Nursing 406 - Adult Health Care » Spring 2020 » Chapter 69 Quiz

Need help with your exam preparation?

Question #1
A nurse is teaching a client with multiple sclerosis (MS). When teaching the client how to reduce fatigue, the nurse should tell the client to:
A.   avoid naps during the day.
B.   rest in an air-conditioned room.
C.   take a hot bath.
D.   increase the dose of muscle relaxants.
Question #2
The primary arthropod vector in North America that transmits encephalitis is the
A.   flea.
B.   tick.
C.   mosquito.
D.   horse.
Question #3
Medical management of arthropod-borne virus (arboviral) encephalitis is aimed at
A.   preventing muscular atrophy.
B.   maintaining hemodynamic stability and adequate cardiac output
C.   preventing renal insufficiency
D.   controlling seizures and increased intracranial pressure.
Question #4
Which drug should be available to counteract the effect of edrophonium chloride?
A.   Prednisone
B.   Atropine
C.   Azathioprine
D.   Pyridostigmine bromide
Question #5
A client with fungal encephalitis receiving IV amphotericin B reports fever, chills, and body aches. What action by the nurse is appropriate?
A.   Assess laboratory values for renal insufficiency.
B.   Administer diphenhydramine and acetaminophen per orders.
C.   Notify the physician and prepare for a lumbar puncture to obtain CSF cultures.
D.   Stop the infusion immediately.
Question #6
A client who recently experienced a stroke tells the nurse that he has double vision. Which nursing intervention is most appropriate?
A.   Instill artificial tears.
B.   Turn out the lights in the room.
C.   Encourage the client to close his eyes.
D.   Alternatively patch one eye every 2 hours.
Question #7
A client is undergoing testing to confirm a diagnosis of myasthenia gravis. The nurse explains that a diagnosis is made if muscle function improves after the client receives an IV injection of a medication. What is the medication the nurse tells the client he'll receive during this test?
A.   Azathioprine (Imuran)
B.   Edrophonium (Tensilon)
C.   Cyclosporine (Sandimmune)
D.   Immunoglobulin G (Iveegam EN)
Question #8
The nurse is taking health history from a client admitted to rule out Guillain-Barre syndrome. An important question to ask related to the diagnosis is which of the following?
A.   Have you experienced any viral infections in the last month?"
B.   Have you experienced any ptosis in the last few weeks?"
C.   Have you had difficulty with urination in the last 6 weeks?"
D.   Have you developed any new allergies in the last year?"
Question #9
A client is diagnosed with meningococcal meningitis. The 22-year-old client shares an apartment with one other person. What would the nurse expect as appropriate care for the client's roommate?
A.   treatment unless the roommate begins to show symptoms
B.   Admission to the nearest hospital for observation
C.   Bedrest at home for 72 hours
D.   Treatment with antimicrobial prophylaxis as soon as possible
Question #10
The nurse is planning care of a client admitted to the neurologic rehabilitation unit following a cerebrovascular accident. Which nursing intervention would be of highest priority?
A.   Include client in planning of care and setting of goals.
B.   Praise client when using adaptive equipment.
C.   Provide instruction on blood-thinning medication.
D.   Assess client for ability to ambulate independently.
Question #11
Which is the primary medical management of arthropod-borne virus (arboviral) encephalitis?
A.   Preventing renal insufficiency
B.   Controlling seizures and increased intracranial pressure
C.   Maintaining hemodynamic stability and adequate cardiac output
D.   Preventing muscular atrophy
Question #12
Which nursing intervention is appropriate for a client with double vision in the right eye due to MS?
A.   Administer eye drops as needed.
B.   Apply an eye patch to the right eye.
C.   Exercise the right eye twice a day.
D.   Place needed items on the right side.
Question #13
The nurse is volunteering for a Red Cross blood drive and is taking the history of potential donors. Which volunteer would the nurse know will not be allowed to donate blood?
A.   A donor who moved to the United States from Canada
B.   A donor who is taking medication for benign prostatic hyperplasia
C.   A donor who was in college in England for 1 year
D.   A donor with a history of hypertension with a blood pressure of 140/90 mm Hg
Question #14
A patient with myasthenia gravis is in the hospital for treatment of pneumonia. The patient informs the nurse that it is very important to take pyridostigmine bromide (Mestinon) on time. The nurse gets busy and does not administer the medication until after breakfast. What outcome will the patient have related to this late dose?
A.   There should not be a problem, since the medication was only delayed by about 2 hours.
B.   The muscles will become fatigued and the patient will not be able to chew food or swallow pills.
C.   The patient will require a double dose prior to lunch.
D.   The patient will go into cardiac arrest.
Question #15
The nurse is caring for a patient in the emergency department with an onset of pain related to trigeminal neuralgia. What subjective data stated by the patient does the nurse determine triggered the paroxysms of pain?
A.   I was brushing my teeth.”
B.   I was putting my shoes on.”
C.   I was taking a bath.”
D.   I was sitting at home watching television.”
Question #16
When providing discharge teaching for a client with multiple sclerosis (MS), the nurse should include which instruction?
A.   Restrict fluid intake to 1,500 ml/day."
B.   Limit your fruit and vegetable intake."
C.   Avoid taking daytime naps."
D.   Avoid hot baths and showers."
Question #17
Bell palsy is a disorder of which cranial nerve?
A.   Trigeminal (V)
B.   Facial (VII)
C.   Vestibulocochlear (VIII)
D.   Vagus (X)
Question #18
A nurse is providing education to a client with newly diagnosed multiple sclerosis (MS). Which of the following will the nurse include?
A.   Take moderate amounts of alcohol
B.   Avoid analgesic medication.
C.   Avoid hot temperatures.
D.   Avoid physical activity.
Question #19
The nurse is performing an initial nursing assessment on a client with possible Guillain-Barre syndrome. Which of the following findings would be most consistent with this diagnosis?
A.   Muscle weakness and hyporeflexia of the lower extremities
B.   Fever and cough
C.   Ptosis and muscle weakness of upper extremities
D.   Hyporeflexia and skin rash
Question #20
While performing an initial nursing assessment on a client admitted with suspected tic douloureux (trigeminal neuralgia), for which of the following would the nurse expect to observe?
A.   Fatigue and depression
B.   Hyporeflexia and weakness of the lower extremities
C.   Ptosis and diplopia
D.   Facial pain in the areas of the fifth cranial nerve
Question #21
The nurse is assessing a client with meningitis. Which of the following signs would the nurse expect to observe?
A.   Numbness and vomiting
B.   Headache and nuchal rigidity
C.   Hyporeflexia in the lower extremities
D.   Ptosis and diplopia
Question #22
A client has been hospitalized for diagnostic testing. The client has just been diagnosed with multiple sclerosis, which the physician explains is an autoimmune disorder. How would the nurse explain an autoimmune disease to the client?
A.   A disorder in which histocompatible cells attack the immunoglobulins
B.   A disorder in which the body has too many immunoglobulins
C.   A disorder in which killer T cells and autoantibodies attack or destroy natural cells—those cells that are “self”
D.   A disorder in which the body does not have enough immunoglobulins
Question #23
Which of the following is the medication of choice in the treatment of herpes simplex virus (HSV)?
A.   Acyclovir (Zovirax)
B.   Phenytoin (Dilantin)
C.   Dexamethasone (Decadron)
D.   Vancomycin
Question #24
Which is a chronic, degenerative, progressive disease of the central nervous system characterized by the occurrence of demyelination in the brain and spinal cord?
A.   Huntington disease
B.   Creutzfeldt-Jakob disease
C.   Multiple sclerosis
D.   Parkinson disease
Question #25
A patient suspected of having Guillain-Barré syndrome has had a lumbar puncture for cerebrospinal fluid (CSF) evaluation. When reviewing the laboratory results, what does the nurse find that is diagnostic for this disease?
A.   White blood cells in the CSF
B.   Glucose in the CSF
C.   Elevated protein levels in the CSF
D.   Red blood cells present in the CSF
Question #26
A 45-year-old client is admitted to the facility with excruciating paroxysmal facial pain. He reports that the episodes occur most often after feeling cold drafts and drinking cold beverages. Based on these findings, the nurse determines that the client is most likely suffering from which neurologic disorder?
A.   Bell's palsy
B.   Angina pectoris
C.   Migraine headache
D.   Trigeminal neuralgia
Question #27
Which is the most common cause of acute encephalitis in the United States?
A.   Herpes simplex virus (HSV)
B.   Western equine bacteria
C.   Human immunodeficiency virus (HIV
D.   Lyme Disease
Question #28
The nurse is assessing a newly admitted client with a diagnosis of meningitis. On assessment, the nurse expects to find which of the following?
A.   Hyper-alertness
B.   Negative Brudzinski's sign
C.   Positive Kernig's sign
D.   Positive Romberg sign
Question #29
The nurse is performing an initial assessment on a client with suspected Bell's palsy. Which of the following findings would the nurse be most focused on related to this medical diagnosis?
A.   Hyporeflexia and weakness of the lower extremities
B.   Facial distortion and pain
C.   Fatigue and depression
D.   Ptosis and diplopia
Question #30
A client with Guillain-Barre syndrome cannot swallow and has a paralytic ileus; the nurse is administering parenteral nutrition intraveneously. The nurse is careful to assess which of the following related to intake of nutrients?
A.   Condition of skin
B.   Gag reflex and bowel sounds
C.   Urinary output and capillary refill
D.   Respiratory status
Question #31
Which of the following tests confirms the diagnosis of myasthenia gravis (MG)?
A.   Tensilon test
B.   Computed tomography (CT) scan
C.   Electromyogram (EMG)
D.   Serum studies
Question #32
A client is brought to the emergency department in a confused state, with slurred speech, characteristics of a headache, and right facial droop. The vital signs reveal a blood pressure of 170/88 mm Hg, pulse of 92 beats/minute, and respirations at 24 breaths/minute. On which bodily system does the nurse focus the nursing assessment?
A.   Endocrine system
B.   Neurovascular system
C.   Respiratory system
D.   Cardiovascular system
Question #33
The nurse is caring for a client with Guillain-Barré syndrome. Which assessment finding would indicate the need for oral suctioning?
A.   Increased pulse rate, respirations of 16 breaths/minute
B.   Decreased pulse rate, abdominal breathing
C.   Increased pulse rate, adventitious breath sounds
D.   Decreased pulse rate, respirations of 20 breaths/minute
Question #34
Myasthenia gravis occurs when antibodies attack which receptor sites?
A.   Gamma-aminobutyric acid
B.   Serotonin
C.   Acetylcholine
D.   Dopamine
Question #35
A client has been brought to the ED with altered LOC, high fever, and a purpura rash on the lower extremities. The family states the client was reporting neck stiffness earlier in the day. What action should the nurse do first?
A.   Initiate isolation precautions.
B.   Ensure the family receives prophylaxis antibiotic treatment.
C.   Administer prescribed antibiotics.
D.   Apply a cooling blanket.
Question #36
A client with Guillain-Barré syndrome has paralysis affecting the respiratory muscles and requires mechanical ventilation. When the client asks the nurse about the paralysis, how should the nurse respond?
A.   You'll be permanently paralyzed; however, you won't have any sensory loss."
B.   You'll first regain use of your legs and then your arms."
C.   The paralysis caused by this disease is temporary."
D.   It must be hard to accept the permanency of your paralysis."
Question #37
The client with herpes simplex virus (HSV) encephalitis is receiving acyclovir. The nurse monitors blood chemistry test results and urinary output for
A.   signs of improvement in the patient's condition.
B.   renal complications related to acyclovir therapy.
C.   signs of relapse.
D.   signs and symptoms of cardiac insufficiency.
Question #38
Which drug should be available to counteract the effect of edrophonium chloride?
A.   Azathioprine
B.   Pyridostigmine bromide
C.   Prednisone
D.   Atropine
Question #39
A client with myasthenia gravis is admitted with an exacerbation. The nurse is educating the client about plasmapherisis and explains this in which of the following statements?
A.   Mestinon therapy is initiated.
B.   The thymus gland is removed.
C.   Immune globulin is given intravenously.
D.   Antibodies are removed from the plasma.
Question #40
The most common cause of cholinergic crisis includes which of the following?
A.   Infection
B.   Compliance with medication
C.   Overmedication
D.   Undermedication
Question #41
A client's spouse relates how the client reported a severe headache, and shortly after was unable to talk or move their right arm and leg. The spouse indicates the client has hypertension. What should be the focus of management during this phase?
A.   assessing vital signs frequently
B.   preventing further neurologic damage
C.   destabilizing client's condition
D.   reporting changes to the physician
Question #42
The initial symptoms of variant Creutzfeldt-Jakob disease (vCJD) include
A.   diplopia and bradykinesia.
B.   muscle rigidity, memory impairment, and cognitive impairment.
C.   akathisia and dysphagia.
D.   sensory disturbance, limb pain, and behavioral changes.
Question #43
The nurse has been educating a client newly diagnosed with MS. Which statement by the client indicates an understanding of the education?
A.   I will stretch daily as directed by the physical therapist.”
B.   exercises should be completed quickly to reduce fatigue.”
C.   I should participate in non–weight-bearing exercises.”
D.   I will take hot tub baths to decrease spasms.”
Question #44
The nurse is assisting with administering a Tensilon test to a patient with ptosis. If the test is positive for myasthenia gravis, what outcome does the nurse know will occur?
A.   After administration of the medication, there will be no change in the status of the ptosis or facial weakness.
B.   The patient will have recovery of symptoms for at least 24 hours after the administration of the Tensilon.
C.   Eight hours after administration, the acetylcholinesterase begins to regenerate the available acetylcholine and will relieve symptoms.
D.   Thirty seconds after administration, the facial weakness and ptosis will be relieved for approximately 5 minutes.
Question #45
Which condition is a rare, transmissible, progressive fatal disease of the central nervous system characterized by spongiform degeneration of the gray matter of the brain?
A.   Creutzfeldt-Jakob disease
B.   Huntington disease
C.   Parkinson disease
D.   Multiple sclerosis
Question #46
The nurse is assessing a client newly diagnosed with myasthenia gravis. Which of the following signs would the nurse most likely observe?
A.   Patchy blindness
B.   Diplopia and ptosis
C.   Loss of proprioception
D.   Numbness
Question #47
Which basic of client care, occurring during the acute phase, is most helpful in promoting the rehabilitation of a client following a debilitating cerebrovascular accident?
A.   Prevention of joint contractures
B.   Creating a positive environment
C.   Use of adaptive equipment
D.   Promoting ability to critically think
Question #48
Which condition is a rare, transmissible, progressive fatal disease of the central nervous system characterized by spongiform degeneration of the gray matter of the brain?
A.   Multiple sclerosis
B.   Huntington disease
C.   Parkinson disease
D.   Creutzfeldt-Jakob disease
Question #49
A client has been diagnosed with a frontal lobe brain abscess. Which nursing intervention is appropriate?
A.   Initiate seizure precautions.
B.   Assess visual acuity.
C.   Assess for facial weakness.
D.   Ensure that client takes nothing by mouth.
Question #50
The diagnosis of multiple sclerosis is based on which test?
A.   Magnetic resonance imaging (MRI)
B.   Evoked potential studies
C.   Neuropsychological testing
D.   Cerebrospinal fluid (CSF) electrophoresis
Question #51
The parents of a client intubated due to the progression of Guillain-Barré syndrome ask whether their child will die. What is the best response by the nurse?
A.   It’s too early to give a prognosis.”
B.   Once Guillain-Barré syndrome progresses to the diaphragm, survival decreases significantly.”
C.   Don’t worry; your child will be fine.”
D.   There are no guarantees, but a large portion of people with Guillain-Barré syndrome survive.”
Question #52
A patient has been diagnosed with meningococcal meningitis at a community living home. When should prophylactic therapy begin for those who have had close contact with the patient?
A.   Within 72 hours after exposure
B.   Therapy is not necessary prophylactically and should only be used if the person develops symptoms.
C.   Within 24 hours after exposure
D.   Within 48 hours after exposure
Question #53
During a Tensilon test to determine if a patient has myasthenia gravis, the patient complains of cramping and becomes diaphoretic. Vital signs are BP 130/78, HR 42, and respiration 18. What intervention should the nurse prepare to do?
A.   Administer diphenhydramine (Benadryl) for the allergic reaction.
B.   Place the patient in the supine position
C.   Call the rapid response team because the patient is preparing to arrest.
D.   Administer atropine to control the side effects of edrophonium.
Question #54
A client with respiratory complications of multiple sclerosis (MS) is admitted to the medical-surgical unit. Which equipment is most important for the nurse to keep at the client's bedside?
A.   Nasal cannula and oxygen
B.   Suction machine with catheters
C.   Sphygmomanometer
D.   Padded tongue blade
Question #55
A client with fungal encephalitis receiving amphotericin B reports fever, chills, and body aches. The nurse knows that these symptoms
A.   indicate the need for immediate blood and cerebral spinal fluid (CSF) cultures.
B.   indicate renal toxicity and a worsening condition.
C.   are primarily associated with infection with Coccidioides immitis and Aspergillus.
D.   may be controlled by the administration of diphenhydramine and acetaminophen approximately 30 minutes before administration of the amphotericin.
Question #56
The diagnosis of multiple sclerosis is based on which test?
A.   CSF electrophoresis
B.   Evoked potential studies
C.   Magnetic resonance imaging
D.   Neuropsychological testing
Question #57
The nurse is assessing a client with meningitis. Which of the following signs would the nurse expect to observe?
A.   Ptosis and diplopia
B.   Numbness and vomiting
C.   Hyporeflexia in the lower extremities
D.   Headache and nuchal rigidity
Question #58
You are the nurse caring for a client with Guillain-Barré syndrome (GBS). The client also has an ascending paralysis. Knowing the complications of the disorder, what should you keep always ready at the bedside?
A.   Nebulizer and thermometer
B.   Incentive spirometer
C.   Intubation tray and suction apparatus
D.   Blood pressure apparatus
Question #59
Which of the following is the first-line therapy for myasthenia gravis (MG)?
A.   Deltasone (Prednisone)
B.   Pyridostigmine bromide (Mestinon)
C.   Azathioprine (Imuran)
D.   Lioresal (Baclofen)
Question #60
Guillain-Barré syndrome is an autoimmune attack on the peripheral myelin sheath. Which of the following is an action of myelin?
A.   Carries message to the next nerve cell
B.   Speeds nerve impulse transmission
C.   Acts as chemical messenger
D.   Represents building block of nervous system
Question #61
While caring for clients who have suffered neurologic deficits from causes such as cerebrovascular accident and closed head injury, an important nursing goal that motivate nurses to offer the best care possible is preventing:
A.   complications.
B.   infection.
C.   choking.
D.   falls.
Question #62
Which is a component of the nursing management of the client with variant Creutzfeldt-Jakob disease (vCJD)?
A.   Administering amphotericin B
B.   Initiating isolation procedures
C.   Preparing for organ donation
D.   Providing palliative care
Question #63
A health care provider asks a nurse to assess a patient being evaluated for aseptic meningitis for a positive Brudzinski sign. Which of the following actions should the nurse take?
A.   Support the patient's neck through normal range of motion and evaluate stiffness.
B.   Assess the patient's sensitivity to light.
C.   Help the patient flex his neck and observe for flexion of the hips and knees
D.   Flex the patient's thigh on his abdomen and assess the extension of the leg.
Question #64
A client is hospitalized with Guillain-Barré syndrome. Which nursing assessment finding is most significant?
A.   Soft, nondistended abdomen
B.   Urine output of 40 ml/hour
C.   Even, unlabored respirations
D.   Warm, dry skin
Question #65
Which well-recognized sign of meningitis is exhibited when the client’s neck is flexed and flexion of the knees and hips is produced?
A.   Photophobia
B.   Positive Brudzinski sign
C.   Positive Kerning sign
D.   Nuchal rigidity
Question #66
A client is suspected to have bacterial meningitis. What is the priority nursing intervention?
A.   Administer prescribed antibiotics.
B.   Encourage oral fluid intake.
C.   Prepare the client for a CT scan.
D.   Assess the CSF fluid laboratory test results

Need help with your exam preparation?