Chapter 42: Care of Patients with Problems of the Central Nervous System: The Brain

Chapter 42: 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. A nurse is teaching a client who experiences migraine headaches and is prescribed a beta blocker. Which statement should the nurse include in this client’s teaching?
   1. “Take this drug only when you have prodromal symptoms indicating the onset of a migraine headache.”
   2. “Take this drug as ordered, even when feeling well, to prevent vascular changes associated with migraine headaches.”
   3. “This drug will relieve the pain during the aura phase soon after a headache has started.”
   4. “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 appropriate uses of the medication.

DIF:     Applying/Application                         REF: 856                     KEY: Medication safety| beta blocker| migraine                                            MSC: Integrated Process: Teaching/Learning                       NOT:                                                 Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

2. A nurse assesses a client who has a history of migraines. Which clinical manifestation should the nurse identify as an early sign of a migraine with aura?
   1. Vertigo
   2. Lethargy
   3. Visual disturbances
   4. 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:     Understanding/Comprehension         REF: 854                     KEY: Migraine| assessment/diagnostic examination                MSC:                         Integrated Process: Nursing Process: Assessment                                       NOT:                          Client Needs Category: Physiological Integrity: Physiological Adaptation

3. A nurse obtains a health history on a client prior to administering prescribed sumatriptan succinate (Imitrex) for migraine headaches. Which condition should alert the nurse to hold the medication and contact the health care provider?
   1. Bronchial asthma
   2. Prinzmetal’s angina
   3. Diabetes mellitus
   4. Chronic kidney disease

ANS:           B

Sumatriptan succinate effectively reduces pain and other associated symptoms of migraine headache 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:            Applying/Application                         REF: 856

KEY:          Medication safety| migraine

MSC:          Integrated Process: Nursing Process: Analysis                      NOT: Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

4. A nurse assesses a client with a history of epilepsy who experiences stiffening of the muscles of the arms and legs, followed by an immediate loss of consciousness and jerking of all extremities. How should the nurse document this activity?
   1. Atonic seizure
   2. Tonic-clonic seizure
   3. Myoclonic seizure
   4. Absence seizure

ANS:           B

Seizure activity that begins with stiffening of the arms and legs, followed by loss of consciousness and jerking of all extremities, is characteristic of a tonic-clonic seizure. An atonic seizure presents as a sudden loss of muscle tone followed by postictal confusion. A myoclonic seizure presents with a brief jerking or stiffening of extremities that may occur singly or in groups. Absence seizures present with automatisms, and the client is unaware of his or her environment.

DIF:            Understanding/Comprehension         REF: 858                    KEY: Seizure MSC:   Integrated Process: Communication and Documentation  NOT:                               Client Needs Category: Physiological Integrity: Physiological Adaptation