CNRN Neurodegenerative Disorders Nursing 3

Question 1

A nurse is teaching a patient with MS about fatigue management. Which strategy is MOST evidence-based?

Accepted Answer

Schedule activities during peak energy periods and incorporate planned rest breaks

Answer

Exercise intensely in the afternoon to build energy reserves over time

Answer

Avoid all physical activity to fully conserve energy throughout the day

Answer

Use stimulant medications continuously to counteract fatigue

Question 2

A patient with Parkinson's disease is evaluated for deep brain stimulation (DBS). Which symptom responds BEST to DBS therapy?

Accepted Answer

Motor fluctuations and levodopa-induced dyskinesias

Answer

Cognitive decline and dementia

Answer

Autonomic dysfunction and orthostatic hypotension

Answer

Olfactory loss and depression

Question 3

A patient with ALS is admitted with declining respiratory status. Which finding MOST urgently requires intervention?

Accepted Answer

Morning headaches, frequent nighttime awakenings, and orthopnea

Answer

Mild exertional dyspnea with an FVC of 65% predicted

Answer

Occasional coughing episodes during meals

Answer

Mild post-physical therapy fatigue

Question 4

When communicating with a patient in the moderate stage of Alzheimer's disease, which nursing approach is MOST appropriate?

Accepted Answer

Use simple short sentences, maintain eye contact, and speak in a calm tone

Answer

Use complex multi-step instructions to stimulate residual cognitive function

Answer

Forcefully reorient the patient whenever confabulation occurs

Answer

Minimize all conversation to prevent confusion and agitation

Question 5

A nurse caring for a patient with advanced Parkinson's disease observes excessive drooling (sialorrhea). This is BEST explained by:

Accepted Answer

Impaired automatic swallowing frequency due to bradykinesia

Answer

Increased saliva production stimulated by elevated dopamine levels

Answer

Anticholinergic medication side effects increasing salivary secretion

Answer

Direct destruction of salivary gland tissue by the disease process

Question 6

Which cerebrospinal fluid (CSF) finding is characteristically associated with Guillain-Barré syndrome?

Accepted Answer

Elevated protein with normal or near-normal cell count (albuminocytological dissociation)

Answer

Markedly elevated white blood cell count with normal protein level

Answer

Decreased glucose with elevated lymphocyte count

Answer

Completely normal CSF in all parameters

Question 7

A patient with ALS is experiencing progressive dysarthria. Which augmentative and alternative communication (AAC) intervention should the nurse PRIORITIZE?

Accepted Answer

Introduce AAC devices early while the patient can still provide input on communication preferences

Answer

Wait until the patient is completely unable to speak before introducing AAC devices

Answer

Advise family members to interpret all communication needs on the patient's behalf

Answer

Instruct the patient to rely exclusively on written communication using paper and pen