Chapter 70 Quiz

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Question #1

The nurse is providing education to a client who is being discharged with an outpatient treatment plan that includes taking a chemotherapeutic agent. What instructions should the nurse include? Select all that apply.,,

A If a dose is missed, the client should take double the amount at the regular time the following day

B The client should ensure no one else handles the medication.

C Hair loss should be expected when taking the medication.

D The client should seek emergency help if nausea or vomiting occur.

E The client should seek emergency care if he or she develops a fever.

Question #2

A health care provider needs help in identifying the precise location of a brain tumor. To measure brain activity, as well as to determine structure, the nurse expects the health care provider to order which of the following tests?

A MRI

B Computer-assisted stereotactic biopsy

C Positron-emission tomography (PET)

D Computed tomography (CT)

Question #3

The nurse teaches the client diagnosed with Huntington disease that it is transmitted as which type of genetic disorder?

A X-linked

B Autosomal recessive

C Non -repeated HTT gene

D Autosomal dominant

Question #4

Which disease is a chronic, progressive, hereditary disease of the nervous system that results in progressive, involuntary dancelike movements and dementia?

A Creutzfeldt-Jakob disease

B Parkinson disease

C Huntington disease

D Multiple sclerosis

Question #5

A new ancillary staff member is assisting the nurse with a client diagnosed with Parkinson’s disease. The client needs assistance with eating but doesn’t require thickened liquids to aid swallowing. Which instruction should the nurse give the ancillary staff member about eating assistance?

A Make sure the client is sitting with the head of bed elevated to 90 degrees.

B Clients with Parkinson’s disease shouldn’t have liquids; remove them from the dinner tray before serving food to the client.

C Assist the client into a comfortable position and stay alert for coughing, which signifies aspiration.

D There are no special precautions for the client with Parkinson’s disease.

Question #6

After undergoing surgery for removal of a spinal cord tumor, the client is placed in the side-lying position. The nurse places a pillow between the client’s knees to prevent:

A body misalignment.

B pressure injury.

C knee flexion.

D cerebrospinal fluid (CSF) leakage.

Question #7

A nurse is providing care to a client who has been diagnosed with metastatic brain cancer. When developing the client’s plan of care, which outcome would the nurse most likely identify?

A Improved quality of life

B Reduced incidence of recurrence

C Removal of all or part of the tumor

D Elimination of distressing signs and symptoms

Question #8

A nurse helps a patient recently diagnosed with a pituitary adenoma understand that:

A Transcranial surgery is usually necessary to remove the tumor.

B Most tumors are malignant (>90%).

C The cause is directly related to prior exposure to radiation.

D Most tumors produce too much of one or more hormones.

Question #9

A patient with amyotrophic lateral sclerosis (ALS) asks if the nurse has heard of a drug that will prolong the patient’s life. The nurse knows that there is a medication that may prolong the life by 3 to 6 months. To which medication is the patient referring?

A Diazepam

B Baclofen

C Dantrolene sodium

D Riluzole

Question #10

In which location are most brain angiomas located?

A Thalamus

B Hypothalamus

C Brainstem

D Cerebellum

Question #11

A client diagnosed with Huntington’s disease has developed severe depression. What would be most important for the nurse to assess for?

A Choreiform movements

B Emotional apathy

C Suicidal ideations

D Loss of bowel and bladder control

Question #12

A client comes to the clinic for evaluation because of complaints of dizzinesss and difficulty walking. Further assessment reveals a staggering gait, marked muscle incoordination, and nystagmus. A brain tumor is suspected. Based on the client’s assessment findings, the nurse would suspect that the tumor is located in which area of the brain?

A Cerebellum

B Motor cortex

C Occipital lobe

D Frontal lobe

Question #13

What is the most common type of brain neoplasm?

A Meningioma

B Neuroma

C Glioma

D Angioma

Question #14

A client seeks care for lower back pain of 2 weeks’ duration. Which assessment finding suggests a herniated intervertebral disk?

A Atrophy of the lower leg muscles

B Pain radiating down the posterior thigh

C Homans’ sign

D Back pain when the knees are flexed

Question #15

The nurse is providing discharge teaching for a client who was admitted to hospital after having complex partial seizures secondary to a glioma. The client has been prescribed levetiracetam to manage the seizures. What should the nurse include in the discharge teaching for this medication?

A Driving a car should be avoided until the you know how this medication effects you.”

B Suicidal ideation is a common side effect of this medication and should be reported immediately.”

C If the previous day’s dose was forgotten, take two at the regular time the next day.”

D If a corticosteroid has been prescribed, do not take it at the same time as this medication.”

Question #16

The nurse is caring for a client who was diagnosed with a glioma 5 months ago. Today, the client was brought to the emergency department by his caregiver because he collapsed at home. The nurse suspects late signs of rising intracranial pressure (ICP) when which blood pressure and pulse readings are noted?

A BP = 150/90 mm Hg; HR = 90 bpm

B BP = 90/50 mm Hg; HR = 75 bpm

C BP = 175/45 mm Hg; HR = 42 bpm

D BP =130/80 mm Hg; HR = 55 bpm

Question #17

The nurse is seeing the mother of a client who states, “I’m so relieved because my son’s doctor told me his brain tumor is benign.” The nurse knows what is true about benign brain tumors?

A prognosis is very poor.

B They can affect vital functioning.

C They do not require surgical removal

D They are all metastatic.

Question #18

A client is diagnosed with a brain angioma. When teaching the client about the risks associated with this type of brain tumor, the nurse would educate about signs and symptoms associated with which condition?

A Hearing loss

B Thyroid disorders

C Visual loss

D Hemorrhagic stroke

Question #19

A 37-year-old mother of three has just been diagnosed with a grade I meningioma. As part of patient education, the nurse tells the patient that:

A The tumor will cause pressure on the eighth cranial nerve.

B Growth is slow and symptoms are caused by compression rather than tissue invasion.

C The tumor is malignant and aggressive

D Surgery, which can result in complete removal of the possible tumor, should be done as soon as possible.

Question #20

What nursing intervention will best assist the client with chorea?

A Assist the client with walking hourly

B Monitor the client on bed rest

C Keep an oral airway at the bedside

D Administer pain medications every 4 hours

Question #21

The nurse is caring for a client hospitalized after a motor vehicle accident. The client has a comorbidity of Parkinson’s disease. Why should the nurse closely monitor the condition and the drug regimen of a client with Parkinson’s disease?

A Clients take an assortment of different drugs.

B Drugs administered may cause a wide variety of adverse effects.

C Drugs administered may not cause the requisite therapeutic effect.

D Clients generally do not adhere to the drug regimen

Question #22

Which of the following outcomes would be most appropriate to include in the plan of care for a client diagnosed with a muscular dystrophy?

A Client describes the importance of diagnostic follow-up to evaluate the disorder.

B Client participates in activities of daily living using adaptive devices.

C Client demonstrates understanding of the need to adhere to medication therapy.

D Client verbalizes understanding of the chronic nature of the disorder.

Question #23

The nursing is assessing a client who has been diagnosed with a pituitary adenoma, but has not yet started treatment. The client reports having increased heart rate, hand tremors, difficulty sleeping, weight loss and hyperthermia. The nurse anticipates the client will require blood work to assess for overproduction of which hormone?

A Thyroid-stimulating hormone

B Prolactin

C Adrenocorticotropic hormone

D Growth hormone

Question #24

The nurse is caring for a client who underwent surgery to remove a spinal cord tumor. When conducting the postoperative assessment, the nurse notes the presence of a bulge at the surgical site. The nurse suspects the client is experiencing what complication from the surgery?

A Cerebrospinal fluid leakage

B Infection at the surgical site

C Impaired tissue healing

D Growth of a secondary tumor

Question #25

The nurse is assessing a client with a confirmed spinal cord tumor. The client states, “I’ve been too embarrassed to tell anyone but, I have been awakened at night because I’ve wet the bed.” It would be a priority for the nurse to further assess the client for which complication?

A Spinal cord compression

B Knowledge deficit

C Impaired skin integrity

D Urinary tract infection

Question #26

The nurse reviews the patient’s drug regimen for treatment of a brain tumor. She explains to the patient why one of the following drugs would not be prescribed, even though it might have therapeutic benefits. Which drug would not be prescribed for this patient?

A Dilantin

B Paclitaxel

C Coumadin

D Decadron

Question #27

A patient is diagnosed with an aggressive, primary malignant brain tumor. The nurse is aware that the glioma:

A Originated within the brain tissue.

B Developed on the cranial nerves.

C Metastasized from a cancer in another part of the body.

D Originated from the coverings of the brain.

Question #28

A patient with a brain tumor is complaining of headaches that are worse in the morning. What does the nurse know could be the reason for the morning headaches?

A Migraines

B The tumor is shrinking.

C Dehydration

D Increased intracranial pressure

Question #29

A client with spinal cord compression from a tumor must undergo diagnostic testing. Which of the following is the most likely procedure for this client?

A Magnetic resonance imaging

B Ultrasonography

C Computed tomography

D Core needle biopsy

Question #30

A male client who has undergone a cervical discectomy is being discharged with a cervical collar. Which of the following would be most appropriate to include the client’s discharge plan?

A Moving the neck from side to side when the collar is off

B Removing the entire collar when shaving

C Wearing the cervical collar when sleeping

D Keeping the head in a neutral position

Question #31

A client with a malignant glioma is scheduled for surgery. The client demonstrates a need for additional teaching about the surgery when he states which of the following?

A Any tissue that was dead will be removed.”

B The surgeon will be able to remove all of the tumor.”

C My headache and nausea should be lessened somwhat.”

D There will be less cancer left that might be resistant to chemotherapy.”

Question #32

A client with a cerebellar brain tumor is admitted to an acute care facility. The nurse formulates a nursing diagnosis of Risk for injury. Which “related-to” phrase should the nurse add to complete the nursing diagnosis statement?

A Related to impaired balance

B Related to difficulty swallowing

C Related to visual field deficits

D Related to psychomotor seizures

Question #33

The nurse is providing discharge teaching to a client with a spinal cord tumor and instructs the client to avoid hot water bottles and heating blankets for what reason?

A Medication side effects

B Motor weakness

C Cognitive impairment

D Impaired sensory perception

Question #34

The nurse is providing health education to a client recently diagnosed with a brain tumor. During the appointment, the client states, “I’m really worried that I will have a seizure while I am at work or with my kids. Should I be concerned about this?” How should the nurse respond?

A There is a risk for seizures in people who have this diagnosis. What have you already discussed with your primary health care provider regarding management of seizures?”

B Seizures are genetic neurological conditions. Do you have anyone in your family with a seizure disorder? If so, this increases the likelihood you will have one.”

C It is not within my scope to discuss this aspect of your care with you. You should talk to your treating primary health care provider about this and discuss options.”

D 60% of people with brain tumors have seizures. There is a strong chance you will have a seizure at some point and should keep a seizure kit close by.”

Question #35

A nurse is providing care to a client recently diagnosed with a brain tumor. When planning this client’s care, the nurse anticipates which therapy as providing the best outcome for the client?

A Surgery

B Radiation therapy

C Chemotherapy

D Immunotherapy

Question #36

The nurse is caring for a patient with Huntington’s disease in the long-term care facility. What does the nurse recognize as the most prominent symptom of the disease that the patient exhibits?

A Rapid, jerky, involuntary movements

B Slow, shuffling gait

C Dementia

D Dysphagia and dysphonia

Question #37

A client with post-polio syndrome displays fatigue and decreased muscle strength. How should the nurse best respond to the client?

A This will pass, you need to relax.”

B Intravenous immunoglobulin infusion may help you.”

C These symptoms are not related to your past diagnosis.”

D Once you sleep, you should be fine.”

Question #38

An acoustic neuroma is a benign tumor of which cranial nerve?

A Fifth

B Ninth

C Seventh

D Eighth

Question #39

Impaired balance and uncontrolled tremors of Parkinson’s disease is correlated with which neurotransmitter?

A Acetylcholine

B Dopamine

C Serotonin

D Glutamate

Question #40

The nurse is assessing a client who was brought to the emergency department due to a severe headache with sudden onset, lowered level of consciousness and slurred, non-sensical speech. The client completed chemotherapy and radiation treatment for a glioma-type brain tumor 6 months ago. The client has been taking low molecular weight heparin since completing treatment. The nurse should be prepared to provide care for which possible problem?

A Deep vein thrombosis

B Pulmonary embolism

C Spinal metastasis

D Intracerebral hemorrhage

Question #41

The nurse is providing discharge teaching to a client who has had surgery for partial removal of a spinal tumor to decompress the spinal cord. Preoperatively, the client had lost sensation to the lower legs. When instructing the client regarding pain management strategies, the nurse should include which information?

A Perform moderate exercise

B Use assistive devices

C Sleep in the recumbent position

D Use heat to decrease back pain

Question #42

The nurse is providing postoperative care for a client who just underwent surgery to remove a metastatic intramedullary tumor. On postoperative day 3, the client states, “I am really looking forward to going running again, it had become too difficult because of the loss of feeling in my feet.” Which should the nurse address in the client’s care plan?

A Knowledge deficit

B Impaired cognition

C Body image disturbance

D Anxiety

Question #43

A patient has recently been diagnosed with an acoustic neuroma. The nurse helps the patient understand that:

A Almost 80% of these tumors become malignant over time.

B Compression of the seventh cranial nerve is a side effect

C Hearing loss usually occurs.

D Surgery is never needed; radiation has proven very effective.

Question #44

A client is admitted reporting low back pain. How will the nurse best determine if the pain is related to a herniated lumbar disc?

A Have the client lie on the back and lift the leg, keeping it straight

B Ask if the client can walk

C Ask the client if there is pain on ambulation

D Ask if the client has had a bowel movement

Question #45

What nursing intervention will best help the client with Huntington disease to increase nutrition? Select all that apply.,,

A Maintain a pureed diet

B Use Relaxation techniques

C Eliminate foods high in fat

D Take phenothiazine prior to meals

E Increase high carbohydrate foods

Question #46

The nurse is caring for a client with mid-to-late stage of an inoperable brain tumor. What teaching is important for the nurse to do with this client?

A Offering family support groups

B Managing muscle weakness

C Explaining hospice care and services

D Optimizing nutrition

Question #47

Which of the following is a late symptom of spinal cord compression?

A Urinary incontinence

B Fecal incontinence

C Urinary retention

D Paralysis

Question #48

Which disease includes loss of motor neurons in the anterior horns of the spinal cord and motor nuclei of the lower brain stem?

A Amyotrophic lateral sclerosis

B Alzheimer disease

C Parkinson disease

D Huntington disease

Question #49

A client is suspected of having amyotrophic lateral sclerosis (ALS). To help confirm this disorder, the nurse prepares the client for various diagnostic tests. The nurse expects the physician to order:

A electromyography (EMG).

B quantitative spectral phonoangiography

C Doppler ultrasonography.

D Doppler scanning

Question #50

The community health nurse is conducting a home visit with a client who was discharged from hospital 3 days ago after surgical resection of a brain tumor and radiation therapy. The client is accompanied by his partner during the nurse’s visit. During the visit, the client’s partner becomes tearful. How should the nurse respond?

A Sometimes people are unhappy about the way they were treated in the hospital. Were you happy with the care your partner received in the hospital?”

B It is okay to say you give up. Are you worried you will not be able to continue to provide care for your partner?”

C Many caregivers experience burnout. Are you experiencing symptoms depression and anxiety?”

D Going through this experience with your partner has been very difficult for you, I’m sure. Can you tell me about your experience so far?”

Question #51

The nurse is caring for a client who has been hospitalized for investigation of a sudden change in gait due to loss of balance and coordination. A magnetic resonance imaging scan reveals the client has a brain tumor. On or close to which brain structure is the tumor most likely situated?

A Brain stem

B Cerebellum

C Pituitary gland

D Temporal lobe

Question #52

The daughter of a patient with Huntington’s disease asks the nurse what the risk is of her inheriting the disease. What is the best response by the nurse?

A If one parent has the disorder, there is an 75% chance that you will inherit the disease.”

B If one parent has the disorder, there is a 50% chance that you will inherit the disease.”

C The disease is inherited and all offspring of a parent will develop the disease.”

D The disease is not hereditary and therefore there is no risk to you.”

Question #53

The nurse is performing an assessment for a patient in the clinic with Parkinson’s disease. The nurse determines that the patient’s voice has changed since the last visit and is now more difficult to understand. How should the nurse document this finding?

A Hypokinesia

B Micrographia

C Dysphonia

D Dysphagia

Question #54

A patient is exhibiting bradykinesia, rigidity, and tremors related to Parkinson’s disease. The nurse understands that these symptoms are directly related to what decreased neurotransmitter level?

A Acetylcholine

B Serotonin

C Phenylalanine

D Dopamine

Question #55

Which of the following diagnostic studies provides visualization of cerebral blood vessels?

A Computer-assisted stereotactic biopsy

B Cytologic studies of cerebrospinal fluid (CSF)

C Positron emission tomography (PET)

D Cerebral angiography

Question #56

A 55-year-old female client presents at the walk-in clinic complaining of feeling like a mask is on her face. While doing the initial assessment, the nurse notes the demonstration of a pill-rolling movement in the right hand and a stooped posture. Physical examination shows bradykinesia and a shuffling gait. What would the nurse suspect is the causative factor for these symptoms?

A Parkinson’s disease

B Myesthenia gravis

C Huntington’s disease

D Multiple sclerosis

Question #57

A Drugs administered may not cause the requisite therapeutic effect

B Clients generally do not adhere to the drug regimen

C Clients take an assortment of different drugs

D Drugs administered may cause a wide variety of adverse effects.

Question #58

The nurse identifies a nursing diagnosis of self-care deficit, bathing related to motor impairment and decreased cognitive function for a client with cerebral metastasis. Which outcome would the nurse most likely identify on this client’s plan of care?

A Client participates in daily hygiene activities with assitive devices.

B Client expreses feelings related to self-care ability.

C Client demonstrates positive coping strategies.

D Client consumes adequate calories to meet energy needs.

Question #59

Which anticholinergic agent is used to control tremor and rigidity in Parkinson disease?

A Levodopa

B Amantadine

C Bromocriptine mesylate

D Benztropine Mesylate

Question #60

The nurse is seeing a client who is suspected of having a glioblastoma multiforme tumor. The nurse anticipates the client will require which diagnostic test to confirm the client has this form of brain tumor?

A Tissue biopsy

B Audible bruit over the skull

C Weber and Rinne test

D increase in prolactin

Question #61

A patient with a brain tumor is complaining of headaches that are worse in the morning. What does the nurse know could be the reason for the morning headaches?

A The tumor is shrinking.

B Increased intracranial pressure

C Migraines

D Dehydration

Question #62

The nurse teaches the client with which disorder that the disease is due to decreased levels of dopamine in the basal ganglia of the brain?

A Huntington disease

B Parkinson disease

C Multiple sclerosis

D Creutzfeldt-Jakob disease

Question #63

The nurse is caring for a client with an inoperable brain tumor. What is a major threat to this client?

A Hypervolemia

B Increased intracranial pressure

C Hypovolemia

D Decreased intracranial pressure

Question #64

Which term is used to describe edema of the optic nerve?

A Papilledema

B Angioneurotic edema

C Lymphedema

D Scotoma

Question #65

Which statement(s) reflect nursing interventions for a client with post-polio syndrome?

A The nurse administers antiretroviral agents per order

B The nurse plans patient activities for evening hours rather then morning hours

C The nurse must avoid the use of heat applications in the treatment of muscle and joint pain

D The nurse provides care aimed at slowing the loss of strength and maintaining the physical, psychological and social well being of the client

Question #66

A client with amyotrophic lateral sclerosis (ALS) tells the nurse, “Sometimes I feel so frustrated. I can’t do anything without help!” This comment best supports which nursing diagnosis?

A Powerlessness

B Anxiety

C Risk for disuse syndrome

D Ineffective denial

Question #67

A client was undergoing conservative treatment for a herniated nucleus pulposus, at L5 – S1, which was diagnosed by magnetic resonance imaging. Because of increasing neurologic symptoms, the client undergoes lumbar laminectomy. The nurse should take which step during the immediate postoperative period?

A Have the client sit up in a chair as much as possible

B Discourage the client from doing any range-of-motion (ROM) exercises

C Logroll the client from side to side

D Elevate the head of the bed to 90 degrees

Question #68

A client is scheduled for a laminectomy to repair a herniated intervertebral disk. When developing the postoperative care plan, the nurse should include which action?

A Keeping a pillow under the client’s knees at all times

B Turning the client from side to side, using the logroll technique

C Maintaining bed rest for 72 hours after the laminectomy

D Placing the client in semi-Fowler’s position

Question #69

Bone density testing will be completed for the client with post-polio syndrome. The nurse teaches the client bone density testing is used to identify what potential complication?

A Pathologic fractures

B Calcification of long bones

C Osteoarthritis

D Low bone mass and osteoporosis

Question #70

Which client should the nurse assess for degenerative neurologic symptoms?

A The client with Huntington disease.

B The client with glioma.

C The client with Paget disease.

D The client with osteomyelitis.

Question #71

What is the only known risk factor for brain tumors?

A Head trauma

B Use of hair dyes

C Cellular telephones

D Ionizing radiation

Question #72

A client has a herniated disk in the region of the third and fourth lumbar vertebrae. Which nursing assessment finding most supports this diagnosis?

A Weakness and atrophy of the arm muscles

B Hypoactive bowel sounds

C Sensory deficits in one arm

D Severe lower back pain

Question #73

A Related to visual field deficits

B Related to psychomotor seizures

C Related to impaired balance

D Related to difficulty swallowing

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