Exam 3) NUR 426 Test 3: Questions & Answers
A patient with a history of cluster headaches is planning to travel overseas by air. What advice should the
nurse give to this patient to decrease the likelihood of such attacks during air travel?
1 Do not travel by air.
2 Avoid eating chocolate while in flight.
3 Take ergotamine before the flight takes off.
4 Massage the neck and apply moist hot packs while in flight. - ANSWER:3
Cluster headache attacks may occur at high altitudes with low oxygen levels during air travel.
Ergotamine, taken before the plane takes off, may decrease the likelihood of these attacks. Patients with
cluster headaches can travel by air with precautions to avoid the headaches. Consumption of food items
including chocolate, cheese, or tomatoes is not related to cluster headaches, but it may trigger migraine
headaches. Massaging and applying moist hot packs to the neck and head can help a patient with
tension-type headaches, but it may not help relieve cluster headaches
A patient is prescribed carbamazepine (Tegretol) for a new onset seizure disorder. The nurse is educating
the patient about this drug. What teaching comment by the nurse is most accurate?
1 This medication is given to treat absence and myloclonic seizures.
2
Don't be concerned if any visual disturbances occur while taking this medication.
3
Do not take this medication with grapefruit.
4
The goal of this medication is to cure your condition and prevent any more seizures. - ANSWER:3
Grapefruit inhibits the activity of the gastrointestinal enzyme that breaks down this medication so that
more of the drug is in the body, and sometimes dangerously high amounts can enter the blood stream.
Tegretol is given to treat generalized tonic-clonic and partial seizures. Patients are instructed to report
any type of visual abnormalities. Antiseizure drugs do not cure the condition but help to prevent seizures
with a minimum of side effects.
A 50-year-old male patient has been diagnosed with amyotrophic lateral sclerosis (ALS). What nursing
intervention is most important to help prevent a common cause of death for patients with ALS?
1 Reduce fat intake
,2
Reduce the risk of aspiration
3
Decrease injury related to falls
4
Decrease pain secondary to muscle weakness - ANSWER:2
Reducing the risk of aspiration can help prevent respiratory infections that are a common cause of death
from deteriorating muscle function. Reducing fat intake may reduce cardiovascular disease, but this is
not a common cause of death for patients with ALS. Decreasing injury related to falls and decreasing
pain secondary to muscle weakness are important nursing interventions for patients with ALS, but are
unrelated to causes of death for these patients.
Which criterion is included to establish that a patient has Parkinson's disease? Select all that apply.
1
Decreased serum dopamine levels.
2
Tumor present in the thymus gland.
3
Magnetic resonance imaging (MRI) shows areas of plaque on cranial nerves.
4
Presence of two of the three classic features: rigidity, bradykinesia, and tremor.
5
Positive response to antiparkinsonian medications. - ANSWER:4 & 5
Presently there is no specific test to diagnose Parkinson's disease. Diagnosis is made when the patient
demonstrates two of the three classic signs: rigidity (increased resistance to passive motion as a
cogwheel); bradykinesia (slowed and loss of automatic coordinated movement); and tremor (a tremor
that is more severe at rest and pill-rolling hand tremor). The diagnosis is confirmed with positive
response to medications used to treat the disease such as carbidopa/levodopa (Sinemet). Parkinson's
disease is caused by decreased dopamine levels in the brain and is not measured in the serum. Tumors
of the thymus gland are associated with myasthenia gravis. Areas of plaque are seen on MRI of patients
with multiple sclerosis
When performing a physical assessment of a patient with myasthenia gravis, what are the manifestations
that the nurse is likely to find? Select all that apply.
, 1
Muscle atrophy
2
Abnormal reflexes
3
Impaired facial mobility
4
Difficulty in swallowing food
5
Voice fading after a long conversation - ANSWER:3, 4, & 5
Myasthenia gravis is characterized by a fluctuating weakness of skeletal muscles. The patient may have
impaired facial mobility and expressions. Chewing and swallowing food may become difficult. Speech
may be affected, and the voice fades after a long conversation. Apart from this muscle weakness, there is
no other dysfunction such as muscle atrophy or abnormal reflexes.
A patient is advised to use diazepam (Valium) for multiple sclerosis. What patient teaching is important
for those taking this drug? Select all that apply
1
Avoid driving while on the drug.
2
Do not stop the drug abruptly.
3
Avoid taking alcohol with the drug.
4
Monitor blood pressure regularly.
5
Avoid contact with large crowds. - ANSWER:1, 2, & 3
Diazepam (Valium) is used as a muscle relaxant. Patients on diazepam should avoid driving and any such
activities requiring the patient to be alert, because of the sedative effects of the drug. They should not
stop the drug abruptly without consulting the health care provider. The drug should not be taken along
with alcohol, because alcohol can potentiate the drug's effect. Monitoring blood pressure is a general
health care measure and is not specific to diazepam. As the drug has no effect on the immune system,
avoiding crowds is not necessary.
A patient with a history of cluster headaches is planning to travel overseas by air. What advice should the
nurse give to this patient to decrease the likelihood of such attacks during air travel?
1 Do not travel by air.
2 Avoid eating chocolate while in flight.
3 Take ergotamine before the flight takes off.
4 Massage the neck and apply moist hot packs while in flight. - ANSWER:3
Cluster headache attacks may occur at high altitudes with low oxygen levels during air travel.
Ergotamine, taken before the plane takes off, may decrease the likelihood of these attacks. Patients with
cluster headaches can travel by air with precautions to avoid the headaches. Consumption of food items
including chocolate, cheese, or tomatoes is not related to cluster headaches, but it may trigger migraine
headaches. Massaging and applying moist hot packs to the neck and head can help a patient with
tension-type headaches, but it may not help relieve cluster headaches
A patient is prescribed carbamazepine (Tegretol) for a new onset seizure disorder. The nurse is educating
the patient about this drug. What teaching comment by the nurse is most accurate?
1 This medication is given to treat absence and myloclonic seizures.
2
Don't be concerned if any visual disturbances occur while taking this medication.
3
Do not take this medication with grapefruit.
4
The goal of this medication is to cure your condition and prevent any more seizures. - ANSWER:3
Grapefruit inhibits the activity of the gastrointestinal enzyme that breaks down this medication so that
more of the drug is in the body, and sometimes dangerously high amounts can enter the blood stream.
Tegretol is given to treat generalized tonic-clonic and partial seizures. Patients are instructed to report
any type of visual abnormalities. Antiseizure drugs do not cure the condition but help to prevent seizures
with a minimum of side effects.
A 50-year-old male patient has been diagnosed with amyotrophic lateral sclerosis (ALS). What nursing
intervention is most important to help prevent a common cause of death for patients with ALS?
1 Reduce fat intake
,2
Reduce the risk of aspiration
3
Decrease injury related to falls
4
Decrease pain secondary to muscle weakness - ANSWER:2
Reducing the risk of aspiration can help prevent respiratory infections that are a common cause of death
from deteriorating muscle function. Reducing fat intake may reduce cardiovascular disease, but this is
not a common cause of death for patients with ALS. Decreasing injury related to falls and decreasing
pain secondary to muscle weakness are important nursing interventions for patients with ALS, but are
unrelated to causes of death for these patients.
Which criterion is included to establish that a patient has Parkinson's disease? Select all that apply.
1
Decreased serum dopamine levels.
2
Tumor present in the thymus gland.
3
Magnetic resonance imaging (MRI) shows areas of plaque on cranial nerves.
4
Presence of two of the three classic features: rigidity, bradykinesia, and tremor.
5
Positive response to antiparkinsonian medications. - ANSWER:4 & 5
Presently there is no specific test to diagnose Parkinson's disease. Diagnosis is made when the patient
demonstrates two of the three classic signs: rigidity (increased resistance to passive motion as a
cogwheel); bradykinesia (slowed and loss of automatic coordinated movement); and tremor (a tremor
that is more severe at rest and pill-rolling hand tremor). The diagnosis is confirmed with positive
response to medications used to treat the disease such as carbidopa/levodopa (Sinemet). Parkinson's
disease is caused by decreased dopamine levels in the brain and is not measured in the serum. Tumors
of the thymus gland are associated with myasthenia gravis. Areas of plaque are seen on MRI of patients
with multiple sclerosis
When performing a physical assessment of a patient with myasthenia gravis, what are the manifestations
that the nurse is likely to find? Select all that apply.
, 1
Muscle atrophy
2
Abnormal reflexes
3
Impaired facial mobility
4
Difficulty in swallowing food
5
Voice fading after a long conversation - ANSWER:3, 4, & 5
Myasthenia gravis is characterized by a fluctuating weakness of skeletal muscles. The patient may have
impaired facial mobility and expressions. Chewing and swallowing food may become difficult. Speech
may be affected, and the voice fades after a long conversation. Apart from this muscle weakness, there is
no other dysfunction such as muscle atrophy or abnormal reflexes.
A patient is advised to use diazepam (Valium) for multiple sclerosis. What patient teaching is important
for those taking this drug? Select all that apply
1
Avoid driving while on the drug.
2
Do not stop the drug abruptly.
3
Avoid taking alcohol with the drug.
4
Monitor blood pressure regularly.
5
Avoid contact with large crowds. - ANSWER:1, 2, & 3
Diazepam (Valium) is used as a muscle relaxant. Patients on diazepam should avoid driving and any such
activities requiring the patient to be alert, because of the sedative effects of the drug. They should not
stop the drug abruptly without consulting the health care provider. The drug should not be taken along
with alcohol, because alcohol can potentiate the drug's effect. Monitoring blood pressure is a general
health care measure and is not specific to diazepam. As the drug has no effect on the immune system,
avoiding crowds is not necessary.
