravis. Therefore, this test is used to diagnose MG.

Question 2

A 30-year-old nurse who works on a busy medical-surgical unit has been diagnosed with multiple sclerosis MS). What is this patient's priority health promotion activity?

Accepted Answer

The patient's priority health promotion activity should be to negotiate a regular schedule of 8-hour day shifts and consider applying for nursing positions that are less stressful and demanding. MS is a chronic autoimmune disease that affects the nervous system and can cause symptoms such as fatigue, weakness, and difficulty with balance and coordination. These symptoms can make it difficult to work in a demanding and stressful job such as nursing. It is important for the patient to prioritize their health and make modifications to their work schedule and job duties to manage their symptoms and prevent further disability. Continuing to work as scheduled or working harder may exacerbate symptoms, while leaving employment may not be necessary if reasonable modifications can be made.

Question 3

A patient with myasthenia gravis is taking pyridostigmine Mestinon). When teaching about this medication, the nurse should instruct the patient to immediately report which conditions? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

A,B,E

Question 4

A patient who is newly diagnosed with Huntington's disease asks the nurse whether this disorder can be passed on to his future children. How should the nurse respond? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

A) The nurse should always encourage patients to discuss genetic concerns with their physician.
D) Huntington's disease has an autosomal dominant inheritance pattern, meaning that each child of an affected individual has a 50% chance of inheriting the gene mutation that causes the disease.

Question 5

A nurse working in a fertility clinic reviews the health history of a patient whose father had Huntington's disease. What initial statement by the nurse would best address this patient's risk factors?

Accepted Answer

The nurse should begin by asking the patient what they know about testing for the disease. This allows the nurse to assess the patient's understanding of the disease and what they may already know about their risk factors. From there, the nurse can provide information about the testing process and what steps the patient can take to manage their risk. Options B and D are options, but they are more direct and may cause undue anxiety for the patient. Option C is inappropriate and assumes that the patient may not want children solely based on their risk factors.

Question 6

The nurse notes tremors and muscle rigidity in an older adult patient diagnosed with Parkinson's disease. Which medication would the nurse expect to administer to combat these symptoms?

Accepted Answer

Benztropine (Cogentin) is an anticholinergic medication commonly used to treat the tremors and rigidity associated with Parkinson's disease. Dantrolene (Dantrium) is a muscle relaxant used to treat muscle spasms, but it is not typically used for Parkinson's disease. Riluzole (Rilutek) is a medication used to treat Amyotrophic lateral sclerosis (ALS) and does not have any effect on Parkinson's disease symptoms. Nitroglycerin (Nitro-bid) is a medication used to treat angina and has no role in managing Parkinson's disease symptoms.

Question 7

The nurse is assessing a patient with myasthenia gravis. Which findings would the nurse attribute to this disease? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

Myasthenia gravis is a neuromuscular disorder characterized by weakness and rapid fatigue of muscles under voluntary control. Visual problems, difficulty in swallowing, and poor articulation in speaking are common symptoms of myasthenia gravis. Routine exercise does not provide improvement in muscle strength, and physical therapy may only provide minor improvements. Therefore, options B and D are incorrect.

Question 8

In order to care for adults with Alzheimer's disease AD), the nurse recognizes which common signs? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

Alzheimer's disease commonly leads to cognitive decline, which manifests as poor or impaired judgment, declining job skills, and discomfort in social situations. Obsession with organization and a focus on abstract thoughts are not typical signs of Alzheimer's disease.

Question 9

A patient complains of occasional periods of confusion and forgetfulness but reports a clear thought process most of the day. The symptoms have been gradually worsening. What is the best initial response by the nurse?

Accepted Answer

The nurse should first assess if there are any potential medical causes for the patient's symptoms, such as medication side effects or underlying health conditions. This can be done by asking if the patient has started any new medications or has any medical history that may contribute to the symptoms.

Question 10

Which medication would the nurse anticipate administering as treatment for mild Alzheimer's disease AD)?

Accepted Answer

Mild Alzheimer's disease is typically treated with cholinesterase inhibitors such as donepezil (Aricept). This medication helps to increase the levels of the neurotransmitter acetylcholine in the brain, which can improve symptoms such as memory loss and confusion. Adrenocorticotropic hormone (ACTH) is not commonly used to treat Alzheimer's disease, and olanzapine (Zyprexa) is an antipsychotic medication that may be used to treat behavioral symptoms in some patients with Alzheimer's disease but is not a first-line treatment for mild AD. Memantine (Namenda) is typically used to treat moderate to severe Alzheimer's disease, but may also be used in some cases of mild AD.

Question 11

A patient states, "My doctor said sometimes I may have an on-and-off problem with this medication. What does that mean?" How should the nurse respond?

Accepted Answer

This response accurately explains that the on periods are when symptoms are controlled and the off periods are when symptoms are increased.

Question 12

Once amyotrophic lateral sclerosis ALS) is diagnosed, what is the priority nursing activity?

Accepted Answer

The priority nursing activity when ALS is diagnosed is to support the patient and family to meet physical and psychosocial needs. This includes providing education and resources, addressing emotional and mental health concerns, and promoting quality of life. While monitoring for infection, assisting the patient to avoid complications, and assisting the patient to adapt to the disease are all important nursing activities, they are not the priority when ALS is first diagnosed.

Question 13

A patient with Alzheimer's disease has lost 5 pounds over the past month. What is the best nursing intervention to address this weight loss?

Accepted Answer

The answer of A patient with Alzheimer's disease has lost...

Question 14

The nurse is completing discharge teaching to a patient with a new diagnosis of myasthenia gravis MG). What information should the nurse provide about the patient's diet?

Accepted Answer

It is important for patients with MG to maintain a healthy weight for their height to avoid putting extra strain on their muscles. There is no specific dietary requirement for MG, but a balanced diet is generally recommended.

Question 15

A patient is hospitalized with amyotrophic lateral sclerosis ALS), and the nursing diagnosis Spontaneous Ventilation, Impaired has been identified. In planning care for this patient, the nurse will prioritize the appropriate interventions. Rank the interventions, with the first being the most critical and the last the least critical. Standard Text: Click and drag the options below to move them up or down.
Choice

Accepted Answer

The most critical interventions are those that will ensure the patient's immediate safety and well-being. Assessing respiratory rate and lung sounds every 4 hours (A) will help to identify any changes in the patient's respiratory status. Monitoring arterial blood gases (B) will help to identify any changes in the patient's oxygenation and ventilation. Maintaining hydration and caloric intake (C) is essential for the patient's overall health and well-being. Educating the patient about further treatment options (D) is less critical than the other interventions, as it can be done at a later time.

Question 16

A home health nurse visits a patient with moderate Alzheimer's disease who lives at home with the spouse. To meet the needs of the spouse, the nurse suggests which action?

Accepted Answer

Finding respite care to come into the home several days a week would provide the spouse with a break from the caregiving responsibilities, while still allowing the patient to remain at home. This would also prevent the need for finding placement in a long-term care facility. Providing the patient with a list of daily activities or arranging for visits to a senior citizens' center may not adequately address the needs and concerns of the spouse.

Question 17

The nurse is having a conversation with an older adult with Parkinson's disease. What would this patient most likely exhibit during the conversation? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

Older adults with Parkinson's disease often have difficulty with speech and language due to muscle rigidity, tremors, and slow movements, leading to a low-pitched monotone voice and slurring/poor articulation of words. Option B and D are less likely as patients with Parkinson's disease have difficulty with facial muscles, leading to a lack of facial expression and difficulty expressing emotions. Option C is more characteristic of individuals with cognitive impairment or aphasia resulting from a stroke, rather than Parkinson's disease.

Question 18

A patient's husband states, "I've noticed that my wife doesn't sleep well anymore and sometimes can't find the right words when we're talking." Which is the most appropriate response by the nurse?

Accepted Answer

The nurse should gather more information about the changes that the patient has been experiencing. Asking how long these changes have been present can provide insight into the onset and duration, which can help guide further assessment and interventions. However, it may also be appropriate to ask additional questions depending on the patient's history and presenting symptoms.

Question 19

The nurse is caring for a patient with amyotrophic lateral sclerosis ALS). The nurse plans care based on which understanding of the patient's prognosis?

Accepted Answer

ALS is a progressive and fatal disease that affects the nerves responsible for controlling voluntary muscles. There is no cure for the disease and the prognosis is poor, with most patients surviving for only 2-5 years after diagnosis. The nurse should plan care based on the understanding that the disease progresses slowly and is fatal.

Question 20

A patient who was diagnosed with Parkinson's disease is exhibiting hypomimia. What will the nurse likely observe in this patient?

Accepted Answer

Hypomimia, also known as "masked facies," is a common symptom of Parkinson's disease that involves a reduction or absence of facial expressions. The other options listed are symptoms of Parkinson's disease as well, but do not pertain to hypomimia specifically.

Quiz 23: Caring for the Patient With Chronic and Degenerative Neurological Disorders

Which test involving injection of a drug would the nurse anticipate being ordered to diagnose myasthenia gravis MG) ?

A 30-year-old nurse who works on a busy medical-surgical unit has been diagnosed with multiple sclerosis MS) . What is this patient's priority health promotion activity?

A patient who is newly diagnosed with Huntington's disease asks the nurse whether this disorder can be passed on to his future children. How should the nurse respond? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply.

A nurse working in a fertility clinic reviews the health history of a patient whose father had Huntington's disease. What initial statement by the nurse would best address this patient's risk factors?

The nurse notes tremors and muscle rigidity in an older adult patient diagnosed with Parkinson's disease. Which medication would the nurse expect to administer to combat these symptoms?

The nurse is assessing a patient with myasthenia gravis. Which findings would the nurse attribute to this disease? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply.

In order to care for adults with Alzheimer's disease AD) , the nurse recognizes which common signs? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply.

A patient complains of occasional periods of confusion and forgetfulness but reports a clear thought process most of the day. The symptoms have been gradually worsening. What is the best initial response by the nurse?

Which medication would the nurse anticipate administering as treatment for mild Alzheimer's disease AD) ?

A patient states, "My doctor said sometimes I may have an on-and-off problem with this medication. What does that mean?" How should the nurse respond?

Once amyotrophic lateral sclerosis ALS) is diagnosed, what is the priority nursing activity?

A patient with Alzheimer's disease has lost 5 pounds over the past month. What is the best nursing intervention to address this weight loss?

The nurse is completing discharge teaching to a patient with a new diagnosis of myasthenia gravis MG) . What information should the nurse provide about the patient's diet?

A home health nurse visits a patient with moderate Alzheimer's disease who lives at home with the spouse. To meet the needs of the spouse, the nurse suggests which action?

The nurse is having a conversation with an older adult with Parkinson's disease. What would this patient most likely exhibit during the conversation? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply.

A patient's husband states, "I've noticed that my wife doesn't sleep well anymore and sometimes can't find the right words when we're talking." Which is the most appropriate response by the nurse?

The nurse is caring for a patient with amyotrophic lateral sclerosis ALS) . The nurse plans care based on which understanding of the patient's prognosis?

A patient who was diagnosed with Parkinson's disease is exhibiting hypomimia. What will the nurse likely observe in this patient?