NUR426 Test 3: Questions Answers

NUR426 Test 3: Questions & Answers

A nurse is caring for a client who has MS. Which of the following findings should the nurse expect?

• Hypoactive DTR
• ascending paralysis
• intention tremors
• increased lacrimation

(Ans- 3

A nurse is assessing a client who has a seizure disorder. The client reports he thinks he is about to have a seizure. Which of the following actions should the nurse implement? Select all that apply.

• provide safety
• ease the patient to the floor if standing
• move furniture away from the patient
• loosen the patient's clothing
• protect the patient's head with padding
• restrain the patient.

(Ans- 1, 2, 3, 4, & 5

A nurse is caring for a client who just had a generalized seizure. WHich of the following actions should the nurse first perform?

• keep the client in a side-lying position
• monitor client's vital signs
• reorient the client to the environment
• check the client for injuries.

(Ans- 1

A nurse is providing discharge instructions to a female client who has a prescription for phenytoin. Which of the following information should the nurse include?

• consider taking oral contraceptives when on this medication
• watch for receding gums when taking this medicine 1 / 3

• take the medicine at the same time everyday
• provide a urine sample to determine therapeutic levels of the medicine

(Ans- 3

A nurse is reviewing trigger factors that can cause seizures with a client who has a new diagnosis of generalized seizures. Which of the following information should the nurse include in this review? select all that apply.

• overwhelming fatigue should be avoided
• caffeinated products should be removed from the diet
• looking at flashing lights should be limited
• aerobic exercise may be performed
• episodes of hypoventilation should be limited
• use of aerosol hairspray is recommended

(Ans- 1, 2, & 3

A nurse is completing discharge teaching to a client who has seizures and received a vagal nerve stimulator to decrease seizure activity. Which of the following information should the nurse include in the teaching?

• The use of a microwave to heat food is permitted
• Inform a provider to order only MRI when a scan is needed
• place a magnet over the implantable devices when an aura occurs
• the use of ultrasound diathermy for pain management is recommended.

(Ans- 3

A patient has been receiving scheduled doses of phenytoin and begins to

experience diplopia. The nurse immediately assess the patient for:

• an aura or focal seizure
• nystagmus or confusion
• abdominal pain or cramping
• irregular pulse or palpitations

(Ans- 2

• / 3

Which characteristic of a patient's recent seizure is consistent with a focal seizure?

• the patient lost consciousness during the seizure
• the seizure involved lip smacking and repetitive movement
• the patient fell to the ground and became stiff for 20 seconds
• the etiology of the seizure involved both sides of the patient's brain

(Ans- 2

Which measure should the nurse prioritize when providing care for a patient with a diagnosis of MS?

• vigilant infection control and adherence to standard precautions
• careful monitoring of neurologic assessment and frequent reorientation
• maintenance of a calorie count and hourly assessment of intake and

output

• assessment of blood pressure and monitoring for signs of OH.

(Ans- 1

A male patient with a diagnosis of PD has been admitted recently to a long- term care facility. Which action should the health care team take in order to promote adequate nutrition for this patient?

• provide multivitamins with each meal
• provide a diet that is low in complex carbohydrates and high in protein
• provide small, frequent meals throughout the day that are easy to chew

and swallow

• provide a patient with a minced or pureed diet that is high in potassium

and low in sodium (Ans- 3

Which nursing diagnosis is likely to be a priority in the care of a patient with MG?

• acute confusion
• bowel incontinence
• activity intolerance
• disturbed sleep pattern

(Ans- 3

• / 3