Nokea
A female patient who has multiple sclerosis (MS) asks the nurse about risks associated with pregnancy. Which of the following responses by the nurse is accurate?
- A. MS symptoms may be worse after the pregnancy.
- B. Women with MS frequently have premature labour.
- C. Symptoms of MS are likely to become worse during pregnancy.
- D. MS is associated with a slightly increased risk for congenital defects.
Correct Answer: A
Rationale: During the postpartum period, women with MS are at greater risk for exacerbation of symptoms. There is no increased risk for congenital defects in infants born of mothers with MS. Symptoms of MS may improve during pregnancy. Onset of labour is not affected by MS.
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Which of the following information about a patient who is being treated with carbidopa/levodopa for Parkinson's disease is most important for the nurse to report to the health care provider?
- A. Shuffling gait
- B. Tremor at rest
- C. Cogwheel rigidity of limbs
- D. Uncontrolled head movement
Correct Answer: D
Rationale: Dyskinesia is an adverse effect of the carbidopa/levodopa, indicating a need for a change in medication or decrease in dose. The other findings are typical with Parkinson's disease.
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?
- A. Atonic
- B. Partial
- C. Absence
- D. Myoclonic
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.
A patient has a new prescription for bromocriptine mesylate to control symptoms of Parkinson's disease. Which of the following information obtained by the nurse may indicate a need for a decrease in the dose?
- A. The patient has a persistent dry cough.
- B. The patient has four loose stools in a day.
- C. The patient develops a deep vein thrombosis.
- D. The patient's blood pressure is 90/46 mm Hg.
Correct Answer: D
Rationale: Hypotension is an adverse effect of bromocriptine mesylate, and the nurse should check with the health care provider before giving the medication. Diarrhea, cough, and deep vein thrombosis are not associated with bromocriptine mesylate use.
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?
- A. Insert an oral airway during the seizure to maintain a patent airway.
- B. Restrain the patient's arms and legs to prevent injury during the seizure.
- C. Avoid touching the patient to prevent further nervous system stimulation.
- D. Time and observe and record the details of the seizure and postictal state.
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.
The nurse is teaching a patient about management of migraine headaches. Which of the following patient statements indicates that the teaching has been effective?
- A. I will take the topiramate as soon as any headaches start.
- B. I should avoid taking Aspirin and sumatriptan at the same time.
- C. I will try to lie down in a dark and quiet area when the headaches begin.
- D. A glass of wine might help me relax and prevent headaches from developing.
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.