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

Pyridostigmine should be given 30 minutes before meals so peak drug effect coincides with swallowing, reducing aspiration risk.

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

Cholinergic crisis from excessive anticholinesterase medication causes SLUDGE symptoms due to excessive acetylcholine stimulation.

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

Remaining flat after LP reduces the risk of post-lumbar puncture headache caused by CSF leakage through the puncture site.

Question 4

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

Accepted Answer

Aplastic anemia and agranulocytosis

Answer

Carbamazepine can cause potentially fatal hematologic reactions including aplastic anemia, requiring routine CBC monitoring.

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

Dual antiplatelet therapy significantly increases bleeding risk; patients must recognize and report signs of bleeding including GI bleeding (melena).

AMSN - Academy of Medical-Surgical Nurses Practice Test

AMSN - Academy of Medical-Surgical Nurses Practice Test

AMSN Neurological Nursing Care 3