Neuro Practice QuestionsMultiple Choice

Identify the choice that best completes the statement or answers the question.

____ 1. The nurse recognizes which pathophysiologic feature as a hallmark of Guillain-Barré syndrome?

a. Nerve impulses are not transmitted to skeletal muscle.

b. The immune system destroys the myelin sheath.

c. The distal nerves degenerate and retract.

d. Antibodies to acetylcholine receptor sites develop.

____ 2. The nurse assesses a client who has Guillain-Barré syndrome. Which clinical manifestation does the

nurse expect to find in this client?

a. Ophthalmoplegia and diplopia

b. Progressive weakness without sensory involvement

c. Progressive, ascending weakness and paresthesia

d. Weakness of the face, jaw, and sternocleidomastoid muscles

____ 3. The intensive care nurse is caring for a client who has Guillain-Barré syndrome. The nurse notes that

the client’s vital capacity has declined to 12 mL/kg, and the client is having difficulty clearing

secretions. Which is the nurse’s priority action?

a. Place the client in a high Fowler’s position.

b. Prepare the client for elective intubation.

c. Administer oxygen via a nasal cannula.

d. Auscultate for breath sounds.

____ 4. A client who has Guillain-Barré syndrome is scheduled for plasmapheresis. Before the procedure,

which clinical manifestation does the nurse use to determine patency of the client’s arteriovenous

shunt?

a. Palpable distal pulses

b. A pink, warm extremity

c. The presence of a bruit

d. Shunt pressure higher than 25 mm Hg

____ 5. The nurse assesses a client with Guillain-Barré syndrome during plasmapheresis. Which

complication does the nurse monitor for during this procedure?

a. Tachycardia

b. Hypovolemia

c. Hyperkalemia

d. Hemorrhage

____ 6. The nurse teaches a client with Guillain-Barré syndrome (GBS) about the recovery rate of this

disorder. Which statement indicates that the client correctly understands the teaching?

a. “I need to see a lawyer because I do not expect to recover from this disease.”

b. “I will have to take things slowly for several months after I leave the hospital.”

c. “I expect to be able to return to work in construction soon after I get discharged.”

d. “I wonder if my family will be able to manage my care now that I am paralyzed.”

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____ 7. The nurse assesses a client who has myasthenia gravis. Which clinical manifestation does the nurse

expect to observe in this client?

a. Inability to perform the six cardinal positions of gaze

b. Lateralization to the affected side during the Weber test

c. Absent deep tendon reflexes

d. Impaired stereognosis

____ 8. The nurse is assessing laboratory results for a client with myasthenia gravis (MG). Which results

does the nurse correlate with this disease process?

a. Elevated serum calcium level

b. Decreased thyroid hormone level

c. Decreased complete blood count

d. Elevated acetylcholine receptor antibody levels

____ 9. A client suspected to have myasthenia gravis is scheduled for the Tensilon (edrophonium chloride)

test. Which prescribed medication does the nurse prepare to administer if complications of this test

occur?

a. Epinephrine

b. Atropine sulfate

c. Diphenhydramine

d. Neostigmine bromide

____ 10. The nurse is caring for a client who has myasthenia gravis. Which nursing intervention does the

nurse implement to reduce muscle weakness in this client?

a. Administer a therapeutic massage.

b. Collaborate with the physical therapist.

c. Perform passive range-of-motion exercises.

d. Reposition the client every 2 hours.

____ 11. The nurse is assessing a client who is experiencing a myasthenia crisis. Which diagnostic test does

the nurse anticipate being ordered?

a. Babinski reflex test

b. Tensilon test

c. Cholinesterase challenge test

d. Caloric reflex test

____ 12. A client who has myasthenia gravis is receiving atropine for a cholinergic crisis. Which intervention

does the nurse implement for this client?

a. Suction the client to remove secretions.

b. Turn and reposition the client every 2 hours.

c. Measure urinary output every 30 minutes.

d. Administer prescribed anticholinergic drugs as needed.

____ 13. The nurse instructs a client who has myasthenia gravis to take prescribed medications on time and to

eat meals 45 to 60 minutes after taking anticholinesterase drugs. The client asks why the timing of

meals is so important. Which is the nurse’s best response?

a. “This timing allows the drug to have maximum effect, so it is easier for you to

chew, swallow, and not choke.”

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b. “This timing prevents your blood sugar level from dropping too low and causing

you to be at risk for falling.”

c. “These drugs are very irritating to your stomach and could cause ulcers if taken too

long before meals.”

d. “These drugs cause nausea and vomiting. By waiting a while after you take the

medication, you are less likely to vomit.”

____ 14. A client with myasthenia gravis is preparing for discharge. Which instructions does the nurse include

when educating the client’s family members or caregiver?

a. Technique for therapeutic massage to the lower extremities

b. Administration of morphine sulfate via an IV pump

c. Instructions for preparing thin, puréed foods

d. Cardiopulmonary resuscitation (CPR)

____ 15. The nurse teaches a client who has autonomic dysfunction about injury prevention. Which statement

indicates that the client correctly understands the teaching?

a. “I will change positions slowly.”

b. “I will avoid wearing cotton socks.”

c. “I will use an electric razor.”

d. “I will use a heating pad on my feet.”

____ 16. The nurse is assessing a client with trigeminal neuralgia. Which clinical manifestation does the nurse

expect to observe?

a. Excruciating pain

b. Decreased mobility

c. Controllable facial twitching

d. Increased talkativeness

____ 17. The nurse is assessing a client who had a dissection of all branches of the right trigeminal nerve.

When asked to wrinkle his forehead, the client wrinkles only the left side. Which is the nurse’s best

action?

a. Place the client in high Fowler’s position.

b. Document the finding.

c. Assess the corneal reflex.

d. Notify the health care provider.

____ 18. A client with trigeminal neuralgia is about to undergo surgery for pain relief. The client asks, “How

will this surgery relieve my pain?” How does the nurse respond?

a. “The surgeon will cut the connection between the cranial nerves.”

b. “The surgeon will use an electrode to bypass the trigeminal nerve conduction.”

c. “An incision is made into the nerve itself, and an anesthetic is applied to the area.”

d. “A small artery compressing the nerve will be relocated.”

____ 19. The nurse is teaching a client who is receiving carbamazepine (Tegretol) for chronic trigeminal

neuralgia. Which statement indicates that the client correctly understands the teaching?

a. “This drug will prevent seizures, which can occur because of trigeminal disease.”

b. “I expect to have surgery soon, so I can stop taking this drug now.”

c. “This medication is very successful in relieving pain. I am glad to be taking it.”

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d. “I will avoid drinking alcohol because it can add to the side effects of this

medicine.”

____ 20. The nurse is obtaining a health history for a 45-year-old woman with Guillain-Barré syndrome

(GBS). Which statement by the client does the nurse correlate with the client’s diagnosis?

a. “My neighbor also had Guillain-Barré syndrome.”

b. “I had a viral infection about 2 weeks ago.”

c. “I am an artist and work with oil paints.”

d. “I have a history of a cardiac dysrhythmia.”

____ 21. A client who had a brain attack was admitted to the intensive care unit yesterday. The nurse observes

that the client is becoming lethargic and is unable to articulate words when speaking. What does the

nurse do next?

a. Check the client’s blood pressure and apical heart rate.

b. Elevate the back rest to 30 degrees and notify the health care provider.

c. Place the client in a supine position with a flat back rest, and observe.

d. Assess the client’s white blood cell count and differential.

____ 22. The nurse is caring for a client admitted to the intensive care unit after incurring a basilar skull

fracture. Which complication of this injury does the nurse monitor for?

a. Aspiration

b. Hemorrhage

c. Pulmonary embolus

d. Myocardial infarction

____ 23. A client who has a head injury is transported to the emergency department. Which assessment does

the emergency department nurse perform immediately?

a. Pupil response

b. Motor function

c. Respiratory status

d. Short-term memory

____ 24. The nurse is caring for a client who has a moderate head injury. The client’s sister asks, “Will my

brother return to his normal functioning level when his brain heals?” How does the nurse respond?

a. “You should expect a full recovery in all ways by the time of discharge.”

b. “Usually, someone with this type of injury returns to baseline within 6 months.”

c. “Your brother may experience many changes in personality and cognitive

abilities.”

d. “Learning complex new skills may be more difficult, but you can expect other

functions to return to normal.”

____ 25. A client who has a severe head injury is placed in a drug-induced coma. The client’s husband states,

“I do not understand. Why are you putting her into a coma?” How does the nurse respond?

a. “These drugs will prevent her from experiencing pain when positioning or

suctioning is required.”

b. “This medication will help her remain cooperative and calm during the painful

treatments.”

c. “This medication will decrease the activity of her brain so that additional damage

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