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13A NRG304 LEC FINALS QUIZ 3

Total questions: 30

Worksheet time: 33mins

Name
Class
Date
1.

Nurse Andrew assesses a patient for signs of meningeal irritation and observes for nuchal rigidity. What indicates the presence of this sign of meningeal irritation?

a)

Tonic spasms of the legs

b)

Curling in a fetal position

c)

Arching of the neck and back

d)

Resistance to flexion of the neck

2.

Nurse Shokutine is caring for a patient admitted with a diagnosis of brain abscess following a head injury. Which changes in the vital signs would the nurse interpret as a manifestation of increased intracranial pressure?

a)

Tachypnea

b)

Bradycardia

c)

Hypotension

d)

Narrow pulse pressure

3.

A client, age 22, is admitted with bacterial meningitis. Which hospital room would be the best choice for this client?

a)

A private room down the hall from the nurses’ station

b)

An isolation room three doors from the nurses’ station

c)

A semiprivate room with a 32-year-old client who has viral meningitis

d)

A two-bed room with a client who previously had bacterial meningitis

4.

A physician diagnoses a client with myasthenia gravis, prescribing pyridostigmine (Mestinon), 60 mg P.O. every 3 hours. Before administering this anticholinesterase agent, the nurse reviews the client’s history. Which preexisting condition would contraindicate the use of pyridostigmine?

a)

Ulcerative colitis

b)

Blood dyscrasia

c)

Intestinal obstruction

d)

Spinal cord injury

5.

Select all the TRUE statements about the pathophysiology of multiple sclerosis:

a)

"The dendrites on the neuron are overstimulated leading to the destruction of the axon."

b)

"The myelin sheath, which is made up of Schwann cells, is damaged along the axon."

c)

"This disease affects the insulating structure found on the neuron in the central nervous system." 

d)

"The dopaminergic neurons in the part of the brain called substantia nigra have started to die."

6.

Which finding below represents a positive Romberg Sign in a patient with multiple sclerosis?

a)

The patient report dark spots in the visual fields during the confrontation visual field test.

b)

When the patient closes the eyes and stands with their feet together they start to lose their balance and sway back and forth.

c)

The patient's sign and symptoms increase when expose to hot temperatures.

d)

The patient reports an electric shock feeling when the head and neck are moved downward.

7.

Your patient is scheduled for a lumbar puncture to help diagnose multiple sclerosis. The patient wants clarification about what will be found in the cerebrospinal fluid during the lumbar puncture to confirm the diagnosis of MS. You explain that ____________ will be present in the fluid if MS is present.

a)

high amounts of IgM

b)

oligoclonal bands

c)

low amounts of WBC

d)

oblong red blood cells and glucose

8.

A patient is receiving Interferon Beta for treatment of multiple sclerosis. As the nurse you will stress the importance of?

a)

Reporting ideation of suicide

b)

Hand hygiene and avoiding infection

c)

Low fat diet

d)

Physical exercise to improve fatigue

9.

Myasthenia gravis occurs when antibodies attack the __________ receptors at the neuromuscular junction leading to ____________.

a)

metabotropic; muscle weakness

b)

acetylcholine; muscle weakness

c)

dopaminergic adrenergic; muscle contraction

d)

nicotinic adrenergic; muscle contraction

10.

You’re educating a patient about the pathophysiology of myasthenia gravis. While explaining the involvement of the thymus gland, the patient asks you where the thymus gland is located. You state it is located?

a)

behind the thyroid gland

b)

within the adrenal glands

c)

behind the sternum in between the lungs

d)

anterior to the hypothalamus

11.

A patient with myasthenia gravis will be eating lunch at 12:00. It is now 10:00 and the patient is scheduled to take Pyridostigmine. At what time should you administer this medication so the patient will have the maximum benefit of this medication?

a)

As soon as possible

b)

1 hour after the patient has eaten (at 13:00)

c)

1 hour before the patient eats (at 11:00)

d)

at 12:00 right before the patient eats

12.

The neurologist is conducting a Tensilon test (Edrophonium) at the bedside of a patient who is experiencing unexplained muscle weakness, double vision, difficulty breathing, and ptosis. Which findings after the administration of Edrophonium would represent the patient has myasthenia gravis?

a)

The patient experiences worsening of the muscle weakness.

b)

The patient experiences wheezing along with facial flushing.

c)

The patient reports a tingling sensation in the eyelids and sudden ringing in the ears.

d)

The patient experiences improved muscle strength

13.

You’re preparing to help the neurologist with conducting a Tensilon test. Which antidote will you have on hand in case of an emergency?

a)

Atropine

b)

Protamine sulfate

c)

Narcan

d)

Leucovorin

14.

Which meal option would be the most appropriate for a patient with myasthenia gravis?

a)

Roasted potatoes and cubed steak

b)

Hamburger with baked fries

c)

Clam chowder with mashed potatoes

d)

Fresh veggie tray with sliced cheese cubes

15.

You’re providing teaching to a group of patients with myasthenia gravis. Which of the following is not a treatment option for this condition?

a)

Plasmapheresis

b)

Cholinesterase medications

c)

Thymectomy

d)

Corticosteroids

16.

You’re a home health nurse providing care to a patient with myasthenia gravis. Today you plan on helping the patient with bathing and exercising. When would be the best time to visit the patient to help these tasks?

a)

Mid-afternoon

b)

Morning

c)

Evening

d)

Before bedtime

17.

You are taking care of patient Nanongito who is diagnosed with meningitis,. All of the following are clinical manifestation of Menigitis, Except? Select all that apply

a)

Positive Kernig sign

b)

Positive Brudzinki sign

c)

Seizure

d)

Hallucinations

18.

You are taking care of a patient with Viral meningitis. Which of the following laboratory results would most likely be evident?

a)

Protein of 18 mg/dL

b)

Leukocytes of 5000 cells/mm3

c)

Neutrophils of <40 %

d)

Glucose of <40 mg/dL

19.

You are the medicating nurse for patient Chusderi who is diagnosed with Bacterial meningitis. Which of the following medication is not appropriate for the patient?

a)

Ceftriaxone

b)

Acyclovir

c)

Dexamethasone

d)

Diazepam

20.

You are assessing patient Bimbimbaby who is diagnosed with a massive temporal lobe abscess. Which of the following signs and symptoms would most likely be present?

a)

Ataxia

b)

Receptive aphasia

c)

Expressive aphasia

d)

Nystagmus

21.

You are giving health teachings to patient and family regarding Creutzfeldt-Jakob disease. Which of the following information is correct?

a)

Its is acquired by ingesting prions from infected meat

b)

People at risk for this disease are bird handlers

c)

This can be transmitted by blood feeding arthropods

d)

This is an autoimmune process

22.

What can be seen in the immunologic assessment of CSF with a patient with West Nile Virtus ?

a)

Protein kinase inhibitor 14-3-3

b)

Fungal antibodies

c)

Several bands of immunoglobulin G bonded together

d)

Presence of Immunoglobulin M antibodies

23.

It is a type of MS that shows progression from onset but with clear acute relapses with or without recovery.

a)

Progressive relapsing MS

b)

Secondary progressive MS

c)

Primary progressive MS

d)

Relapsing remitting

24.

What is the most common cause of peripheral neuropathy?

a)

Hypertension

b)

Diabetes

c)

Atherosclerosis

d)

Thrombosis

25.

You are taking care of a patient with Bell's palsy. Which of the following is not a clinical manifestation of this disorder? Select all that apply.

a)

Unable to close eyelids

b)

Speech difficulties

c)

Pain during washing the face

d)

Unable to eat on the affected side

26.

You are giving care to a patient with Bell's palsy. Which of the following nursing management is incorrect?

a)

Eye should be covered with a protective shield at night

b)

Moisturizing eye drops during the day and eye ointment at bedtime may help prevent injury

c)

Massaging the face several times daily, using a gentle downward motion, to maintain muscle tone

d)

Exposure of the face to cold and drafts is avoided.

27.

You are the medicating nurse for patient Edturde who is diagnosed with Trigeminal neuralgia. Which of the following medication is not part of the pharmacologic management of the patient?

a)

Carbamazepine

b)

Gabapentin

c)

Phenytoin

d)

Dexamethasone

28.

You are assessing the patient with Trigeminal neuralgia. Which of the following is not part of the Branches of the Trigeminal nerve?

a)

Opthalmic

b)

Paranasal

c)

Mandibular

d)

Maxillary

29.

Which of the following information about Guillain–Barré Syndrome is incorrect?

a)

It is also known as acute idiopathic polyneuritis

b)

Weakness in the lower extremities, which progresses upward and has the potential for respiratory failure

c)

Miller–Fisher variant, presents with ataxia, areflexia, and opthalmoplegia; Rarest type

d)

Elevated protein levels are detected in CSF evaluation, with an increase in other cells

30.

Which medication should be given approximately 30 minutes before giving amphotericin B may prevent flulike side effects.

a)

aspirin

b)

acetaminophen

c)

atropine

d)

ascorbic acid