Week 9 Study Guide NURSING 6420

Question 1.1. The three cardinal features of Parkinson’s disease are: Essential tremor, postural rigidity, and infarcts of the basal ganglion Bradykinesia, rigidity, and tremor Shuffling gait, c ...

Question 1.1. The three cardinal features of Parkinson’s disease are: Essential tremor, postural rigidity, and infarcts of the basal ganglion Bradykinesia, rigidity, and tremor Shuffling gait, constipation, positional freezing. Dementia, incontinence, and infarcts of the basal ganglion Question 2. 2. When assessing a patient who complains of a tremor, the nurse practitioner must differentiate essential tremor from the tremor of Parkinson’s disease. Which of the following findings are consistent with essential tremor? The handwriting is not affected by the tremor The tremor occurs with purposeful movements The tremor occurs at rest The tremor gets worse with alcohol ingestion Question 3. 3. An older adult client with a history of a seizure disorder comes into the clinic for a routine check-up. Although seizure free, the client continues on long-term phenytoin treatment. The nurse practitioner would assess for which of the following long-term effects? Lid lag and nystagmus Gingival hyperplasia and nystagmus Nystagmus and microcytic anemia Gingival hyperplasia and iron deficiency anemia Question 4. 4. An elderly patient is maintained on phenytoin therapy for a history of a seizure disorder. In addition to periodic serum drug concentrations, which of the following are needed for annual evaluation? Complete blood count, liver function tests, and renal function tests Complete blood count, liver function tests, and platelet count Because of megaloblastic anemia? Renal function and calculated creatinine clearance Serum albumin, liver function tests, and renal function tests Question 5. 5. An elderly patient has had a CVA in the anterior cerebral circulatory system (frontal lobe). What symptoms are most likely expressed? Neglect of body and difficulty organizing space Wernicke’s aphasia (difficulty understanding speech) Disorders of behavior and cognition Bilateral motor and sensory problem Question 6. 6. The most common neurological cause of seizures in an older adult is: Alzheimer’s disease Multiple sclerosis Stroke Peripheral neuropathy Question 7. 7. Mr. Andrews experienced a brief onset of right-sided weakness, slurred speech, and confusion yesterday. The symptoms have resolved. What should the nurse practitioner do? Assure the patient that he will not experience the symptoms again Identify modifiable cardiovascular risk factors Do a thorough medication review and a CT scan Order a stat EEG and administer O2 by mask Question 8. 8. An older male patient is experiencing acute onset of right-sided weakness, slurred speech, and confusion. What should the nurse practitioner do promptly? Administer an aspirin by mouth Evaluate for stroke and arrange transport to the hospital right away Do a thorough medication review and stat blood sugar Order an EKG and administer O2 by cannula immediately Question 9. 9. When assessing an elderly client who reports a tremor, which assessment findings would be most reliable in identifying Parkinson’s disease? Any presence of tremor Symptoms of slowed movement, unstable angina, and tremor Resting tremor, slow unsteady gait, and cogwheel resistance Cogwheel rigidity, bradykinesia, and amnesia Question 10. 10. A middle-aged patient has been diagnosed with Parkinson’s disease. What influences the nurse practitioner’s decision to begin pharmacological treatment for this patient? Intentional tremors Gait instability requiring use of a cane Symptoms interfering with functional ability Medications initiated at first sign of unilateral involvement Question 11. 11. The Mini-Cog is a short screening tool used to assess cognition. Which of the following statements pertaining to the test is a true statement? The patient will be asked to repeat five words immediately following the directions by the practitioner. The patient is asked to draw the hour and minute hands on a picture of an analog clock. A score of 0-2 is a positive screen for dementia. The patient is asked to recall five images from picture cards following the drawing of the clock hands. Question 12. 12. A female patient presents to the clinic with complaints of a severe, throbbing, unilateral headache. She complains of seeing flashes of light prior to the headache. She complains of sound and light sensitivity as well as nausea. The clinician should recognize these as symptoms of: Epilepsy with aura Cluster headache Migraine headache Normal pressure hydrocephalus Question 13. 13. Which of the following is a common trigger of migraine headache? Missed meals Menses Alcohol All of the above Question 14. 14. A 65-year-old woman is accompanied by her daughter for a physical examination. She has mild heart failure and takes digitalis and an ACE inhibitor. As you examine the patient, you note flat affect, hand tremor, and slowed movements. The tremor is worsened at rest. There are no neurologic deficits. Hand grip, sensation of face and extremities, and lower extremity muscle strength are within normal limits and bilaterally equal. DTRs are equal bilaterally. CN II to XII are intact. The mental status exam is normal. These are key signs of: Chiari malformation Normal pressure hydrocephalus Parkinson’s disease Drug toxicity Question 15. 15. A 65-year-old male complains of a headache that feels “like a knife is cutting into his head.” He also reports feeling right-sided scalp and facial pain and “seeing double” at times. He has a history of hypertension and hyperlipidemia. His medications include beta blocker, statin drug, and an ACE inhibitor. On physical examination, you note palpable tenderness over the right side of the forehead. There are no neurological deficits. Vision is 20/20 with lenses. No weakness of extremities. CN II to XII are intact. The history corresponds to which of the following disorders? Drug toxicity Giant cell arteritis Cluster headache Migraine headache Question 16. 16. Which type of seizure is involved following a head injury or febile event? Epileptic Isolated Atonic Clonic-tonic Question 17. 17. M. L. is a 40-year-old female that has been recently diagnosed with Multiple Sclerosis (MS). As you provide primary care for your patient you inform her that: MS presents with a classis triad of symptoms, which are blurred vision, vertigo, and tinnitus MS has a predictable course and can easily be managed MS has a predictable course and can easily be managed Often MS has a varying pattern of exacerbation and remissions Question 18. 18. Ms. Smith, 37-year-old, comes to the clinic today complaining of dull, throbbing bilateral headaches almost every evening. You suspect she is experiencing: cluster headaches migraine headaches tension headaches benign intracranial hypertension Question 19. 19. The FNP is seeing Mr. Smith a 78-year-old gentleman accompanied by his wife to the health clinic. His wife reports that he has been falling down, tripping and stumbling. The FNP suspects a problem in: Peripheral nervous system Brainstem Cerebrum Cerebellum Question 20. 20. Educating your patient about headache management should include information about all but: Headache diary Rebound headaches Trigger identification Common laboratory testing for diagnosis