MDC 4 NUR2755 FINAL EXAM: Complete Medical-Surgical Nursing
Review (Latest 2026/2027 Update) | Q&A | Grade A | 100% Correct
(Verified Answers) – Nursing Program
Subject: MDC 4 – Alzheimer's Disease, Parkinson's, Migraines, Multiple Sclerosis, Meningitis,
Seizures, Stroke, ICP, Guillain-Barré, Myasthenia Gravis, Burns, Shock, ARDS, PE,
Pneumothorax, Ventilators, Post-Op Care
Source: NUR2755 Final Exam / Medical-Surgical Nursing / NCLEX Blueprint
Format: Q&A Guide with Clinical Rationale | 100% Verified
1: What are the clinical manifestations of mild-stage Alzheimer's disease?
Correct Answer: Forgets names; misplaces household items; short-term memory loss; difficulty
recalling new information; subtle changes in personality and behavior.
1. Early AD: recent memory loss, difficulty learning new information.
2. Personality changes subtle; patient may still function independently.
2: What are the clinical manifestations of moderate-stage Alzheimer's disease?
Correct Answer: Disoriented to time, place, and event; difficulty driving; gets lost; incontinent;
psychotic behaviors (delusions, hallucinations, paranoia); wandering; trouble sleeping.
1. Moderate AD: requires assistance with ADLs; behavioral symptoms emerge.
2. Safety concerns: wandering, unable to drive, risk of getting lost.
3: What are the clinical manifestations of late-stage Alzheimer's disease?
Correct Answer: Totally incapacitated; bedridden; totally dependent in ADLs; agnosia; hallucinations;
incontinence; difficulty eating.
1. Late AD: complete dependence, loss of verbal skills, swallowing difficulties.
2. Risk of aspiration pneumonia and infection.
4: What is apraxia?
Correct Answer: Difficulty with motor planning to perform tasks or movements.
1. Apraxia = inability to perform learned movements despite intact motor function.
2. Example: unable to wave goodbye or use a fork.
5: What is aphasia?
Correct Answer: Inability to speak or understand language.
1. Expressive aphasia (Broca's) = difficulty producing speech.
2. Receptive aphasia (Wernicke's) = difficulty understanding speech.
6: What is anomia?
Correct Answer: Inability to recall the names of everyday objects.
1. Anomia is a type of aphasia; word-finding difficulty.
2. Patient may say "thing" instead of "pen."
,7: What is agnosia?
Correct Answer: Loss of sensory comprehension, including facial recognition.
1. Visual agnosia: cannot recognize familiar faces (prosopagnosia).
2. Sensory information intact but cannot interpret meaning.
8: How is Alzheimer's disease diagnosed?
Correct Answer: No laboratory test can confirm AD. Definitive diagnosis is made on brain tissue
examination at autopsy, confirming neurofibrillary tangles and neuritic plaques.
1. Clinical diagnosis based on history, cognitive tests, and ruling out other causes.
2. Biomarkers (CSF, PET) support diagnosis but not definitive.
9: What medications are used for Alzheimer's disease?
Correct Answer: Cholinesterase inhibitors (Donepezil, galantamine) and NMDA receptor antagonists
(Memantine).
1. Cholinesterase inhibitors increase acetylcholine levels.
2. Memantine regulates glutamate activity; used in moderate-severe AD.
10: What are the clinical manifestations of Parkinson's disease?
Correct Answer: Slow, shuffling, propulsive gait; resting tremors; muscle rigidity;
bradykinesia/akinesia; mask-like face; drooling; postural instability.
1. TRAP: Tremor (resting), Rigidity, Akinesia/Bradykinesia, Postural instability.
2. Progresses over years; affects quality of life.
11: How is Parkinson's disease diagnosed?
Correct Answer: Diagnosis typically based on manifestations, progression, and ruling out other
disease. Analysis of CSF may show decreased dopamine levels.
1. No definitive diagnostic test; clinical diagnosis.
2. Response to levodopa supports diagnosis.
12: What is the primary medication for Parkinson's disease?
Correct Answer: Carbidopa/Levodopa (Sinemet)
1. Levodopa is dopamine precursor that crosses blood-brain barrier.
2. Carbidopa prevents peripheral breakdown, reducing side effects.
13: What are common migraine triggers?
Correct Answer: Caffeine, red wine, MSG, foods high in tyramine (aged cheeses, yogurt).
1. Triggers vary among individuals; headache diary helps identify.
2. Other triggers: stress, hormonal changes, weather changes.
14: What are abortive therapies for migraines?
Correct Answer: Acetaminophen, ibuprofen, naproxen, triptans, ergotamine derivatives.
1. Triptans (sumatriptan) are first-line for moderate-severe migraine.
2. Ergotamines used for prolonged migraines.
, 15: What are preventive therapies for migraines?
Correct Answer: Beta blockers, calcium channel blockers, antiepileptics, Botox.
1. Propranolol, topiramate, amitriptyline commonly used for prevention.
2. Botox approved for chronic migraines (≥15 days/month).
16: What are symptoms of migraine aura?
Correct Answer: Visual disturbances (flashing lights/lines/spots), numbness of lips/tongue, acute
confused state, aphasia, vertigo, unilateral weakness, offensive smell, "deja vu" feeling.
1. Aura occurs before or during migraine headache.
2. Typically resolves within 60 minutes.
17: What are clinical manifestations of multiple sclerosis (MS)?
Correct Answer: Muscle weakness and spasticity; intention tremors; diplopia; nystagmus;
depression/labile mood.
1. MS symptoms vary based on lesion location in CNS.
2. Common triad: optic neuritis, sensory deficits, motor weakness.
18: How is multiple sclerosis diagnosed?
Correct Answer: MRI of the brain and spinal cord demonstrates plaques in at least 2 areas
(dissemination in space and time).
1. McDonald criteria require evidence of lesions separated in space and time.
2. CSF analysis may show oligoclonal bands.
19: What are clinical manifestations of meningitis?
Correct Answer: Nuchal rigidity (neck stiffness), Kernig sign, Brudzinski sign, decreased level of
consciousness, photosensitivity.
1. Classic triad: fever, neck stiffness, altered mental status.
2. Kernig: resistance/pain with knee extension; Brudzinski: hip/knee flexion with neck flexion.
20: What is Kernig sign?
Correct Answer: Resistance and pain with extension of the client's leg from a flexed position.
1. Indicates meningeal irritation.
2. Positive in meningitis.
21: What is Brudzinski sign?
Correct Answer: Flexion of the knees and hips occurring with deliberate flexion of the client's neck.
1. Involuntary flexion of hips/knees when neck is flexed.
2. Positive indicates meningeal irritation.
22: How is meningitis diagnosed?
Correct Answer: Lumbar puncture. Appearance of CSF: cloudy (bacterial) or clear (viral).
1. Bacterial meningitis: elevated WBC, elevated protein, low glucose.
2. CSF culture identifies specific organism.
Review (Latest 2026/2027 Update) | Q&A | Grade A | 100% Correct
(Verified Answers) – Nursing Program
Subject: MDC 4 – Alzheimer's Disease, Parkinson's, Migraines, Multiple Sclerosis, Meningitis,
Seizures, Stroke, ICP, Guillain-Barré, Myasthenia Gravis, Burns, Shock, ARDS, PE,
Pneumothorax, Ventilators, Post-Op Care
Source: NUR2755 Final Exam / Medical-Surgical Nursing / NCLEX Blueprint
Format: Q&A Guide with Clinical Rationale | 100% Verified
1: What are the clinical manifestations of mild-stage Alzheimer's disease?
Correct Answer: Forgets names; misplaces household items; short-term memory loss; difficulty
recalling new information; subtle changes in personality and behavior.
1. Early AD: recent memory loss, difficulty learning new information.
2. Personality changes subtle; patient may still function independently.
2: What are the clinical manifestations of moderate-stage Alzheimer's disease?
Correct Answer: Disoriented to time, place, and event; difficulty driving; gets lost; incontinent;
psychotic behaviors (delusions, hallucinations, paranoia); wandering; trouble sleeping.
1. Moderate AD: requires assistance with ADLs; behavioral symptoms emerge.
2. Safety concerns: wandering, unable to drive, risk of getting lost.
3: What are the clinical manifestations of late-stage Alzheimer's disease?
Correct Answer: Totally incapacitated; bedridden; totally dependent in ADLs; agnosia; hallucinations;
incontinence; difficulty eating.
1. Late AD: complete dependence, loss of verbal skills, swallowing difficulties.
2. Risk of aspiration pneumonia and infection.
4: What is apraxia?
Correct Answer: Difficulty with motor planning to perform tasks or movements.
1. Apraxia = inability to perform learned movements despite intact motor function.
2. Example: unable to wave goodbye or use a fork.
5: What is aphasia?
Correct Answer: Inability to speak or understand language.
1. Expressive aphasia (Broca's) = difficulty producing speech.
2. Receptive aphasia (Wernicke's) = difficulty understanding speech.
6: What is anomia?
Correct Answer: Inability to recall the names of everyday objects.
1. Anomia is a type of aphasia; word-finding difficulty.
2. Patient may say "thing" instead of "pen."
,7: What is agnosia?
Correct Answer: Loss of sensory comprehension, including facial recognition.
1. Visual agnosia: cannot recognize familiar faces (prosopagnosia).
2. Sensory information intact but cannot interpret meaning.
8: How is Alzheimer's disease diagnosed?
Correct Answer: No laboratory test can confirm AD. Definitive diagnosis is made on brain tissue
examination at autopsy, confirming neurofibrillary tangles and neuritic plaques.
1. Clinical diagnosis based on history, cognitive tests, and ruling out other causes.
2. Biomarkers (CSF, PET) support diagnosis but not definitive.
9: What medications are used for Alzheimer's disease?
Correct Answer: Cholinesterase inhibitors (Donepezil, galantamine) and NMDA receptor antagonists
(Memantine).
1. Cholinesterase inhibitors increase acetylcholine levels.
2. Memantine regulates glutamate activity; used in moderate-severe AD.
10: What are the clinical manifestations of Parkinson's disease?
Correct Answer: Slow, shuffling, propulsive gait; resting tremors; muscle rigidity;
bradykinesia/akinesia; mask-like face; drooling; postural instability.
1. TRAP: Tremor (resting), Rigidity, Akinesia/Bradykinesia, Postural instability.
2. Progresses over years; affects quality of life.
11: How is Parkinson's disease diagnosed?
Correct Answer: Diagnosis typically based on manifestations, progression, and ruling out other
disease. Analysis of CSF may show decreased dopamine levels.
1. No definitive diagnostic test; clinical diagnosis.
2. Response to levodopa supports diagnosis.
12: What is the primary medication for Parkinson's disease?
Correct Answer: Carbidopa/Levodopa (Sinemet)
1. Levodopa is dopamine precursor that crosses blood-brain barrier.
2. Carbidopa prevents peripheral breakdown, reducing side effects.
13: What are common migraine triggers?
Correct Answer: Caffeine, red wine, MSG, foods high in tyramine (aged cheeses, yogurt).
1. Triggers vary among individuals; headache diary helps identify.
2. Other triggers: stress, hormonal changes, weather changes.
14: What are abortive therapies for migraines?
Correct Answer: Acetaminophen, ibuprofen, naproxen, triptans, ergotamine derivatives.
1. Triptans (sumatriptan) are first-line for moderate-severe migraine.
2. Ergotamines used for prolonged migraines.
, 15: What are preventive therapies for migraines?
Correct Answer: Beta blockers, calcium channel blockers, antiepileptics, Botox.
1. Propranolol, topiramate, amitriptyline commonly used for prevention.
2. Botox approved for chronic migraines (≥15 days/month).
16: What are symptoms of migraine aura?
Correct Answer: Visual disturbances (flashing lights/lines/spots), numbness of lips/tongue, acute
confused state, aphasia, vertigo, unilateral weakness, offensive smell, "deja vu" feeling.
1. Aura occurs before or during migraine headache.
2. Typically resolves within 60 minutes.
17: What are clinical manifestations of multiple sclerosis (MS)?
Correct Answer: Muscle weakness and spasticity; intention tremors; diplopia; nystagmus;
depression/labile mood.
1. MS symptoms vary based on lesion location in CNS.
2. Common triad: optic neuritis, sensory deficits, motor weakness.
18: How is multiple sclerosis diagnosed?
Correct Answer: MRI of the brain and spinal cord demonstrates plaques in at least 2 areas
(dissemination in space and time).
1. McDonald criteria require evidence of lesions separated in space and time.
2. CSF analysis may show oligoclonal bands.
19: What are clinical manifestations of meningitis?
Correct Answer: Nuchal rigidity (neck stiffness), Kernig sign, Brudzinski sign, decreased level of
consciousness, photosensitivity.
1. Classic triad: fever, neck stiffness, altered mental status.
2. Kernig: resistance/pain with knee extension; Brudzinski: hip/knee flexion with neck flexion.
20: What is Kernig sign?
Correct Answer: Resistance and pain with extension of the client's leg from a flexed position.
1. Indicates meningeal irritation.
2. Positive in meningitis.
21: What is Brudzinski sign?
Correct Answer: Flexion of the knees and hips occurring with deliberate flexion of the client's neck.
1. Involuntary flexion of hips/knees when neck is flexed.
2. Positive indicates meningeal irritation.
22: How is meningitis diagnosed?
Correct Answer: Lumbar puncture. Appearance of CSF: cloudy (bacterial) or clear (viral).
1. Bacterial meningitis: elevated WBC, elevated protein, low glucose.
2. CSF culture identifies specific organism.
