Question 1

The nurse is caring for a client with epilepsy. Which of the following laboratory results should the nurse expect?

Accepted Answer

The blood work results of a client with epilepsy would show an increased creatinine level. The other results that would be expected are a decreased blood glucose level, increased BUN, and increased liver function tests.

Question 2

Which of the following parameters should the nurse assess when caring for a client who is experiencing a cluster headache?

Accepted Answer

Unilateral eye edema, tearing, and ptosis are characteristic of cluster headaches. Nuchal rigidity suggests meningeal irritation, such as occurs with meningitis. Although nausea and vomiting may occur with migraine headaches, projectile vomiting is more consistent with increases in intracranial pressure (ICP). Unilateral sharp, stabbing pain, rather than throbbing pain, is characteristic of cluster headaches.

Question 3

The nurse is caring for a client with multiple sclerosis (MS) who has urinary retention caused by a flaccid bladder. Which of the following actions should the nurse plan to take?

Accepted Answer

Bladder control is a major problem for many patients with MS. Although anticholinergics may be beneficial for some patients to decrease spasticity, other patients may need to be taught self-catheterization. Decreasing fluid intake will not improve bladder emptying and may increase risk for urinary tract infection (UTI) and dehydration. The use of incontinence briefs and frequent toileting will not improve bladder emptying.

Question 4

Afemale client who has multiple sclerosis (MS) asks the nurse about risks associated with pregnancy. Which of the following responses by the nurse is accurate?

Accepted Answer

During the postpartum period, women with MS are at greater risk for exacerbation of symptoms. There is no increased risk for congenital defects in infants born of mothers with MS. Symptoms of MS may improve during pregnancy. Onset of labour is not affected by MS.

Question 5

The nurse is caring for a client who is diagnosed with early Huntington's disease (HD). Which of the following information should the nurse include in the teaching plan for the client, partner, and children?

Accepted Answer

Genetic testing is available to determine whether an asymptomatic individual has the HD gene. The client and family should be informed of the benefits and problems associated with genetic testing. Sinemet will increase symptoms of HD given that HD involves an increase in dopamine. Antibiotic therapy will not reduce the risk for aspiration. There are no effective treatments or lifestyle changes that delay the progression of symptoms in HD.

Question 6

Aclient has a tonic-clonic seizure while the nurse is in the client's room. Which of the following actions should the nurse take?

Accepted Answer

Because diagnosis and treatment of seizures frequently are based on the description of the seizure, recording the length and details of the seizure is important. Insertion of an oral airway and restraining the client during the seizure are contraindicated. The nurse may need to move the client to decrease the risk of injury during the seizure.

Question 7

The nurse is caring for a hospitalized client who has a moderate bilateral headache that radiates from the base of the skull. Which of the following prescribed PRN medications should the nurse administer initially?

Accepted Answer

The client's symptoms are consistent with a tension headache, and initial therapy usually involves a nonopioid analgesic such as acetaminophen, sometimes combined with a sedative or muscle relaxant. Lorazepam may be used in conjunction with acetaminophen but would not be appropriate as the initial monotherapy. Morphine sulphate and butalbital and Aspirin would be more appropriate for a headache that did not respond to a nonopioid analgesic.

Question 8

A client has a new prescription for bromocriptine mesylate to control symptoms of Parkinson's disease. Which of the following information obtained by the nurse may indicate a need for a decrease in the dose?

Accepted Answer

Hypotension is an adverse effect of bromocriptine mesylate, and the nurse should check with the health care provider before giving the medication. Diarrhea, cough, and deep vein thrombosis are not associated with bromocriptine mesylate use.

Question 9

The nurse is caring for a client with amyotrophic lateral sclerosis (ALS) who is hospitalized with pneumonia. Which of the following actions should be included in the plan of care?

Accepted Answer

ALS causes progressive muscle weakness. Clients should be guided to use moderate-intensity, endurance-type exercises for the trunk and limbs, since this may help reduce ALS spasticity. When hospitalized with other health concerns, it is important to complete ROM to maintain strength. Psychotic symptoms such as agitation and paranoia are not associated with ALS. Cognitive function is not affected by ALS, and the client's ability to understand procedures will not be impaired. Muscle relaxants will further increase muscle weakness and depress respirations.

Question 10

The nurse assesses a client in the health clinic who has symptoms of a stooped posture, shuffling gait, and pill rolling-type tremor. Which of the following topics should the nurse include in the plan of care?

Accepted Answer

The diagnosis of Parkinson's is made when two of the three characteristic signs of tremor, rigidity, and bradykinesia are present. The confirmation of the diagnosis is made on the basis of improvement when antiparkinsonian drugs are administered. This client has symptoms of tremor and bradykinesia; the next anticipated step will be treatment with medications. MRI and EEG are not useful in diagnosing Parkinson's disease, and corticosteroid therapy is not used to treat it.

Question 11

The nurse is providing teaching to a client with myasthenia gravis (MG) about management of the disease? Which of the following information should the nurse include in the teaching plan?

Accepted Answer

Muscles are generally strongest in the morning, and activities involving muscle activity should be scheduled then. Plasmapheresis is not routinely scheduled but is used for myasthenia crisis or for situations in which corticosteroid therapy should be discontinued. There is no decrease in sensation with MG, and muscle atrophy does not occur because muscles are used during part of the day.

Question 12

The nurse is obtaining a health history and physical assessment from a client withpossible multiple sclerosis (MS). Which of the following assessments should the nurse include?

Accepted Answer

Urinary tract problems with incontinence or retention are common symptoms of MS. Chest pain and skin rashes are not symptoms of MS. A decrease in libido is common with MS.

Question 13

The nurse is caring for a client with multiple sclerosis (MS) who is to begin treatment with glatiramer acetate. Which of the following information should the nurse include in client teaching?

Accepted Answer

Copaxone is administered by self-injection. Oral contraceptives are an appropriate choice for birth control. There is no need to avoid driving or drink large fluid volumes when taking glatiramer.

Question 14

Aclient found in a tonic-clonic seizure reports afterward that the seizure was preceded by numbness and tingling of the arm. Which of the following types of seizures should the nurse document based upon this finding?

Accepted Answer

The initial symptoms of a partial seizure involve clinical manifestations that are localized to a particular part of the body or brain. Symptoms of an absence seizure are staring and a brief loss of consciousness. In an atonic seizure, the client loses muscle tone and (typically) falls to the ground. Myoclonic seizures are characterized by a sudden jerk of the body or extremities.

Question 15

Which action will the nurse take when evaluating a client who is taking phenytoin for adverse effects of the medication?

Accepted Answer

Phenytoin can cause gingival hyperplasia, but does not affect bowel tones, lung sounds, or pupil reaction to light.

Question 16

The nurse is assessing a client in the outpatient clinic who has restless legs syndrome. Which of the following over-the-counter medications that the client is taking routinely should the nurse discuss with the client?

Accepted Answer

Antihistamines can aggravate restless legs syndrome. The other medications will not contribute to the restless legs syndrome.

Question 17

The nurse is assessing a client at the health clinic who has a severe migraine headache and tells the nurse about having four similar headaches in the last 3 months. Which of the following actions should the nurse take initially?

Accepted Answer

The initial nursing action should be further assessment of the precipitating causes of the headaches, quality, and location of pain, etc. Stress reduction, muscle relaxation, and the triptan drugs may be helpful, but more assessment is needed first.

Question 18

A client with Parkinson's disease has a nursing diagnosis of impaired physical mobility related to bradykinesia. Which of the following actions should the nurse include in the plan of care?

Accepted Answer

Rocking the body from side to side stimulates balance and improves mobility. The client will be encouraged to continue exercising because this will maintain functional abilities. Maintaining a wide base of support will help with balance. The client should lift the feet and avoid a shuffling gait.

Question 19

The nurse is teaching a client about management of migraine headaches. Which of the following client statements indicates that the teaching has been effective?

Accepted Answer

It is recommended that the client with a migraine rest in a dark, quiet area. Topiramate is used to prevent migraines and must be taken for several months to determine effectiveness. Aspirin or other nonsteroidal anti-inflammatory medications can be taken with the triptans. Alcohol may precipitate migraine headaches.

Question 20

An elementary teacher who has just been diagnosed with epilepsy after having a generalized tonic-clonic seizure tells the nurse, "I cannot teach anymore, it will be too upsetting if I have a seizure at work." Which of the following responses by the nurseisbest?

Accepted Answer

The nurse should inform the client that about 50% clients with seizure disorders are controlled with medication and another 30% have a decrease in the intensity and frequency of seizures. The other information may be necessary if the client seizures persist after treatment with antiseizure drugs is implemented.

Quiz 61: Nursing Management Chronic Neurological Problems