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A patient diagnosed with Bell's palsy is having decreased sensitivity to touch of the involved nerve. What should the nurse recommend to prevent atrophy of the muscles?
- A. Blowing up balloons
- B. Deliberately frowning
- C. Smiling repeatedly
- D. Whistling
Correct Answer: D
Rationale: Whistling, along with other facial exercises like wrinkling the forehead, prevents muscle atrophy in Bell's palsy. Blowing balloons, frowning, and smiling are less effective.
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A 35-year-old woman is diagnosed with a peripheral neuropathy. When making her plan of care, the nurse knows to include what in patient teaching? Select all that apply.
- A. Inspect the lower extremities for skin breakdown.
- B. Footwear needs to be accurately sized.
- C. Immediate family members should be screened for the disease.
- D. Assistive devices may be needed to reduce the risk of falls.
- E. Dietary modifications are likely necessary.
Correct Answer: A,B,D
Rationale: Peripheral neuropathy requires inspecting for skin breakdown, proper footwear, and assistive devices to prevent falls. It is not genetic, and diet is unrelated.
The nurse is developing a plan of care for a patient newly diagnosed with Bell's palsy. The nurse's plan of care should address what characteristic manifestation of this disease?
- A. Tinnitus
- B. Facial paralysis
- C. Pain at the base of the tongue
- D. Diplopia
Correct Answer: B
Rationale: Bell's palsy causes facial paralysis due to cranial nerve VII dysfunction. Tinnitus, tongue pain, and diplopia are not characteristic of this condition.
A male patient presents to the clinic complaining of a headache. The nurse notes that the patient is guarding his neck and tells the nurse that he has stiffness in the neck area. The nurse suspects the patient may have meningitis. What is another well-recognized sign of this infection?
- A. Negative Brudzinski's sign
- B. Positive Kernig's sign
- C. Hyperpatellar reflex
- D. Sluggish pupil reaction
Correct Answer: B
Rationale: A positive Kernig's sign, where leg extension causes pain due to meningeal irritation, is a classic sign of meningitis. Brudzinski's sign is positive, not negative, and reflexes or pupil reactions are not typical signs.
A patient with metastatic cancer has developed trigeminal neuralgia and is taking carbamazepine (Tegretol) for pain relief. What principle applies to the administration of this medication?
- A. Tegretol is not known to have serious adverse effects.
- B. The patient should be monitored for bone marrow depression.
- C. Side effects of the medication include renal dysfunction.
- D. The medication should be first taken in the maximum dosage form to be effective.
Correct Answer: B
Rationale: Carbamazepine can cause bone marrow depression, requiring monitoring. It has serious side effects like aplastic anemia, not renal dysfunction, and is started at a low dose, gradually increased.
The nurse is creating a plan of care for a patient who has a recent diagnosis of MS. Which of the following should the nurse include in the patient's care plan?
- A. Encourage patient to void every hour.
- B. Order a low-residue diet.
- C. Provide total assistance with all ADLs.
- D. Instruct the patient on daily muscle stretching.
Correct Answer: D
Rationale: Daily muscle stretching helps manage spasticity in MS. Voiding every 30 minutes after drinking, high-fiber diets, and encouraging independence in ADLs are more appropriate.