Question 1

The nurse is providing care to a patient with Guillain-Barré syndrome.Which laboratory result should the nurse evaluate first?

Accepted Answer

ABGs monitor respiratory status,which is essential in case the patient's respiratory muscles become affected.B.Blood urea nitrogen (BUN)monitors kidney function.D.Hgb and Hct monitor blood loss or anemia.A.Electrolytes monitor fluid and electrolyte balance.

Question 2

The nurse is providing eye care to a patient with Bell's palsy.Which nursing action is most appropriate to help protect the affected eye?

Accepted Answer

Eyedrops and a patch can help keep the eye closed and protect the patient's eye.D.A warm compress will not protect the eye,especially if it is only used three times a day.A.B.Dimming the lights and checking pupils will not protect the eye.

Question 3

The nurse is caring for a patient experiencing an acute exacerbation of multiple sclerosis (MS).Which pathophysiological change should the nurse recognize as causing the manifestations of MS?

Accepted Answer

In multiple sclerosis,the myelin sheath begins to break down or degenerates as a result of the activation of the body's immune system.The nerve becomes inflamed and edematous.Nerve impulses to the muscles slow down.As the disease progresses,sclerosis or scar tissue damages the nerve.A.Myelin does not build up.C.GABA is an inhibitory neurotransmitter.D.Acetylcholine receptors are damaged in myasthenia gravis.

Question 4

The nurse is preparing a patient with myasthenia gravis to undergo plasmapheresis.Which laboratory tests should the nurse verify and place on the medical record before the procedure?

Accepted Answer

Plasmapheresis is used to remove the patient's plasma and replace it with fresh plasma.Complete blood cell count,platelet count,and clotting studies are assessed prior to the procedure.A.B.D.Laboratory tests such as urinalysis,urine protein,BUN,creatinine,blood type,electrolytes,and albumin are not necessary before having a plasmapheresis.

Question 5

A mother of three young children who has a 3-year history of myasthenia gravis has had to stop helping in the children's classrooms in the morning because of fatigue.What should the nurse say to help the patient best cope with the problem?

Accepted Answer

The patient should be instructed to schedule activities at times when medication is at peak action so that muscle strength is increased.A.C.These statements may also be true but medication is needed to get through an activity.D.Taking the medication after the activity will help with strength after,not during,the activity.

Question 6

The nurse is caring for a patient with an exacerbation of multiple sclerosis (MS).What should the nurse include when teaching the patient about risk factors for exacerbation?

Accepted Answer

A variety of factors can trigger the onset of symptoms or aggravate the condition,including extreme heat and cold,fatigue,infection,and physical and emotional stress.A.B.C.Sun,sedentary lifestyle,and vegetarian diet are not known to exacerbate multiple sclerosis.

Question 7

A patient with Bell's palsy has lost 10 pounds since being diagnosed.Why should the nurse plan interventions to address the risk for nutrition problems?

Accepted Answer

Difficulty eating may cause the patient to eat less and lose weight.A,C,and D are not affected by Bell's palsy.

Question 8

A patient who is prescribed neostigmine (Prostigmin)for newly diagnosed myasthenia gravis (MG)asks how the medication works.What should the nurse respond to the patient?

Accepted Answer

Medications used to treat MG include the anticholinesterase (ACh)drugs neostigmine (Prostigmin)and pyridostigmine (Mestinon).These drugs improve symptoms of MG by destroying the acetylcholinesterase that breaks down ACh.A.B.This medication does not provide potassium or relax the muscles.D.Steroids reduce inflammation.

Question 9

The nurse is assisting with the administration of a Tensilon test.What response to the test causes the nurse to suspect that the patient has myasthenia gravis?

Accepted Answer

A test for myasthenia gravis involves an intravenous injection of edrophonium (Tensilon,an anticholinesterase drug).If muscle strength improves dramatically (e.g.,the patient can suddenly open the eyes wide),MG is diagnosed.A.B.C.Dyspnea,weakness,or cramping is not expected after Tensilon administration.

Question 10

A patient with multiple sclerosis is unable to verbally communicate needs.Which approach should the nurse use to assess this patient for pain?

Accepted Answer

The patient may not be able to verbally state that pain is present.The nurse should assess the patient for nonverbal signs of pain or distress,such as restlessness,agitation,and grimacing.B.The patient might not be able to press the call light.C.D.Pain medication should not be routinely provided around the clock or with other medications without completing an adequate pain assessment.

Question 11

The nurse is reviewing nursing diagnoses identified for a patient with trigeminal neuralgia.Which nursing diagnosis should the nurse identify as a priority for this patient?

Accepted Answer

Pain takes priority.D.If pain is controlled,then the patient will be able to eat,and nutrition will not be a problem.A.Ineffective coping can be addressed after physiological problems.B.Hygiene is important but is not as high a priority as pain and nutrition.

Question 12

A patient with amyotrophic lateral sclerosis has difficulty swallowing and copious pulmonary secretions.What equipment should the nurse ensure is at the bedside at all times?

Accepted Answer

Suction is necessary in case the patient aspirates because of difficulty swallowing.A.C.Oxygen and tissues may be helpful but will not clear the airway.D.A tongue blade is not necessary.

Question 13

A patient with Bell's palsy is experiencing symptoms.Which symptom should the nurse address first?

Accepted Answer

While all the problems will be disturbing to the patient,inability to close the eye could cause eye damage.A.B.C.The other problems do not usually cause permanent damage,and preventive measures will not be as helpful.

Question 14

The nurse is helping a patient with trigeminal neuralgia with bathing.Which action should the nurse take when washing the patient's face?

Accepted Answer

Lukewarm water and soft cotton may be less likely to exacerbate pain.A.C.D.A rough washcloth or temperature extremes can cause pain.

Question 15

A patient is scheduled for a thymectomy.For which peripheral nervous system disorder should the nurse plan care for this patient?

Accepted Answer

No cure has been found for MG.Treatment is aimed at control of symptoms.Removal of the thymus gland (thymectomy)can decrease production of anticholinesterase (ACh)receptor antibodies and decrease symptoms in most patients.A.C.D.A thymectomy is not indicated in the treatment of MS,GBS,or ALS.

Question 16

A patient with trigeminal neuralgia is admitted to the hospital for diagnostic testing and possible surgery.What intervention would be the most appropriate for this patient?

Accepted Answer

Activities such as talking,face washing,teeth brushing,shaving,and eating can cause pain in patients with trigeminal neuralgia.Soft foods at room temperature may be better tolerated than hot or cold foods.B.D.A fan or toothbrush can exacerbate pain.A.Patients with Bell's palsy may drool but not patients with trigeminal neuralgia.

Question 17

A patient diagnosed with Guillain-Barré syndrome (GBS)asks how the disease developed since the patient rarely has an illness.What nursing response is the most accurate?

Accepted Answer

GBS is believed to be caused by an autoimmune response to some type of viral infection or vaccination.A.No one does have an exact cause however this statement is not the most accurate.C.It is believed to occur after a viral infection.D.It is not hereditary.

Question 18

A patient in the plateau stage of Guillain-Barre syndrome is frustrated because there has not been any improvement in manifestations for 5 days.What should the nurse explain to the patient?

Accepted Answer

GBS is divided into three stages.The second stage is the plateau stage,when symptoms are most severe but progression has stopped.It can last from 2 to 14 days.Patients may become discouraged if no improvement is evident.B.The first stage starts with the onset of symptoms and lasts until the progression of symptoms stops.This stage can last from 24 hours to 3 weeks.C.D.Axonal regeneration and remyelination occur during the third state,recovery.This stage lasts from 6 to 24 months and symptoms slowly improve.

Question 19

The nurse is caring for a patient with an exacerbation of multiple sclerosis.Which medication should the nurse anticipate administering to this patient?

Accepted Answer

Steroids such as ACTH,prednisone,and other corticotropic medications are given to decrease inflammation and edema of the neuron,which may relieve some symptoms.C.Benadryl is an antihistamine.B.Pyridostigmine (Mestinon)is used in myasthenia gravis.A.Thyrotropin stimulates release of thyroid hormone.

Question 20

The nurse is assisting with discharging a patient with myasthenia gravis after hospitalization for severe respiratory distress.Which patient statement indicates that the nurse's discharge teaching has been effective?

Accepted Answer

With insufficient anticholinesterase medication,muscles can become weak.If respiratory muscles are affected,the patient can develop respiratory distress.C.Medication must be taken consistently to prevent weakness,not prn.A.D.Quinine and anticholinergic agents can exacerbate muscle weakness.

Quiz 50: Nursing Care of Patients With Peripheral Nervous System Disorders