Chapter 65-Management of Patients With Oncologic or Degenerative Neurologic Disorders

Chapter 65-Management of Patients With Oncologic or Degenerative Neurologic Disorders Brunner: Medical-Surgical Nursing, 11th Edition Test Bank Chapter 65: Management of Patients With Oncologic or Degenerative Neurologic Disorders Multiple Choice 1. The nurse is likely to expect to find which of the following symptoms upon assessment of a patient with an acoustic neuroma who has been admitted to the oncology unit? 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 Cognitive Level: Application Difficulty: Moderate Integrated Process: Nursing Process Objective: 2 Patient Needs: D-4 Feedback: An acoustic neuroma is a tumor of cranial nerve VIII, 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. 2. The family of a patient with brain metastases who is not receiving treatment questions the nurse about the length of time the patient has to live. The nurse's best response is that patients with this condition generally have a mean survival time of: A) 2 weeks B) 1 month C) 6 months D) 1 year Ans: B Chapter: 65 Cognitive Level: Application Difficulty: Difficult Integrated Process: Teaching/Learning Objective: 1 Patient Needs: D-4 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. 3. The nurse has determined that an appropriate nursing diagnosis for a patient with a brain tumor is anxiety related to lack of control over the health care needs and situation. The nurse will identify which measure as appropriate for the plan of care of this patient? A) The patient will receive antianxiety 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 will forget about the anxiety. Ans: C Chapter: 65 Cognitive Level: Application Difficulty: Easy Integrated Process: Nursing Process Objective: 3 Patient Needs: C-1 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 do not allow the patient to gain control over his situation or discuss his feelings. 4. A patient with a suspected spinal cord tumor is undergoing diagnostic testing for loss of motor function and sensation possibly related to compression of the spinal cord. In preparation for diagnostic studies, the nurse will inform the patient that the most commonly used study to diagnose spinal cord compression from a tumor is a(n): A) X-ray B) Ultrasound C) CT scan D) MRI scan Ans: D Chapter: 65 Cognitive Level: Application Difficulty: Moderate Integrated Process: Teaching/Learning Objective: 2 Patient Needs: D-4 Feedback: The MRI scan is the most commonly used, most sensitive diagnostic tool that is particularly helpful in detecting epidural spinal cord compression and vertebral bone metastases. 5. A patient has returned to the unit after surgery for a tumor within the spine. When positioning the patient for comfort and to reduce injury to the surgical site, the nurse will position the patient in which of the following positions? A) Lithotomy position B) Flat side-lying position C) Trendelenburg position D) Reverse Trendelenburg position Ans: B Chapter: 65 Cognitive Level: Application Difficulty: Moderate Integrated Process: Nursing Process Objective: 2 Patient Needs: D-3 Feedback: After spinal surgery, the bed is kept flat initially. The side-lying position is usually the most comfortable because it puts the least pressure on the surgical site.