NCLEX - Neurological Questions (Saunders)
NCLEX - Neurological Questions (Saunders)
Study online at https://quizlet.com/_6w4emp
1. The client with myasthenia gravis is Hypertension
suspected of having cholinergic crisis. Rationale: Cholinergic crisis occurs as a result
Which sign/symptom indicates this crisis of an overdose of medication. Indications of
is taking place? cholinergic crisis include gastrointestinal dis-
1. Ataxia turbances, nausea, vomiting, diarrhea, abdom-
2.Mouth sores inal cramps, increased salivation and tearing,
3.Hypothermia miosis, hypertension, sweating, and increased
4.Hypertension bronchial secretions.
2. The client is receiving meperidine hy- 2. Tremors
drochloride for pain. Which signs/symp- 3.Drowsiness
toms are side and adverse effects of this 4.Hypotension
medication? Select all that apply.
1.Diarrhea Rationale: Meperidine hydrochloride is an opi-
2.Tremors oid analgesic. Side and adverse effects include
3.Drowsiness respiratory depression, drowsiness, hypoten-
4.Hypotension sion, constipation, urinary retention, nausea,
5.Urinary frequency vomiting, and tremors.
6.Increased respiratory rate
3. The client with myasthenia gravis be- 4.A temporary worsening of the condition
comes increasingly weak. The primary
health care provider (PHCP) prepares to Rationale: An edrophonium injection makes the
identify whether the client is reacting to client experiencing cholinergic crisis temporari-
an overdose of the medication (cholin- ly worse. This is known as a negative test. An im-
ergic crisis) or increasing severity of the provement of weakness would occur if the client
disease (myasthenic crisis). An injection were experiencing myasthenia gravis. Options 1
of edrophonium is administered. Which and 2 would not occur in either crisis.
change in condition indicates that the
client is in cholinergic crisis?
1.No change in the condition
2.Complaints of muscle spasms
actualstudy 1
, NCLEX - Neurological Questions (Saunders)
NCLEX - Neurological Questions (Saunders)
Study online at https://quizlet.com/_6w4emp
3.An improvement of the weakness
4.A temporary worsening of the condi-
tion
4. Carbidopa-levodopa is prescribed for 4. Impaired voluntary movements
a client with Parkinson's disease, and
the nurse monitors the client for ad- Rationale: Dyskinesia and impaired voluntary
verse effects of the medication. Which movement may occur with high levodopa
sign/symptom indicates the client is ex- dosages. Nausea, anorexia, dizziness, orthosta-
periencing an adverse effect? tic hypotension, bradycardia, and akinesia (the
1. Pruritus temporary muscle weakness that lasts 1 minute
2.Tachycardia to 1 hour, also known as the "on-off phenome-
3.Hypertension non") are frequent side effects of the medica-
4.Impaired voluntary movements tion.
5. Phenytoin, 100 mg orally three times 1. "I will use a soft toothbrush to brush my
daily, has been prescribed for a client teeth."
for seizure control. The nurse reinforces Rationale: Phenytoin is an anticonvulsant. Gin-
instructions regarding the medication to gival hyperplasia, bleeding, swelling, and ten-
the client. Which statement by the client derness of the gums can occur with the use of
indicates an understanding of the in- this medication. The client needs to be taught
structions? good oral hygiene, gum massage, and the
1) "I will use a soft toothbrush to brush need for regular dentist visits. The client should
my teeth." not skip medication doses because this could
2."It's all right to break the capsules to precipitate a seizure. Capsules should not be
make it easier for me to swallow them." chewed or broken, and they must be swallowed.
3."If I forget to take my medication, I can The client needs to be instructed to report a
wait until the next dose and eliminate sore throat, fever, glandular swelling, or any skin
that dose." reaction because this indicates hematological
4."If my throat becomes sore, it's a nor- toxicity.
mal effect of the medication and it's
nothing to be concerned about."
actualstudy 2
, NCLEX - Neurological Questions (Saunders)
NCLEX - Neurological Questions (Saunders)
Study online at https://quizlet.com/_6w4emp
6. The client is taking phenytoin for seizure 2. 15 mcg/mL (59.52 mcmol/L)
control, and a blood sample for a serum
drug level is drawn. Which laboratory Rationale: The therapeutic serum drug level
finding indicates a therapeutic serum range for phenytoin is 10 to 20 mcg/mL (39.68
drug result? to 79.36 mcmol/L). Therefore, options 1, 3, and
1. 5 mcg/mL (19.84 mcmol/L) 4 are incorrect.
2.15 mcg/mL (59.52 mcmol/L)
3.25 mcg/mL (99.2 mcmol/L)
4.30 mcg/mL (119.0 mcmol/L)
7. Ibuprofen is prescribed for a client. 1. Take with 8 oz of milk.
Which instruction should the nurse give Rationale: Ibuprofen is a nonsteroidal antiin-
the client about taking this medication? flammatory drug (NSAID). NSAIDs should be
1. Take with 8 oz of milk. given with milk or food to prevent gastrointesti-
2. Take in the morning after arising. nal irritation. Options 2, 3, and 4 are incorrect.
3.Take 60 minutes before breakfast.
4.Take at bedtime on an empty stomach.
8. The nurse is caring for a client who is 3. potential for decreased effectiveness of the
taking phenytoin for control of seizures. birth control pills exists while taking phenytoin.
During data collection, the nurse notes
that the client is taking birth control pills. Rationale: Phenytoin enhances the rate of estro-
Which information should the nurse pro- gen metabolism, which can decrease the effec-
vide to the client? tiveness of some birth control pills. Options 1, 2,
1. Pregnancy should be avoided while are 4 are not accurate.
taking phenytoin.
2.The client may stop taking the pheny-
toin if it is causing severe gastrointesti-
nal effects.
3.The potential for decreased effective-
ness of the birth control pills exists while
taking phenytoin.
actualstudy 3
, NCLEX - Neurological Questions (Saunders)
NCLEX - Neurological Questions (Saunders)
Study online at https://quizlet.com/_6w4emp
4.The increased risk of thrombophlebitis
exists while taking phenytoin and birth
control pills together.
9. The client with trigeminal neuralgia 3. White blood cell count, 3000 mm3 (3 ×
is being treated with carbamazepine. 109/L)
Which laboratory result indicates that
the client is experiencing an adverse ef- Rationale: Adverse effects of carbamazepine
fect of the medication? appear as blood dyscrasias, including aplas-
1. Sodium level, 140 mEq/L (140 tic anemia, agranulocytosis, thrombocytopenia,
mmol/L) leukopenia, cardiovascular disturbance, throm-
2.Uric acid level, 5.0 mg/dL (0.3 mmol/L) bophlebitis, dysrhythmia, and dermatological
3.White blood cell count, 3000 mm3 (3 × effects. Options 1, 2, and 4 identify normal lab-
109/L) oratory values.
4.Blood urea nitrogen (BUN) level, 15
mg/dL (5.4 mmol/L)
10. The client with myasthenia gravis is re- 3. Atropine sulfate
ceiving pyridostigmine. The nurse moni- Rationale: The antidote for cholinergic crisis is
tors for signs and symptoms of choliner- atropine sulfate. Acetylcysteine is the antidote
gic crisis caused by overdose of the med- for acetaminophen. Vitamin K is the antidote for
ication. The nurse checks the medication warfarin and protamine sulfate is the antidote
supply to ensure that which medication for heparin.
is available for administration if a cholin-
ergic crisis occurs?
1. Vitamin K
2.Acetylcysteine
3.Atropine sulfate
4.Protamine sulfate
11. The nurse is caring for an older client 4. I can change the time of my medication on
with a diagnosis of myasthenia gravis the mornings that I feel strong."
actualstudy 4
NCLEX - Neurological Questions (Saunders)
Study online at https://quizlet.com/_6w4emp
1. The client with myasthenia gravis is Hypertension
suspected of having cholinergic crisis. Rationale: Cholinergic crisis occurs as a result
Which sign/symptom indicates this crisis of an overdose of medication. Indications of
is taking place? cholinergic crisis include gastrointestinal dis-
1. Ataxia turbances, nausea, vomiting, diarrhea, abdom-
2.Mouth sores inal cramps, increased salivation and tearing,
3.Hypothermia miosis, hypertension, sweating, and increased
4.Hypertension bronchial secretions.
2. The client is receiving meperidine hy- 2. Tremors
drochloride for pain. Which signs/symp- 3.Drowsiness
toms are side and adverse effects of this 4.Hypotension
medication? Select all that apply.
1.Diarrhea Rationale: Meperidine hydrochloride is an opi-
2.Tremors oid analgesic. Side and adverse effects include
3.Drowsiness respiratory depression, drowsiness, hypoten-
4.Hypotension sion, constipation, urinary retention, nausea,
5.Urinary frequency vomiting, and tremors.
6.Increased respiratory rate
3. The client with myasthenia gravis be- 4.A temporary worsening of the condition
comes increasingly weak. The primary
health care provider (PHCP) prepares to Rationale: An edrophonium injection makes the
identify whether the client is reacting to client experiencing cholinergic crisis temporari-
an overdose of the medication (cholin- ly worse. This is known as a negative test. An im-
ergic crisis) or increasing severity of the provement of weakness would occur if the client
disease (myasthenic crisis). An injection were experiencing myasthenia gravis. Options 1
of edrophonium is administered. Which and 2 would not occur in either crisis.
change in condition indicates that the
client is in cholinergic crisis?
1.No change in the condition
2.Complaints of muscle spasms
actualstudy 1
, NCLEX - Neurological Questions (Saunders)
NCLEX - Neurological Questions (Saunders)
Study online at https://quizlet.com/_6w4emp
3.An improvement of the weakness
4.A temporary worsening of the condi-
tion
4. Carbidopa-levodopa is prescribed for 4. Impaired voluntary movements
a client with Parkinson's disease, and
the nurse monitors the client for ad- Rationale: Dyskinesia and impaired voluntary
verse effects of the medication. Which movement may occur with high levodopa
sign/symptom indicates the client is ex- dosages. Nausea, anorexia, dizziness, orthosta-
periencing an adverse effect? tic hypotension, bradycardia, and akinesia (the
1. Pruritus temporary muscle weakness that lasts 1 minute
2.Tachycardia to 1 hour, also known as the "on-off phenome-
3.Hypertension non") are frequent side effects of the medica-
4.Impaired voluntary movements tion.
5. Phenytoin, 100 mg orally three times 1. "I will use a soft toothbrush to brush my
daily, has been prescribed for a client teeth."
for seizure control. The nurse reinforces Rationale: Phenytoin is an anticonvulsant. Gin-
instructions regarding the medication to gival hyperplasia, bleeding, swelling, and ten-
the client. Which statement by the client derness of the gums can occur with the use of
indicates an understanding of the in- this medication. The client needs to be taught
structions? good oral hygiene, gum massage, and the
1) "I will use a soft toothbrush to brush need for regular dentist visits. The client should
my teeth." not skip medication doses because this could
2."It's all right to break the capsules to precipitate a seizure. Capsules should not be
make it easier for me to swallow them." chewed or broken, and they must be swallowed.
3."If I forget to take my medication, I can The client needs to be instructed to report a
wait until the next dose and eliminate sore throat, fever, glandular swelling, or any skin
that dose." reaction because this indicates hematological
4."If my throat becomes sore, it's a nor- toxicity.
mal effect of the medication and it's
nothing to be concerned about."
actualstudy 2
, NCLEX - Neurological Questions (Saunders)
NCLEX - Neurological Questions (Saunders)
Study online at https://quizlet.com/_6w4emp
6. The client is taking phenytoin for seizure 2. 15 mcg/mL (59.52 mcmol/L)
control, and a blood sample for a serum
drug level is drawn. Which laboratory Rationale: The therapeutic serum drug level
finding indicates a therapeutic serum range for phenytoin is 10 to 20 mcg/mL (39.68
drug result? to 79.36 mcmol/L). Therefore, options 1, 3, and
1. 5 mcg/mL (19.84 mcmol/L) 4 are incorrect.
2.15 mcg/mL (59.52 mcmol/L)
3.25 mcg/mL (99.2 mcmol/L)
4.30 mcg/mL (119.0 mcmol/L)
7. Ibuprofen is prescribed for a client. 1. Take with 8 oz of milk.
Which instruction should the nurse give Rationale: Ibuprofen is a nonsteroidal antiin-
the client about taking this medication? flammatory drug (NSAID). NSAIDs should be
1. Take with 8 oz of milk. given with milk or food to prevent gastrointesti-
2. Take in the morning after arising. nal irritation. Options 2, 3, and 4 are incorrect.
3.Take 60 minutes before breakfast.
4.Take at bedtime on an empty stomach.
8. The nurse is caring for a client who is 3. potential for decreased effectiveness of the
taking phenytoin for control of seizures. birth control pills exists while taking phenytoin.
During data collection, the nurse notes
that the client is taking birth control pills. Rationale: Phenytoin enhances the rate of estro-
Which information should the nurse pro- gen metabolism, which can decrease the effec-
vide to the client? tiveness of some birth control pills. Options 1, 2,
1. Pregnancy should be avoided while are 4 are not accurate.
taking phenytoin.
2.The client may stop taking the pheny-
toin if it is causing severe gastrointesti-
nal effects.
3.The potential for decreased effective-
ness of the birth control pills exists while
taking phenytoin.
actualstudy 3
, NCLEX - Neurological Questions (Saunders)
NCLEX - Neurological Questions (Saunders)
Study online at https://quizlet.com/_6w4emp
4.The increased risk of thrombophlebitis
exists while taking phenytoin and birth
control pills together.
9. The client with trigeminal neuralgia 3. White blood cell count, 3000 mm3 (3 ×
is being treated with carbamazepine. 109/L)
Which laboratory result indicates that
the client is experiencing an adverse ef- Rationale: Adverse effects of carbamazepine
fect of the medication? appear as blood dyscrasias, including aplas-
1. Sodium level, 140 mEq/L (140 tic anemia, agranulocytosis, thrombocytopenia,
mmol/L) leukopenia, cardiovascular disturbance, throm-
2.Uric acid level, 5.0 mg/dL (0.3 mmol/L) bophlebitis, dysrhythmia, and dermatological
3.White blood cell count, 3000 mm3 (3 × effects. Options 1, 2, and 4 identify normal lab-
109/L) oratory values.
4.Blood urea nitrogen (BUN) level, 15
mg/dL (5.4 mmol/L)
10. The client with myasthenia gravis is re- 3. Atropine sulfate
ceiving pyridostigmine. The nurse moni- Rationale: The antidote for cholinergic crisis is
tors for signs and symptoms of choliner- atropine sulfate. Acetylcysteine is the antidote
gic crisis caused by overdose of the med- for acetaminophen. Vitamin K is the antidote for
ication. The nurse checks the medication warfarin and protamine sulfate is the antidote
supply to ensure that which medication for heparin.
is available for administration if a cholin-
ergic crisis occurs?
1. Vitamin K
2.Acetylcysteine
3.Atropine sulfate
4.Protamine sulfate
11. The nurse is caring for an older client 4. I can change the time of my medication on
with a diagnosis of myasthenia gravis the mornings that I feel strong."
actualstudy 4
