Tiêu đề PB1 - NP 5 - STUDENT COPY ✅

4 | Page Situation: Ensuring mastery of the basics in neurologic assessment is essential in prompt intervention. 50. A patient involved in a road accident is rushed to the emergency department. The patient’s eyes open spontaneously, he is confused and disoriented when he speaks, and upon stimulus, he withdraws his arm in response to pain. What is the patient’s GCS score? A. 10 B. 11 C. 12 D. 13 51. A patient is found unconscious after a severe fall. The patient’s eyes do not open, makes incomprehensible sounds, and extends limbs in response to pain (posturing). What is the patient’s GCS score? A. 5 B. 6 C. 7 D. 8 52. A patient opens their eyes only when spoken to, is confused when answering questions, and withdraws their hand when pinched. What is their GCS score? A. 13 B. 10 C. 11 D. 12 53. Which of the following best describes a GCS motor score of 3? A. Obeys commands B. Withdraws to pain C. Decorticate posturing D. No response 54. A patient arrives at the ER after a motor vehicle accident. The patient does not open their eyes , makes sounds that cannot understand, and extends their arms abnormally in response to painful stimulus. What is the patient’s GCS score? A. 4 B. 5 C. 6 D. 7 Situation: You are caring for patients diagnosed with multiple sclerosis 55. A 35-year-old woman with relapsing-remitting multiple sclerosis (RRMS) reports weakness in her lower limbs and blurred vision after a viral illness. The clinician suspects a new exacerbation. Which pathophysiologic process most likely explains these new symptoms? A. Demyelination due to an autoimmune attack by sensitized T-cells B. Axonal demyelination following a previous lesion C. Viral replication within the central nervous system D. Accumulation of neurofibrillary tangles and beta- amyloid plaques 56. Mitoxantrone is used in aggressive multiple sclerosis when disease progression cannot be adequately controlled by first line treatments. What should the nurse closely monitor in a patient receiving Mitoxantrone? A. Serum calcium and phosphorus levels for abnormalities B. Cardiac function due to the risk of cardiotoxic effects C. Renal output to detect acute kidney dysfunction D. Serum sodium to watch for seizure Situation: You are caring for patients diagnosed with Trigeminal Neuralgia 57. A 55-year-old woman with tic douloureux reports severe, brief attacks of facial pain triggered by washing her face and chewing food. What is the most likely pathophysiologic cause of her condition? A. Demyelination of trigeminal roots by a nearby blood vessel B. Inflammation of the trigeminal motor branch C. Axonal degeneration due to diabetes mellitus D. Autoimmune attack by T-cells against trigeminal Ganglion 58. 60-year-old patient with trigeminal neuralgia is experiencing severe attacks of unilateral facial pain upon touching her face and even when a chilly breeze crosses her face. What behavioral adaptation might you observe in this patient? A. She avoids washing or touching her face B. She frequently chews hard food to ease the attacks C. She prefers warm showers to reduce stimulus D. She requests strong analgesics for symptom relief 59. A patient with trigeminal neuralgia is currently experiencing severe attacks and their clinician prescribes Carbamazepine. What is the most important follow-up by the nurse during long-term therapy with Carbamazepine? A. Monitor for bone marrow depression B. Assess for arrhythmias C. Watch for seizures upon withdrawal D. Measure plasma sodium levels frequently Situation: You are caring for patients diagnosed with GBS 60. A patient is experiencing weakness starting in their lower limbs and progressing upward, alongside respiratory distress and areflexia. Serum laboratory results show normal white cells but elevated protein in the cerebrospinal fluid (CSF). What is the most likely pathophysiologic mechanisms involved in this condition? A. Cell mediated and humoral immune attack on peripheral nerve myelin proteins B. Demyelination due to a metabolic dysfunction in Schwann cells C. Viral replication within peripheral nerves D. Axonal destruction by a neurotoxin 61. The health care team is preparing to perform plasmapheresis (plasma exchange) on a patient with GBS. What is the main therapeutic aim of this procedure? A. Reduce the amount of myelin debris in peripheral nerves B. Remove the circulating antibodies that attack peripheral myelin C. Improve muscle strength by adding plasma components D. Provide additional platelets to aid coagulation Situation: You are caring for patients diagnosed with Myasthenia Gravis 62. What is the underlying pathophysiologic process in Myasthenia Gravis that contributes to muscle weakness? A. Demyelination of peripheral nerves B. Autoimmune attack on acetylcholine receptors C. Destruction of motor neurons in spinal cord D. Blockade of sodium channels in muscle membrane 63. Edrophonium chloride (Tensilon) test is used in the diagnosis of Myasthenia Gravis. What should the nurse be prepared to do if bradycardia occurs after administration? A. Provide additional rest periods for the patient B. Support respiration with mechanical ventilation C. Prepare a dose of Atropine sulfate D. Perform plasmapheresis immediately 64. What is the first line of treatment for Myasthenia Gravis? A. Intravenous Immune Globulin (IVIG) B. Pyridostigmine Bromide (Anticholinesterase) C. Thymectomy (Surgical Removal of Thymus) D. Cytotoxic Drugs (Azathioprine) 65. What happens after plasmapheresis? A. Improvement in muscle weakness within hours B. Temporary reduction in antibody levels C. An acute bradycardia requiring Atropine administration D. An increase in total IgG concentration in plasma 66. Thymectomy is considered the only treatment with potential for complete remission in Myasthenia Gravis. What is the most desirable patient profile for this procedure? A. Older than 60 with disease duration >3 years B. Younger than 60 with disease duration < 3 years C. Patients with severe respiratory muscle weakness D. Patients with predominantly oculomotor symptoms