Question 1

A patient has newly diagnosed multiple sclerosis (MS)and asks many questions about the disease.When teaching the patient about MS,what should the nurse explain?

Accepted Answer

MS is an autoimmune disease where the body's immune system attacks the myelin sheath that surrounds nerve fibers in the brain and spinal cord. This leads to symptoms such as muscle weakness, numbness or tingling, and problems with coordination and vision. There is no known cure for MS, but treatments can help manage symptoms and slow the progression of the disease.

Question 2

A 20-year-old woman is seen at the health clinic with a severe migraine headache.The headaches began 3 months ago,and she has had four headaches since that time.During assessment,the patient tells the nurse she is afraid to make social plans because she never knows when she will be incapacitated with the pain.What is the most appropriate nursing intervention in response to the patient's comments?

Accepted Answer

Keeping a diary of headache episodes may help the patient identify potential triggers for her headaches, allowing her to better manage her symptoms and potentially reduce the frequency of her headaches. Referring the patient for counseling, encouraging the use of holistic techniques, or simply reassuring the patient may be helpful interventions, but they do not directly address the patient's concern about social isolation due to her headaches.

Question 3

A 28-year-old woman has had MS for 3 years and wants to have children before her disease becomes worse.When she asks about the risks associated with pregnancy,the nurse should explain which of the following information?

Accepted Answer

MS does not appear to have a significant effect on pregnancy and lactation. However, women with MS are at an increased risk for an exacerbation of their symptoms in the postpartum period. Therefore, close monitoring and management of MS during pregnancy and after delivery is important. Option A and B are incorrect as pregnancy does not appear to accelerate the course of the disease or cause a long-lasting exacerbation. Option C is incorrect as MS is not known to have a strong genetic component that would greatly impact future generations.

Question 4

A patient has a tonic-clonic seizure while the nurse is in the patient's room.During the seizure,what is it important for the nurse to do?

Accepted Answer

During a tonic-clonic seizure, it is important for the nurse to time the seizure, observe and record the details of the seizure and the postictal phase, as this information is important for diagnosis and treatment planning. It is not recommended to insert an oral airway during the seizure as the patient may bite down and cause injury, and restraining the patient can also lead to injury. Avoiding touching the patient is not necessary and may hamper the nurse's ability to assist the patient if necessary.

Question 5

What is the most important nursing tool in diagnosing a cluster headache?

Accepted Answer

The patient history is the most important nursing tool in diagnosing a cluster headache. Cluster headache is a clinical diagnosis, which means it is diagnosed based on the signs, symptoms, and medical history of the patient. Imaging studies such as MRI and CT scans may be done to rule out other possible causes of the headache, but they are not the primary tool for diagnosing cluster headaches. Electromyography is a test used to evaluate muscle and nerve function and is not directly related to diagnosing a cluster headache.

Question 6

Which one of the following should the nurse teach the patient to avoid because it may trigger a headache?

Accepted Answer

Hot dogs have nitrates, which can trigger headaches in some people. Tylenol is a medication used to treat headaches, and popsicles and fried chicken are not known to trigger headaches.

Question 7

A patient with a headache describes it as affecting both sides of his head with a moderate intensity that becomes worse when he is physically active.The nurse knows that the patient's clinical manifestations are characteristic of which of the following disorders?

Accepted Answer

The clinical manifestations described by the patient are indicative of tension-type headaches, which typically present as a dull or pressure-like pain on both sides of the head, often associated with stress or tension. The worsening of pain with physical activity is also a characteristic feature of tension-type headaches. Cluster headaches typically present as a severe, one-sided pain, while migraines are typically characterized by a pulsing or throbbing pain on one side of the head. Headaches associated with trigeminal neuralgia involve sharp, stabbing pain that is usually confined to one side of the face.

Question 8

After experiencing a generalized tonic-clonic seizure in the classroom,a 25-year-old high school teacher is evaluated and diagnosed with idiopathic epilepsy.The patient cries when told of the diagnosis and tells the nurse that she can never go back to teaching after experiencing the seizure in front of her students.What is an appropriate nursing diagnosis for the patient?

Accepted Answer

The patient believes she cannot return to teaching due to her seizure, indicating a misunderstanding about epilepsy and its management, which affects her perception of her role as a teacher.

Question 9

Following recovery from a stroke,a 68-year-old patient developed complex partial seizures with motor symptoms beginning in the right arm with progression to unconsciousness.The physician prescribes phenytoin (Dilantin)for control of the seizures.Which of the following statements by the patient indicates understanding of what self-care related to this drug includes?

Accepted Answer

Phenytoin levels need to be monitored frequently to maintain therapeutic levels and prevent toxicity. Regular blood tests are necessary to ensure proper dosing. Using soft swabs instead of a toothbrush for oral care can prevent bleeding gums, but this is not directly related to self-care with phenytoin. Calling an ambulance for every seizure is not necessary unless it is prolonged or there are other concerning symptoms. Taking the medication at the beginning of the seizure before losing consciousness is not recommended because the patient may not be able to swallow the medication or it may not be absorbed in time to prevent the seizure from progressing.

Question 10

When caring for a patient with epilepsy who was hospitalized and successfully treated for status epilepticus,what is a precaution that the nurse should institute as part of the care?

Accepted Answer

Placing oxygen and suction equipment at the bedside is important as patients with status epilepticus may experience respiratory distress and require immediate intervention to maintain adequate oxygenation and airway clearance. Assigning an assistant to stay with the patient at all times may not always be feasible or necessary, and keeping a tongue blade available is contraindicated as it can cause injury during a seizure. Instructing the patient to stay in bed and call for assistance to go to the bathroom may not necessarily relate to the management of status epilepticus.

Question 11

A patient with MS is to begin treatment with glatiramer acetate (Copaxone).In planning the patient teaching necessary with the use of the drug,the nurse recognizes the patient will need to be taught which of the following information?

Accepted Answer

Glatiramer acetate is administered via subcutaneous injection, so the patient will need to learn proper self-injection techniques.

Answer: B 
 Glatiramer acetate may interfere with the effectiveness of oral contraceptives, so the patient should use alternative methods of birth control.

Answer: D 
 Glatiramer acetate is used to manage symptoms of MS and does not have an impact on the progression of the disease.

Therefore, the best choices are A and B.

Question 12

A patient experiences cluster headaches that occur about every year for 2 months.During assessment of the patient during an episode of the headache,what would the nurse expect to find?

Accepted Answer

Cluster headaches are characterized by severe unilateral pain usually around the eye accompanied by ipsilateral nasal congestion or rhinorrhea, conjunctival injection, eyelid edema, and/or ptosis. Nuchal rigidity and nausea/vomiting are not typical with cluster headaches. Bilateral headache is also not a common symptom of cluster headaches.

Question 13

When teaching a patient about management of her migraine headaches,the nurse determines that teaching has been effective when the patient gives which of the following responses?

Accepted Answer

Lying down in a dark and quiet place is a recommended non-pharmacologic intervention for managing migraine headaches. A is incorrect because topiramate is a prophylactic medication taken daily to prevent migraines, not taken as needed for acute treatment. B is incorrect because sumatriptan is a vasoconstrictor, meaning it narrows the blood vessels in the brain, not increasing blood flow. D is incorrect because alcohol can actually trigger migraines and should be avoided.

Question 14

According to the International Classification of Seizure Disorders,what would be the classification of a clonic seizure?

Accepted Answer

A clonic seizure is a type of generalized seizure characterized by rhythmic jerking movements in the arms and legs, which is classified under the generalized seizure category in the International Classification of Seizure Disorders.

Question 15

When the nurse is obtaining a health history from a patient undergoing diagnostic testing for MS,which of the following is a finding identified as characteristic of early MS?

Accepted Answer

Weakness of the legs is a common symptom of early MS, as it may result from damage to the nerves that control the muscles in the legs. Memory lapses, intermittent fever, and constipation are not typically associated with early MS.

Question 16

The nurse witnesses a patient with a seizure disorder as he suddenly jerks his arms and legs,falls to the floor,and regains consciousness immediately.What type of seizure is demonstrated by this patient that the nurse must document?

Accepted Answer

The answer of The nurse witnesses a patient with a...

Question 17

A patient with MS has a nursing diagnosis of urinary retention related to sensorimotor deficits.What is an appropriate nursing intervention for this problem?

Accepted Answer

The Credé manoeuvre involves applying manual pressure over the bladder to help with emptying, which can be beneficial for patients with urinary retention due to sensorimotor deficits.

Question 18

When a patient experiences a generalized tonic-clonic seizure in the emergency department after a head injury,all of the following orders are received.Which one will the nurse implement first?

Accepted Answer

Administering midazolam (Versed) is prioritized to stop the seizure activity, which is critical for patient safety and to prevent further complications.

Question 19

The nurse identifies the nursing diagnosis of impaired physical mobility related to bradykinesia for a patient with Parkinson's disease.To assist the patient to ambulate safely,what should the nurse do?

Accepted Answer

Rocking back and forth can help initiate leg movement in patients with Parkinson's disease, who experience bradykinesia, by providing momentum.

Question 20

A patient found in a tonic-clonic seizure reports,after gaining consciousness,that the seizure was preceded by numbness and tingling of the arm.What does the nurse know that this finding indicates?

Accepted Answer

The answer of A patient found in a tonic-clonic seizure...

Quiz 61: Nursing Management: Chronic Neurological Problems

A patient has newly diagnosed multiple sclerosis (MS) and asks many questions about the disease.When teaching the patient about MS,what should the nurse explain?