NURS 321 Final Exam | Comprehensive Medical-Surgical Nursing and Pharmacology Review
Which of the following would be appropriate to utilize in diagnosing increased ICP? Select all that apply.
a. Cranial X-ray
b. CT Scan of the brain
c. Neurological Assessment
d. Ventriculostomy - (ANSWER)b, c, and d
In assessing the patient with scleroderma for pending renal crisis, which findings require an intervention
by the nurse? (Select all that apply.)
A. Significant weight gain
B. Blood pressure 174/100 mm Hg
C. Creatinine 1.9 mg/dL
D. Clear urine output
E. BUN 15 mg/dL - (ANSWER)A, B, and C
Which is true regarding the pathophysiology of myasthenia gravis (MG)?
a. An inadequate amount of acetylcholine (Ach) is released.
b. Acetylcholine (Ach) crosses the synaptic clefts and attaches to Ach receptors (AchR).
c. T cells or T lymphocytes are produced by the thymus gland.
d. Sensitivity to normal amounts of acetylcholine is diminished. - (ANSWER)d. Sensitivity to normal
amounts of acetylcholine is diminished.
Which type of surgery is usually performed for a patient with myasthenia gravis (MG)?
a. Microvascular decompression
b. Thymectomy
,NURS 321 Final Exam | Comprehensive Medical-Surgical Nursing and Pharmacology Review
c. Percutaneous rhizotomy
d. Sterotactic radiosurgery - (ANSWER)b. Thymectomy
Which nursing intervention is essential while caring for a patient with myasthenia gravis (MG)?
a. Keeping the head of the bed in a lowered position
b. Providing meals when medications are at trough levels
c. Offering soft foods and thickened liquids per the order of the speech therapist
d. Encouraging the patient to refrain from taking breaks by keeping him or her involved in activities of
daily living (ADLs) - (ANSWER)c. Offering soft foods and thickened liquids per the order of the speech
therapist
A nurse is teaching about nursing actions for caring for patients with Guillain-Barré syndrome (GBS).
Which statement indicates a need for further teaching?
a. "Do not keep the patient in a single position."
b. "Do not offer any kind of diversions to the patient."
c. "Establish methods of communication, and provide a method to call the nurse."
d. "Discuss the use of analgesics or nonopioids with the healthcare provider." - (ANSWER)b. "Do not
offer any kind of diversions to the patient."
Which feature of a cholinergic crisis may a patient encounter if he or she has myasthenia gravis (MG)?
a. Pale and cool skin
b. Tachycardia
c. Excessive secretions
d. Flaccid muscles - (ANSWER)c. Excessive secretions
Which is true regarding a cholinergic crisis?
,NURS 321 Final Exam | Comprehensive Medical-Surgical Nursing and Pharmacology Review
a. It is caused by lack of anticholinesterase medication.
b. It is an exacerbation of myasthenic gravis weakness that provokes an acute episode of respiratory
failure.
c. It is characterized by a clinical feature such as tachycardia.
d. It is caused by an excessive intake of anticholinesterase medication. - (ANSWER)d. It is caused by an
excessive intake of anticholinesterase medication.
Which is a clinical feature of a myasthenic crisis? Select all that apply.
a. Tachycardia
b. Sweating and excessive secretions
c. Pale, cool skin
d. Bradycardia
e. Flaccid muscles - (ANSWER)a, c, and e
Rationale: Sweating, excessive secretions, & bradycardia are symptoms of cholinergic crisis
Which diagnostic test is useful in distinguishing a myasthenic crisis from a cholinergic crisis?
a. Repetitive nerve stimulation (RNS)
b. Tensilon test
c. Chest computed tomography (CT) scan
d. Serological test - (ANSWER)b. Tensilon test
The nurse is caring for a patient with amyotrophic lateral sclerosis (ALS). What risks require additional
actions by the nurse?
a. Seizures
, NURS 321 Final Exam | Comprehensive Medical-Surgical Nursing and Pharmacology Review
b. Paralysis
c. Pneumonia
d. Muscle spasm - (ANSWER)c. Pneumonia
Which are clinical manifestations of amyotrophic lateral sclerosis (ALS)? Select all that apply.
a. Double or blurred vision
b. Difficulty swallowing
c. Fasciculation
d. Tremor
e. Memory loss - (ANSWER)b and c
After assessing a patient with amyotrophic lateral sclerosis, the nurse finds that the oral communication
of the patient is impaired. Which should the nurse document in the patient's medical record?
a. Dysarthria
b. Motor neuron death
c. Muscle weakness
d. Respiratory muscle weakness - (ANSWER)a. Dysarthria
The nurse is assessing a patient who reports severe, unrelenting pain in and around the eye. The pain
occurs around the same time for several weeks, more often at night. Which kind of headache is the
patient most likely experiencing?
a. Cluster headaches
b. Migraine headaches
c. Episodic tension headaches
d. Chronic tension headaches - (ANSWER)a. Cluster headaches
Which of the following would be appropriate to utilize in diagnosing increased ICP? Select all that apply.
a. Cranial X-ray
b. CT Scan of the brain
c. Neurological Assessment
d. Ventriculostomy - (ANSWER)b, c, and d
In assessing the patient with scleroderma for pending renal crisis, which findings require an intervention
by the nurse? (Select all that apply.)
A. Significant weight gain
B. Blood pressure 174/100 mm Hg
C. Creatinine 1.9 mg/dL
D. Clear urine output
E. BUN 15 mg/dL - (ANSWER)A, B, and C
Which is true regarding the pathophysiology of myasthenia gravis (MG)?
a. An inadequate amount of acetylcholine (Ach) is released.
b. Acetylcholine (Ach) crosses the synaptic clefts and attaches to Ach receptors (AchR).
c. T cells or T lymphocytes are produced by the thymus gland.
d. Sensitivity to normal amounts of acetylcholine is diminished. - (ANSWER)d. Sensitivity to normal
amounts of acetylcholine is diminished.
Which type of surgery is usually performed for a patient with myasthenia gravis (MG)?
a. Microvascular decompression
b. Thymectomy
,NURS 321 Final Exam | Comprehensive Medical-Surgical Nursing and Pharmacology Review
c. Percutaneous rhizotomy
d. Sterotactic radiosurgery - (ANSWER)b. Thymectomy
Which nursing intervention is essential while caring for a patient with myasthenia gravis (MG)?
a. Keeping the head of the bed in a lowered position
b. Providing meals when medications are at trough levels
c. Offering soft foods and thickened liquids per the order of the speech therapist
d. Encouraging the patient to refrain from taking breaks by keeping him or her involved in activities of
daily living (ADLs) - (ANSWER)c. Offering soft foods and thickened liquids per the order of the speech
therapist
A nurse is teaching about nursing actions for caring for patients with Guillain-Barré syndrome (GBS).
Which statement indicates a need for further teaching?
a. "Do not keep the patient in a single position."
b. "Do not offer any kind of diversions to the patient."
c. "Establish methods of communication, and provide a method to call the nurse."
d. "Discuss the use of analgesics or nonopioids with the healthcare provider." - (ANSWER)b. "Do not
offer any kind of diversions to the patient."
Which feature of a cholinergic crisis may a patient encounter if he or she has myasthenia gravis (MG)?
a. Pale and cool skin
b. Tachycardia
c. Excessive secretions
d. Flaccid muscles - (ANSWER)c. Excessive secretions
Which is true regarding a cholinergic crisis?
,NURS 321 Final Exam | Comprehensive Medical-Surgical Nursing and Pharmacology Review
a. It is caused by lack of anticholinesterase medication.
b. It is an exacerbation of myasthenic gravis weakness that provokes an acute episode of respiratory
failure.
c. It is characterized by a clinical feature such as tachycardia.
d. It is caused by an excessive intake of anticholinesterase medication. - (ANSWER)d. It is caused by an
excessive intake of anticholinesterase medication.
Which is a clinical feature of a myasthenic crisis? Select all that apply.
a. Tachycardia
b. Sweating and excessive secretions
c. Pale, cool skin
d. Bradycardia
e. Flaccid muscles - (ANSWER)a, c, and e
Rationale: Sweating, excessive secretions, & bradycardia are symptoms of cholinergic crisis
Which diagnostic test is useful in distinguishing a myasthenic crisis from a cholinergic crisis?
a. Repetitive nerve stimulation (RNS)
b. Tensilon test
c. Chest computed tomography (CT) scan
d. Serological test - (ANSWER)b. Tensilon test
The nurse is caring for a patient with amyotrophic lateral sclerosis (ALS). What risks require additional
actions by the nurse?
a. Seizures
, NURS 321 Final Exam | Comprehensive Medical-Surgical Nursing and Pharmacology Review
b. Paralysis
c. Pneumonia
d. Muscle spasm - (ANSWER)c. Pneumonia
Which are clinical manifestations of amyotrophic lateral sclerosis (ALS)? Select all that apply.
a. Double or blurred vision
b. Difficulty swallowing
c. Fasciculation
d. Tremor
e. Memory loss - (ANSWER)b and c
After assessing a patient with amyotrophic lateral sclerosis, the nurse finds that the oral communication
of the patient is impaired. Which should the nurse document in the patient's medical record?
a. Dysarthria
b. Motor neuron death
c. Muscle weakness
d. Respiratory muscle weakness - (ANSWER)a. Dysarthria
The nurse is assessing a patient who reports severe, unrelenting pain in and around the eye. The pain
occurs around the same time for several weeks, more often at night. Which kind of headache is the
patient most likely experiencing?
a. Cluster headaches
b. Migraine headaches
c. Episodic tension headaches
d. Chronic tension headaches - (ANSWER)a. Cluster headaches
