Chapter 58: Chronic Neurologic Problems Lewis: Medical-Surgical Nursing, 10th Edition Exam Questions and Answers

Chapter 58: Chronic Neurologic Problems Lewis: Medical-Surgical Nursing, 10th Edition Exam Questions and Answers 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. "I will lie down someplace dark and quiet when the headaches begin." 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 ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 2/36 other nonsteroidal antiinflammatory medications can be taken with the triptans. Alcohol may precipitate migraine headaches. 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 ptosis. Unilateral eye edema, tearing, and ptosis are characteristic of cluster headaches. Nuchal rigidity suggests meningeal irritation, such as occurs with meningitis. 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. ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 3/36 d. Avoid touching the patient to prevent further nervous system stimulation. - Ans:-c. Time and observe and record the details of the seizure and postictal state. 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. 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. "Epilepsy usually can be well controlled with medications." The nurse should inform the patient that most patients with seizure disorders are controlled with medication. ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 4/36 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. Inspect the oral mucosa. *Phenytoin* can cause *gingival hyperplasia*, but does not affect bowel sounds, lung sounds, or pupil reaction to light. A patient reports feeling numbness and tingling of the left arm before experiencing a seizure. The nurse determines that this history is consistent with what type of seizure? a. Focal c. Absence b. Atonic d. Myoclonic - Ans:-a. Focal ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 5/36 The initial symptoms of a focal seizure involve clinical manifestations that are localized to a particular part of the body or brain. When obtaining a health history and physical assessment for a 36-yr-old female patient with possible *multiple sclerosis (MS)*, the nurse should a. assess for the presence of chest pain. b. inquire about urinary tract problems. c. inspect the skin for rashes or discoloration. d. ask the patient about any increase in libido. - Ans:-b. inquire about urinary tract problems. *Urinary tract problems* with incontinence or retention are common symptoms of *MS*. A woman who has multiple sclerosis (MS) asks the nurse about risks associated with pregnancy. Which response by the nurse is accurate? a. "MS symptoms may be worse after the pregnancy." b. "Women with MS frequently have premature labor." c. "MS is associated with an increased risk for congenital defects." ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 6/36 d. "Symptoms of MS are likely to become worse during pregnancy." - Ans:-a. "MS symptoms may be worse after the pregnancy." During the postpartum period, women with MS are at greater risk for exacerbation of symptoms. There is no increased risk for congenital defects in infants born of mothers with MS. Symptoms of MS may improve during pregnancy. Onset of labor is not affected by MS. A 33-yr-old patient with *multiple sclerosis (MS)* is to begin treatment with *glatiramer acetate (Copaxone)*. Which information will the nurse include in patient teaching? a. Recommendation to drink at least 4 L of fluid daily b. Need to avoid driving or operating heavy machinery c. How to draw up and administer injections of the medication d. Use of contraceptive methods other than oral contraceptives - Ans:-c. How to draw up a