Neurological Disorders: MS, Alzheimer's, and Related Conditions - Questions & Answers, Exams of Nursing

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Which finding below represents a positive Romberg Sign in a patient with multiple sclerosis? A. The patient report dark spots in the visual fields during the confrontation visual field test. B. When the patient closes the eyes and stands with their feet together they start to lose their balance and sway back and forth. C. The patient's sign and symptoms increase when expose to hot temperatures. D. The patient reports an electric shock feeling when the head and neck are moved downward. ---------CORRECT ANSWER-----------------B Your patient is scheduled for a lumbar puncture to help diagnose multiple sclerosis. The patient wants clarification about what will be found in the cerebrospinal fluid during the lumbar puncture to confirm the diagnosis of MS. You explain that ____________ will be present in the fluid if MS is present. A. high amounts of IgM B. oligoclonal bands C. low amounts of WBC D. oblong red blood cells and glucose ---------CORRECT ANSWER-----------------B

During your discharge teaching to a patient with multiple sclerosis, you educate the patient on how to avoid increasing symptoms and relapses. You tell the patient to avoid: A. Cold temperatures B. Infection C. Overexertion D. Salt F. Stress ---------CORRECT ANSWER-----------------B, C, F Which medications below can help treat muscle spasms in a patient with multiple sclerosis? Select all that apply: A. Propranolol B. Isoniazid C. Baclofen D. Diazepam E. Modafinil ---------CORRECT ANSWER-----------------C, D A nurse is caring for a client who has early stage Alzheimer's disease and a new prescription for donepezil. The nurse should include which of the following statements when teaching the client about the med?

C. "Would you describe your current eating habits?" D. "At what weight do you believe you will look better?" E. "Can you discuss your feelings about your appearance?" ---------CORRECT ANSWER-----------------A, C, E A nurse is caring for an adolescent who has anorexia nervosa with recent rapid weight loss and a current weight of 90 pounds. Which of the following statements indicates the client is experiencing the cognitive distortion of catastrophizing? A. "Life isn't worth living if I gain weight" B. "Don't pretend like you don't know how fat I am" C. "If I could be skinny, I know I'd be popular" D. "When I look in the mirror I see myself as obese" ---------CORRECT ANSWER------ -----------A A nurse is performing an admission assessment of a client who has bulimia nervosa with purging behavior. Which of the following is an expected finding? (Select all that apply) A. Amenorrhea B. Hypokalemia C. Yellowing of the skin D. Slightly elevated body weight E. Presence of lanugo on the face ---------CORRECT ANSWER-----------------B, D

A nurse is planning care for a client who has anorexia nervosa with binge eating and purging behavior. Which of the following actions should the nurse include in the client's plan of care? A. Allow the client to select preferred meal times B. Establish consequences for purging behavior C. Provide the client with a high fat diet at the start of treatment D. Implement one to one observation during meal times ---------CORRECT ANSWER-----------------D A nurse is caring for a client who has bulimia nervosa and has stopped purging behavior. The client tells the nurse about fears of gaining weight. Which of the following responses should the nurse make? A. "The dietician will ensure that you don't get too many calories in your diet" B. "Instead of worrying about your weight try to focus on other problems at this time" C. "I understand you have concerns about your weight, but first, lets talk about your recent accomplishments" ---------CORRECT ANSWER-----------------C What does the term purging mean, in reference to anorexia nervosa?

a. Glasgow Coma Scale (GCS) score of 12 b. GCS score of 10 c. Systolic blood pressure of 100 mm Hg d. Systolic blood pressure of 80 mm Hg --- ------CORRECT ANSWER-----------------D Mark's physician decides to initiate ICP monitoring by placing an external ventricular drain (EVD). Which of the following statements about EVD is correct? a. It's placed in the brain's lateral ventricle using sterile technique. b. It does not allow intrathecal medication administration. c. It can lose accuracy over time because of drift. d. It doesn't allow system recalibration. ---------CORRECT ANSWER-----------------A Mark's mean arterial pressure is 70 mm Hg and his ICP is 15 mm Hg. You calculate his cerebral perfusion pressure (CPP) as: a. 4 mm Hg. b. 8 mm Hg. c. 55 mm Hg. d. 85 mm Hg. ---------CORRECT ANSWER-----------------C Which ICP reading indicates a need for treatment?

a. 22 mm Hg b. 16 mm Hg c. 12 mm Hg d. 10 mm Hg ---------CORRECT ANSWER-----------------A Which statement about neurologic assessment tools is correct? a. With the GCS, the patient's score is based on best eye opening, verbal, and sensory responses. b. With the GCS, the patient's score is based on best eye opening, verbal, and motor responses. c. The Ranchos Los Amigos Scale is inadequate for monitoring a patient's readiness for rehabilitation. d. Scores on the Ranchos Los Amigos Scale range from 0 to 18. ---------CORRECT ANSWER-----------------B A nurse is assessing a client who experienced sexual assault. Which of the following findings indicate the client is experiencing an emotional reaction of rape trauma syndrome? (Select all that apply) A. Genitourinary soreness B. Difficulties with low self esteem C. Sleep disturbances

A community health nurse is leading a discussion about rape with a neighborhood task force. Which of the following statements by a neighborhood citizen indicates an understanding of the teaching? A. "Rape is a crime of passion" B. "Acquaintance rape often involves alcohol" C. "Young adults are the typical victims o sexual assault" D. "The majority of rapists are unknown to the victims" ---------CORRECT ANSWER- ----------------B Sertraline is a... ---------CORRECT ANSWER-----------------SSRI FDA approved drug for PTSD ---------CORRECT ANSWER-----------------SSRIs Adverse effects are headache, nausea, anxiety and dry mouth ---------CORRECT ANSWER-----------------SNRI List three adverse reactions to an SSRI ---------CORRECT ANSWER-----------------1. Black box warning

2. SI
3. Insomnia
4. Decreased sex drive

5. Serotonin syndrome
6. Agitation List three adverse reactions to an SNRI ---------CORRECT ANSWER-----------------1. Can't take when pregnant
7. Can't take with hepatic disease
8. Can't take with alcohol
9. No abrupt cessation Assessment tool used to assess for PTSD in children ---------CORRECT ANSWER------ -----------Child dissociative checklist Trauma symptoms checklist for children Children sexual behavior inventory combined with developmental assessment List three symptoms of PTSD in children ---------CORRECT ANSWER----------------- Reduction in play Self blame Detachment Estrangement Mood changes Sleep disturbances Hyper-vigilance

Dissociative experiences ---------CORRECT ANSWER-----------------Flashbacks Describe the kind of care nurses should use when caring for a client who experienced trauma ---------CORRECT ANSWER-----------------Trauma informed care List three frequent places nurses will use trauma informed care ---------CORRECT ANSWER-----------------Homeless shelters Inpatient mental health facilities Child welfare practice Primary health care settings Emergency departments List three coping strategies nurses can do to help combat PTSD ---------CORRECT ANSWER-----------------Number of support system Stress relief activities Coworker relationships List three reactions of nurses' reaction to stress ---------CORRECT ANSWER----------- ------Burnout Compassion fatigue

Compassion satisfaction List three reasons why nurses are exposed to traumatic events ---------CORRECT ANSWER-----------------Years in nursing Years in current role Percent direct patient care Hours per shift Hours per week This stage stops self destructive behavior ---------CORRECT ANSWER----------------- Stage 1 This stage the client will start finding comfort in others ---------CORRECT ANSWER-- ---------------Stage 2 This stage the client will improve attention and decrease dissociation of event ----- ----CORRECT ANSWER-----------------Stage 2 This stage the nurse will need to educate the client about trauma and its negative effects ---------CORRECT ANSWER-----------------Stage 1

A nurse is caring for a client who is to begin taking fluoxetine for treatment of panic disorder. Which of the following statements indicates the client understands the use of this med? A. "I will take this med at bedtime" B. "I will follow a low sodium diet while taking this med" C. "I will need to discontinue this med slowly" D. "I will be at risk for weight loss with long term use of this med" ---------CORRECT ANSWER-----------------C A nurse is assessing a client 4 hr after receiving an initial dose of fluoxetine. Which of the following findings should the nurse report to the provider as indications of serotonin syndrome? (Select all that apply) A. Hypothermia B. Hallucinations C. Muscular flaccidity D. Diaphoresis E. Agitation ---------CORRECT ANSWER-----------------B, D, E A nurse is caring for a client who takes paroxetine to treat PTSD. The client states, "I grind my teeth during the night, which causes pain in my mouth." The nurse

should identify which of the following interventions as possible measures to manage client's bruxism. (Select all that apply) A. Concurrent administration of buspirone B. Administration of a different SSRI C. Use of mouth guard D. Changing to a different class of antianxiety med E. Increasing the dose of paroxetine ---------CORRECT ANSWER-----------------A, C, D A nurse manager is discussing care of a client who has a personality disorder with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching? A. "I can promote my client's sense of control by establishing a schedule" B. "I should encourage clients who have schizoid personality disorder to increase socialization" C. "I should practice limit setting to help prevent client manipulation" D. "I should implement assertiveness t ---------CORRECT ANSWER-----------------C A nurse is caring for a client who has avoidant personality disorder. Which of the following statements is expected from a client who has this type of personality disorder? A. "I'm scared you're going to leave me"

To help avoid increased ICP, you keep the head of Mark's bed at: a. 0 to 10 degrees. b. 20 to 25 degrees. c. 30 to 45 degrees. d. 60 to 90 degrees ---------CORRECT ANSWER-----------------C Which statement should you consider when managing Mark's temperature? a. Temperature elevation is a positive prognostic sign. b. Fever can increase metabolic demands as much as 25% per degree C. c. Fever can increase metabolic demands as much as 10% per degree C. d. Vasodilation from fever reduces CPP. ---------CORRECT ANSWER-----------------C An expected treatment goal for Mark is to: a. avoid antipyretics for managing fever. b. keep his oxygen saturation above 90%. c. keep his blood pressure slightly below normal. d. keep his partial pressure of arterial O2 (PaO2) above 50 mm Hg. --------- CORRECT ANSWER-----------------B

Mark is started on nitroprusside to control his high blood pressure. Which of the following is a potential side effect you should watch for? a. White blood cell dysfunction b. Orthostatic hypertension c. Reflex bradycardia d. Thiocyanate toxicity ---------CORRECT ANSWER-----------------D Mark's increased ICP resists treatment, so clinicians decide to start him on osmotic therapy. Which statement about this therapy is correct? a. Continuous infusion of hypotonic saline solution is a common choice. b. The goal is to achieve a serum sodium level of 125 to 135 mEq/L. c. Bolus infusion of hypotonic saline solution is a common choice. d. The goal is to achieve a serum sodium level of 150 to 155 mEq/L. --------- CORRECT ANSWER-----------------D If the physician decides to add hyperventilation to Mark's regimen, which of the following should you keep in mind? a. It isn't recommended as a first-line therapy. b. It can cause vasodilation. c. It's administered over a period of several hours.