Question 1

Which neurotransmitter is depleted in clients with Parkinson's disease?

Accepted Answer

Parkinson's disease is caused by the progressive loss of dopamine-producing neurons in an area of the brain called the substantia nigra. This depletion of dopamine affects movement control and contributes to the characteristic motor symptoms of Parkinson's disease.

Question 2

Which instruction should the nurse provide to a client who is prescribed an anticholinergic drug for symptomatic relief of Parkinson's disease?

Accepted Answer

Anticholinergic drugs commonly cause side effects such as dry mouth, blurred vision, and urinary retention. The nurse should inform the client of these potential side effects and advise them to monitor for any signs of adverse reactions. The other options are incorrect: B is incorrect because anticholinergic drugs may cause drowsiness or confusion, which could affect the client's ability to perform daily activities; C is incorrect because exercise therapy may help manage Parkinson's symptoms and should not be avoided unless specifically contraindicated; and D is incorrect because anticholinergic drugs are not known to precipitate tremors during initiation of therapy, although they may improve tremors that are caused by excessive cholinergic activity.

Question 3

The nurse is discussing the interictal period with a group of student nurses. Which statement made by the student nurse indicates effective learning?

Accepted Answer

The interictal period is the phase between seizures when the brain activity returns to baseline and no seizures are occurring.

Question 4

A client suffering from myasthenia gravis is admitted to the intensive care unit after being diagnosed with respiratory failure. Which factor could have precipitated this condition in the client?

Accepted Answer

All of the above factors could have precipitated respiratory failure in a client with myasthenia gravis. A tapered dose of immunosuppressants could result in an exacerbation of symptoms, while a microbial infection could worsen the already compromised respiratory function. Surgery, especially if it involves the muscles affected by myasthenia gravis, could also lead to respiratory failure. All these factors should be considered in the management of the client in the intensive care unit.

Question 5

A client is diagnosed with narrowing of the spinal cord. Based on which test did the primary health-care provider confirm this diagnosis?

Accepted Answer

Computed tomography (CT) scans provide detailed images of the body, including the spine, and can reveal narrowing of the spinal cord or spinal stenosis. This makes it a key diagnostic tool for such conditions.

Question 6

Which neurotransmitter dysfunction has been implicated in Tourette's syndrome?

Accepted Answer

Dopamine dysfunction has been implicated in Tourette's syndrome, specifically an overactivity of dopamine in certain regions of the brain. This is supported by the fact that medication that reduces dopamine activity (such as antipsychotics) can help reduce tics in some individuals with Tourette's. Serotonin and acetylcholine have not been directly implicated in Tourette's.

Question 7

Which client is expected to have status epilepticus?

Accepted Answer

Status epilepticus is a medical emergency characterized by continuous or repetitive seizures without full recovery between them or a single seizure lasting longer than 5 minutes. A client who is experiencing a series of three tonic-clonic seizures is at risk for developing status epilepticus. Prompt medical intervention is needed to prevent further complications.

Question 8

Which diagnostic test is used to measure the brain and body activity during sleep?

Accepted Answer

Polysomnogram is a diagnostic test used to measure the brain and body activity during sleep. It involves the use of electrodes to monitor brain waves, eye movements, muscle activity, heart rate, and breathing patterns. This test is commonly used for the evaluation of sleep disorders such as sleep apnea, insomnia, and narcolepsy. A and B are not related to sleep studies, and D is used to assess sensory nerve function in response to stimuli.

Question 9

Which pathophysiological condition particularly activates the trigeminovascular system?

Accepted Answer

Cluster headache is the only condition that particularly activates the trigeminovascular system. This leads to vasodilation and inflammation of the blood vessels in the brain, resulting in intense pain. Epilepsy, Parkinson's disease, and tension headaches do not specifically activate this system.

Question 10

The nursing instructor is teaching a group of student nurses about the preventive therapy for migraine. Which client requires preventive therapy to be prioritized first?

Accepted Answer

A female client on therapy with vasodilators requires preventive therapy to be prioritized first because vasodilators can trigger migraines, increasing the frequency and severity of attacks.

Question 11

In a client with Guillain-Barré syndrome, the health-care provider has found that the possibility of performing plasmapheresis is low. Which other alternative treatment can be recommended to this client to produce the same effect as that of plasmapheresis?

Accepted Answer

The answer of In a client with Guillain-Barré syndrome, the...

Question 12

The nursing instructor is teaching a group of student nurses about the most important intervention for clients with myasthenic crisis. Which statement made by a student nurse indicates effective learning?

Accepted Answer

Monitoring the forced vital capacity and negative inspiratory force every 2 to 4 hours is the most important intervention for clients experiencing myasthenic crisis. This helps to evaluate the effectiveness of their respiratory function and identify any deterioration that may require immediate intervention. Monitoring arterial blood gases and heart rate are also important but do not take precedence over monitoring the client's respiratory function. Immunosuppressant agents should not be withdrawn completely without consulting with the healthcare provider as sudden withdrawal can worsen symptoms.

Question 13

Which statement by the student nurse indicates the need for further teaching about cerebrospinal fluid (CSF) analysis?

Accepted Answer

The correct instruction is to have the client remain lying flat and avoid any strenuous activity for several hours after the procedure, not to stand still. Option A is correct, as a lumbar puncture is the technique used to obtain CSF. Option B is also correct, as the client is usually positioned in a side-lying, fetal position during the procedure. Option C is correct, as a local anesthetic is injected into the lower back to numb the area before the procedure is performed.

Question 14

A nursing instructor is teaching a group of student nurses about athetosis movements in clients with Huntington's disease. Which statement made by the student nurse indicates effective learning?

Accepted Answer

Athetosis movements are slow, twisting, and writhing movements of the limbs or body, which are a common symptom of Huntington's disease. Option A correctly defines athetosis movements. Option B describes chorea movements instead, and option C refers to ballismus, a more severe form of hyperkinetic movement disorder. Option D is incorrect because antipsychotics are not typically used to treat athetosis movements; instead, other medications such as tetrabenazine and deutetrabenazine are used to manage them.

Question 15

The nurse is caring for a client who had a head injury in a motor vehicle accident. The client complains of lack of coordination and imbalance since the accident. Which part of the cerebrum would the nurse suspect to have been damaged?

Accepted Answer

The cerebellum is responsible for coordination and balance, so damage to this part of the brain would likely result in the client's symptoms.

Question 16

The student nurse is performing a Babinski reflex test in a client to assess his or her neurologic system. Which is the correct interpretation by the student nurse?

Accepted Answer

A positive Babinski reflex, where the client has flaring of the toes in response to stimulation of the sole of the foot, indicates an upper motor neuron disorder. A negative Babinski reflex should show no response or downward motion of the toes upon stimulation. A positive Babinski reflex indicates an abnormal reflex and can indicate a variety of neurologic disorders including brain or spinal cord injuries, multiple sclerosis, and cerebral palsy. It is important to note that a positive Babinski reflex is normal in infants until approximately 2 years of age.

Question 17

Which type of epileptic seizure is characterized by a sudden lapse of consciousness for 5 to 30 seconds?

Accepted Answer

A petit mal seizure, also known as an absence seizure, is characterized by a sudden lapse of consciousness for a short period of time, typically 5 to 30 seconds. The person may appear to be staring off into space and may not respond to stimuli during the seizure. Tonic seizures involve muscle stiffness and rigidity, clonic seizures involve rhythmic muscle contractions, and tonic-clonic seizures involve a combination of both stiffening and rhythmic contractions.

Question 18

While reviewing the medication chart of a client, the nurse finds that the client is on a therapy to decrease the release of the excitatory neurotransmitter glutamate. Which disorder will the nurse suspect in the client?

Accepted Answer

Amyotrophic lateral sclerosis (ALS) is associated with excessive glutamate activity, and medications that decrease the release of glutamate are used to manage this condition.

Question 19

Which statement relates to multiple sclerosis?

Accepted Answer

Multiple sclerosis is a demyelinating disorder, meaning that the protective covering around nerve fibers in the brain and spinal cord become damaged, leading to communication problems between the brain and the rest of the body. The other answer choices do not accurately describe multiple sclerosis.

Question 20

After a theoretical session about edrophonium (Tensilon) testing, the nursing instructor asks a student nurse to perform the test in a group of clients with different neurological disorders. Which client should the student nurse choose to perform the test?

Accepted Answer

Edrophonium testing is used to diagnose myasthenia gravis, as it helps to differentiate between a myasthenic crisis (worsening of symptoms due to insufficient medication) and a cholinergic crisis (worsening of symptoms due to excess medication). It is not useful in clients with other neurological disorders such as multiple sclerosis, Huntington's disease, or Guillain-Barré syndrome.

Quiz 34: Chronic and Degenerative Neurologic Disorders