Chapter 65 Management of Patients With Oncologic or Degenerative Neurologic Disorders

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Chapter 65  Management of Patients With Oncologic or Degenerative Neurologic Disorders

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

Multiple Choice

1. A nurse is assessing a patient with an acoustic neuroma who has been recently admitted to an oncology unit. What symptoms is the nurse likely to find during the assessment?
A) Loss of hearing, tinnitus, and vertigo
B) Loss of vision, change in mental status, and hyperthermia

C) Loss of hearing, increased sodium retention, and hypertension D) Loss of vision, headache, and tachycardia

Ans: A
Chapter: 65
Client Needs: D-4
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process Objective: 2
Page and Header: 1977, Primary Brain Tumors

Feedback: An acoustic neuroma is a tumor of the eighth cranial nerve, the cranial nerve most responsible for hearing and balance. The patient with an acoustic neuroma usually experiences loss of hearing, tinnitus, and episodes of vertigo and staggering gait. Acoustic neuromas do not

cause loss of vision, increased sodium retention, or tachycardia.

2. A 25-year-old female with brain metastases asks the nurse about the length of time she has to live. Based upon the fact that the patient is not receiving treatment for the brain metastases, the nurse’s best response is that patients with this condition generally have a mean survival time of what?

A) 2 weeks B) 1 month C) 6 months D) 1 year

Ans: B
Chapter: 65
Client Needs: D-4
Cognitive Level: Application
Difficulty: Difficult
Integrated Process: Teaching/Learning Objective: 1
Page and Header: 1981, Cerebral Metastases

Feedback: The median survival time for patients with no treatment for brain metastases is 1 month; with corticosteroid treatment alone it is 2 months; radiation therapy extends the median survival to 3 to 6 months. Therefore, options A, C, and D are incorrect.

3. The nurse is writing a care plan for a patient with brain metastases. The nurse decides that an appropriate nursing diagnoses is “Anxiety related to lack of control over the health care needs and situation.” In establishing this plan of care for the patient, the nurse will identify which measure as appropriate for the care of this patient?

A) The patient will receive anti-anxiety medications every 4 hours.
B) The patient’s family will be instructed on measures to implement when providing care for the patient.
C) The patient will be encouraged to verbalize concerns related to the disease and its treatment. D) The patient will begin a busy schedule of therapy, so that he or she will forget about the anxiety.

Ans: C
Chapter: 65
Client Needs: C
Cognitive Level: Application Difficulty: Easy

Integrated Process: Nursing Process Objective: 3
Page and Header: 1983, Cerebral Metastases

Feedback: Patients need the opportunity to exercise some control over their situation. A sense of mastery can be gained as they learn to understand the disease and its treatment and how to deal with their feelings. Distraction, assuming care responsibilities, and administering medications will not allow the patient to gain some control over their situation or discuss their feelings.

4. A patient with suspected Parkinson’s disease is being initially assessed by the nurse. The nurse would expect the patient to have a tremor. When is the best time to assess for the tremor? A) During a period of time when the patient is resting
B) During a period of time when the patient is brushing the teeth

C) During a period of time when the patient is preparing his or her meal tray to eat D) During a period of time when the patient is participating in occupational therapy

Ans: A
Chapter: 65
Client Needs: D-4
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process Objective: 4
Page and Header: 1986, Parkinson’s Disease

Feedback: The tremor is present while the patient is at rest; it increases when the patient is walking, concentrating, or feeling anxious. Resting tremor characteristically disappears with purposeful movement but is evident when the extremities are motionless. Therefore options B, C, and D are incorrect.

5. The clinic nurse caring for a patient with Parkinson’s disease notes that the patient has been taking levodopa and carbidopa (Sinemet) for 7 years. What common side effects of Sinemet would the nurse assesses this patient for?
A) Pruritus

B) Dyskinesia
C) Lactose intolerance D) Diarrhea

Ans: B

Chapter: 65
Client Needs: D-2
Cognitive Level: Analysis
Difficulty: Easy
Integrated Process: Nursing Process Objective: 5
Page and Header: 1988, Parkinson’s Disease

Feedback: Within 5 to 10 years of taking levodopa, most patients develop a response to the medication characterized by dyskinesia (abnormal involuntary movements). Another potential complication of long-term dopaminergic medication use is neuroleptic malignant syndrome characterized by severe rigidity, stupor, and hyperthermia. Side effects of long-term Sinemet therapy are not pruritus, lactose intolerance, or diarrhea.

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