ATI LPN
Test Bank for Medical Surgical Nursing: Concepts for Interprofessional Collaborative Care 10th Edition
Chapter 42 : Care of Patients with Problems of the CNS: The Brain Questions
Question 1 of 5
A nurse prepares to discharge a client with Alzheimer's disease. Which statement should the nurse include in the discharge teaching for this clients caregiver?
Correct Answer: C
Rationale: Clients with Alzheimer's disease tend to wander, especially at night. Installing deadbolt locks on all outside doors prevents the client from going outdoors unsupervised, enhancing safety. The other options do not address wandering directly.
Question 2 of 5
A nurse is teaching a client who experiences migraine headaches. Which statement should the nurse include in the teaching to help prevent the onset of migraine headaches?
Correct Answer: B
Rationale: At the onset of a migraine attack, lying down in a darkened room can alleviate pain. The client may cover both eyes and use a cool cloth on the forehead. If the client falls asleep, they should remain undisturbed. The other options are not recognized therapies for migraines.
Question 3 of 5
A nurse delegates care for a client with Parkinson disease to an unlicensed assistive personnel (UAP). Which statement should the nurse include when delegating this clients care?
Correct Answer: A
Rationale: Frequent and meticulous oral care is important for clients with Parkinson disease due to swallowing difficulties and drooling, which increase the risk of oral complications. Assessing swallowing is a nursing responsibility, not suitable for UAP delegation. Scheduling appointments and frequent blood pressure monitoring are not specific to Parkinson disease care.
Question 4 of 5
A nurse plans care for a client with epilepsy. Which interventions should the nurse include in this clients plan of care? (Select all that apply.)
Correct Answer: A,C,E
Rationale: Oxygen and suctioning equipment with an airway must be readily available. Bed rails should be up at all times to prevent injury from a fall during a seizure. A saline lock provides venous access for IV drug therapy to manage seizures. Padded tongue blades are dangerous, dietary restrictions are not indicated, and strict bedrest is not necessary.
Question 5 of 5
A nurse assesses a client who is experiencing a cluster headache. Which clinical manifestations should the nurse expect to find? (Select all that apply.)
Correct Answer: A,B,E
Rationale: Cluster headache is usually accompanied by ipsilateral tearing, miosis, rhinorrhea or nasal congestion, ptosis, eyelid edema, and facial sweating. Abrupt loss of consciousness, neck and shoulder tenderness, and exophthalmos are not associated with cluster headaches.