Question 1

The critical care nurse is caring for a client with bacterial meningitis. The client has developed cerebral vasculitis and increased ICP. What neurologic sequelae might this client develop?
A) Damage to the optic nerve
B) Damage to the vagal nerve
C) Damage to the olfactory nerve
D) Damage to the facial nerve

Accepted Answer

Damage to the optic nerve can occur due to increased intracranial pressure (ICP) and cerebral vasculitis, as the optic nerve is susceptible to changes in pressure within the skull, potentially leading to vision problems or loss.

Question 2

A client with Parkinson's disease asks the nurse what their treatment is supposed to do since the disease is progressive. What would be the nurse's best response?
A) "Treatment aims at keeping you independent as long as possible."
B) "Treatment really doesn't matter; the disease is going to progress anyway."
C) "Treatment for Parkinson's is only palliative; it keeps you comfortable."
D) " Treatment aims at keeping you emotionally healthy by making you think you are doing something to fight this disease."

Accepted Answer

Treatment for Parkinson's disease does not cure the disease, but it can help manage symptoms and improve quality of life. The goal of treatment is to maximize independence, reduce symptoms, and slow the progression of the disease as much as possible.

Question 3

A client is experiencing muscle weakness and an ataxic gait. The client has a diagnosis of multiple sclerosis (MS). Based on these symptoms, the nurse formulates "Impaired physical mobility" as one of the nursing diagnoses applicable to the client. What nursing intervention should be most appropriate to address the nursing diagnosis?
A) Use pressure-relieving devices when the client is in bed or in a wheelchair.
B) Change body position every 2 hours.
C) Help the client perform range-of-motion (ROM) exercises every 8 hours.
D) Use a footboard and trochanter rolls.

Accepted Answer

Helping the client perform range-of-motion (ROM) exercises every 8 hours is most appropriate for addressing impaired physical mobility, especially in a client with MS experiencing muscle weakness and an ataxic gait. ROM exercises can help maintain joint and muscle function, reduce stiffness, and improve mobility.

Question 4

What drug, prescribed for Parkinson's disease, has neuroprotective properties?
A) Amantadine (Symmetrel)
B) Selegiline (Eldepryl)
C) Bromocriptine (Parlodel)
D) Levodopa (Larodopa)

Accepted Answer

Selegiline (Eldepryl) has been shown to have neuroprotective properties in animal models and some studies in humans with Parkinson's disease. It is believed to work by inhibiting the breakdown of dopamine in the brain, as well as by reducing oxidative stress and inflammation. The other drugs listed are used to treat the symptoms of Parkinson's disease, but do not have established neuroprotective effects.

Question 5

A client diagnosed with Parkinson's disease has developed slurred speech and drooling. The nurse knows that these symptoms indicate which of the following?
A) The client is having an exacerbation.
B) Medication needs to be adjusted to higher doses.
C) The client is exhibiting signs of medication overdose.
D) The disease has entered the late stages.

Accepted Answer

Slurred speech and drooling are characteristic symptoms of Parkinson's disease in its advanced stages, as the degeneration of nerve cells in the brain continues to progress over time. It is not indicative of an exacerbation or medication overdose, and adjusting medication doses may not necessarily alleviate these symptoms.

Question 6

A client you are caring for experiences a seizure. What would be a priority nursing action?
A) Restrain the client during the seizure.
B) Insert a tongue blade between the teeth.
C) Protect the client from injury.
D) Suction the mouth during the convulsion.

Accepted Answer

The priority nursing action when a client experiences a seizure is to protect the client from injury. This can be done by carefully lowering the client to the floor or bed, removing any objects that may cause harm, and loosening any tight clothing around the client's neck. Restraint should never be used during a seizure as it can cause further injury. It is also not appropriate to insert a tongue blade between the teeth as this can cause damage to the mouth and teeth during the violent muscle contractions of a seizure. Suctioning the mouth during a seizure is not recommended as it can cause injury and does not significantly affect the outcome of the seizure.

Question 7

A 55-year-old female client presents at the walk-in clinic complaining of feeling like a mask is on her face. While doing the initial assessment, the nurse notes the demonstration of a pill-rolling movement in the right hand and a stooped posture. Physical examination shows bradykinesia and a shuffling gait. What would the nurse suspect is the causative factor for these symptoms?
A) Multiple sclerosis
B) Myesthenia gravis
C) Parkinson's disease
D) Huntington's disease

Accepted Answer

The symptoms of mask-like face, pill-rolling movement, stooped posture, bradykinesia, and shuffling gait suggest Parkinson's disease, a neurodegenerative disorder that affects movement and is caused by the deterioration of dopamine-producing neurons in the brain. Multiple sclerosis is a chronic autoimmune disease that affects the central nervous system and causes symptoms such as muscle weakness and coordination problems, but does not typically cause the specific symptoms described in the scenario. Myasthenia gravis is a neuromuscular disorder that causes muscle weakness and fatigue, but does not typically cause movement disorders. Huntington's disease is a genetic disorder that causes involuntary movements and cognitive decline, but typically does not cause the specific symptoms described in the scenario.

Question 8

The nurse is caring for a client with trigeminal neuralgia (tic douloureux). The care plan for this client reflects the client's problem eating due to jaw pain. To assist the client in meeting the adequate nutritional needs, what should the nurse suggest?
A) Take small meals of soft consistency
B) Increase the intake of calcium and proteins.
C) Include additional servings of fruits and raw vegetables
D) Include fish, liver, and chicken in diet

Accepted Answer

Taking small meals of soft consistency will help the client to eat without exacerbating the jaw pain associated with trigeminal neuralgia. Increasing calcium and proteins, including fruits and raw vegetables, or including specific meats are not necessarily helpful in reducing pain while eating.

Question 9

A female client is prescribed phenytoin which she takes regularly for seizure control. The client suffers from constipation and complains to the nurse about the problem. What diet-related advice may the nurse offer the client?
A) Decrease the intake of fluids
B) Decrease the intake of iron
C) Include soft fruit or fruit puree in the daily menu
D) Increase the intake of fats and proteins

Accepted Answer

Including soft fruit or fruit puree in the daily menu can help relieve constipation, as they contain fiber that promotes bowel movements. Decreasing fluid intake can worsen constipation, so option A is incorrect. Iron intake is not directly related to constipation, so option B is also incorrect. Increasing fat and protein intake may actually worsen constipation, as these nutrients do not contain fiber that promotes bowel movements.

Question 10

You are caring for a client with a neuromuscular disorder who faces the risk of impaired skin integrity. What should you do to ensure that the client's skin remains intact?
A) Administer tepid sponge baths.
B) Use pressure-relieving devices when the client is in bed or in a wheelchair.
C) Assist the client to move as much as possible.
D) Maintain adequate hydration.

Accepted Answer

The answer of You are caring for a client with...

Question 11

An older client complains of a constant headache. A physical examination shows papilledema. What may the symptoms indicate in this client?
A) Epilepsy
B) Trigeminal neuralgia
C) Hypostatic pneumonia
D) Brain tumor

Accepted Answer

The symptoms of a constant headache and papilledema (swelling of the optic nerve) may indicate a brain tumor. It is important for the client to undergo further evaluation and testing to confirm the diagnosis and determine appropriate treatment.

Question 12

You are the nurse caring for a client with Guillain-Barré syndrome (GBS). The client also has an ascending paralysis. Knowing the complications of the disorder, what should you keep always ready at the bedside?
A) Nebulizer and thermometer
B) Intubation tray and suction apparatus
C) Blood pressure apparatus
D) Incentive spirometer

Accepted Answer

Clients with Guillain-Barré syndrome may develop respiratory compromise due to ascending paralysis that affects the muscles required for breathing. Therefore, it is important to have an intubation tray and a suction apparatus ready at the bedside in case of emergency. The other options listed are not necessary preparations for clients with GBS and ascending paralysis.

Question 13

The nurse is caring for a client hospitalized with a severe exacerbation of Myesthenia Gravis. When administering medications to this client what is a priority nursing action?
A) Assess client's reaction to new medication schedule.
B) Administer medications at exact intervals ordered.
C) Document medication given and dose.
D) Give client plenty of fluids with medications.

Accepted Answer

Administering medications at exact intervals ordered is crucial in Myasthenia Gravis management as the disease is highly responsive to drug treatment and maintaining consistent medication levels is important for symptom control.

Question 14

Because of the pain in her facial muscles and jaws a young female client with Bell's palsy is upset because she is unable to communicate properly. What advice can be given to the client to improve her speech?
A) Speak slowly and in short sentences.
B) Speak in monosyllables.
C) Don't speak but instead gesticulate.
D) Speak in short sentences but loudly.

Accepted Answer

Speaking slowly and in short sentences can help the client improve her speech because it allows her to concentrate on the movement of her facial muscles and control her speech more effectively. Speaking in monosyllables or loudly may not be as effective and gesticulating may not always be a practical option.

Question 15

You are taking care of a client who is taking an anticonvulsant. Why should you advise the client not to stop taking the drug abruptly?
A) It may cause loss in appetite.
B) It may trigger status epilepticus.
C) It may cause alopecia.
D) It may cause severe and ugly skin rashes.

Accepted Answer

Abruptly stopping an anticonvulsant can cause rebound seizures and may trigger status epilepticus, which is a life-threatening seizure disorder. It is important to taper off the drug slowly under the supervision of a healthcare provider. Loss of appetite, alopecia, and skin rashes are potential side effects of anticonvulsants, but they are not the reason why the client should not stop taking the drug abruptly.

Question 16

A client diagnosed with Huntington's disease has developed severe depression. What would be most important for the nurse to assess for?
A) Loss of bowel and bladder control
B) Choreiform movements
C) Suicidal ideations
D) Emotional apathy

Accepted Answer

Although loss of bowel and bladder control, choreiform movements, and emotional apathy are common symptoms of Huntington's disease, severe depression can lead to suicidal ideations, which is the most important issue that requires immediate attention from the nurse. The nurse should assess the client for any suicidal ideations, plans, or attempts and take appropriate safety measures if needed.

Question 17

The nursing instructor gives their students an assignment of making a plan of care for a client with Huntington's disease. What would be important for the students to include in the teaching portion of the care plan?
A) How to exercise
B) How to perform household tasks
C) How to take a bath
D) How to facilitate tasks such as using both hands to hold a drinking glass

Accepted Answer

Facilitating tasks such as using both hands to hold a drinking glass is important in the care of a client with Huntington's disease, as it is a common motor symptom of the disease. While exercise, performing household tasks, and taking a bath may also be important considerations for overall care, the teaching portion of the plan should focus specifically on addressing the unique needs and challenges associated with the disease.

Question 18

You are teaching a class on your unit about the assessment of neurologic clients who have infectious or inflammatory disease processes. After completing an initial assessment, what would you teach the nurses on your unit is the next step in caring for these clients?
A) Auscultate the lungs every 4 to 8 hours.
B) Evaluate the client's ability to swallow.
C) Provide for intake and output measurements.
D) Initiate an assessment flow sheet.

Accepted Answer

The answer of You are teaching a class on your...

Question 19

You are caring for a client with an inoperable brain tumor. What is a major threat to this client?
A) Increased ICP
B) Decreased ICP
C) Hypervolemia
D) Hypovolemia

Accepted Answer

An inoperable brain tumor can cause an increase in intracranial pressure (ICP) which can lead to a variety of issues such as decreased blood flow to the brain, compression of brain tissue, and possible brain herniation. This is a major threat to the client and requires careful management including monitoring for signs of increased ICP and interventions to reduce it if necessary. Decreased ICP, hypervolemia, and hypovolemia are not typically associated with this condition.

Question 20

The nurse is caring for a client hospitalized after a motor vehicle accident. The client has a comorbidity of Parkinson's disease. Why should the nurse closely monitor the condition and the drug regimen of a client with Parkinson's disease?
A) Drugs administered may not cause the requisite therapeutic effect.
B) Clients take an assortment of different drugs.
C) Clients generally do not adhere to the drug regimen.
D) Drugs administered may cause a wide variety of adverse effects.

Accepted Answer

Clients with Parkinson's disease often require complex medication regimens that can cause adverse effects such as confusion, hallucinations, and motor fluctuations. It is important for the nurse to closely monitor the client's response to medications and watch for any adverse effects.

Quiz 37: Caring for Clients With Central and Peripheral Nervous System Disorders

The critical care nurse is caring for a client with bacterial meningitis. The client has developed cerebral vasculitis and increased ICP. What neurologic sequelae might this client develop?

A client with Parkinson's disease asks the nurse what their treatment is supposed to do since the disease is progressive. What would be the nurse's best response?

What drug, prescribed for Parkinson's disease, has neuroprotective properties?

A client diagnosed with Parkinson's disease has developed slurred speech and drooling. The nurse knows that these symptoms indicate which of the following?

A client you are caring for experiences a seizure. What would be a priority nursing action?

The nurse is caring for a client with trigeminal neuralgia (tic douloureux) . The care plan for this client reflects the client's problem eating due to jaw pain. To assist the client in meeting the adequate nutritional needs, what should the nurse suggest?

A female client is prescribed phenytoin which she takes regularly for seizure control. The client suffers from constipation and complains to the nurse about the problem. What diet-related advice may the nurse offer the client?

You are caring for a client with a neuromuscular disorder who faces the risk of impaired skin integrity. What should you do to ensure that the client's skin remains intact?

An older client complains of a constant headache. A physical examination shows papilledema. What may the symptoms indicate in this client?

You are the nurse caring for a client with Guillain-Barré syndrome (GBS) . The client also has an ascending paralysis. Knowing the complications of the disorder, what should you keep always ready at the bedside?

The nurse is caring for a client hospitalized with a severe exacerbation of Myesthenia Gravis. When administering medications to this client what is a priority nursing action?

Because of the pain in her facial muscles and jaws a young female client with Bell's palsy is upset because she is unable to communicate properly. What advice can be given to the client to improve her speech?

You are taking care of a client who is taking an anticonvulsant. Why should you advise the client not to stop taking the drug abruptly?

A client diagnosed with Huntington's disease has developed severe depression. What would be most important for the nurse to assess for?

The nursing instructor gives their students an assignment of making a plan of care for a client with Huntington's disease. What would be important for the students to include in the teaching portion of the care plan?

You are teaching a class on your unit about the assessment of neurologic clients who have infectious or inflammatory disease processes. After completing an initial assessment, what would you teach the nurses on your unit is the next step in caring for these clients?

You are caring for a client with an inoperable brain tumor. What is a major threat to this client?

The nurse is caring for a client hospitalized after a motor vehicle accident. The client has a comorbidity of Parkinson's disease. Why should the nurse closely monitor the condition and the drug regimen of a client with Parkinson's disease?