Chapter 64 Management of Patients With Neurologic Infections, Autoimmune Disorders, and Neuropathies

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Chapter 64  Management of Patients With Neurologic Infections, Autoimmune Disorders, and Neuropathies

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

Multiple Choice

1. A patient with possible bacterial meningitis is admitted to the ICU. What assessment data would the nurse know is an expected finding for a patient with bacterial meningitis?
A) Pain upon ankle dorsiflexion of the foot
B) Neck flexion produces flexion of knees and hips

C) Inability to stand with eyes closed and arms extended without swaying D) Numbness and tingling in the lower extremities

Ans: B
Chapter: 64
Client Needs: A-1
Cognitive Level: Application Difficulty: Moderate
Integrated Process: Nursing Process Objective: 1
Page and Header: 1951, Meningitis

Feedback: Clinical manifestations of bacterial meningitis include positive Brudzinski’s sign. Neck flexion producing flexion of knees and hips correlates with a positive Brudzinski’s sign. Positive Homan’s sign (pain upon dorsiflexion of the foot) and negative Romberg’s sign (inability

to stand with eyes closed and arms extended) are not expected assessment findings for the patient with bacterial meningitis. Peripheral neuropathy manifests as numbness and tingling in the lower extremities. Again, this would not be an initial assessment to rule out bacterial meningitis.

2. The nurse is planning discharge teaching for a patient with trigeminal neuralgia. The nurse knows to include information about factors that precipitate an attack. What would the nurse be correct in teaching the patient to avoid?
A) Washing his face

B) Exposing his skin to sunlight
C) Using artificial tears
D) Drinking liquids at room temperature

Ans: A
Chapter: 64
Client Needs: D-1
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Teaching/Learning
Objective: 5
Page and Header: 1970, Trigeminal Neuralgia (Tic Douloureux)

Feedback: Washing the face should be avoided if possible, due to the fact that this activity can trigger an attack of pain in a patient with trigeminal neuralgia. Using artificial tears and drinking liquids at room temperature would be appropriate behaviors. Exposing the skin to sunlight would not be harmful to this patient.

3. The nurse is caring for a patient with multiple sclerosis. The patient tells the nurse the hardest thing to deal with is the fatigue. When teaching the patient how to reduce fatigue, what should the nurse tell the patient to do?
A) Take a hot bath.
B) Rest in an air-conditioned room.
C) Increase the dose of muscle relaxants.
D) Avoid naps during the day.

Ans: B
Chapter: 64
Client Needs: D-1
Cognitive Level: Application Difficulty: Moderate
Integrated Process: Teaching/Learning

Objective: 3
Page and Header: 1958, Multiple Sclerosis

Feedback: Fatigue is a common symptom in patients with multiple sclerosis. Lowering the body temperature by resting in an air-conditioned room may relieve fatigue; however, extreme cold should be avoided. A hot bath or shower can increase body temperature producing fatigue. Muscle relaxants, prescribed to reduce spasticity, can cause drowsiness and fatigue. Planning for frequent rest periods and naps can relieve fatigue. Other measures to reduce fatigue in the patient with multiple sclerosis include treating depression, using occupational therapy to learn energy conservation techniques, and reducing spasticity.

4. A patient with Guillain-Barré syndrome is being assessed by the nurse. What clinical manifestation would alert the nurse that the patient’s status is deteriorating?
A) Tidal volume of 500 mL
B) Residual lung volume of 1200 mL

C) Vital capacity of 11 mL/kg D) Oxygen saturation of 97%

Ans: C
Chapter: 64
Client Needs: B
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 2
Page and Header: 1967, Guillain-Barré Syndrome

Feedback: A vital capacity of 12 to 15 mL/kg in a patient with Guillain-Barré syndrome would mean that the patient’s condition has deteriorated to the point that mechanical ventilation may be needed. The tidal volume, residual lung volume, and oxygen saturation are within normal values. Breathing in a Guillain-Barré patient would become increasingly labored as the paralysis ascended towards the intercostals and diaphragm.

5. A patient diagnosed with Bell’s palsy is being cared for on an outpatient basis. An expected nursing intervention for this patient would be what?
A) Applying a protective eye shield
B) Encourage to eat on affected side

C) Avoid analgesics
D) Avoid brushing teeth

Ans: A
Chapter: 64
Client Needs: A-1
Cognitive Level: Application Difficulty: Moderate
Integrated Process: Nursing Process Objective: 4
Page and Header: 1973, Bell’s Palsy

Feedback: Corneal irritation and ulceration may occur if the eye is unprotected. While paralysis lasts, the involved eye must be protected. The patient should be encouraged to eat on the unaffected side, due to swallowing difficulties. Analgesics are used to control the facial pain. The patient should continue to provide self-care including oral hygiene.

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