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MED SURG III EXAM 3 (CH. 58, 59) REVISION QUESTIONS WITH VERIFIED ANSWERS/UPDATED, Exams of Nursing

Western University of Health Sciences (WesternU)Nursing

A set of multiple-choice questions and verified answers covering chapters 58 and 59 of a medical-surgical nursing textbook. It is designed to help students prepare for an exam on topics related to neurological disorders, including migraines, seizures, multiple sclerosis, parkinson's disease, myasthenia gravis, restless legs syndrome, amyotrophic lateral sclerosis, and huntington's disease. The questions cover a range of concepts, including pathophysiology, clinical manifestations, diagnostic tests, treatment options, and nursing management.

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2024/2025

Available from 03/08/2025

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MED SURG III EXAM 3 (CH. 58 , 59 ) REV ISION Q UESTI ONS W IT H
VERIFIED ANSWERS/UPDATED
1. 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."-
: C
2. The nurse expects the assessment of a patient who is experiencing a cluster headache
to include
A. nuchal rigidity.
B. unilateral ptosis.
C. projectile vomiting.
D. throbbing, bilateral facial pain.: B
3. 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.
D. Avoid touching the patient to prevent further nervous system stimulation.-
: C
4. 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."
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Download MED SURG III EXAM 3 (CH. 58, 59) REVISION QUESTIONS WITH VERIFIED ANSWERS/UPDATED and more Exams Nursing in PDF only on Docsity!

MED SURG III EXAM 3 (CH. 58 , 59 ) REVISION QUESTIONS WITH

VERIFIED ANSWERS/UPDATED

  1. 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."- : C
  2. The nurse expects the assessment of a patient who is experiencing a cluster headache to include A. nuchal rigidity. B. unilateral ptosis. C. projectile vomiting. D. throbbing, bilateral facial pain.: B
  3. 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. D. Avoid touching the patient to prevent further nervous system stimulation.- : C
  4. 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 retrain- ing.": B

  1. 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. B. Listen to the lung sounds. C. Auscultate the bowel sounds. D. Check pupil reaction to light.: A
  2. 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 B. Atonic C. Absence D. Myoclonic: A
    1. 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.: B
  4. 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." D. "Symptoms of MS are likely to become worse during pregnancy.": A

D. Teach the patient to keep the feet in contact with the floor and slide them forward.: B

  1. A 62-yr-old patient who has Parkinson's disease is taking bromocriptine (Parlodel). Which information obtained by the nurse may indicate a need for a decrease in the dosage? A. The patient has a chronic dry cough. B. The patient has four loose stools in a day. C. The patient develops a deep vein thrombosis. D. The patient's blood pressure is 92/52 mm Hg.: D
  2. The nurse advises a patient with myasthenia gravis (MG) to A. perform physically demanding activities early in the day. B. anticipate the need for weekly plasmapheresis treatments. C. do frequent weight-bearing exercise to prevent muscle atrophy. D. protect the extremities from injury due to poor sensory perception.: A
  3. Which medication taken by a patient with restless legs syndrome should the nurse discuss with the patient? A. Ibuprofen B. Multivitamin C. Acetaminophen D. Diphenhydramine: D
  4. A patient who has amyotrophic lateral sclerosis (ALS) is hospitalized with pneumonia. Which nursing action will be included in the plan of care? A. Observe for agitation and paranoia. B. Assist with active range of motion (ROM). C. Give muscle relaxants as needed to reduce spasms. D. Use simple words and phrases to explain procedures.: B
  5. A 40-yr-old patient is diagnosed with early Huntington's disease (HD). When teaching the patient, spouse, and adult children about this disorder, the nurse will provide information about the

A. use of levodopa-carbidopa (Sinemet) to help reduce HD symptoms. B. prophylactic antibiotics to decrease the risk for aspiration pneumonia. C. option of genetic testing for the patient's children to determine their own HD risks. D. lifestyle changes of improved nutrition and exercise that delay disease progression.: C

  1. When a 74-yr-old patient is seen in the health clinic with new development of a stooped posture, shuffling gait, and pill rolling-type tremor, the nurse will anticipate teaching the patient about A. oral corticosteroids. B. antiparkinsonian drugs. C. magnetic resonance imaging (MRI). D. electroencephalogram (EEG) testing.: B
  2. A 22-yr-old patient seen at the health clinic with a severe migraine headache tells the nurse about having similar headaches recently. Which initial action should the nurse take? A. Teach about the use of triptan drugs. B. Refer the patient for stress counseling. C. Ask the patient to keep a headache diary. D. Suggest the use of muscle-relaxation techniques.: C
  3. A hospitalized patient complains of a bilateral headache (4/10 on the pain scale) that radiates from the base of the skull. Which prescribed PRN medications should the nurse administer initially? A. Lorazepam (Ativan) B. Acetaminophen (Tylenol) C. Morphine sulfate (MS Contin) D. Butalbital and aspirin (Fiorinal): B
  4. A patient tells the nurse about using acetaminophen (Tylenol) several times every day for recurrent bilateral headaches. Which action will the nurse plan to take first?

D. Teach the patient about magnetic resonance imaging (MRI).: A

  1. The health care provider is considering the use of sumatriptan (Imitrex) for a 54-yr- old male patient with migraine headaches. Which information obtained by the nurse is most important to report to the health care provider? A. The patient drinks 1 to 2 cups of coffee daily. B. The patient had a recent acute myocardial infarction. C. The patient has had migraine headaches for 30 years. D. The patient has taken topiramate (Topamax) for 2 months.: B
  2. The nurse observes a patient ambulating in the hospital hall when the patient's arms and legs suddenly jerk and the patient falls to the floor. The nurse will first A. assess the patient for a possible injury. B. give the scheduled divalproex (Depakote). C. document the timing and description of the seizure. D. notify the patient's health care provider about the seizure.: A
  3. Which prescribed intervention will the nurse implement first for a patient in the emergency department who is experiencing continuous tonic-clonic seizures? A. Give phenytoin (Dilantin) 100 mg IV. B. Monitor level of consciousness (LOC). C. Administer lorazepam (Ativan) 4 mg IV. D. Obtain computed tomography (CT) scan.: C
  1. The home health registered nurse (RN) is planning care for a patient with a seizure disorder related to a recent head injury. Which nursing action can be delegated to a licensed practical/vocational nurse (LPN/LVN)? A. Make referrals to appropriate community agencies. B. Place medications in the home medication organizer. C. Teach the patient and family how to manage seizures. D. Assess for use of medications that may precipitate seizures.: B
  2. A patient is being treated with carbidopa/levodopa (Sinemet) for Parkin- son's disease. Which information indicates a need for change in the medica- tion or dosage? A. Shuffling gait B. Tremor at rest C. Cogwheel rigidity of limbs D. Uncontrolled head movement: D
  3. Which nursing diagnosis is of highest priority for a patient with Parkin- son's disease who is unable to move the facial muscles? A. Activity intolerance B. Self-care deficit: toileting C. Ineffective self-health management D. Imbalanced nutrition: less than body requirements: D
  4. Which assessment is most important for the nurse to make regarding a patient with myasthenia gravis? A. Pupil size

C Patient has minor elevations in the liver function tests. D. Patient's most recent blood pressure is 156/92 mm Hg.: C

  1. After change-of-shift report, which patient should the nurse assess first? A. Patient with myasthenia gravis who is reporting increased muscle weak- ness B. Patient with a bilateral headache described as "like a band around my head" C. Patient with seizures who is scheduled to receive a dose of phenytoin (Dilantin) D. Patient with Parkinson's disease who has developed cogwheel rigidity of the arms: A
  2. A patient who has been treated for status epilepticus in the emergency department will be transferred to the medical nursing unit. Which equipment should the nurse have available in the patient's assigned room (select all that apply)? A. Side-rail pads B. Tongue blade C. Oxygen mask D. Suction tubing E. Urinary catheter F. Nasogastric tube: A, C, D
  3. A patient with Parkinson's disease is admitted to the hospital for treatment of pneumonia. Which nursing interventions will be included in the plan of care (select all that apply)? A. Provide an elevated toilet seat. B. Cut patient's food into small pieces. C. Serve high-protein foods at each meal. D. Place an armchair at the patient's bedside. E Observe for sudden exacerbation of symptoms.: A, B, D
  1. A patient who is hospitalized with pneumonia is disoriented and confused 3 days after admission. Which information indicates that the patient is experi- encing delirium rather than dementia? A. The patient was oriented and alert when admitted. B. the patient's speech is fragmented and incoherent. C. The patient is oriented to person but disoriented to place and time. D. The patient has a history of increasing confusion over several years.: A
  2. Which intervention will the nurse include in the plan of care for a patient with moderate dementia who had a fractured hip repair 2 days ago? A. Provide complete personal hygiene care for the patient. B. Remind the patient frequently about being in the hospital. C. Reposition the patient frequently to avoid skin breakdown. D. Place suction at the bedside to decrease the risk for aspiration.: B
  3. When administering a mental status examination to a patient with delirium, the nurse should A. wait until the patient is well-rested. B. administer an anxiolytic medication. C. choose a place without distracting stimuli. D. reorient the patient during the examination.: C
  4. The nurse is concerned about a postoperative patient's risk for injury during an episode of delirium. The most appropriate action by the nurse is to A. secure the patient in bed using a soft chest restraint. B. ask the health care provider to order an antipsychotic drug. C. instruct family members to remain at the patient's bedside and prevent injury. D. assign unlicensed assistive personnel (UAP) to stay with and reorient the patient.: D
  5. A patient seen in the outpatient clinic is diagnosed with mild cognitive impairment (MCI). Which action will the nurse include in the plan of care?

A. "Are you sad right now?" B. "How is your self-image?" C. "What did you eat for lunch?"

D "Where were you were born?": C

  1. A patient is being evaluated for Alzheimer's disease (AD). The nurse ex- plains to the patient's adult children that A. the most important risk factor for AD is a family history of the disorder. B. a diagnosis of AD is made only after other causes of dementia are ruled out. C. new drugs have been shown to reverse AD deterioration dramatically in some patients. D. brain atrophy detected by magnetic resonance imaging (MRI) would confirm the diagnosis of AD: B
  2. Which nursing action will be most effective in ensuring daily medication compliance for a patient with mild dementia? A. Setting the medications up monthly in a medication box B. Having the patient's family member administer the medication C. Posting reminders to take the medications in the patient's house D. Calling the patient weekly with a reminder to take the medication: B
  3. A patient who has severe Alzheimer's disease (AD) is being admitted to the hospital for surgery. Which intervention will the nurse include in the plan of care? A. Encourage the patient to discuss events from the past. B. Maintain a consistent daily routine for the patient's care. C. Reorient the patient to the date and time every 2 to 3 hours. D. Provide the patient with current newspapers and magazines.: B
  4. A patient with Alzheimer's disease (AD) who is being admitted to a long-term care facility has had several episodes of wandering away from home. Which action will the nurse include in the plan of care?

A. Patient with Alzheimer's disease who has long-term memory deficit B. Patient with vascular dementia who takes medications for depression C. Patient with new-onset confusion, restlessness, and irritability after surgery D. Patient with dementia who has an abnormal Mini-Mental State Examination- : C

  1. After change-of-shift report on the Alzheimer's disease/dementia unit, which patient will the nurse assess first? A. Patient who has not had a bowel movement for 5 days B. Patient who has a stage II pressure ulcer on the coccyx C. Patient who is refusing to take the prescribed medications D. Patient who developed a new cough after eating breakfast: D
  2. After reviewing the health record shown in the accompanying figure for a patient who has multiple risk factors for Alzheimer's disease (AD), which topic will be most important for the nurse to discuss with the patient? A. Tobacco use B. Family history c. Cholesterol level d. Head injury history: A
  3. The spouse of a 67-yr-old male patient with early stage Alzheimer's disease (AD) tells the nurse, "I am exhausted from worrying all the time. I don't know what to do." Which actions are best for the nurse to take next (select all that apply)? A. Suggest that a long-term care facility be considered. B. Offer ideas for ways to distract or redirect the patient. C. Teach the spouse about adult day care as a possible respite. D. Suggest that the spouse consult with the physician for antianxiety drugs.

E. Ask the spouse what she knows and has considered about dementia care options.: B, C, E

  1. Which actions could the nurse delegate to a licensed practical/vocational nurse (LPN/LVN) who is part of the team caring for a patient with Alzheimer's disease (select all that apply)? A. Develop a plan to minimize difficult behavior. B. Administer the prescribed memantine (Namenda). C. Remove potential safety hazards from the patient's environment. D. Refer the patient and caregivers to appropriate community resources. E. Help the patient and caregivers choose memory enhancement methods. F. Evaluate the effectiveness of the prescribed enteral feedings on patient nutrition.: B, C