Nokea
The nurse is planning discharge education for a patient with trigeminal neuralgia. The nurse knows to include information about factors that precipitate an attack. What would the nurse be correct in teaching the patient to avoid?
- A. Washing his face
- B. Exposing his skin to sunlight
- C. Using artificial tears
- D. Drinking large amounts of fluids
Correct Answer: A
Rationale: Washing the face can trigger pain in trigeminal neuralgia due to stimulation of the affected nerve. Sunlight exposure, artificial tears, and fluid intake do not typically precipitate attacks.
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A 48-year-old patient has been diagnosed with trigeminal neuralgia following recent episodes of unilateral face pain. The nurse should recognize what implication of this diagnosis?
- A. The patient will likely require lifelong treatment with anticholinergic medications.
- B. The patient has a disproportionate risk of developing myasthenia gravis later in life.
- C. The patient needs to be assessed for MS.
- D. The disease is self-limiting and the patient will achieve pain relief over time.
Correct Answer: C
Rationale: Trigeminal neuralgia in patients under 50 may indicate MS, necessitating evaluation. It is not treated with anticholinergics, not linked to myasthenia gravis, and not self-limiting.
The nurse is caring for a patient who is hospitalized with an exacerbation of MS. To ensure the patient's safety, what nursing action should be performed?
- A. Ensure that suction apparatus is set up at the bedside.
- B. Pad the patient's bed rails.
- C. Maintain bed rest whenever possible.
- D. Provide several small meals each day.
Correct Answer: A
Rationale: MS exacerbations increase aspiration risk due to dysphagia, so suction apparatus at the bedside is critical for safety. Bed rest should be minimized, and padding or small meals are not priority.
The nurse is developing a plan of care for a patient with Guillain-Barr?© syndrome. Which of the following interventions should the nurse prioritize for this patient?
- A. Using the incentive spirometer as prescribed
- B. Maintaining the patient on bed rest
- C. Providing aids to compensate for loss of vision
- D. Assessing frequently for loss of cognitive function
Correct Answer: A
Rationale: Incentive spirometry maximizes respiratory function, critical in Guillain-Barr?© due to potential respiratory muscle weakness. Bed rest increases complications, and vision or cognition are not typically affected.
The nurse is caring for a patient with multiple sclerosis (MS). The patient tells the nurse the hardest thing to deal with is the fatigue. When teaching the patient how to reduce fatigue, what action should the nurse suggest?
- A. Taking a hot bath at least once daily
- B. Resting in an air-conditioned room whenever possible
- C. Increasing the dose of muscle relaxants
- D. Avoiding naps during the day
Correct Answer: B
Rationale: Resting in a cool, air-conditioned environment reduces body temperature, which can alleviate MS-related fatigue. Hot baths exacerbate fatigue, muscle relaxants may worsen it, and naps are beneficial.
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.