Deck 71: Management of Clients with Peripheral Nervous System Disorders

Question 1

Before the administration of the first dose of carbamazepine (Tegretol) to a client with trigeminal neuralgia, the nurse should

A) assess the client's deep tendon reflexes.
B) check the client's blood pressure.
C) determine if the client abuses alcohol.
D) remind the client to remain in bed for 20 minutes after receiving the drug.

Answer 1

determine if the client abuses alcohol.

Question 2

The client hospitalized for severe lumbar disk pain asks the nurse to equip his bed with a trapeze. In response to this request, the nurse should

A) apply the trapeze mount to the bed.
B) call the physician for an order for the trapeze.
C) delay applying the trapeze mount until the client is more comfortable.
D) explain that a trapeze is contraindicated because it promotes twisting.

Answer 2

explain that a trapeze is contraindicated because it promotes twisting.

Question 3

The nurse would assist the client with low back pain resulting from herniated lumbar disk into the position of

A) either to the right or left side with knees straight.
B) prone with a very small pillow under the head.
C) side-lying with knees flexed.
D) supine with head elevated 90 degrees.

Answer 3

side-lying with knees flexed.

Question 4

The nurse instructs a group of secretaries that which activities could prevent carpal tunnel syndrome?

A) Getting up and walking every hour
B) Routine use of nonsteroidal anti-inflammatory medication
C) Splinting and elevation of the hand
D) Worksite evaluation and modifications

Question 5

When the client who had a cervical spinal fusion this morning complains of a sudden radicular pain, the nurse is

A) alerted because this indicates possible infection.
B) concerned because this indicates possible meningitis.
C) distressed because of the possible need to repeat the surgery.
D) relieved because this indicates a reduction in edema.

Question 6

The nurse would question a client with suspected trigeminal neuralgia about facial pain that is

A) characterized by intermittent episodes of severe pain with gradual onset.
B) characterized by intermittent episodes of severe pain with sudden onset.
C) constant and aching or burning in nature.
D) constant, severe, and sharp in nature.

Question 7

A client's medical record notes a forward slipping of the L5 vertebra. The nurse expects that the diagnosis at the end of the report will state

A) back strain.
B) disk herniation.
C) lordosis.
D) spondylolisthesis.

Question 8

On the second postoperative day following herniated disk surgery, the client says, "My legs are numb. I thought surgery was going to fix my problems." The nurse's best response to explain the continued pain is

A) "Because of the surgery, there is some swelling, which should subside."
B) "This pain is from the anesthesia and will subside by this afternoon."
C) "This pain is positional and will subside if you roll over on your side."
D) "You are probably moving around too much. I will raise the knee gatch."

Question 9

Important discharge instructions for the client with a cervical disk problem being discharged with a cervical collar include

A) ambulate carefully to avoid falls.
B) perform active range-of-motion exercises four times daily.
C) release the Velcro strap every 2 hours while awake.
D) wash the collar with mild soap and water daily.

Question 10

In performing a neurologic evaluation of a client who had lumbar surgery 36 hours ago, it is important that the nurse assess

A) ability to move shoulders.
B) leg movement.
C) level of consciousness.
D) reflex response.

Question 11

A client with Bell's palsy tells the nurse that s/he is very depressed about having the disease. The most informative response from the nurse would be

A) "Bell's palsy can be treated successfully with medication."
B) "I understand how you feel; it is difficult to live with a chronic disease."
C) "Surgery has been very successful in improving the problem."
D) "The symptoms are likely to disappear or get better within a few weeks."

Question 12

The nurse conducting an admission interview for a client with a herniated lumbar disk would be certain to ask the client about a history of

A) abdominal trauma.
B) developmental problems of the spine.
C) history of meningitis.
D) previous back injury.

Question 13

On the first postoperative day, a client who had a cervical surgery requests the bedpan often, but cannot void. Based on these observations, the nurse should

A) assess for bladder distention.
B) assess for manifestations of urinary tract infection.
C) document this outcome as normal.
D) increase fluid intake.

Question 14

The nurse points out the physical therapy modality that would be avoided in the treatment for a client with Bell's palsy is

A) cold packs.
B) facial nerve stimulation with faradic current.
C) gentle massage.
D) moist heat.

Question 15

The spouse of a client who suffers from chronic back pain is exasperated by the client's crankiness and sarcastic way of talking. The nurse should base a response to the spouse based on the knowledge that

A) chronic pain can lead to depression and personality changes.
B) clients with back pain often become addicted to narcotics.
C) often spouses are not supportive and this frustrates the clients.
D) when clients are non-compliant with treatment plans, they often act out.

Question 16

The nurse would instruct a client who has undergone microvascular decompression surgery of the trigeminal nerve to

A) chew on the affected side of the mouth.
B) eat foods that are very warm or very cold for better taste.
C) resume a full diet immediately.
D) use a water jet device instead of a toothbrush.

Question 17

The nurse explains that the client diagnosed with a spinal tumor will receive

A) radiation and/or chemotherapy.
B) radiation therapy and/or immunotherapy.
C) surgery and/or chemotherapy.
D) surgery and/or radiation therapy.

Question 18

A client with acute disk herniation began using ice for analgesia along with medication therapy. The nurse explains that the client will be switched to heat therapy after

A) 24 hours.
B) 48 hours.
C) 72 hours.
D) 96 hours.

Question 19

The nurse should assess a client who has had unrelieved trigeminal neuralgia for the past 6 months for

A) alcohol consumption.
B) suicidal ideation.
C) vocational rehabilitation.
D) weight gain.

Question 20

The nurse would recommend that the habit that should be modified to reduce the incidence of back pain is

A) eating a high-fiber diet.
B) mild exercise three times a week.
C) sitting for long periods, rather than standing.
D) using leg muscles when lifting.

Question 21

A client has returned to the nursing unit after having a cervical fusion from the anterior approach. What piece of equipment does the nurse ensure is at the bedside?

A) A patient-controlled analgesia (PCA) pump
B) Emergency tracheostomy set
C) Humidified oxygen
D) Suction setup and rigid suction catheter

Question 22

The nurse explains that the assessment of the salivary nicotine levels before a spinal fusion surgery is done to reduce the risk of

A) cardiac dysrhythmias.
B) nonunion.
C) sudden hypertension.
D) vasospasm.

Question 23

The point the nurse should stress in giving home instructions to the client regarding home care following carpal tunnel release surgery is

A) flex and extend the fingers every 4 hours while awake.
B) notify the physician if part of the hand becomes cold or tingly.
C) restrict lifting for 2 weeks.
D) wear a splint for 24 to 48 hours.

Question 24

To promote back health, nursing personnel are instructed in good body mechanics, which include (Select all that apply)

A) avoid twisting the body when lifting.
B) hold objects away from the body when lifting in case they are dropped.
C) keep heavy objects close to the body when lifting.
D) participate in exercises to strengthen abdominal and back muscles.

Question 25

The nurse outlines that the usual remedy to achieve wrist rest for a client with carpal tunnel syndrome is

A) applying a wrist splint.
B) encouraging use of analgesics.
C) supporting the hand on a pillow.
D) using a special adaptor on a keyboard.