200 Nursezone Medical-surgical Nursing Final Coaching Part 1 (1 To 25)

25 Questions | Total Attempts: 58

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Medical Surgical Nursing Quizzes & Trivia

Questions and Answers
  • 1. 
    SITUATION: Mr. Ambo is a 75 year old man with Parkinson’s disease. He is admitted to the hospital after experiencing severe nightmare and periods of confusion. During lucid periods, he is very disturbed by these manifestations. At other time, he believes that his wife is participating in a conspiracy to harm him   Degenerative neurologic disorders pose a great challenge to the client, the family, and the caregiver. Which is true about Parkinson’s disease?
    • A. 

      It is an inflammatory disease of unknown origin that involves degeneration of the myelin sheath of peripheral nerves

    • B. 

      It is an idiopathic syndrome characterized by disability from tremor and rigidity

    • C. 

      It involves the degeneration of nor-epinephrine-producing cells in the substantia nigra

    • D. 

      It is an infectious disease caused by the Cytomegalovirus

  • 2. 
    SITUATION: Mr. Ambo is a 75 year old man with Parkinson’s disease. He is admitted to the hospital after experiencing severe nightmare and periods of confusion. During lucid periods, he is very disturbed by these manifestations. At other time, he believes that his wife is participating in a conspiracy to harm him   During her initial assessment, the nurse observes which cardinal features of Parkinson’s disease? Select all that apply: 1. Freezing movement; 2. Paranoia; 3. Flexed posture of the neck, trunk and limbs; 4. Hallucinations; 5. Tremor at rest; 6. Rigidity
    • A. 

      1, 3, 5, 6

    • B. 

      2, 3, 4

    • C. 

      1, 5, 6

    • D. 

      3, 4, 5, 6

  • 3. 
    SITUATION: Mr. Ambo is a 75 year old man with Parkinson’s disease. He is admitted to the hospital after experiencing severe nightmare and periods of confusion. During lucid periods, he is very disturbed by these manifestations. At other time, he believes that his wife is participating in a conspiracy to harm him   Can the client’s manifestations be related to treatment or to some other cause other than Parkinson’s disease?
    • A. 

      No, Parkinson’s disease usually affect the intellectual ability of a patient

    • B. 

      Yes, it can be a manifestation of Alzheimer’s disease

    • C. 

      No, in severe Parkinson’s the patient experiences dementia, paranoia and hallucination same with Alzheimer’s disease

    • D. 

      Yes, it can be a manifestation of Huntington’s disease

  • 4. 
    SITUATION: Mr. Ambo is a 75 year old man with Parkinson’s disease. He is admitted to the hospital after experiencing severe nightmare and periods of confusion. During lucid periods, he is very disturbed by these manifestations. At other time, he believes that his wife is participating in a conspiracy to harm him   The nurse observes changes in behavior on the patient and proceeds with a focused assessment to differentiate dementia and delirium. Choose all the assessments that are unique to delirium: 1. Impaired judgment; 2. Intervals of lucidity; 3. Distorted perceptions; 4. Hyperkinetic behavior; 5. Abrupt onset of symptoms
    • A. 

      1, 2, 5

    • B. 

      3, 4, 5

    • C. 

      2, 4, 5

    • D. 

      3, 4, 5

  • 5. 
    SITUATION: Mr. Ambo is a 75 year old man with Parkinson’s disease. He is admitted to the hospital after experiencing severe nightmare and periods of confusion. During lucid periods, he is very disturbed by these manifestations. At other time, he believes that his wife is participating in a conspiracy to harm him   The nurse evaluates the health teaching on a client with Parkinson’s disase. Further teaching is required when the nurse observes the following, except:
    • A. 

      The client grips the arms of the chair to reduce embarrassing hand tremors

    • B. 

      The patient does range of motion exercises 3 times a week

    • C. 

      The mattress where the client is sleeping is bouncy and soft

    • D. 

      The client sleeps with 2 piles of pillow under his head

  • 6. 
    SITUATION: A 34 year old woman with myasthenia gravis is taking pyridostigmine and prednisone. She is complaining of increased fatigue and weakness and has difficulty breathing   Nurse Ludy knowledgeably tells a student nurse that the primary feature of Myasthenia Gravis is:
    • A. 

      Emotional disturbances and mental deterioration

    • B. 

      Increasing weakness with sustained muscle contraction

    • C. 

      Ascending weakness, usually beginning in the lower extremities

    • D. 

      Vague psychiatric or behavior changes suggesting a personality change

  • 7. 
    SITUATION: A 34 year old woman with myasthenia gravis is taking pyridostigmine and prednisone. She is complaining of increased fatigue and weakness and has difficulty breathing   A nurse observes a patient when the physician does the diagnostic test to confirm MG. The physician injects 2 mg test does of Edrophonium to the client. No untoward reaction occurred. Another 8 mg was injected and the patient suddenly lifts his weak hand without difficulty. The nurse knows that which test was done to diagnose MG?
    • A. 

      Interferon test

    • B. 

      Prostigmine test

    • C. 

      Mestinon test

    • D. 

      Tensilon test

  • 8. 
    SITUATION: A 34 year old woman with myasthenia gravis is taking pyridostigmine and prednisone. She is complaining of increased fatigue and weakness and has difficulty breathing   The nurse in the emergency department is suspecting a cholinergic crisis from the patient with myasthenia gravis. Aside from weakness and difficulty of breathing, what other signs and symptoms will the nurse anticipate:
    • A. 

      Severe respiratory distress and cyanosis

    • B. 

      Absent cough and swallow reflex

    • C. 

      Sudden marked increase in blood pressure due to hypoxia

    • D. 

      Apprehension, nausea, vomiting and abdominal cramps

  • 9. 
    SITUATION: A 34 year old woman with myasthenia gravis is taking pyridostigmine and prednisone. She is complaining of increased fatigue and weakness and has difficulty breathing   The nurse caring for this patient would do which of the following first?
    • A. 

      Providing adequate ventilatory support

    • B. 

      Discontinue all cholinergic drugs until cholinergic effects subside

    • C. 

      Administer 1 mg atropine to counteract severe cholinergic reactions

    • D. 

      Increase doses of cholinergic drugs as long as the client responds positively to edrophonium treatment

  • 10. 
    SITUATION: A 34 year old woman with myasthenia gravis is taking pyridostigmine and prednisone. She is complaining of increased fatigue and weakness and has difficulty breathing   The patient’s MG is in its early course. The physician recommends a thymectomy. The nurse in the surgical ward is preparing the client for surgery. Which action by the nurse will denote a violation of the bio-ethical principle non-maleficence?
    • A. 

      Removing dentures and contact lens in the client’s room

    • B. 

      Endorsing valuables to relatives

    • C. 

      Blood standby available

    • D. 

      Letting the patient void after giving preoperative medications

  • 11. 
    SITUATION: A 35 year old female, wheelchair bound, is diagnosed with multiple sclerosis. She has a neurogenic bladder. She complains of a sudden onset of generalized weakness, fever, and chills and is admitted to the hospital   A variety of precipitating factors can precede the onset or an exacerbation of Multiple sclerosis. All of the following are precipitating factors of MS, except:
    • A. 

      Pregnancy

    • B. 

      Lactation

    • C. 

      Physical injury

    • D. 

      Emotional stress

  • 12. 
    SITUATION: A 35 year old female, wheelchair bound, is diagnosed with multiple sclerosis. She has a neurogenic bladder. She complains of a sudden onset of generalized weakness, fever, and chills and is admitted to the hospital   The most appropriate nursing diagnosis that a nurse could formulate regarding this client is:
    • A. 

      Impaired physical mobility related to generalized weakness

    • B. 

      Knowledge deficit related to diagnosis of MS

    • C. 

      Self-esteem disturbance related to loss of independence and fear of disability

    • D. 

      Altered urinary elimination related to bladder function

  • 13. 
    SITUATION: A 35 year old female, wheelchair bound, is diagnosed with multiple sclerosis. She has a neurogenic bladder. She complains of a sudden onset of generalized weakness, fever, and chills and is admitted to the hospital   With the patient’s alteration in urinary elimination, the nurse conducts a health teaching to the client regarding self catheterization. Which statement when made by the client denotes effective teaching?
    • A. 

      “I could use the clean red rubber catheter for 2 weeks as long as it is washed properly”

    • B. 

      “I should maintain the sterility of the catheter when I sue it as home”

    • C. 

      “I could use the cle3an red rubber catheter for up to 1 week, as long as it is washed with running water”

    • D. 

      “After using the catheter I should wash it thoroughly with soap and water and keep it in a clean, tightly sealed plastic bag”

  • 14. 
    SITUATION: A 35 year old female, wheelchair bound, is diagnosed with multiple sclerosis. She has a neurogenic bladder. She complains of a sudden onset of generalized weakness, fever, and chills and is admitted to the hospital   What do generalized weakness, fever and chills suggest to any client with MS?
    • A. 

      Exacerbation is caused by the neurogenic bladder and results in fever and chills

    • B. 

      Fever and chills manifests sepsis

    • C. 

      Fever and chills suggest infection that caused the exacerbation of MS leading to weakness

    • D. 

      The weakness suggests exacerbation. The fever and chills are not related to the exacerbation

  • 15. 
    SITUATION: A 35 year old female, wheelchair bound, is diagnosed with multiple sclerosis. She has a neurogenic bladder. She complains of a sudden onset of generalized weakness, fever, and chills and is admitted to the hospital   With the nursing diagnosis of knowledge deficit related to diagnosis of MS. The nurse reiterates the following interventions to prevent exacerbations of MS to the patient, except:
    • A. 

      Identify aggravating factors that lead to exacerbations

    • B. 

      Increase the body’s resistance to illness with intake of citrus fruits

    • C. 

      Confront people who are making her life miserable and try to resolve it

    • D. 

      Avoid stressors such as tiring activities and having a negative outlook in life

  • 16. 
    SITUATION: The diagnosis of degenerative neurologic disease is most often made in an out-patient setting. However, hospital admission may be necessary when acute relapses or life-threatening events occur   Guillain-Barre syndrome is an inflammatory disease of unknown origin. Although many organism have been suspected, Campylobacter jejuni is the organism most often implicated. This gram-negative rod is found in:
    • A. 

      Shellfish

    • B. 

      Poultry

    • C. 

      The soil

    • D. 

      Airborne

  • 17. 
    SITUATION: The diagnosis of degenerative neurologic disease is most often made in an out-patient setting. However, hospital admission may be necessary when acute relapses or life-threatening events occur   Mr. Noble is admitted to the hospital with a diagnosis of Guillain-Barre syndrome. Nurse Patty inquires during the nursing admission interview if the client has a history of:
    • A. 

      Respiratory or gastrointestinal infection during the previous month

    • B. 

      Meningitis during the last 5 years

    • C. 

      Back injury or trauma to the spinal cord

    • D. 

      Seizures or trauma to the brain

  • 18. 
    SITUATION: The diagnosis of degenerative neurologic disease is most often made in an out-patient setting. However, hospital admission may be necessary when acute relapses or life-threatening events occur   The patient has an ascending paralysis to the level of the waist. Knowing the complications of the disorder, the nurse brings which of the following items into the client’s room?
    • A. 

      Flashlight and incentive spirometer

    • B. 

      Electrocardiographic monitoring electrodes and intubation tray

    • C. 

      Blood pressure cuff and suction machine

    • D. 

      Nebulizer and pulse oximeter

  • 19. 
    SITUATION: The diagnosis of degenerative neurologic disease is most often made in an out-patient setting. However, hospital admission may be necessary when acute relapses or life-threatening events occur   Mr. Noble has ascending paralysis and is intubated and is receiving mechanical ventilation. Which of the following strategies would the nurse incorporate in the plan of care to help the client cope with this illness?
    • A. 

      Providing positive feedback and encouraging active range of motion

    • B. 

      Providing information, giving postage feedback, and encouraging relaxation

    • C. 

      Giving client full control over care decisions and restricting visitors

    • D. 

      Providing intravenously administered sedatives, reducing distractions, and limiting visitors

  • 20. 
    SITUATION: The diagnosis of degenerative neurologic disease is most often made in an out-patient setting. However, hospital admission may be necessary when acute relapses or life-threatening events occur   Nurse Ofelia is evaluating the respiratory outcomes for the client. She determines that which of the following is the least optimal outcome for the client?
    • A. 

      Oxygen saturation of 97%

    • B. 

      Adventitious breath sounds

    • C. 

      Spontaneous breathing

    • D. 

      Vital capacity within normal change

  • 21. 
    SITUATION: By their very nature, degenerative neurologic disorders cause progressive decline in neurologic function. Some progress relatively quickly whereas others progress more gradually, sometimes over decades. A major goal intervention is to help client achieve an optimal level of functioning in light of chronic neurologic deficits   Eaton-Lambert (Myasthenic) syndrome is a myasthenia-like condition in which weakness is noted in the limbs. Because MG can precede the development of cancer by many years, clients with this syndrome should be assessed for the development of cancer:
    • A. 

      Yearly

    • B. 

      Every six months

    • C. 

      Every 5 years

    • D. 

      Every month

  • 22. 
    SITUATION: By their very nature, degenerative neurologic disorders cause progressive decline in neurologic function. Some progress relatively quickly whereas others progress more gradually, sometimes over decades. A major goal intervention is to help client achieve an optimal level of functioning in light of chronic neurologic deficits   Supportive nursing care is an important aspect of managing Amyotrophic Lateral Sclerosis (ALS). Which is the most therapeutic intervention of the community health nurse when interacting with the client and the client’s family?
    • A. 

      Leave the client and family when they are discussing about problems regarding ALS

    • B. 

      Instruct patient on how to use a walker

    • C. 

      After doing morning care, assist patient with active range of motion exercises

    • D. 

      Discourage clients to complete advance directives

  • 23. 
    SITUATION: By their very nature, degenerative neurologic disorders cause progressive decline in neurologic function. Some progress relatively quickly whereas others progress more gradually, sometimes over decades. A major goal intervention is to help client achieve an optimal level of functioning in light of chronic neurologic deficits   A 40 year old man, diagnosed with Huntington’s disease chorea, was brought to the hospital. He is emaciated as a result of dysphagia. Which of the following nursing interventions is not appropriate?
    • A. 

      Include chopped meat and gravy with mashed potatoes in diet

    • B. 

      Allow visiting relatives to join in meal times

    • C. 

      Small frequent feedings should be avoided

    • D. 

      Instruct patient not to hold breath when swallowing

  • 24. 
    SITUATION: By their very nature, degenerative neurologic disorders cause progressive decline in neurologic function. Some progress relatively quickly whereas others progress more gradually, sometimes over decades. A major goal intervention is to help client achieve an optimal level of functioning in light of chronic neurologic deficits   A 72 year old female client has Alzheimer’s disease. Her caregiver phones the community health clinic and asks the nurse some advice on the care of this patient, all of the following are inappropriate, except:
    • A. 

      Never laugh with caregivers when talking to them. They might think it’s not a serious matter

    • B. 

      Encourage caregivers to share their knowledge and experience with newly assigned health care staff

    • C. 

      Invalidate the caregiver’s feelings of anger, guilt, exhaustion, and frustration

    • D. 

      Tell caregivers to complain to relatives and not disturb the clinic for irrational complaints regarding the patient with Alzheimer’s

  • 25. 
    SITUATION: By their very nature, degenerative neurologic disorders cause progressive decline in neurologic function. Some progress relatively quickly whereas others progress more gradually, sometimes over decades. A major goal intervention is to help client achieve an optimal level of functioning in light of chronic neurologic deficits   A client is experiencing chronic insomnia. The nurse interprets that which of the following areas of the brain is involved?
    • A. 

      Temporal lobe and frontal lobe

    • B. 

      Limbic system and cerebral hemispheres

    • C. 

      Hippocampus and frontal lobe

    • D. 

      Reticular activating system and cerebral hemispheres

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