AMSN Neurological Nursing Care 3

Question 1

A patient with myasthenia gravis receives pyridostigmine (Mestinon). The nurse should administer this medication:

Accepted Answer

30 minutes before meals

Answer

At bedtime only

Answer

With a full glass of milk

Answer

Only during periods of symptom flare

Question 2

The nurse differentiates a myasthenic crisis from a cholinergic crisis in a patient with myasthenia gravis. Which finding suggests a cholinergic crisis?

Accepted Answer

SLUDGE symptoms: salivation, lacrimation, urination, defecation, GI upset, emesis

Answer

Muscle weakness that improves with edrophonium (Tensilon)

Answer

Ptosis and diplopia without other autonomic symptoms

Answer

Rapid fatigue with repetitive muscle use

Question 3

Which patient position is safest for a patient who had a lumbar puncture (LP) 30 minutes ago?

Accepted Answer

Flat or prone for 1–4 hours per facility protocol

Answer

High Fowler's position

Answer

Left lateral with knees flexed

Answer

Reverse Trendelenburg

Question 4

A patient taking carbamazepine (Tegretol) for seizure management requires monitoring for which serious adverse effect?

Accepted Answer

Aplastic anemia and agranulocytosis

Answer

Hypertension

Answer

Nephrolithiasis

Answer

Pulmonary fibrosis

Question 5

A patient with a recent ischemic stroke is on aspirin and clopidogrel (Plavix) dual antiplatelet therapy. The nurse's priority teaching includes:

Accepted Answer

Reporting unusual bleeding, bruising, or black tarry stools

Answer

Avoiding all physical activity for 6 weeks

Answer

Taking both medications on an empty stomach

Answer

Stopping medications if headache occurs

Question 6

Which finding requires the nurse to hold a scheduled dose of phenobarbital and contact the provider?

Accepted Answer

Respiratory rate of 8 breaths/min and decreased LOC

Answer

Mild drowsiness after the first dose

Answer

Blood pressure 130/80 mmHg

Answer

Mild nausea reported by the patient