ATI LPN
Lewis's Medical Surgical Nursing in Canada, 5th Edition
Chapter 61 Questions
Question 1 of 5
The partner of a patient with Parkinson's disease (PD) is upset and asks the nurse why he is no longer able to read the affectionate notes that the patient writes for him. Which of the following information is the basis for the nurse's response?
Correct Answer: C
Rationale: The best answer is that the nurse's response will be based upon the fact that micrographia is handwriting deterioration and often occurs in patients with Parkinson's disease. PD patients have characteristic slow speech but that does not cause illegible writing. Cogwheel rigidity makes it difficult to walk and balance. Although depression is common in PD, this does not directly lead to denying affectionate feelings.
Question 2 of 5
The health care provider is considering the use of sumatriptan for a patient with migraine headaches. Which of the following information obtained by the nurse is most important to report to the health care provider?
Correct Answer: C
Rationale: The triptans cause coronary artery vasoconstriction and should be avoided in patients with coronary artery disease. The other information will be reported to the health care provider, but none of it is an indication that sumatriptan would be an inappropriate treatment.
Question 3 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 4 of 5
The nurse witnesses a patient with a seizure disorder as the patient suddenly jerks the arms and legs, falls to the floor, and regains consciousness immediately. Which of the following actions is priority for the nurse to take initially?
Correct Answer: A
Rationale: The patient who has had a myoclonic seizure and fall is at risk for head injury and should be evaluated and treated for this possible complication first. Documentation of the seizure, notification of the seizure, and administration of antiseizure drugs also are appropriate actions, but the initial action should be assessment for injury.
Question 5 of 5
A patient was noted to have a generalized seizure reports afterward that the seizure was preceded by numbness and tingling of the arm. What type of seizure would this be classified as?
Correct Answer: B
Rationale: The initial symptoms of a partial seizure involve clinical manifestations that are localized to a particular part of the body or brain. Symptoms of an absence seizure are staring and a brief loss of consciousness. In an atonic seizure, the patient loses muscle tone and (typically) falls to the ground. Myoclonic seizures are characterized by a sudden jerk of the body or extremities.