Understanding Medical Surgical Nursing 5th Edition by Linda S. Williams Paula D. Hopper
Understanding Medical Surgical Nursing 5th Edition by Linda S. Williams Paula D. Hopper
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Chapter 50. Nursing Care of Patients With Peripheral Nervous System Disorders
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. The nurse is caring for a patient experiencing an acute exacerbation of multiple sclerosis (MS). Which pathophysiological change should the nurse recognize as causing the manifestations of MS?
| a. | Myelin buildup in the central nervous system |
| b. | Demyelination and destruction of nerve fibers |
| c. | Gamma aminobutyric acid (GABA) deficiency |
| d. | Reduced acetylcholine receptors with impaired nerve impulse transmission |
____ 2. The nurse is caring for a patient with an exacerbation of multiple sclerosis. Which medication should the nurse anticipate administering to this patient?
| a. | Thyrotropin |
| b. | Pyridostigmine (Mestinon) |
| c. | Diphenhydramine (Benadryl) |
| d. | Adrenocorticotropic hormone (ACTH) |
____ 3. The nurse is caring for a patient with an exacerbation of multiple sclerosis (MS). What should the nurse include when teaching the patient about risk factors for exacerbation?
| a. | Vegetarian diet |
| b. | Exposure to sun |
| c. | Sedentary lifestyle |
| d. | Urinary tract infection |
____ 4. The nurse is assisting with the administration of a Tensilon test. What response to the test causes the nurse to suspect that the patient has myasthenia gravis?
| a. | Dyspnea develops |
| b. | Muscle cramps develop |
| c. | Muscles become very weak. |
| d. | Ptosis is temporarily improved. |
____ 5. A patient who is prescribed neostigmine (Prostigmin) for newly diagnosed myasthenia gravis (MG) asks how the medication works. What should the nurse respond to the patient?
| a. | “It is a muscle relaxant that prevents the cramping in your muscles.” |
| b. | “It provides potassium to your muscles so that they will contract better.” |
| c. | “It makes more neurotransmitter available so that your muscles can contract.” |
| d. | “It reduces the inflammation in your nerves so that they transmit signals better.” |
MULTIPLE CHOICE
In multiple sclerosis, the myelin sheath begins to break down or degenerates as a result of the activation of the body’s immune system. The nerve becomes inflamed and edematous. Nerve impulses to the muscles slow down. As the disease progresses, sclerosis or scar tissue damages the nerve. A. Myelin does not build up. C. GABA is an inhibitory neurotransmitter. D. Acetylcholine receptors are damaged in myasthenia gravis.
PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Physiological Adaptation | Cognitive Level: Analysis
Steroids such as ACTH, prednisone, and other corticotropic medications are given to decrease inflammation and edema of the neuron, which may relieve some symptoms. C. Benadryl is an antihistamine. B. Pyridostigmine (Mestinon) is used in myasthenia gravis. A. Thyrotropin stimulates release of thyroid hormone.
PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Pharmacological and Parenteral Therapies | Cognitive Level: Application
A variety of factors can trigger the onset of symptoms or aggravate the condition, including extreme heat and cold, fatigue, infection, and physical and emotional stress. A. B. C. Sun, sedentary lifestyle, and vegetarian diet are not known to exacerbate multiple sclerosis.
PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Reduction of Risk Potential | Cognitive Level: Application
A test for myasthenia gravis involves an intravenous injection of edrophonium (Tensilon, an anticholinesterase drug). If muscle strength improves dramatically (e.g., the patient can suddenly open the eyes wide), MG is diagnosed. A. B. C. Dyspnea, weakness, or cramping is not expected after Tensilon administration.
PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Reduction of Risk Potential | Cognitive Level: Analysis
Medications used to treat MG include the anticholinesterase (ACh) drugs neostigmine (Prostigmin) and pyridostigmine (Mestinon). These drugs improve symptoms of MG by destroying the acetylcholinesterase that breaks down ACh. A. B. This medication does not provide potassium or relax the muscles. D. Steroids reduce inflammation.
PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Pharmacological and Parenteral Therapies | Cognitive Level: Application
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