Chapter 21 Medical Surgical Nursing Preparation For Practice 2nd Edition

Chapter 21  Medical Surgical Nursing Preparation For Practice 2nd Edition

Complete Chapter Questions And Answers
 

Sample Questions

Question 1
Type: MCSA
A patient comes to the clinic complaining of repetitive episodes of sudden severe pain on the right side of the face. The nurse anticipates additional testing for which disorder?
1. Trigeminal neuralgia
2. Parkinson’s disease
3. Bell’s palsy
4. Myasthenia gravis
Correct Answer: 1
Rationale 1: The cause of trigeminal neuralgia is not known, but contributing factors are recent flulike illness, trauma or infection of the teeth or jaw, and arteriosclerotic changes of an artery close to the nerve. It is manifested by repetitive episodes of sudden severe pain on the affected side of the face.
Rationale 2: The facial symptom associated with Parkinson’s disease is decreased facial movement resulting in a masklike presentation. Severe facial pain is not associated with Parkinson’s disease.
Rationale 3: Bell’s palsy results in paralysis of one side of the face. Severe espisodic facial pain is not associated with Bell’s palsy.
Rationale 4: Myasthenia gravis results in drooping of the eyelid. Severe espisodic facial pain is not associated with myasthenia gravis.
Global Rationale:

Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Physiological Adaptation
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 21-1

Question 2
Type: MCSA
A patient has just been diagnosed with trigeminal neuralgia. What would the nurse teach this patient about treatment for this disorder?
1. Drugs used to treat seizure disorders are generally effective.
2. Drug therapy will begin with a trial of antiviral drugs.
3. The primary treatment focus will be on supporting respiratory function until the condition resolves.
4. Gargling with hot salt water will help reduce pain and keep tissues moistened.
Correct Answer: 1
Rationale 1: Trigeminal neuralgia is treated by a pharmacologic approach to pain control with anticonvulsants such as carbamazepine (Tegretol).
Rationale 2: There is no evidence that trigeminal neuralgia is a viral illness or that antiviral drugs are indicated.
Rationale 3: Respiratory support is not necessary to treat this condition.
Rationale 4: Contact with hot or cold substances is often a trigger that induces pain and should be avoided.
Global Rationale:

Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Pharmacological and Parenteral Therapies
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 21-1

Question 3
Type: MCMA
A 25-year-old female is diagnosed with tic douloureux. How should the nurse describe this disorder to the patient?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. “This condition is also called Bell’s palsy.”
2. “You are the typical age for onset of this condition.”
3. “More women than men have this condition.”
4. “More testing will be necessary.”
5. “The treatment for this condition is to allow it to run its course, which is typically 5 to 7 days.”
Correct Answer: 3,4
Rationale 1: The other name for this condition is trigeminal neuralgia.
Rationale 2: The condition generally begins after age 40, with the typical onset at 60 to 70 years in approximately 90% of patients.
Rationale 3: This condition affects twice as many women as men.
Rationale 4: Occurrence of this condition in people 20 to 40 years of age may indicate other diseases such as multiple sclerosis.
Rationale 5: This condition does not abate untreated. Pharmacotherapy is necessary. If pharmacotherapy is not successful, surgical treatments are considered.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Physiological Integrity
Client Need Sub: Physiological Adaptation
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 21-1