Chapter 59: Nursing Management: Chronic Neurologic Problems

Chapter 59: Nursing Management: Chronic Neurologic Problems

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE
1. After teaching a patient about management of migraine headaches, the nurse determines
that the teaching has been effective when the patient says,
a. “I will take the (Topamax) as soon as any headaches start.”
b. “I should avoid taking aspirin and sumatriptan (Imitrex) at the same time.”
c. “I will try to lie down someplace dark and quiet when the headaches begin.”
d. “A glass of wine might help me relax and prevent headaches from developing.”
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 anti-inflammatory medications can
be taken with the triptans. Alcohol may precipitate migraine headaches.
DIF: Cognitive Level: Application REF: 1490-1494 TOP: Nursing Process:
Evaluation
MSC: NCLEX: Physiological Integrity
2. When a patient is experiencing a cluster headache, the nurse will plan to assess for
a. nuchal rigidity.
b. projectile vomiting.
c. unilateral eyelid swelling.
d. throbbing, bilateral facial pain.
ANS: C
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 increases in intracranial pressure (ICP). Unilateral sharp, stabbing pain, rather than
throbbing pain, is characteristic of cluster headaches.
DIF: Cognitive Level: Comprehension REF: 1490
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
3. A patient has a tonic-clonic seizure while the nurse is in the patient’s room. 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. Avoid touching the patient to prevent further nervous system stimulation.
d. Time and observe and record the details of the seizure and postictal state.
ANS: D
Test Bank 59-2
Because 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: Application REF: 1501
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
4. An elementary teacher who has just been diagnosed with epilepsy after having a
generalized tonic-clonic seizure tells the nurse, “I cannot teach anymore, it will be too
upsetting if I have a seizure at work.” Which response by the nurse is best?
a. “You may want to contact the Epilepsy Foundation for assistance.”
b. “You might benefit from some psychologic counseling at this time.”
c. “The Department of Vocational Rehabilitation can help with work retraining.”
d. “Most patients with epilepsy are well controlled with antiseizure medications.”
ANS: D
The nurse should inform the patient that most patients with seizure disorders are
controlled with medication. The other information may be necessary if the patient
seizures persist after treatment with antiseizure medications is implemented.
DIF: Cognitive Level: Application REF: 1497-1498 | 1501-1502
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
5. Which action will the nurse take when evaluating a patient who is taking phenytoin
(Dilantin) for adverse effects of the medication?
a. Inspect the oral mucosa.
b. Listen to the lung sounds.
c. Auscultate the bowel tones.
d. Check pupil reaction to light.
ANS: A
Phenytoin can cause gingival hyperplasia, but does not affect bowel tones, lung sounds,
or pupil reaction to light.
DIF: Cognitive Level: Application REF: 1498 TOP: Nursing Process:
Evaluation
MSC: NCLEX: Physiological Integrity