1. EARLY lab results that are definitive of herpes simplex encephalitis includes:
a. Viral DNA found in the CSF
b. CT scan of the brain
c. Characteristic temporal sharp waves seen on the EEG
d. A 4 times increase in serum antibody titer
2. What nutritional advice is best for a patient who will be d/c'd home on coumadin to prevent recurrence of embolic stroke?
a. Green leafy vegetables are OK to eat regularly and in moderation
b. Iron supplements are advised to counteract the anemia associated with silent microscopic GI bleeding
c. Take Vitamin K supplement, because coumadin inhibits vitamin K
d. Do not drink more than 2 glasses of wine or 1 mixed drink per week
3. Your patient is about to undergo a lumbar puncture at bedside. What is the most important part of your nursing preparation?
a. Keeping the patient NPO for the next 3 hours.
b. Check coagulation panel and platelet count.
c. Education patient and family about procedure, and possible complications during procedure.
d. Have patient use bathroom prior to procedure to empty bladder.
4. Antibiotic therapy is an important aspect of care for the patient with bacterial meningitis. Which statement below is reflective of antibiotic therapy?
a. Antibiotics should be given prior to giving any steroids.
b. Do not administer antibiotics until specific disease causing organism has been identified.
c. Initial antibiotics is based on most likely causative agent and should be reassess as soon as CSF lab results return.
d. Bacteristatic and bactericidal types of antibiotics are equally acceptable.
5. G. Tee is being discharge from the hospital after an early diagnosis and treatment of Lyme disease. What is an important element of education for this patient?
a. Inform the patient about the long-term effects of disease including joint damage.
b. Educate the patient regarding the use of isolation until all antibiotics are complete.
c. Stress the importance of finishing all antibiotics.
d. Reassure the patient that she has conferred immunity to B. burgdorferi, the causative agent of Lyme disease.
6. When caring for a patient with viral meningitis, which of the following is not an important nursing intervention?
a. Keep patient in isolation until the patient is afebrile for at least 24 hours, without antipyretics.
b. Keep room cool to avoid hyperthermia. Apply cooling measures: apply cool clothes to head and antipyretics as necessary.
c. Assess neuro status frequently to detect ALOC or focal abnormalities
d. Implement steps to prevent increased ICP. Maintain head & neck in alignment, start bowel program to prevent the stimulating the valsalva response.
7. You are a nurse working in the ER when a college student is brought in with fever, severe headache, and weird/strange behavior. The symptoms have been present the last few hours. The conjunctiva and skin show petechiae. What is the most URGENT supportive measure needed in preparing the patient for a lumbar puncture?
a. Administer antipyretics.
b. Prepare for intubation.
c. Provide adequate IV access.
d. Educate patient and roommate about meningitis vaccination.
8. A patient with multiple sclerosis is about to start in a exercise class. The most effective way to cool core body temperature during exercise is:
a. Wear a cooling vest.
b. Dress in light clothes.
c. Drink cool liquids.
d. Prior to exercise take antipyretics.
9. H. Ten has relapsing multiple sclerosis. She is your patient and has told you that she would like to stop taking interferon beta-1b. She stated that there has been no improvements since starting the medications several years ago. The most appropriate response is:
a. Suggest changing to interferon beta-1a or glatiramer acetate.
b. Since depression is a known side-effect of interferon therapy and a symptom of multiple sclerosis, evaluate her for depression.
c. Explain to her that the goals of therapy are to delay disability development & decrease the frequency & severity of exacerbations. Provide regular phone calls with f/u to support her in continuing the treatment.
d. Assist with the management of flu-like symptoms by pretreating with NSAIDS or Tylenol.
10. Your patient is diagnosised with myasthenia grava. What is the best dietary advice to give her?
a. Do not eat if fatigued.
b. Take anti-cholinergic meds before every meal.
c. Consume a liquid diet on days when the muscles of mastication feel weak.
d. Eat small meals that are mechanically soft.
