Nokea
The nurse is discharging a patient home after surgery for trigeminal neuralgia. What advice should the nurse provide to this patient in order to reduce the risk of injury?
- A. Avoid watching television or using a computer for more than 1 hour at a time.
- B. Use OTC antibiotic eye drops for at least 14 days.
- C. Avoid rubbing the eye on the affected side of the face.
- D. Rinse the eye on the affected side with normal saline daily for 1 week.
Correct Answer: C
Rationale: Surgery may cause sensory loss, making eye rubbing dangerous as pain from injury may not be felt. TV use, antibiotic drops, and saline rinses are not relevant to injury prevention.
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The critical care nurse is caring for a 25-year-old man admitted to the ICU with a brain abscess. What is a priority nursing responsibility in the care of this patient?
- A. Maintaining the patient's functional independence
- B. Providing health education
- C. Monitoring neurologic status closely
- D. Promoting mobility
Correct Answer: C
Rationale: Close neurologic monitoring is critical for brain abscess patients to detect changes like increased intracranial pressure. Independence, education, and mobility are secondary in acute care.
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.
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.
The nurse is preparing to provide care for a patient diagnosed with myasthenia gravis. The nurse should know that the signs and symptoms of the disease are the result of what?
- A. Genetic dysfunction
- B. Upper and lower motor neuron lesions
- C. Decreased conduction of impulses in an upper motor neuron lesion
- D. A lower motor neuron lesion
Correct Answer: D
Rationale: Myasthenia gravis results from a lower motor neuron lesion at the myoneural junction, causing muscle weakness. It is not genetic, nor does it involve upper motor neurons.
A patient diagnosed with MS has been admitted to the medical unit for treatment of an MS exacerbation. Included in the admission orders is baclofen (Lioresal). What should the nurse identify as an expected outcome of this treatment?
- A. Reduction in the appearance of new lesions on the MRI
- B. Decreased muscle spasms in the lower extremities
- C. Increased muscle strength in the upper extremities
- D. Decreased severity and duration of exacerbations
Correct Answer: B
Rationale: Baclofen reduces muscle spasms in MS by acting as a GABA agonist. It does not affect MRI lesions, upper extremity strength, or exacerbation duration.