Question 1

A patient who has been treated for status epilepticus in the emergency department will be transferred to the medical nursing unit. Which equipment should the nurse have available in the patient's assigned room ?

Accepted Answer

The patient is at risk for further seizures,and O? and suctioning may be needed after any seizures to clear the airway and maximize oxygenation. The bed's side rails should be padded to minimize the risk for patient injury during a seizure. Use of tongue blades during a seizure is contraindicated. Insertion of a nasogastric (NG)tube is not indicated because the airway problem is not caused by vomiting or abdominal distention. A urinary catheter is not required unless there is urinary retention.

Question 2

After a thymectomy,a patient with myasthenia gravis receives the usual dose of pyridostigmine (Mestinon). An hour later,the patient complains of nausea and severe abdominal cramps. Which action should the nurse take first?

Accepted Answer

The patient's history and symptoms indicate a possible cholinergic crisis. The health care provider should be notified immediately,and it is likely that atropine will be prescribed. The other actions will be appropriate if the patient is not experiencing a cholinergic crisis.

Question 3

The nurse observes a patient ambulating in the hospital hall when the patient's arms and legs suddenly jerk and the patient falls to the floor. The nurse will first

Accepted Answer

The patient who has had a myoclonic seizure and fall is at risk for head injury and should first be evaluated and treated for this possible complication. Documentation of the seizure,notification of the health care provider,and administration of antiseizure medications are also appropriate actions,but the initial action should be assessment for injury.

Question 4

Which information about a patient who has a new prescription for phenytoin (Dilantin)indicates that the nurse should consult with the health care provider before administration of the medication?

Accepted Answer

Many older patients (especially with compromised liver function)may not be able to metabolize phenytoin. The health care provider may need to choose another antiseizure medication. Phenytoin is an appropriate medication for patients with tonic-clonic seizures,with or without an aura. Hypertension is not a contraindication for phenytoin therapy.

Question 5

Which intervention will the nurse include in the plan of care for a patient with primary restless legs syndrome (RLS)who is having difficulty sleeping?

Accepted Answer

Nondrug interventions such as getting regular exercise are initially suggested to improve sleep quality in patients with RLS. Antihistamines may aggravate RLS. Massage does not alleviate RLS symptoms,and RLS is likely to progress in most patients.

Question 6

A patient with Parkinson's disease is admitted to the hospital for treatment of pneumonia. Which nursing interventions will be included in the plan of care ?

Accepted Answer

Because the patient with Parkinson's disease has difficulty chewing,food should be cut into small pieces. An armchair should be used when the patient is seated so that the patient can use the arms to assist with getting up from the chair. An elevated toilet seat will facilitate getting on and off the toilet. High-protein foods will decrease the effectiveness of L-dopa. Parkinson's disease is a steadily progressive disease without acute exacerbations.

Question 7

A patient who is having an acute exacerbation of multiple sclerosis has a prescription for methylprednisolone (Solu-Medrol)150 mg IV. The label on the vial reads: methylprednisolone 125 mg in 2 mL. How many mL will the nurse administer?

Accepted Answer

The answer of A patient who is having an acute...

Question 8

A patient is being treated with carbidopa/levodopa (Sinemet)for Parkinson's disease. Which information indicates a need for change in the medication or dosage?

Accepted Answer

Dyskinesia is an adverse effect of the Sinemet,indicating a need for a change in medication or decrease in dose. The other findings are typical with Parkinson's disease.

Question 9

A patient tells the nurse about using acetaminophen (Tylenol)several times every day for recurrent bilateral headaches. Which action will the nurse plan to take first?

Accepted Answer

The headache description suggests that the patient is experiencing medication overuse headache. The initial action will be withdrawal of the medication. The other actions may be needed if the headaches persist.

Question 10

Which nursing diagnosis is of highest priority for a patient with Parkinson's disease who is unable to move the facial muscles?

Accepted Answer

The data about the patient indicate that poor nutrition will be a concern because of decreased swallowing. The other diagnoses may also be appropriate for a patient with Parkinson's disease,but the data do not indicate that they are current problems for this patient.

Question 11

Which assessment is most important for the nurse to make regarding a patient with myasthenia gravis?

Accepted Answer

Because respiratory insufficiency may be life threatening,it will be most important to monitor respiratory function. The other data also will be assessed but are not as critical.

Question 12

The home health registered nurse (RN)is planning care for a patient with a seizure disorder related to a recent head injury. Which nursing action can be delegated to a licensed practical/vocational nurse (LPN/LVN)?

Accepted Answer

LPN/LVN education includes administration of medications. The other activities require RN education and scope of practice.

Question 13

After change-of-shift report,which patient should the nurse assess first?

Accepted Answer

Because increased muscle weakness may indicate the onset of a myasthenic crisis,the nurse should assess this patient first. The other patients should also be assessed but do not appear to need immediate nursing assessments or actions to prevent life-threatening complications.

Question 14

The health care provider is considering the use of sumatriptan (Imitrex)for a 54-yr-old male patient with migraine headaches. Which information obtained by the nurse is most important to report to the health care provider?

Accepted Answer

The triptans cause coronary artery vasoconstriction and should be avoided in patients with coronary artery disease. The other information will be reported to the health care provider,but none of it indicates that sumatriptan would be an inappropriate treatment.

Question 15

A hospitalized patient with a history of cluster headache awakens during the night with a severe stabbing headache. Which action should the nurse take first?

Accepted Answer

Acute treatment for cluster headache is administration of 100% O? at 6 to 8 L/min. If the patient obtains relief with the O?,there is no immediate need to notify the health care provider. Cluster headaches last only 60 to 90 minutes,so oral pain medications have minimal effect. Hot packs are helpful for tension headaches but are not as likely to reduce pain associated with a cluster headache.

Question 16

Which prescribed intervention will the nurse implement first for a patient in the emergency department who is experiencing continuous tonic-clonic seizures?

Accepted Answer

To prevent ongoing seizures,the nurse should administer rapidly acting antiseizure medications such as the benzodiazepines. A CT scan is appropriate,but prevention of any seizure activity during the CT scan is necessary. Phenytoin will also be administered,but it is not rapidly acting. Patients who are experiencing tonic-clonic seizures are nonresponsive,although the nurse should assess LOC after the seizure.

Quiz 58: Chronic Neurologic Problems

A patient who has been treated for status epilepticus in the emergency department will be transferred to the medical nursing unit. Which equipment should the nurse have available in the patient's assigned room ?

After a thymectomy,a patient with myasthenia gravis receives the usual dose of pyridostigmine (Mestinon) . An hour later,the patient complains of nausea and severe abdominal cramps. Which action should the nurse take first?

The nurse observes a patient ambulating in the hospital hall when the patient's arms and legs suddenly jerk and the patient falls to the floor. The nurse will first

Which information about a patient who has a new prescription for phenytoin (Dilantin) indicates that the nurse should consult with the health care provider before administration of the medication?

Which intervention will the nurse include in the plan of care for a patient with primary restless legs syndrome (RLS) who is having difficulty sleeping?

A patient with Parkinson's disease is admitted to the hospital for treatment of pneumonia. Which nursing interventions will be included in the plan of care ?

A patient who is having an acute exacerbation of multiple sclerosis has a prescription for methylprednisolone (Solu-Medrol)150 mg IV. The label on the vial reads: methylprednisolone 125 mg in 2 mL. How many mL will the nurse administer?

A patient is being treated with carbidopa/levodopa (Sinemet) for Parkinson's disease. Which information indicates a need for change in the medication or dosage?

A patient tells the nurse about using acetaminophen (Tylenol) several times every day for recurrent bilateral headaches. Which action will the nurse plan to take first?

Which nursing diagnosis is of highest priority for a patient with Parkinson's disease who is unable to move the facial muscles?

Which assessment is most important for the nurse to make regarding a patient with myasthenia gravis?

The home health registered nurse (RN) is planning care for a patient with a seizure disorder related to a recent head injury. Which nursing action can be delegated to a licensed practical/vocational nurse (LPN/LVN) ?

After change-of-shift report,which patient should the nurse assess first?

The health care provider is considering the use of sumatriptan (Imitrex) for a 54-yr-old male patient with migraine headaches. Which information obtained by the nurse is most important to report to the health care provider?

A hospitalized patient with a history of cluster headache awakens during the night with a severe stabbing headache. Which action should the nurse take first?

Which prescribed intervention will the nurse implement first for a patient in the emergency department who is experiencing continuous tonic-clonic seizures?