NSG 233 Med Surg 2 Exam 4 2023 Questions and Answers

  1. While the nurse is transporting a patient on a stretcher to the
    radiology department, the patient begins having a tonic-clonic seizure.
    Which action should the nurse take
    Insert an oral airway during the seizure to maintain a patent airway.
    Restrain the patient’s arms and legs to prevent injury during the seizure.
    Time and observe and record the details of the seizure and postictal state.
    Avoid touching the patient to prevent further nervous system stimulation.
    ANS – Time and observe and record the details of the seizure and
    postictal state.
    Because the diagnosis and treatment of seizures frequently are based
    on the description of the seizure, recording the length and details of
    the seizure is impor- tant. Insertion of an oral airway and restraining
    the patient during the seizure are contraindicated. The nurse may need
    to move the patient to decrease the risk of injury during the seizure.
  2. A high school teacher who has just been diagnosed with epilepsy after

    having a generalized tonic-clonic seizure tells the nurse, “I cannot teach
    anymore, it will be too upsetting if I have a seizure at work.” Which
    response by the nurse is best
    “You might benefit from some psychologic counseling.”
    “Epilepsy usually can be well controlled with
    medications.”
    “You will want to contact the Epilepsy Foundation for assistance.”
    “The Department of Vocational Rehabilitation can help with work retraining.”-
    ANS “Epilepsy usually can be well controlled with medications.”
  3. A patient has been taking phenytoin (Dilantin) for 2 years. Which action
    will the nurse take when evaluating for adverse effects of the medication
    Inspect the oral mucosa.
    Listen to the lung sounds.
    Auscultate the bowel
    tones.
    Check pupil reaction to light. ANS Inspect the oral mucosa.
    Phenytoin can cause gingival hyperplasia, but does not affect bowel
    tones, lung sounds, or pupil reaction to light.
  4. A patient reports feeling numbness and tingling of the left arm before
    experiencing a tonic-clonic seizure. The nurse determines that this history

    is consistent with what type of seizure

    Focal
    Atonic
    Absence
    Myoclonic ANS Focal
    The initial symptoms of a focal seizure involve clinical manifestations
    that are localized to a particular part of the body or brain. Symptoms of
    an absence seizure are staring and a brief loss of consciousness. In an
    atonic seizure, the patient loses muscle tone and (typically) falls to the
    ground. Myoclonic seizures are characterized by a sudden jerk of the
    body or extremities.
  5. A 73-year-old patient with Parkinson’s disease has a nursing diagnosis
    of impaired physical mobility related to bradykinesia. Which action will the
    nurse include in the plan of care
    Instruct the patient in activities that can be done while lying or sitting.
    Suggest that the patient rock from side to side to initiate leg movement.
    Have the patient take small steps in a straight line directly in front of the
    feet. Teach the patient to keep the feet in contact with the floor and slide
    them forward. ANS Suggest that the patient rock from side to side to
    initiate leg movement.
    Rocking the body from side to side stimulates balance and improves
    mobility. The patient will be encouraged to continue exercising

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