Question 1

A hospitalized patient complains of a bilateral headache (4/10 on the pain scale)that radiates from the base of the skull. Which prescribed PRN medications should the nurse administer initially?

Accepted Answer

A)  Lorazepam (Ativan) 
B)  Acetaminophen (Tylenol) 
C)  Morphine sulfate (MS Contin) 
D)  Butalbital and aspirin (Fiorinal)  B

Question 2

A patient has been taking phenytoin (Dilantin)for 2 years. Which action will the nurse take when evaluating for adverse effects of the medication?

Accepted Answer

A)  Inspect the oral mucosa.
B)  Listen to the lung sounds.
C)  Auscultate the bowel sounds.
D)  Check pupil reaction to light. A

Question 3

A patient with Parkinson's disease has bradykinesia. Which action will the nurse include in the plan of care?

Accepted Answer

A)  Instruct the patient in activities that can be done while lying or sitting.
B)  Suggest that the patient rock from side to side to initiate leg movement.
C)  Have the patient take small steps in a straight line directly in front of the feet.
D)  Teach the patient to keep the feet in contact with the floor and slide them forward. B

Question 4

A high school teacher who has been diagnosed with epilepsy after having a generalized tonic-clonic seizure tells the nurse,"I cannot teach any more. It will be too upsetting if I have a seizure at work." Which response by the nurse specifically addresses the patient's concern?

Accepted Answer

A)  "You might benefit from some psychologic counseling."
B)  "Epilepsy usually can be well controlled with medications."
C)  "You will want to contact the Epilepsy Foundation for assistance."
D)  "The Department of Vocational Rehabilitation can help with work retraining."

Question 5

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 6

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

A)  Patient has tonic-clonic seizures.
B)  Patient experiences an aura before seizures.
C)  Patient has minor elevations in the liver function tests.
D)  Patient's most recent blood pressure is 156/92 mm Hg.

Question 7

Which information about a 60-yr-old patient with multiple sclerosis indicates that the nurse should consult with the health care provider before giving the prescribed dose of dalfampridine (Ampyra)?

Accepted Answer

A)  The patient walks a mile each day for exercise.
B)  The patient complains of pain with neck flexion.
C)  The patient has an increased serum creatinine level.
D)  The patient has the relapsing-remitting form of MS.

Question 8

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

A)  The patient drinks 1 to 2 cups of coffee daily.
B)  The patient had a recent acute myocardial infarction.
C)  The patient has had migraine headaches for 30 years.
D)  The patient has taken topiramate (Topamax)  for 2 months.

Question 9

A 62-yr-old patient who has Parkinson's disease is taking bromocriptine (Parlodel). Which information obtained by the nurse may indicate a need for a decrease in the dosage?

Accepted Answer

A)  The patient has a chronic dry cough.
B)  The patient has four loose stools in a day.
C)  The patient develops a deep vein thrombosis.
D)  The patient's blood pressure is 92/52 mm Hg.

Question 10

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

A)  Discuss the need to stop taking the acetaminophen.
B)  Suggest the use of biofeedback for headache control.
C)  Describe the use of botulism toxin (Botox)  for headaches.
D)  Teach the patient about magnetic resonance imaging (MRI) .

Question 11

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

Accepted Answer

A)  Activity intolerance
B)  Self-care deficit: toileting
C)  Ineffective self-health management
D)  Imbalanced nutrition: less than body requirements

Question 12

The nurse determines that teaching about management of migraine headaches has been effective when the patient says which of the following?

Accepted Answer

A)  "I can take the (Topamax)  as soon as a headache starts."
B)  "A glass of wine might help me relax and prevent a headache."
C)  "I will lie down someplace dark and quiet when the headaches begin."
D)  "I should avoid taking aspirin and sumatriptan (Imitrex)  at the same time."

Question 13

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

A)  Teach about the use of antihistamines to improve sleep.
B)  Suggest that the patient exercise regularly during the day.
C)  Make a referral to a massage therapist for deep massage of the legs.
D)  Assure the patient that the problem is transient and likely to resolve.

Question 14

When obtaining a health history and physical assessment for a 36-yr-old female patient with possible multiple sclerosis (MS),the nurse should

Accepted Answer

A)  assess for the presence of chest pain.
B)  inquire about urinary tract problems.
C)  inspect the skin for rashes or discoloration.
D)  ask the patient about any increase in libido.

Question 15

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

A)  Auscultate the patient's bowel sounds.
B)  Notify the patient's health care provider.
C)  Administer the prescribed PRN antiemetic drug.
D)  Give the scheduled dose of prednisone (Deltasone) .

Question 16

Which action will the nurse plan to take for a patient with multiple sclerosis who has urinary retention caused by a flaccid bladder?

Accepted Answer

A)  Encourage a decreased evening intake of fluid.
B)  Teach the patient how to use the Credé method.
C)  Suggest the use of adult incontinence briefs for nighttime only.
D)  Assist the patient to the commode every 2 hours during the day.

Question 17

A patient who has amyotrophic lateral sclerosis (ALS)is hospitalized with pneumonia. Which nursing action will be included in the plan of care?

Accepted Answer

A)  Observe for agitation and paranoia.
B)  Assist with active range of motion (ROM) .
C)  Give muscle relaxants as needed to reduce spasms.
D)  Use simple words and phrases to explain procedures.

Question 18

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

Accepted Answer

A)  Give phenytoin (Dilantin)  100 mg IV.
B)  Monitor level of consciousness (LO
C)  .
C)  Administer lorazepam (Ativan)  4 mg IV.
D)  Obtain computed tomography (CT)  scan.

Question 19

A 22-yr-old patient seen at the health clinic with a severe migraine headache tells the nurse about having similar headaches recently. Which initial action should the nurse take?

Accepted Answer

A)  Teach about the use of triptan drugs.
B)  Refer the patient for stress counseling.
C)  Ask the patient to keep a headache diary.
D)  Suggest the use of muscle-relaxation techniques.

Question 20

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

A)  Put a moist hot pack on the patient's neck.
B)  Start the prescribed PRN O2 at 6 L/min.
C)  Give the ordered PRN acetaminophen (Tylenol) .
D)  Notify the patient's health care provider immediately.

Exam 58: Chronic Neurologic Problems

A hospitalized patient complains of a bilateral headache (4/10 on the pain scale) that radiates from the base of the skull. Which prescribed PRN medications should the nurse administer initially?

A patient has been taking phenytoin (Dilantin) for 2 years. Which action will the nurse take when evaluating for adverse effects of the medication?

A patient with Parkinson's disease has bradykinesia. Which action will the nurse include in the plan of care?

A high school teacher who has been diagnosed with epilepsy after having a generalized tonic-clonic seizure tells the nurse,"I cannot teach any more. It will be too upsetting if I have a seizure at work." Which response by the nurse specifically addresses the patient's concern?

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?

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 information about a 60-yr-old patient with multiple sclerosis indicates that the nurse should consult with the health care provider before giving the prescribed dose of dalfampridine (Ampyra) ?

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 62-yr-old patient who has Parkinson's disease is taking bromocriptine (Parlodel) . Which information obtained by the nurse may indicate a need for a decrease in the 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?

The nurse determines that teaching about management of migraine headaches has been effective when the patient says which of the following?

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?

When obtaining a health history and physical assessment for a 36-yr-old female patient with possible multiple sclerosis (MS) ,the nurse should

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?

Which action will the nurse plan to take for a patient with multiple sclerosis who has urinary retention caused by a flaccid bladder?

A patient who has amyotrophic lateral sclerosis (ALS) is hospitalized with pneumonia. Which nursing action will be included in the plan of care?

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

A 22-yr-old patient seen at the health clinic with a severe migraine headache tells the nurse about having similar headaches recently. Which initial action should the nurse take?

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?