ATI LPN
Lewis's Medical Surgical Nursing in Canada, 5th Edition
Chapter 61 Questions
Question 1 of 5
The nurse is teaching a patient about management of migraine headaches. Which of the following patient statements indicates that the teaching has been effective?
Correct Answer: C
Rationale: It is recommended that the patient with a migraine rest in a dark, quiet area.
Topiramate is used to prevent migraines and must be taken for several months to determine effectiveness. Aspirin or other nonsteroidal anti-inflammatory medications can be taken with the triptans. Alcohol may precipitate migraine headaches.
Question 2 of 5
Which of the following parameters should the nurse assess when caring for a patient who is experiencing a cluster headache?
Correct Answer: C
Rationale: Unilateral eye edema, tearing, and ptosis are characteristic of cluster headaches. Nuchal rigidity suggests meningeal irritation, such as occurs with meningitis. Although nausea and vomiting may occur with migraine headaches, projectile vomiting is more consistent with increases in intracranial pressure (ICP). Unilateral sharp, stabbing pain, rather than throbbing pain, is characteristic of cluster headaches.
Question 3 of 5
A patient has a tonic-clonic seizure while the nurse is in the patient's room. Which of the following actions should the nurse take?
Correct Answer: D
Rationale: Because diagnosis and treatment of seizures frequently are based on the description of the seizure, recording the length and details of the seizure is important. Insertion of an oral airway and restraining the patient during the seizure are contraindicated. The nurse may need to move the patient to decrease the risk of injury during the seizure.
Question 4 of 5
An elementary teacher who has just been diagnosed with epilepsy after having a generalized tonic-clonic seizure tells the nurse, 'I cannot teach anymore, it will be too upsetting if I have a seizure at work.' Which of the following responses by the nurse is best?
Correct Answer: D
Rationale: The nurse should inform the patient that about 50% patients with seizure disorders are controlled with medication and another 30% have a decrease in the intensity and frequency of seizures. The other information may be necessary if the patient seizures persist after treatment with antiseizure drugs is implemented.
Question 5 of 5
Which action will the nurse take when evaluating a patient who is taking phenytoin for adverse effects of the medication?
Correct Answer: A
Rationale: Phenytoin can cause gingival hyperplasia, but does not affect bowel tones, lung sounds, or pupil reaction to light.