Chapter 58: Chronic Neurologic Problems

Chapter 58: Chronic Neurologic Problems

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. The nurse determines that teaching about management of migraine headaches has been effective when the patient says which of the following?

a.	“I can take the (Topamax) as soon as a headache starts.”
b.	“A glass of wine might help me relax and prevent a headache.”
c.	“I will lie down someplace dark and quiet when the headaches begin.”
d.	“I should avoid taking aspirin and sumatriptan (Imitrex) at the same time.”

 

 

ANS:  C

It is recommended that the patient with a migraine rest in a dark, quiet area. Topiramate (Topamax) is used to prevent migraines and must be taken for several months to determine effectiveness. Aspirin or other nonsteroidal antiinflammatory medications can be taken with the triptans. Alcohol may precipitate migraine headaches.

 

DIF:    Cognitive Level: Apply (application)           REF:               1373

TOP:   Nursing Process: Evaluation            MSC:  NCLEX: Physiological Integrity

 

2. The nurse expects the assessment of a patient who is experiencing a cluster headache to include

a.	nuchal rigidity.	c.	projectile vomiting.
b.	unilateral ptosis.	d.	throbbing, bilateral facial pain.

 

 

ANS:  B

Unilateral eye edema, tearing, and ptosis are characteristic of cluster headaches. Nuchal rigidity suggests meningeal irritation, such as occurs with meningitis. Although nausea and vomiting may occur with migraine headaches, projectile vomiting is more consistent with increased intracranial pressure. Unilateral sharp, stabbing pain, rather than throbbing pain, is characteristic of cluster headaches.

 

DIF:    Cognitive Level: Understand (comprehension)                   REF:   1371

TOP:   Nursing Process: Assessment           MSC:  NCLEX: Physiological Integrity

 

3. While the nurse is transporting a patient on a stretcher to the radiology department, the patient begins having a tonic-clonic seizure. Which action should the nurse take?

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.	Time and observe and record the details of the seizure and postictal state.
d.	Avoid touching the patient to prevent further nervous system stimulation.

 

 

ANS:  C

Because the diagnosis and treatment of seizures frequently are based on the description of the seizure, recording the length and details of the seizure is important. Insertion of an oral airway and restraining the patient during the seizure are contraindicated. The nurse may need to move the patient to decrease the risk of injury during the seizure.

 

DIF:    Cognitive Level: Apply (application)           REF:               1381

TOP:   Nursing Process: Implementation     MSC:  NCLEX: Physiological Integrity

 

4. A high school teacher who has been diagnosed with epilepsy after having a generalized tonic-clonic seizure tells the nurse, “I cannot teach any more. It will be too upsetting if I have a seizure at work.” Which response by the nurse specifically addresses the patient’s concern?

a.	“You might benefit from some psychologic counseling.”
b.	“Epilepsy usually can be well controlled with medications.”
c.	“You will want to contact the Epilepsy Foundation for assistance.”
d.	“The Department of Vocational Rehabilitation can help with work retraining.”

 

 

ANS:  B

The nurse should inform the patient that most patients with seizure disorders are controlled with medication. The other information may be necessary if the seizures persist after treatment with antiseizure medications is implemented.

 

DIF:    Cognitive Level: Apply (application)           REF:               1381

TOP:   Nursing Process: Implementation     MSC:  NCLEX: Psychosocial Integrity

 

5. A patient has been taking phenytoin (Dilantin) for 2 years. Which action will the nurse take when evaluating for adverse effects of the medication?

a.	Inspect the oral mucosa.	c.	Auscultate the bowel sounds.
b.	Listen to the lung sounds.	d.	Check pupil reaction to light.

 

 

ANS:  A

Phenytoin can cause gingival hyperplasia, but does not affect bowel sounds, lung sounds, or pupil reaction to light.

 

DIF:    Cognitive Level: Apply (application)           REF:               1379

TOP:   Nursing Process: Evaluation            MSC:  NCLEX: Physiological Integrity