Question 1

A 28-year-old woman who has multiple sclerosis (MS) asks the nurse about risks associated with pregnancy. Which response by the nurse is accurate?

Accepted Answer

A)  "MS symptoms may be worse after the pregnancy." 
B)  "Women with MS frequently have premature labor." 
C)  "Symptoms of MS are likely to become worse during pregnancy." 
D)  "MS is associated with a slightly increased risk for congenital defects."

Question 2

A patient has a tonic-clonic seizure while the nurse is in the patient's room. Which action should the nurse take?

Accepted Answer

A)  Insert an oral airway during the seizure to maintain a patent airway. 
B)  Restrain the patient's arms and legs to prevent injury during the seizure. 
C)  Avoid touching the patient to prevent further nervous system stimulation. 
D)  Time and observe and record the details of the seizure and postictal state.

Question 3

When the home health RN is planning care for a patient with a seizure disorder, which nursing action can be delegated to an LPN/LVN?

Accepted Answer

A)  Make referrals to appropriate community agencies. 
B)  Place medications in the home medication organizer. 
C)  Teach the patient and family how to manage seizures. 
D)  Assess for use of medications that may precipitate seizures.

Question 4

A patient is seen in the health clinic with symptoms of a stooped posture, shuffling gait, and pill rolling-type tremor. The nurse will anticipate teaching the patient about

Accepted Answer

A)  oral corticosteroids. 
B)  antiparkinsonian drugs. 
C)  the purpose of electroencephalogram (EEG) testing. 
D)  preparation for magnetic resonance imaging (MRI).

Question 5

A hospitalized 24-year-old 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)  Start the ordered PRN oxygen at 6 L/min. 
B)  Put a moist hot pack on the patient's neck. 
C)  Give the ordered PRN acetaminophen (Tylenol). 
D)  Notify the patient's health care provider immediately.

Question 6

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 response by the nurse is best?

Accepted Answer

A)  "You may want to contact the Epilepsy Foundation for assistance." 
B)  "You might benefit from some psychologic counseling at this time." 
C)  "The Department of Vocational Rehabilitation can help with work retraining." 
D)  "Most patients with epilepsy are well controlled with antiseizure medications."

Question 7

A patient with Parkinson's disease has decreased tongue mobility and an inability to move the facial muscles. Which nursing diagnosis is of highest priority?

Accepted Answer

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

Question 8

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

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 90/46 mm Hg.

Question 9

A patient found in a tonic-clonic seizure reports afterward that the seizure was preceded by numbness and tingling of the arm. The nurse knows that this finding indicates what type of seizure?

Accepted Answer

A)  Atonic 
B)  Partial 
C)  Absence 
D)  Myoclonic

Question 10

The nurse witnesses a patient with a seizure disorder as the patient suddenly jerks the arms and legs, falls to the floor, and regains consciousness immediately. It will be most important for the nurse to

Accepted Answer

A)  assess the patient for a possible head injury. 
B)  give the scheduled dose of divalproex (Depakote). 
C)  document the timing and description of the seizure. 
D)  notify the patient's health care provider about the seizure.

Question 11

Which information about a patient who is being treated with carbidopa/levodopa (Sinemet) for Parkinson's disease is most important for the nurse to report to the health care provider?

Accepted Answer

A)  Shuffling gait 
B)  Tremor at rest 
C)  Cogwheel rigidity of limbs 
D)  Uncontrolled head movement

Question 12

A hospitalized patient complains of a moderate bilateral headache that radiates from the base of the skull. Which of these prescribed PRN medications should the nurse administer initially?

Accepted Answer

A)  lorazepam (Ativan) 
B)  acetaminophen (Tylenol) 
C)  morphine sulfate (Roxanol) 
D)  butalbital and aspirin (Fiorinal)

Exam 59: Nursing Management: Chronic Neurologic Problems