CMSRN Neurological and Musculoskeletal Care 3

Question 1

A nurse is providing discharge education to a patient prescribed oral prednisone for rheumatoid arthritis. Which instruction is most important?

Accepted Answer

Do not stop the medication abruptly

Answer

Take the medication on an empty stomach

Answer

Expect immediate improvement within 24 hours

Answer

Increase potassium-rich foods only if potassium is low

Question 2

The nurse is caring for a patient with multiple sclerosis (MS) who is experiencing an exacerbation. Which intervention addresses fatigue, the most common MS symptom?

Accepted Answer

Plan rest periods between activities and prioritize energy conservation

Answer

Schedule all activities in the late afternoon

Answer

Encourage high-intensity exercise to build endurance

Answer

Limit fluid intake to reduce fatigue

Question 3

A patient is admitted with acute exacerbation of gout. Which dietary teaching is most appropriate?

Accepted Answer

Limit high-purine foods such as red meat, shellfish, and alcohol

Answer

Increase intake of organ meats for protein

Answer

Encourage a high-fat diet to lower uric acid

Answer

Restrict all protein sources including dairy

Question 4

Which nursing intervention is the priority for a patient who has just returned from surgery for an open reduction internal fixation (ORIF) of a tibial fracture?

Accepted Answer

Perform neurovascular checks every 1–2 hours

Answer

Administer the prescribed analgesic

Answer

Encourage active range of motion exercises immediately

Answer

Apply ice to the cast for 72 hours

Question 5

A patient with myasthenia gravis is admitted for a myasthenic crisis. Which clinical manifestation differentiates a myasthenic crisis from a cholinergic crisis?

Accepted Answer

Muscle weakness responds to edrophonium (Tensilon) test — improvement indicates myasthenic crisis

Answer

Presence of bradycardia in myasthenic crisis

Answer

Excessive secretions and miosis in myasthenic crisis

Answer

Hypertension distinguishes myasthenic crisis

Question 6

A patient with a seizure disorder is in active status epilepticus. After ensuring airway patency, which medication does the nurse anticipate administering first?

Accepted Answer

IV lorazepam or diazepam

Answer

Phenytoin IV loading dose

Answer

Oral carbamazepine

Answer

Intramuscular phenobarbital