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A patient with herpes simplex virus encephalitis (HSV) has been admitted to the ICU. What medication would the nurse expect the physician to order for the treatment of this disease process?
- A. Cyclosporine (Neoral)
- B. Acyclovir (Zovirax)
- C. Cyclobenzaprine (Flexeril)
- D. Ampicillin (Prinicipen)
Correct Answer: B
Rationale: Acyclovir is an antiviral effective against HSV by inhibiting viral DNA replication. Cyclosporine, cyclobenzaprine, and ampicillin do not treat viral infections.
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A patient presents at the clinic complaining of pain and weakness in her hands. On assessment, the nurse notes diminished reflexes in the upper extremities bilaterally and bilateral loss of sensation. The nurse knows that these findings are indicative of what?
- A. Guillain-Barr?© syndrome
- B. Myasthenia gravis
- C. Trigeminal neuralgia
- D. Peripheral nerve disorder
Correct Answer: D
Rationale: Pain, weakness, diminished reflexes, and sensory loss in the extremities indicate a peripheral nerve disorder. Guillain-Barr?© involves ascending paralysis, myasthenia gravis affects voluntary muscles, and trigeminal neuralgia causes facial pain.
To alleviate pain associated with trigeminal neuralgia, a patient is taking Tegretol (carbamazepine). What health education should the nurse provide to the patient before initiating this treatment?
- A. Concurrent use of calcium supplements is contraindicated.
- B. Blood levels of the drug must be monitored.
- C. The drug is likely to cause hyperactivity and agitation.
- D. Tegretol can cause tinnitus during the first few days of treatment.
Correct Answer: B
Rationale: Carbamazepine requires monitoring of blood levels to ensure therapeutic efficacy and avoid toxicity. It does not cause hyperactivity or tinnitus, and calcium supplements are not contraindicated.
A 33-year-old patient presents at the clinic with complaints of weakness, incoordination, dizziness, and loss of balance. The patient is hospitalized and diagnosed with MS. What sign or symptom, revealed during the initial assessment, is typical of MS?
- A. Diplopia, history of increased fatigue, and decreased or absent deep tendon reflexes
- B. Flexor spasm, clonus, and negative Babinski's reflex
- C. Blurred vision, intention tremor, and urinary hesitancy
- D. Hyperactive abdominal reflexes and history of unsteady gait and episodic paresthesia in both legs
Correct Answer: C
Rationale: Blurred vision (optic neuritis), intention tremor, and urinary hesitancy are typical MS symptoms due to demyelination. Deep tendon reflexes are hyperactive, Babinski's is positive, and abdominal reflexes are absent in MS.
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.
The nurse is caring for a 77-year-old woman with MS. She states that she is very concerned about the progress of her disease and what the future holds. The nurse should know that elderly patients with MS are known to be particularly concerned about what variables? Select all that apply.
- A. Possible nursing home placement
- B. Pain associated with physical therapy
- C. Increasing disability
- D. Becoming a burden on the family
- E. Loss of appetite
Correct Answer: A,C,D
Rationale: Elderly MS patients worry about increasing disability, family burden, and potential nursing home placement due to progressive loss of function. Pain from therapy and appetite loss are not primary concerns.