Medical-Surgical Nursing, 13th Edition -
Exam 2 Study Questions latest update
A+ graded
1. A patient with possible bacterial meningitis is admitted to the ICU. What assessment
finding would the nurse expect for a patient with this diagnosis?
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
Feedback:
Clinical manifestations of bacterial meningitis include a 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 education 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 large amounts of fluids - Ans: A
Feedback:
Washing the face should be avoided if possible because this activity can trigger an
attack of pain in a patient with trigeminal neuralgia. Using artificial tears would be an
appropriate behavior. Exposing the skin to sunlight would not be harmful to this patient.
Temperature extremes in beverages should be avoided.
3. The nurse is caring for a patient with multiple sclerosis (MS). The patient tells the
nurse the hardest thing to deal with is the fatigue. When teaching the patient how to
reduce fatigue, what action should the nurse suggest?
A) Taking a hot bath at least once daily
B) Resting in an air-conditioned room whenever possible
C) Increasing the dose of muscle relaxants
D) Avoiding naps during the day - Ans: B
Feedback:
Fatigue is a common symptom of patients with MS. 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 MS include treating depression, using occupational
therapy to learn energy conservation techniques, and reducing spasticity.
4. A patient with Guillain-Barré syndrome has experienced a sharp decline in vital
capacity. What is the nurse's most appropriate action?
A) Administer bronchodilators as ordered.
B) Remind the patient of the importance of deep breathing and coughing exercises.
C) Prepare to assist with intubation.
D) Administer supplementary oxygen by nasal cannula. - Ans: C
Feedback:
For the patient with Guillain-Barré syndrome, mechanical ventilation is required if the
vital capacity falls, making spontaneous breathing impossible and tissue oxygenation
inadequate. Each of the other listed actions is likely insufficient to meet the patient's
oxygenation needs.
5. A patient diagnosed with Bell's palsy is being cared for on an outpatient basis. During
health education, the nurse should promote which of the following actions?
,A) Applying a protective eye shield at night
B) Chewing on the affected side to prevent unilateral neglect
C) Avoiding the use of analgesics whenever possible
D) Avoiding brushing the teeth - Ans: A
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.
6. The nurse is working with a patient who is newly diagnosed with MS. What basic
information should the nurse provide to the patient?
A) MS is a progressive demyelinating disease of the nervous system.
B) MS usually occurs more frequently in men.
C) MS typically has an acute onset.
D) MS is sometimes caused by a bacterial infection. - Ans: A
Feedback:
MS is a chronic, degenerative, progressive disease of the central nervous system,
characterized by the occurrence of small patches of demyelination in the brain and
spinal cord. The cause of MS is not known, and the disease affects twice as many
women as men.
7. The nurse is creating a plan of care for a patient who has a recent diagnosis of MS.
Which of the following should the nurse include in the patient's care plan?
A) Encourage patient to void every hour.
B) Order a low-residue diet.
C) Provide total assistance with all ADLs.
D) Instruct the patient on daily muscle stretching. - Ans: D
Feedback:
A patient diagnosed with MS should be encouraged to increase the fiber in his or her
diet and void 30 minutes after drinking to help train the bladder. The patient should
participate in daily muscle stretching to help alleviate and relax muscle spasms.
8. A patient with metastatic cancer has developed trigeminal neuralgia and is taking
carbamazepine (Tegretol) for pain relief. What principle applies to the administration of
this medication?
, A) Tegretol is not known to have serious adverse effects.
B) The patient should be monitored for bone marrow depression.
C) Side effects of the medication include renal dysfunction.
D) The medication should be first taken in the maximum dosage form to be effective. -
Ans: B
Feedback:
The anticonvulsant agents carbamazepine (Tegretol) and phenytoin (Dilantin) relieve
pain in most patients diagnosed with trigeminal neuralgia by reducing the transmission
of impulses at certain nerve terminals. Side effects include nausea, dizziness,
drowsiness, and aplastic anemia. Carbamazepine should be gradually increased until
pain relief is obtained.
9. A male patient presents to the clinic complaining of a headache. The nurse notes that
the patient is guarding his neck and tells the nurse that he has stiffness in the neck
area. The nurse suspects the patient may have meningitis. What is another well-
recognized sign of this infection?
A) Negative Brudzinski's sign
B) Positive Kernig's sign
C) Hyperpatellar reflex
D) Sluggish pupil reaction - Ans: B
Feedback:
Meningeal irritation results in a number of well-recognized signs commonly seen in
meningitis, such as a positive Kernig's sign, a positive Brudzinski's sign, and
photophobia. Hyperpatellar reflex and a sluggish pupil reaction are not commonly
recognized signs of meningitis.
10. The nurse is developing a plan of care for a patient newly diagnosed with Bell's
palsy. The nurse's plan of care should address what characteristic manifestation of this
disease?
A) Tinnitus
B) Facial paralysis
C) Pain at the base of the tongue
D) Diplopia - Ans: B
Feedback:
Exam 2 Study Questions latest update
A+ graded
1. A patient with possible bacterial meningitis is admitted to the ICU. What assessment
finding would the nurse expect for a patient with this diagnosis?
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
Feedback:
Clinical manifestations of bacterial meningitis include a 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 education 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 large amounts of fluids - Ans: A
Feedback:
Washing the face should be avoided if possible because this activity can trigger an
attack of pain in a patient with trigeminal neuralgia. Using artificial tears would be an
appropriate behavior. Exposing the skin to sunlight would not be harmful to this patient.
Temperature extremes in beverages should be avoided.
3. The nurse is caring for a patient with multiple sclerosis (MS). The patient tells the
nurse the hardest thing to deal with is the fatigue. When teaching the patient how to
reduce fatigue, what action should the nurse suggest?
A) Taking a hot bath at least once daily
B) Resting in an air-conditioned room whenever possible
C) Increasing the dose of muscle relaxants
D) Avoiding naps during the day - Ans: B
Feedback:
Fatigue is a common symptom of patients with MS. 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 MS include treating depression, using occupational
therapy to learn energy conservation techniques, and reducing spasticity.
4. A patient with Guillain-Barré syndrome has experienced a sharp decline in vital
capacity. What is the nurse's most appropriate action?
A) Administer bronchodilators as ordered.
B) Remind the patient of the importance of deep breathing and coughing exercises.
C) Prepare to assist with intubation.
D) Administer supplementary oxygen by nasal cannula. - Ans: C
Feedback:
For the patient with Guillain-Barré syndrome, mechanical ventilation is required if the
vital capacity falls, making spontaneous breathing impossible and tissue oxygenation
inadequate. Each of the other listed actions is likely insufficient to meet the patient's
oxygenation needs.
5. A patient diagnosed with Bell's palsy is being cared for on an outpatient basis. During
health education, the nurse should promote which of the following actions?
,A) Applying a protective eye shield at night
B) Chewing on the affected side to prevent unilateral neglect
C) Avoiding the use of analgesics whenever possible
D) Avoiding brushing the teeth - Ans: A
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.
6. The nurse is working with a patient who is newly diagnosed with MS. What basic
information should the nurse provide to the patient?
A) MS is a progressive demyelinating disease of the nervous system.
B) MS usually occurs more frequently in men.
C) MS typically has an acute onset.
D) MS is sometimes caused by a bacterial infection. - Ans: A
Feedback:
MS is a chronic, degenerative, progressive disease of the central nervous system,
characterized by the occurrence of small patches of demyelination in the brain and
spinal cord. The cause of MS is not known, and the disease affects twice as many
women as men.
7. The nurse is creating a plan of care for a patient who has a recent diagnosis of MS.
Which of the following should the nurse include in the patient's care plan?
A) Encourage patient to void every hour.
B) Order a low-residue diet.
C) Provide total assistance with all ADLs.
D) Instruct the patient on daily muscle stretching. - Ans: D
Feedback:
A patient diagnosed with MS should be encouraged to increase the fiber in his or her
diet and void 30 minutes after drinking to help train the bladder. The patient should
participate in daily muscle stretching to help alleviate and relax muscle spasms.
8. A patient with metastatic cancer has developed trigeminal neuralgia and is taking
carbamazepine (Tegretol) for pain relief. What principle applies to the administration of
this medication?
, A) Tegretol is not known to have serious adverse effects.
B) The patient should be monitored for bone marrow depression.
C) Side effects of the medication include renal dysfunction.
D) The medication should be first taken in the maximum dosage form to be effective. -
Ans: B
Feedback:
The anticonvulsant agents carbamazepine (Tegretol) and phenytoin (Dilantin) relieve
pain in most patients diagnosed with trigeminal neuralgia by reducing the transmission
of impulses at certain nerve terminals. Side effects include nausea, dizziness,
drowsiness, and aplastic anemia. Carbamazepine should be gradually increased until
pain relief is obtained.
9. A male patient presents to the clinic complaining of a headache. The nurse notes that
the patient is guarding his neck and tells the nurse that he has stiffness in the neck
area. The nurse suspects the patient may have meningitis. What is another well-
recognized sign of this infection?
A) Negative Brudzinski's sign
B) Positive Kernig's sign
C) Hyperpatellar reflex
D) Sluggish pupil reaction - Ans: B
Feedback:
Meningeal irritation results in a number of well-recognized signs commonly seen in
meningitis, such as a positive Kernig's sign, a positive Brudzinski's sign, and
photophobia. Hyperpatellar reflex and a sluggish pupil reaction are not commonly
recognized signs of meningitis.
10. The nurse is developing a plan of care for a patient newly diagnosed with Bell's
palsy. The nurse's plan of care should address what characteristic manifestation of this
disease?
A) Tinnitus
B) Facial paralysis
C) Pain at the base of the tongue
D) Diplopia - Ans: B
Feedback:
