Neuro
You’re caring for a patient with Parkinson’s Disease that has tremors. Select the option that is INCORRECT about tremors experienced in this disease:
A. The tremors are most likely to occur with purposeful movements.
B. A common term used to describe the tremors in the hands and fingers is called “pill-rolling”.
C. Tremors are one of the most common signs and symptoms in Parkinson’s Disease.
D. Tremors in this disease can occur in the hands, fingers, arms, legs and even the lips and tongue
A. is incorrect because tremors with PD tend to occur at rest and will actually improve with movment
Distal to proximal; death from respiratory failure once the disease hits the diaphragm
A client appears upset and tearful, but denies pain and refuses pain medication, because “my sibling is a drug addict and has ruined out lives.” What is the priority intervention for this client?
A. Encourage expression of fears on past experiences.
B. Provide accurate information about use of pain medication.
C. Explain that addiction is unlikely among acute care clients.
D. Seek family assistance in resolving this problem.
A patient with severe COPD is having an episode of extreme shortness of breath and requests their inhaler. Which type of inhaler ordered by the physician would provide the FASTEST relief for the patient based on this particular situation?
A. Spiriva
B. Salmeterol
C. Symbicort
D. Albuterol
D. Albuterol
Type of COPD associated with copious sputum and a productive cough
Chronic Bronchitis (blue bloater)
What is the purpose of Carbidopa?
It is used as a "transporter" to prevent Levidopa from being converted to DA before getting to the brain
Damage to the right posterior column of the spinal cord will cause loss of what sensations and on which side of the body?
Loss of tactile sensation; proprioception, delicate touch, vibration on the right side (ipsilateral)
Place the examples of drugs in the order of usage according to the World Health Organization (WHO) analgesic ladder.
A. Morphine, hydromorphone, acetaminophen and lorazepam
B. NSAIDs and corticosteroids
C. Codeine, oxycodone and diphenhydramine
B, C, A;
Step 1 includes non-opioids and adjuvant drugs. Step 2 includes opioids for mild pain plus Step 1 drugs and adjuvant drugs as needed.
Step 3 includes opioids for severe pain (replacing Step 2 opioids) and continuing Step 1 drugs and adjuvant drugs as needed
You are providing care to a patient with COPD who is receiving medical treatment for exacerbation. The patient has a history of diabetes, hypertension, and hyperlipidemia. The patient is experiencing extreme hyperglycemia. In addition, the patient has multiple areas of bruising on the arms and legs. Which medication ordered for this patient can cause hyperglycemia and bruising?
A. Prednisone
B. Atrovent
C. Flagyl
D. Levaquin
A. Prednisone
A patient with emphysema may present with all of the following symptoms EXCEPT?
A. Barrel chest
B. Hyperinflation of the lung
C. Hypoventilation
D. Hypercapnia
C. Hypoventilation
Parkinson's disease affects the ________ of the midbrain which leads to the depletion of the neurotransmitter _______.
A. red nucleus, acetylcholine
B. leminisci, norepinephrine
C. substantia nigra, dopamine
D. tectum nigra, dopamine
C. substantia nigra, dopamine
How do a lot of Topical Non-opioids work in relation to the gate-control theory of pain?
The A-beta fibers are stimulated which help to close/block the painful stimulus; the less painful stimulus is getting though and the painful stimulus is not
Which client is at greater risk for respiratory depression while receiving opioids for analgesia?
A. An elderly chronic pain client with a hip fracture
B. A client with a heroin addiction and back pain
C. A young female client with advanced multiple myeloma
D. A child with an arm fracture and cystic fibrosis
D. child with fractured arm and cystic fibrosis
-greatest risk= elderly, opiate naive, underlying pulmonary disease; the child has two of three
Used for long term control for asthma and COPD. What should you avoid with this drug
Methylxanthines; avoid caffeine
Select ALL the options that are TRUE about chronic bronchitis and emphysema:
A. Patients with chronic bronchitis have the ability to fully exhale but have limited airflow.
B. Emphysema and chronic bronchitis are irreversible.
C. An incentive spirometer is used to diagnose both chronic bronchitis and emphysema.
D. Patients with chronic bronchitis are sometimes referred to as “blue bloaters, while patients with emphysema are sometimes referred to as “pink puffers”.
B (emphysema and chronic bronchitis are irreversible), D (chronic bronchitis= blue bloaters and emphysema= pink puffers)
9. During your discharge teaching to a patient with multiple sclerosis, you educate the patient on how to avoid increasing symptoms and relapses. You tell the patient to avoid:
A. Cold temperatures
B. Infection
C. Overexertion
D. Salt
F. Stress
B, C, F
-they should also avoid extreme heat which can increase symptoms
An injury to the Anterolateral/Spinothalamic tract on the Left side will cause a loss of what and on what side of the body?
Loss of pain, thermal sensation, crude touch and pressure on the right side (Contralateral)
What is the best way to schedule medication for a client with constant pain?
A. PRN at the client’s request
B. Q 4 hour dosing
C. IV bolus after pain assessment
D. PCA pump
D. PCA pump provides the most steady analgesia and pain control
Used prophylactically to decrease inflammation, bronchial hyperactivity and decrease mucus production in the airway
Beclamethasone
What is the stimulus for those with COPD to breathe vs. for those without COPD (normal breathing stimulus)
hypoxic drive vs. hypercapneic drive
Order in which we give meds for MS (1st, 2nd, 3rd line)
1st= corticosteroids (for acute attack; inflammation)
2nd=interferon-B (immune enhancing cytokine; reduce exacerbations)
3rd= treat symptoms; Baclofen or diazepam (muscle relaxants, antidepresants)
A patient is receiving Interferon Beta for treatment of multiple sclerosis. As the nurse you will stress the importance of?
A. Physical exercise to improve fatigue
B. Low fat diet
C. Hand hygiene and avoiding infection
D. Reporting ideation of suicide
C. Interferon Beta decreases the number of relapses of symptoms in MS patients by decreasing the immune system response, but it lowers the white blood cells count. Hence, there is a risk of infection. It is very important the nurse stresses the importance of hand hygiene and avoiding infection.
Considered "the new frontier" of pain management. Does not deal with passing from mother to daughter cells but how DNA changes its 3D conformation
Epigenetics
First line prophylaxis for asthma; prevents exercise induced bronchospasm
Cromolyn and Nedocromil
This disease has both symptoms of pulmonary disease and right heart failure
Cor Pulmonale: it is right heart failure caused by pulmonary HTN and lung disease