ATI RN
NCLEX Questions on Neurological System Questions
Question 1 of 5
When an edrophonium (Tensilon) test is carried out, which of the following drugs must be available as an antidote?
Correct Answer: A
Rationale: The correct answer is A) Atropine sulfate. In the context of an edrophonium (Tensilon) test, which is used to diagnose myasthenia gravis, atropine sulfate must be available as an antidote. Edrophonium is a cholinesterase inhibitor that temporarily increases acetylcholine levels at the neuromuscular junction, potentially causing cholinergic crisis characterized by excessive muscarinic stimulation. Atropine sulfate, an anticholinergic agent, is used to counteract the muscarinic effects by blocking the action of acetylcholine at muscarinic receptors, effectively reversing the cholinergic crisis symptoms. The other options are incorrect because: - B) Diazepam (Valium) is a benzodiazepine used for its anxiolytic and anticonvulsant properties, not for reversing cholinergic crisis. - C) Ephedrine is a sympathomimetic amine that acts on adrenergic receptors, not muscarinic receptors like atropine sulfate. - D) Corticosteroids are anti-inflammatory agents that are not indicated for acute cholinergic crisis management. Understanding the appropriate antidotes and interventions for potential complications during diagnostic tests is crucial for nursing practice. Knowing the specific antidote needed for cholinergic crisis in the context of an edrophonium test is essential to ensure prompt and effective management of adverse reactions, thereby improving patient safety and outcomes.
Question 2 of 5
Proper body alignment of the hemiplegic patient with the use of a footboard, trochanter rolls, and pillows will minimize the development of
Correct Answer: A
Rationale: Proper body alignment is crucial for hemiplegic patients to prevent complications like contractures. In this case, using a footboard helps maintain neutral ankle position, preventing plantar extension. Trochanter rolls aid in hip alignment, reducing internal hip rotation. Pillows support the affected side, preventing shoulder abduction. Choosing option A, plantar extension, as the correct answer is supported by the need to maintain proper foot alignment to prevent deformities. Plantar extension can lead to issues like foot drop and contractures, hence aligning the foot is essential. Option B, shoulder abduction, is incorrect as the question focuses on lower body alignment, not upper body positioning. Similarly, internal and external hip rotation (options C and D) are controlled by trochanter rolls, not footboard use. Educationally, understanding proper body alignment strategies for hemiplegic patients is vital for nursing practice. It promotes patient comfort, prevents complications, and supports overall rehabilitation efforts. Nurses must be knowledgeable about these interventions to provide holistic care and promote optimal patient outcomes.
Question 3 of 5
In helping Mr. Hall to maintain proper body alignment in bed to prevent dislocation of the prosthetic head and hip contracture, the nurse should assist the patient to lie
Correct Answer: A
Rationale: The correct answer is A) straight in bed alternating head position from flat to 30° elevation and left leg abducted. This position helps prevent dislocation of the prosthetic head and hip contracture by maintaining proper alignment of the body. Placing the head at a slight elevation reduces pressure on the hip joint. Abducting the left leg also helps prevent hip contracture by keeping the joint in a neutral position. Option B) diagonally toward the right side of the bed with legs together would not provide optimal alignment for preventing hip dislocation and contracture. Option C) flat on back in bed for first 48 hours with legs adducted may increase the risk of hip contracture due to prolonged adduction. Option D) on the right side only with the left leg in front of the right leg does not promote equal weight distribution and proper alignment. In an educational context, understanding proper body alignment in bed is crucial for preventing complications such as hip dislocation and contractures, especially in patients with prosthetic hips. Nurses must be knowledgeable about positioning techniques to promote patient comfort, prevent complications, and facilitate optimal recovery.
Question 4 of 5
In the initial nursing assessment of Mr. Singer it is important to remember that malignant rheumatoid arthritis
Correct Answer: B
Rationale: In the initial nursing assessment of Mr. Singer, understanding that malignant rheumatoid arthritis may also involve the heart, lungs, and other body systems is crucial. This is because rheumatoid arthritis is a systemic autoimmune disorder that can affect multiple organs besides the joints. The correct answer (B) is right because complications of rheumatoid arthritis can lead to cardiovascular issues, pulmonary complications, and systemic inflammation impacting various organs. Option A is incorrect because rheumatoid arthritis is not limited to synovial joints; it is a systemic disease. Option C is incorrect as rheumatoid arthritis is a chronic condition with periods of exacerbations and remissions, rather than purely episodic. Option D is incorrect as rheumatoid arthritis typically affects small joints, not just proximal joints. Educationally, this question highlights the importance of understanding the systemic nature of rheumatoid arthritis in a nursing assessment. Nurses need to assess not only joint symptoms but also be vigilant for potential complications in other body systems to provide holistic care for patients with rheumatoid arthritis.
Question 5 of 5
MRS. Post is concerned about the effect of her diagnosis of systemic lupus erythematosus on childbearing. In discharge planning with Mrs. Post, you should
Correct Answer: B
Rationale: In this scenario, the correct answer is B) tell her pregnancy may cause an exacerbation of symptoms. Explanation: - Systemic lupus erythematosus (SLE) is an autoimmune disease that can have significant impacts on pregnancy due to the potential exacerbation of symptoms. - Pregnancy can trigger lupus flares, leading to complications for both the mother and the fetus. - Educating Mrs. Post about the risks associated with pregnancy in SLE is crucial for her to make informed decisions about family planning and managing her condition. Why other options are wrong: - Option A is incorrect because an intrauterine device (IUD) is not the best choice for birth control in a patient with SLE, as it does not address the potential exacerbation of symptoms during pregnancy. - Option C is incorrect because pregnancy can indeed affect lupus symptoms, so telling her that her symptoms will not change is inaccurate. - Option D is incorrect as birth control pills do not specifically address the potential exacerbation of lupus symptoms during pregnancy. Educational context: Understanding the implications of systemic lupus erythematosus on childbearing is crucial for nurses and healthcare providers caring for women with this condition. Providing accurate information and support to patients like Mrs. Post empowers them to make informed decisions about pregnancy planning and managing their health effectively. It is essential to tailor education to individual patient needs and considerations to optimize patient outcomes and quality of life.