Another one for the nervous system

Ignatavicius & Workman: Medical-Surgical Nursing: Critical Thinking for Collaborative Care, 4th Edition

Self-Assessment Questions

Chapter 42: Interventions for Clients with Problems of the Central Nervous
System: The Brain


1.     Which of the following clients is most likely to experience migraine headaches?

A.     30-year-old woman
B.     30-year-old man
C.     70-year-old woman
D.     70-year-old man

Correct Answer: A


2.     You are caring for a client recently diagnosed with migraine headaches. Which statement made by the client demonstrates an understanding of the treatment plan? “I will

A.     avoid caffeine.”
B.     drink red wine if I desire an alcoholic beverage.”
C.     sleep using two pillows for elevation of the neck.”
D.     sit by the window wearing sunglasses during an attack.”

Correct Answer: A


3.     Which of the following clinical manifestations best describes an absence seizure? A seizure:

A.     that begins with automatisms
B.     that begins with muscle stiffening or rigidity
C.     characterized by clonic jerking of the extremities
D.     characterized by brief periods of loss of consciousness

Correct Answer: D


4.     Which of the following nursing measures is most likely to prevent injury for the client with a seizure disorder?

A.     Keeping a padded tongue blade at the bedside
B.     Keeping the bed in the lowest possible position
C.     Placing the client in a vest-style restraint
D.     Assisting the client with all ambulation

Correct Answer: B


5.     During a generalized tonic-clonic seizure, the nurse observes the client to be cyanotic. What is the best nursing action for this situation?

A.     Document the observation.
B.     Tilt the client’s head back.
C.     Administer oxygen by mask during the seizure.
D.     Insert an oral airway between the client’s teeth.

Correct Answer: A


6.     Which of the following statements made by the client with epilepsy who has started taking a new antiepilepsy drug indicates correct understanding of the drug regimen?

A.     “I will take my medication one hour before or two hours after eating.”
B.     “If I have nausea or vomiting, I will not take my medication.”
C.     “If I have a seizure, I will double the drug the next day.”
D.     “I will always take my medication on time.”

Correct Answer: D


7.     You are caring for a client with bacterial meningitis. Which nursing intervention is aimed at preventing complications associated with this illness?

A.     Performing neurologic checks every two hours
B.     Elevating the head of the bed to 30 degrees
C.     Administering pain medication as ordered
D.     Maintaining isolation precautions

Correct Answer: A


8.     Which of the following statements regarding Parkinson’s disease is true?

A.     It has a cyclic pattern of periods of exacerbation followed by periods of remission.
B.     It has a pattern of progressive changes in voluntary muscle movement.
C.     It is characterized by severe muscle flaccidity.
D.     It is inherited as an x-linked recessive trait.

Correct Answer: B


9.     Which of the following nursing actions fosters independence in feeding for the client with Parkinson’s disease?

A.     Weighing the client weekly
B.     Providing soft, cold foods that are easy to chew and swallow
C.     Scheduling medication administration so that peak action occurs at mealtimes
D.     Ensuring that the amount of calories derived from protein is at least 30% of the total diet

Correct Answer: C


10.     Which of the following outcomes would be considered appropriate for a client with late-stage Alzheimer’s disease? The client will:

A.     be independent in toileting.
B.     have no episodes of memory loss.
C.     have decreased periods of agitation.
D.     not have speech or language difficulties.

Correct Answer: C


11.     Which of the following statements made by a family member of the client with Alzheimer’s disease indicates correct understanding of the usefulness of sertraline (Zoloft) as therapy for Alzheimer’s disease? “This drug will:

A.     improve my relative’s depression.”
B.     increase my relative’s memory.”
C.     decrease my relative’s aggressive behavior.”
D.     improve my relative’s ability to bathe and feed himself.”

Correct Answer: A


12.     Which instructions should you include in a teaching plan for a caregiver of a client with Alzheimer’s disease?

A.     Avoid using night lights in the client’s bedroom.
B.     Minimize physical activity to avoid overexertion.
C.     Prepare soft foods that are easy to chew and swallow.
D.     Maintain an unstructured environment and schedule to prevent boredom.

Correct Answer: C


13.     Which statement concerning the legal or ethical concerns of genetic testing for Huntington’s disease is true?

A.     Genetic testing can identify susceptible individuals early enough to cure the disease.
B.     There are no accurate genetic tests for the detection of Huntington’s disease.
C.     Genetic testing localizes the chromosomal abnormality and stabilizes it.
D.     Clients should consider the effect of the results of genetic testing on themselves and families.

Correct Answer: D