Med surge exam 1 (neuro) test bank
Med s u r g e e x a m 1 (ne ur o) t e s t
b a n k questions a nd verified
solutions
Question 1
pts
A nurse is te ach ing a client with multiple sclerosis who is prescribed
cyc lo pho spham ide (Cy to xan) a n d methylprednisolone (Medrol). Which statement
should the nurse include in this client’s dis ch a rg e teaching?
"Avoid crowds a n d people with
colds.” “ T a k e you medication
before bedtime.”
" C h e c k blood su ga r before be dtim e to monitor for
hy p o g ly cem i a.” “ T a k e prescribed medications when
s ym p to m s occur"
T h e client should b e taught to avoid people with a n y type of upper respiratory illness
b e c a u s e these medications are i mm uno su ppress i v e . Warm baths will exac e rbate the
client’s sym ptom s . Assistive de v i c e s m a y b e required for safe ambulation.
Medication should b e t aken at all times a n d should not b e stopped.
Question 2
pts
Which medication taken b y a patient with restless l e g s syndrom e should the nurse
d i s c u s s with the patient?
Folic
Acid
Asprin
D iphenhy d ra m i
, Med surge exam 1 (neuro) test bank
n e Vitamin B-
12
Antihistamines c a n a gg r a v a t e restless le g s syndrome. T h e other medications will
not contribute to restless l e g s syndrom e.
Question 3
pts
Which patient a s s e s s m e n t will help the nurse identify potential complications of
trigeminal neuralgia?
Inspect the oral m u c o s a a n d
teeth. H a v e the patient cl enc h the
jaws.
Identify trigger zo nes b y lightly touching the affected
side. As ses s lu n g so unds for possible aspiration.
Oral h y g i e n e is frequently neglec ted b e c a u s e of fear of triggering facial pai n a n d
m a y lead to g u m d i sea s e , dental caries, or a n a b s c e s s . H a v i n g the patient clen c h
the facial m u s c l e s will not b e useful b e c a u s e the sensory br anc h e s (rather than
motor bran c he s) of the nerve are affected b y trigeminal neuralgia. Light touch a n d
palpation m a y b e triggers for pai n a n d should b e avoided. Aspiration is not a h ig h
priority risk factor for TN.
Question 4
pts
Which information about a 60-yr-old patient with multiple sclerosis indicates that
the nurse should consult with the health care provider before g i v i n g the prescribed
dose of dalfampridine (Ampyra)?
T h e patient com plains of som nolence since starting this medication.
, Med surge exam 1 (neuro) test bank
T h e patient reports no difference in sym pto m s after taking this medication for 1 0
days.
T h e patient h a s a n increase d s e r um creatinine
level. T h e patient walks a m ile e a c h d a y for
exe rcise.
Dalfampridine should not b e g i v e n to patients with impaired renal function. T h e other
information will not impac t whether the dalfampridine should b e administered.
Therapeutic affect will b e in 6 weeks.
Question 5
pts
A nurse a s s e s s e s a client with a neurologic disorder. Which a s s e s s m e n t finding
should the nurse identify a s a late manifestation of amyotrophic lateral sclerosis
(ALS)?
Dysarthria
Muscle
w e a k ne ss
Dysphagia
Impairment of respiratory m u s c l e s
In ALS, progressive m u s c l e atrophy occurs until a flaccid quadripl egia develops.
Ev entually, the respiratory m u s c l e s are involved, which l e a d s to respiratory
compromise. Dysarthria, d y s p h a g i a , a n d m u s c l e we a k n e s s are early clinical
manifestations of A L S
Question 6
pts
T h e health care provider is considering the u s e of sumatriptan (Imitrex) for a 54-yr-
, Med surge exam 1 (neuro) test bank
old m a l e patient with m i grai ne he a d a c h e s . Which information obtained b y the nurse
is most important to report to the health care provider?
T h e patient h a s taken topiramate (T o p am a x) for 2
months. T h e patient h a d a recent myocardi al
infarction.
F am i l y reports patient h a s b e e n found often sitting alone in a
dark room. T h e patient recently joined the g y m .
T h e triptans c a u s e coronary artery vasoconstriction a n d should be avo ided in
patients with coronary artery d is ea se . T h e other information will b e reported to the
health care provider, but none of it indicates that sumatriptan would b e a n
inappropriate treatment.
Question 7
pts
A client with m y ast h en i a grav i s is prescribed pyridostigmine (Mestinon). What
teachi n g should the nurse plan regardin g this medication? (Select all that appl y.)
“ T a k e this drug on a n em p ty stomach for best absorption.”
“ S e e k im m ed ia te care if you develop trouble swallowing.”
“Do not eat a full m e a l for 4 5 mi nutes after taking the
drug.” “Your urine m a y turn a reddish-orange color
while on this drug.”
“ T h e dose m a y c h a n g e frequently d e p e n d i n g on sym p to m s.”
Pyridostigmine should b e g i v e n with a sm a l l amount of food to prevent GI upset,
but the client should wait to eat a full m e a l d u e to the potential for aspiration. If
d i f i c u l t y with swallowing occurs, the client should s e e k im m e d ia te attention. T h e
dose c a n c h a n g e on a day-to-day b a s is d e pe n d i n g on the client’s manifestations.
T a k i n g the drug on a n em p t y stom ach is not related although the client n e e d s to
Med s u r g e e x a m 1 (ne ur o) t e s t
b a n k questions a nd verified
solutions
Question 1
pts
A nurse is te ach ing a client with multiple sclerosis who is prescribed
cyc lo pho spham ide (Cy to xan) a n d methylprednisolone (Medrol). Which statement
should the nurse include in this client’s dis ch a rg e teaching?
"Avoid crowds a n d people with
colds.” “ T a k e you medication
before bedtime.”
" C h e c k blood su ga r before be dtim e to monitor for
hy p o g ly cem i a.” “ T a k e prescribed medications when
s ym p to m s occur"
T h e client should b e taught to avoid people with a n y type of upper respiratory illness
b e c a u s e these medications are i mm uno su ppress i v e . Warm baths will exac e rbate the
client’s sym ptom s . Assistive de v i c e s m a y b e required for safe ambulation.
Medication should b e t aken at all times a n d should not b e stopped.
Question 2
pts
Which medication taken b y a patient with restless l e g s syndrom e should the nurse
d i s c u s s with the patient?
Folic
Acid
Asprin
D iphenhy d ra m i
, Med surge exam 1 (neuro) test bank
n e Vitamin B-
12
Antihistamines c a n a gg r a v a t e restless le g s syndrome. T h e other medications will
not contribute to restless l e g s syndrom e.
Question 3
pts
Which patient a s s e s s m e n t will help the nurse identify potential complications of
trigeminal neuralgia?
Inspect the oral m u c o s a a n d
teeth. H a v e the patient cl enc h the
jaws.
Identify trigger zo nes b y lightly touching the affected
side. As ses s lu n g so unds for possible aspiration.
Oral h y g i e n e is frequently neglec ted b e c a u s e of fear of triggering facial pai n a n d
m a y lead to g u m d i sea s e , dental caries, or a n a b s c e s s . H a v i n g the patient clen c h
the facial m u s c l e s will not b e useful b e c a u s e the sensory br anc h e s (rather than
motor bran c he s) of the nerve are affected b y trigeminal neuralgia. Light touch a n d
palpation m a y b e triggers for pai n a n d should b e avoided. Aspiration is not a h ig h
priority risk factor for TN.
Question 4
pts
Which information about a 60-yr-old patient with multiple sclerosis indicates that
the nurse should consult with the health care provider before g i v i n g the prescribed
dose of dalfampridine (Ampyra)?
T h e patient com plains of som nolence since starting this medication.
, Med surge exam 1 (neuro) test bank
T h e patient reports no difference in sym pto m s after taking this medication for 1 0
days.
T h e patient h a s a n increase d s e r um creatinine
level. T h e patient walks a m ile e a c h d a y for
exe rcise.
Dalfampridine should not b e g i v e n to patients with impaired renal function. T h e other
information will not impac t whether the dalfampridine should b e administered.
Therapeutic affect will b e in 6 weeks.
Question 5
pts
A nurse a s s e s s e s a client with a neurologic disorder. Which a s s e s s m e n t finding
should the nurse identify a s a late manifestation of amyotrophic lateral sclerosis
(ALS)?
Dysarthria
Muscle
w e a k ne ss
Dysphagia
Impairment of respiratory m u s c l e s
In ALS, progressive m u s c l e atrophy occurs until a flaccid quadripl egia develops.
Ev entually, the respiratory m u s c l e s are involved, which l e a d s to respiratory
compromise. Dysarthria, d y s p h a g i a , a n d m u s c l e we a k n e s s are early clinical
manifestations of A L S
Question 6
pts
T h e health care provider is considering the u s e of sumatriptan (Imitrex) for a 54-yr-
, Med surge exam 1 (neuro) test bank
old m a l e patient with m i grai ne he a d a c h e s . Which information obtained b y the nurse
is most important to report to the health care provider?
T h e patient h a s taken topiramate (T o p am a x) for 2
months. T h e patient h a d a recent myocardi al
infarction.
F am i l y reports patient h a s b e e n found often sitting alone in a
dark room. T h e patient recently joined the g y m .
T h e triptans c a u s e coronary artery vasoconstriction a n d should be avo ided in
patients with coronary artery d is ea se . T h e other information will b e reported to the
health care provider, but none of it indicates that sumatriptan would b e a n
inappropriate treatment.
Question 7
pts
A client with m y ast h en i a grav i s is prescribed pyridostigmine (Mestinon). What
teachi n g should the nurse plan regardin g this medication? (Select all that appl y.)
“ T a k e this drug on a n em p ty stomach for best absorption.”
“ S e e k im m ed ia te care if you develop trouble swallowing.”
“Do not eat a full m e a l for 4 5 mi nutes after taking the
drug.” “Your urine m a y turn a reddish-orange color
while on this drug.”
“ T h e dose m a y c h a n g e frequently d e p e n d i n g on sym p to m s.”
Pyridostigmine should b e g i v e n with a sm a l l amount of food to prevent GI upset,
but the client should wait to eat a full m e a l d u e to the potential for aspiration. If
d i f i c u l t y with swallowing occurs, the client should s e e k im m e d ia te attention. T h e
dose c a n c h a n g e on a day-to-day b a s is d e pe n d i n g on the client’s manifestations.
T a k i n g the drug on a n em p t y stom ach is not related although the client n e e d s to
