NURS MISC EXAM 4 QUESTIONS WITH ANSWERS CARE OF
PATIENTS WITH PROBLEMS OF THE CNS 2023 A+
CM4 Exam 4
Chapter 42: Care of Patients with Problems of the CNS: The Brain
1. A nurse is teaching a client who experiences migraine headaches and is prescribed a beta
blocker. Which statement should the nurse include in this clients teaching?
a. Take this drug only when you have prodromal symptoms indicating the onset of a migraine headache.
b. Take this drug as ordered, even when feeling well, to prevent vascular changes associated
with migraine headaches.
c. This drug will relieve the pain during the aura phase soon after a headache has started.
d. This medication will have no effect on your heart rate or blood pressure because you are taking it
for migraines.
Beta blockers are prescribed as prophylactic treatment to prevent the vascular changes that initiate
migraine headaches. Heart rate and blood pressure will also be affected, and the client should monitor
these side effects. The other responses do not discuss appropriate uses of the medication.
*2. A nurse assesses a client who has a history of migraines. Which clinical manifestation should the nurse
identify as an early sign of a migraine with aura?
a. Vertigo
b. Lethargy
c. Visual disturbances
d. Numbness of the tongue
Early warning of impending migraine with aura usually consists of visual changes, flashing lights, or
diplopia. The other manifestations are not associated with an impending migraine with aura.
*3. A nurse obtains a health history on a client prior to administering prescribed sumatriptan succinate
(Imitrex) for migraine headaches. Which condition should alert the nurse to hold the medication and
contact the health care provider?
a. Bronchial asthma
b. Prinzmetals angina
c. Diabetes mellitus
d. Chronic kidney disease
Sumatriptan succinate effectively reduces pain and other associated symptoms of migraine headache by
binding to serotonin receptors and triggering cranial vasoconstriction. Vasoconstrictive effects are not
confined to the cranium and can cause coronary vasospasm in clients with Prinzmetals angina. The other
conditions would not affect the clients treatment.
, NURS MISC EXAM 4 QUESTIONS WITH ANSWERS CARE OF
PATIENTS WITH PROBLEMS OF THE CNS 2023 A+
*4. A nurse assesses a client with a history of epilepsy who experiences stiffening of the muscles of the
arms and legs, followed by an immediate loss of consciousness and jerking of all extremities. How should
the nurse document this activity?
a. Atonic seizure
b. Tonic-clonic seizure
c. Myoclonic seizure
d. Absence seizure
Seizure activity that begins with stiffening of the arms and legs, followed by loss of consciousness and
jerking of all extremities, is characteristic of a tonic-clonic seizure. An atonic seizure presents as a sudden
loss of muscle tone followed by postictal confusion. A myoclonic seizure presents with a brief jerking or
stiffening of extremities that may occur singly or in groups. Absence seizures present with automatisms,
and the client is unaware of his or her environment.
*5. A nurse witnesses a client begin to experience a tonic-clonic seizure and loss of consciousness. Which
action should the nurse take?
a. Start fluids via a large-bore catheter.
b. Turn the clients head to the side.
c. Administer IV push diazepam.
d. Prepare to intubate the client.
The nurse should turn the clients head to the side to prevent aspiration and allow drainage of secretions.
Anticonvulsants are administered on a routine basis if a seizure is sustained. If the seizure is sustained
(status epilepticus), the client must be intubated and should be administered oxygen, 0.9% sodium
chloride, and IV push lorazepam or diazepam.
*6. A nurse cares for a client who is experiencing status epilepticus. Which prescribed medication should
the nurse prepare to administer?
a. Atenolol (Tenormin)
b. Lorazepam (Ativan)
c. Phenytoin (Dilantin)
d. Lisinopril (Prinivil)
Initially, intravenous lorazepam is administered to stop motor movements. This is followed by the
administration of phenytoin. Atenolol, a beta blocker, and lisinopril, an angiotensin-converting enzyme
inhibitor, are not administered for seizure activity. These medications are typically administered for
hypertension and heart failure.
*7. After teaching a client who is diagnosed with new-onset status epilepticus and prescribed phenytoin
(Dilantin), the nurse assesses the clients understanding. Which statement by the client indicates a correct
, NURS MISC EXAM 4 QUESTIONS WITH ANSWERS CARE OF
PATIENTS WITH PROBLEMS OF THE CNS 2023 A+
understanding of the teaching?
a. To prevent complications, I will drink at least 2 liters of water daily.
b. This medication will stop me from getting an aura before a seizure.
c. I will not drive a motor vehicle while taking this medication.
d. Even when my seizures stop, I will continue to take this drug.
Discontinuing antiepileptic drugs can lead to the recurrence of seizures or status epilepticus. The
client does not need to drink more water and can drive while taking this medication. The medication
will not stop an aura before a seizure.
*8. After teaching a client newly diagnosed with epilepsy, the nurse assesses the clients
understanding. Which statement by the client indicates a need for additional teaching?
a. I will wear my medical alert bracelet at all times.
b. While taking my epilepsy medications, I will not drink any alcoholic beverages.
c. I will tell my doctor about my prescription and over-the-counter medications.
d. If I am nauseated, I will not take my epilepsy medication.
The nurse must emphasize that antiepileptic drugs must be taken even if the client is nauseous.
Discontinuing the medication can predispose the client to seizure activity and status epilepticus. The
client should not drink alcohol while taking seizure medications. The client should wear a medical alert
bracelet and should make the doctor aware of all medications to prevent complications of polypharmacy.
*9. A nurse obtains a focused health history for a client who is suspected of having bacterial meningitis.
Which question should the nurse ask?
a. Do you live in a crowded residence?
b. When was your last tetanus vaccination?
c. Have you had any viral infections recently?
d. Have you traveled out of the country in the last month?
Meningococcal meningitis tends to occur in multiple outbreaks. It is most likely to occur in areas of high-
density population, such as college dormitories, prisons, and military barracks. A tetanus vaccination
would not place the client at increased risk for meningitis or protect the client from meningitis. A viral
infection would not lead to bacterial meningitis but could lead to viral meningitis. Simply knowing if the
client traveled out of the country does not provide enough information. The nurse should ask about travel
to specific countries in which the disease is common, for example, sub-Saharan Africa.
*10. After teaching the wife of a client who has Parkinson disease, the nurse assesses the wifes
understanding. Which statement by the clients wife indicates she correctly understands changes
associated with this disease?
a. His masklike face makes it difficult to communicate, so I will use a white board.
, NURS MISC EXAM 4 QUESTIONS WITH ANSWERS CARE OF
PATIENTS WITH PROBLEMS OF THE CNS 2023 A+
b. He should not socialize outside of the house due to uncontrollable drooling.
c. This disease is associated with anxiety causing increased perspiration.
d. He may have trouble chewing, so I will offer bite-sized portions.
Because chewing and swallowing can be problematic, small frequent meals and a supplement are better
for meeting the clients nutritional needs. A masklike face and drooling are common in clients with
Parkinson disease. The client should be encouraged to continue to socialize and communicate as
normally as possible. The wife should understand that the clients masklike face can be misinterpreted
and additional time may be needed for the client to communicate with her or others. Excessive
perspiration is also common in clients with Parkinson disease and is associated with the autonomic
nervous systems response.
*11. A nurse plans care for a client with Parkinson disease. Which intervention should the nurse include
in this clients plan of care?
a. Ambulate the client in the hallway twice a day.
b. Ensure a fluid intake of at least 3 liters per day.
c. Teach the client pursed-lip breathing techniques.
d. Keep the head of the bed at 30 degrees or greater.
Elevation of the head of the bed will help prevent aspiration. The other options will not prevent
aspiration, which is the greatest respiratory complication of Parkinson disease, nor do these
interventions address any of the complications of Parkinson disease. Ambulation in the hallway is
usually implemented to prevent venous thrombosis. Increased fluid intake flushes out toxins from the
clients blood. Pursed-lip breathing increases exhalation of carbon dioxide.
12. A nurse is teaching the daughter of a client who has Alzheimers disease. The daughter asks, Will
the medication my mother is taking improve her dementia? How should the nurse respond?
a. It will allow your mother to live independently for several more years.
b. It is used to halt the advancement of Alzheimers disease but will not cure it.
c. It will not improve her dementia but can help control emotional responses.
d. It is used to improve short-term memory but will not improve problem solving.
Drug therapy is not effective for treating dementia or halting the advancement of Alzheimers disease.
However, certain drugs may help suppress emotional disturbances and psychiatric manifestations.
Medication therapy may not allow the client to safely live independently.
13. A nurse assesses a client with Alzheimers disease who is recently admitted to the hospital.
Which psychosocial assessment should the nurse complete?
a. Assess religious and spiritual needs while in the hospital.
b. Identify the clients ability to perform self-care activities.
PATIENTS WITH PROBLEMS OF THE CNS 2023 A+
CM4 Exam 4
Chapter 42: Care of Patients with Problems of the CNS: The Brain
1. A nurse is teaching a client who experiences migraine headaches and is prescribed a beta
blocker. Which statement should the nurse include in this clients teaching?
a. Take this drug only when you have prodromal symptoms indicating the onset of a migraine headache.
b. Take this drug as ordered, even when feeling well, to prevent vascular changes associated
with migraine headaches.
c. This drug will relieve the pain during the aura phase soon after a headache has started.
d. This medication will have no effect on your heart rate or blood pressure because you are taking it
for migraines.
Beta blockers are prescribed as prophylactic treatment to prevent the vascular changes that initiate
migraine headaches. Heart rate and blood pressure will also be affected, and the client should monitor
these side effects. The other responses do not discuss appropriate uses of the medication.
*2. A nurse assesses a client who has a history of migraines. Which clinical manifestation should the nurse
identify as an early sign of a migraine with aura?
a. Vertigo
b. Lethargy
c. Visual disturbances
d. Numbness of the tongue
Early warning of impending migraine with aura usually consists of visual changes, flashing lights, or
diplopia. The other manifestations are not associated with an impending migraine with aura.
*3. A nurse obtains a health history on a client prior to administering prescribed sumatriptan succinate
(Imitrex) for migraine headaches. Which condition should alert the nurse to hold the medication and
contact the health care provider?
a. Bronchial asthma
b. Prinzmetals angina
c. Diabetes mellitus
d. Chronic kidney disease
Sumatriptan succinate effectively reduces pain and other associated symptoms of migraine headache by
binding to serotonin receptors and triggering cranial vasoconstriction. Vasoconstrictive effects are not
confined to the cranium and can cause coronary vasospasm in clients with Prinzmetals angina. The other
conditions would not affect the clients treatment.
, NURS MISC EXAM 4 QUESTIONS WITH ANSWERS CARE OF
PATIENTS WITH PROBLEMS OF THE CNS 2023 A+
*4. A nurse assesses a client with a history of epilepsy who experiences stiffening of the muscles of the
arms and legs, followed by an immediate loss of consciousness and jerking of all extremities. How should
the nurse document this activity?
a. Atonic seizure
b. Tonic-clonic seizure
c. Myoclonic seizure
d. Absence seizure
Seizure activity that begins with stiffening of the arms and legs, followed by loss of consciousness and
jerking of all extremities, is characteristic of a tonic-clonic seizure. An atonic seizure presents as a sudden
loss of muscle tone followed by postictal confusion. A myoclonic seizure presents with a brief jerking or
stiffening of extremities that may occur singly or in groups. Absence seizures present with automatisms,
and the client is unaware of his or her environment.
*5. A nurse witnesses a client begin to experience a tonic-clonic seizure and loss of consciousness. Which
action should the nurse take?
a. Start fluids via a large-bore catheter.
b. Turn the clients head to the side.
c. Administer IV push diazepam.
d. Prepare to intubate the client.
The nurse should turn the clients head to the side to prevent aspiration and allow drainage of secretions.
Anticonvulsants are administered on a routine basis if a seizure is sustained. If the seizure is sustained
(status epilepticus), the client must be intubated and should be administered oxygen, 0.9% sodium
chloride, and IV push lorazepam or diazepam.
*6. A nurse cares for a client who is experiencing status epilepticus. Which prescribed medication should
the nurse prepare to administer?
a. Atenolol (Tenormin)
b. Lorazepam (Ativan)
c. Phenytoin (Dilantin)
d. Lisinopril (Prinivil)
Initially, intravenous lorazepam is administered to stop motor movements. This is followed by the
administration of phenytoin. Atenolol, a beta blocker, and lisinopril, an angiotensin-converting enzyme
inhibitor, are not administered for seizure activity. These medications are typically administered for
hypertension and heart failure.
*7. After teaching a client who is diagnosed with new-onset status epilepticus and prescribed phenytoin
(Dilantin), the nurse assesses the clients understanding. Which statement by the client indicates a correct
, NURS MISC EXAM 4 QUESTIONS WITH ANSWERS CARE OF
PATIENTS WITH PROBLEMS OF THE CNS 2023 A+
understanding of the teaching?
a. To prevent complications, I will drink at least 2 liters of water daily.
b. This medication will stop me from getting an aura before a seizure.
c. I will not drive a motor vehicle while taking this medication.
d. Even when my seizures stop, I will continue to take this drug.
Discontinuing antiepileptic drugs can lead to the recurrence of seizures or status epilepticus. The
client does not need to drink more water and can drive while taking this medication. The medication
will not stop an aura before a seizure.
*8. After teaching a client newly diagnosed with epilepsy, the nurse assesses the clients
understanding. Which statement by the client indicates a need for additional teaching?
a. I will wear my medical alert bracelet at all times.
b. While taking my epilepsy medications, I will not drink any alcoholic beverages.
c. I will tell my doctor about my prescription and over-the-counter medications.
d. If I am nauseated, I will not take my epilepsy medication.
The nurse must emphasize that antiepileptic drugs must be taken even if the client is nauseous.
Discontinuing the medication can predispose the client to seizure activity and status epilepticus. The
client should not drink alcohol while taking seizure medications. The client should wear a medical alert
bracelet and should make the doctor aware of all medications to prevent complications of polypharmacy.
*9. A nurse obtains a focused health history for a client who is suspected of having bacterial meningitis.
Which question should the nurse ask?
a. Do you live in a crowded residence?
b. When was your last tetanus vaccination?
c. Have you had any viral infections recently?
d. Have you traveled out of the country in the last month?
Meningococcal meningitis tends to occur in multiple outbreaks. It is most likely to occur in areas of high-
density population, such as college dormitories, prisons, and military barracks. A tetanus vaccination
would not place the client at increased risk for meningitis or protect the client from meningitis. A viral
infection would not lead to bacterial meningitis but could lead to viral meningitis. Simply knowing if the
client traveled out of the country does not provide enough information. The nurse should ask about travel
to specific countries in which the disease is common, for example, sub-Saharan Africa.
*10. After teaching the wife of a client who has Parkinson disease, the nurse assesses the wifes
understanding. Which statement by the clients wife indicates she correctly understands changes
associated with this disease?
a. His masklike face makes it difficult to communicate, so I will use a white board.
, NURS MISC EXAM 4 QUESTIONS WITH ANSWERS CARE OF
PATIENTS WITH PROBLEMS OF THE CNS 2023 A+
b. He should not socialize outside of the house due to uncontrollable drooling.
c. This disease is associated with anxiety causing increased perspiration.
d. He may have trouble chewing, so I will offer bite-sized portions.
Because chewing and swallowing can be problematic, small frequent meals and a supplement are better
for meeting the clients nutritional needs. A masklike face and drooling are common in clients with
Parkinson disease. The client should be encouraged to continue to socialize and communicate as
normally as possible. The wife should understand that the clients masklike face can be misinterpreted
and additional time may be needed for the client to communicate with her or others. Excessive
perspiration is also common in clients with Parkinson disease and is associated with the autonomic
nervous systems response.
*11. A nurse plans care for a client with Parkinson disease. Which intervention should the nurse include
in this clients plan of care?
a. Ambulate the client in the hallway twice a day.
b. Ensure a fluid intake of at least 3 liters per day.
c. Teach the client pursed-lip breathing techniques.
d. Keep the head of the bed at 30 degrees or greater.
Elevation of the head of the bed will help prevent aspiration. The other options will not prevent
aspiration, which is the greatest respiratory complication of Parkinson disease, nor do these
interventions address any of the complications of Parkinson disease. Ambulation in the hallway is
usually implemented to prevent venous thrombosis. Increased fluid intake flushes out toxins from the
clients blood. Pursed-lip breathing increases exhalation of carbon dioxide.
12. A nurse is teaching the daughter of a client who has Alzheimers disease. The daughter asks, Will
the medication my mother is taking improve her dementia? How should the nurse respond?
a. It will allow your mother to live independently for several more years.
b. It is used to halt the advancement of Alzheimers disease but will not cure it.
c. It will not improve her dementia but can help control emotional responses.
d. It is used to improve short-term memory but will not improve problem solving.
Drug therapy is not effective for treating dementia or halting the advancement of Alzheimers disease.
However, certain drugs may help suppress emotional disturbances and psychiatric manifestations.
Medication therapy may not allow the client to safely live independently.
13. A nurse assesses a client with Alzheimers disease who is recently admitted to the hospital.
Which psychosocial assessment should the nurse complete?
a. Assess religious and spiritual needs while in the hospital.
b. Identify the clients ability to perform self-care activities.
