Chapter 44: Care of Patients with Problems of the Central Nervous System: The Brain

Chapter 44: Care of Patients with Problems of the Central Nervous System: The Brain

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. The nurse is caring for a client experiencing migraine headaches who is receiving a beta blocker to help manage this disorder. When preparing a teaching plan, which instruction does the nurse plan to provide?

a.	“Take this drug only when you have prodromal symptoms indicating the onset of a migraine headache.”
b.	“Take this drug as ordered, even when feeling well, to prevent vascular changes associated with migraine headaches.”
c.	“This drug will relieve the pain during the aura phase soon after a headache has started.”
d.	“This medication will have no effect on your heart rate or blood pressure because you are taking it for migraines.”

 

 

ANS:  B

Beta blockers are prescribed as prophylactic treatment to prevent the vascular changes that initiate migraine headaches. Heart rate and blood pressure will also be affected, and the client should monitor these side effects. The other responses do not discuss an appropriate use of the medication.

 

DIF:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Physiological Integrity (Pharmacological and Parenteral Therapies—Expected Actions/Outcomes)    MSC:  Integrated Process: Teaching/Learning

 

2. The nurse is assessing a client with a history of migraines. Which clinical manifestation is an early sign of a migraine with aura?

a.	Vertigo
b.	Lethargy
c.	Visual disturbances
d.	Numbness of the tongue

 

 

ANS:  C

Early warning of impending migraine with aura usually consists of visual changes, flashing lights, or diplopia. The other manifestations are not associated with an impending migraine with aura.

 

DIF:    Cognitive Level: Comprehension/Understanding               REF:   p. 928

TOP:   Client Needs Category: Physiological Integrity (Physiological Adaptation—Pathophysiology)

MSC:  Integrated Process: Nursing Process (Assessment)

 

3. The nurse is reviewing a client’s prescription for sumatriptan succinate (Imitrex). Which condition in this client’s medical history does the nurse report to the health care provider?

a.	Bronchial asthma
b.	Gonorrhea
c.	Prinzmetal’s angina
d.	Chronic kidney disease

 

 

ANS:  C

Sumatriptan succinate effectively reduces pain and other associated symptoms of migraine by binding to serotonin receptors and triggering cranial vasoconstriction. Vasoconstrictive effects are not confined to the cranium and can cause coronary vasospasm in clients with Prinzmetal’s angina. The other conditions would not affect the client’s treatment.

 

DIF:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Physiological Integrity (Pharmacological and Parenteral Therapies—Adverse Effects/Contraindications/Side Effects/Interactions)

MSC:  Integrated Process: Nursing Process (Analysis)

 

4. The nurse is assessing a client with a cluster headache. Which clinical manifestation does the nurse expect to find?

a.	Ipsilateral tearing of the eye
b.	Exophthalmos
c.	Abrupt loss of consciousness
d.	Neck and shoulder tenderness

 

 

ANS:  A

Cluster headache is usually accompanied by ipsilateral tearing, rhinorrhea or nasal congestion, ptosis, eyelid edema, facial sweating, and miosis. The other manifestations are not associated with cluster headaches.

 

DIF:    Cognitive Level: Comprehension/Understanding               REF:   p. 931

TOP:   Client Needs Category: Physiological Integrity (Physiological Adaptation—Pathophysiology)

MSC:  Integrated Process: Nursing Process (Assessment)