Chapter 61: Nursing Management: Peripheral Nerve and Spinal Cord Problems

Chapter 61: Nursing Management: Peripheral Nerve and Spinal Cord Problems

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE
1. When assessing a patient with newly diagnosed trigeminal neuralgia, the nurse will ask
the patient about
a. triggers that lead to facial pain.
b. visual problems caused by ptosis.
c. poor appetite caused by a loss of taste.
d. weakness on the affected side of the face.
ANS: A
The major clinical manifestation of trigeminal neuralgia is severe facial pain that is
triggered by cutaneous stimulation of the nerve. Ptosis, loss of taste, and facial weakness
are not characteristics of trigeminal neuralgia.
DIF: Cognitive Level: Application REF: 1541-1543
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
2. Which action should the nurse take when assessing a patient with trigeminal neuralgia?
a. Examine the mouth and teeth thoroughly.
b. Have the patient clench and relax the jaw and eyes.
c. Identify trigger zones by lightly touching the affected side.
d. Gently palpate the face to compare skin temperature bilaterally.
ANS: A
Oral hygiene is frequently neglected because of fear of triggering facial pain. Having the
patient clench the facial muscles will not be useful because the sensory branches of the
nerve are affected by trigeminal neuralgia. Light touch and palpation may be triggers for
pain and should be avoided.
DIF: Cognitive Level: Application REF: 1542-1543
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
3. When evaluating a patient with trigeminal neuralgia who has had a glycerol rhizotomy,
the nurse will
a. ask whether the patient is using an eye shield at night.
b. determine whether the patient is doing daily facial exercises.
c. question the patient about social activities with family and friends.
d. remind the patient to chew food on the unaffected side of the mouth.
ANS: C
Test Bank 61-2
Because withdrawal from social activities is a common manifestation of trigeminal
neuralgia, asking about social activities will help in evaluating whether the patient’s
symptoms have improved. Glycerol rhizotomy does not damage the corneal reflex or
motor functions of the trigeminal nerve, so there is no need to use an eye shield, do facial
exercises, or take precautions with chewing.
DIF: Cognitive Level: Application REF: 1542 TOP: Nursing Process:
Evaluation
MSC: NCLEX: Physiological Integrity
4. Which action will the nurse include in the plan of care when caring for a patient who is
experiencing trigeminal neuralgia?
a. Teach facial and jaw relaxation techniques.
b. Assess intake and output and dietary intake.
c. Apply ice packs for no more than 20 minutes.
d. Spend time at the bedside talking with the patient.
ANS: B
The patient with an acute episode of trigeminal neuralgia may be unwilling to eat or
drink, so assessment of nutritional and hydration status is important. Because stimulation
by touch is the precipitating factor for pain, relaxation of the facial muscles will not
improve symptoms. Application of ice is likely to precipitate pain. The patient will not
want to engage in conversation, which may precipitate attacks.
DIF: Cognitive Level: Application REF: 1542-1543 TOP: Nursing Process:
Planning
MSC: NCLEX: Physiological Integrity
5. When teaching patients who are at risk for Bell’s palsy because of previous herpes
simplex infection, which information should the nurse include?
a. “Call the doctor if pain or herpes lesions occur near the ear.”
b. “Treatment of herpes with antiviral agents prevents Bell’s palsy.”
c. “You may be able to prevent Bell’s palsy by doing facial exercises regularly.”
d. “Medications to treat Bell’s palsy work only if started before paralysis onset.”
ANS: A
Pain or herpes lesions near the ear may indicate the onset of Bell’s palsy and rapid
corticosteroid treatment may reduce the duration of Bell’s palsy symptoms. Antiviral
therapy for herpes simplex does not reduce the risk for Bell’s palsy. Corticosteroid
therapy will be most effective in reducing symptoms if started before paralysis is
complete but will still be somewhat effective when started later. Facial exercises do not
prevent Bell’s palsy.
DIF: Cognitive Level: Application REF: 1543-1544
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity