SPINAL CORD INJURY

1. The nurse is caring for a patient with a complete Spinal Cord Injury, what should the
nurse note the pathological response that would indicate the complication of such injury?
a. Loss of parasympathetic nervous system
b. Changes of vascular smooth muscle tone
c. Infarction and necrosis of the cord caused by edema
d. Inadequate blood supply to the affected area caused by edema
e. urinary stasis due to neurogenic bladder
2. Mr. Dimaala is a newly admitted patient from the ER with a C4 spinal cord injury
following a football accident, which of the following clinical signs would the nurse
evaluate that the patient has quadriplegia?
a. Poor balance and difficulty walking
b. Stiffness or weakness while grasping or holding on to objects
c. Pins and needles sensation and contracted muscles
d. Complete paralysis of the upper extremities
e. Impaired motor skills
3. Based on the question given above, what will the nurse importantly anticipate what the
patient will need?
a. Help patient to turn on the other side of the bed
b. Mechanical ventilation
c. Nasogastric suctioning
d. Encourage patient to have muscle relaxation exercises
e. Assist patient to stand

4. While caring for the patient with SCI, as a nurse you know that Deep vein thrombosis
(DVT) is a potential complication of immobility and is common in patients with SCI. What
should you avoid to prevent life threatening complications?
a. anti-embolism stockings
b. pneumatic compression
c. Low dose heparin
d. Massage the calves or thighs
e. Indwelling filters
Rationale: The calves or thighs should never be massaged because of the
danger of dislodging an undetected thromboemboli.
5. A 37 year old patient is rushed into the ER with suspected cord lesion with the following
vital signs, BP: 200/150mmHg, RR: 14cpm, HR: 56/min. Which of the following actions
should the nurse do first?
a. The patient is placed immediately in a sitting position to lower blood
pressure.
b. Rapid assessment is performed to identify and alleviate the cause.
c. The bladder is emptied immediately via a urinary catheter. If an indwelling
catheter is not patent, it is irrigated or replaced with another catheter.
d. The skin is examined for any areas of pressure, irritation, or broken skin.
 e. The patient is instructed about prevention and management measures.
6. Nurse Myka is taking care of a patient with Long-Term complication of SCI. Having this
condition, this then takes awhile for the patient's and family's understanding of the
situation. Through the severity of the impairment, you can expect them to go through
stages of development, astonishment, disbelief, denial, wrath, despair, and other forms
of grieving acceptance. What would be the appropriate nursing diagnosis of Nurse Myka
to her patient based on the patient’s current condition?
a. Risk for disuse syndrome
b. Deficient knowledge about requirements for longterm management
c. Ineffective coping related to impact of disability on daily living
d. Risk for ineffective coping related to impact of disability on daily living
e. Risk for deficient knowledge about requirements for longterm management
7. 18 year old Maria is recovering from spinal shock after a spinal cord injury. The nurse
knows that the patient should not have a full bladder. What kind of emergency can occur
if it isn't dealt with right away?
a. Orthostatic hypotension
b. DVT
c. Autonomic dysreflexia
d. Respiratory Depression
e. Sudden High blood pressure
8. You are taking care of a patient having Spinal Cord Injury. The nurse assists the patient
to compensate for sensory and perceptual alterations that occur with SCI. What
strategies should the nurse execute to promote patient independence?
a. Providing prism glasses to enable the patient to see from the supine position
b. Encouraging use of hearing aids, if indicated, to enable the patient to hear
conversations and environmental sounds
c. Providing emotional support to the patient
d. Teaching the patient strategies to compensate for or cope with sensory deficits
9. You are taking care of a 37 year old patient with Acute SCI in the ER, how will you
carefully assess and examine the patient?
a. Motor ability is tested by asking the patient to spread the fingers, squeeze
the examiner’s hand, and move the toes or turn the feet.
b. Prepare the patient for endotracheal intubation and mechanical ventilation
c. Assess lung sounds and respiratory rate and depth
d. Sensation is evaluated by abrasive pinching the skin or touching it lightly with an
object
10. Patient M just arrived conscious in the ER through ambulance, you are told by the medic
that the patient had a vehicular accident. While going through the assessment, what
would be the first thing to take note from your patient having a complete spinal cord
lesion?
a. motor paralysis
b. loss of bladder and bowel control
c. loss of sweating and vasomotor tone
 d. complains of acute pain in the back or neck, which may radiate along the
involved nerve.
11. Nezuko, a 16 year old patient with T1 level-spinal cord injury complains “nausea and a
pounding headache”. Which of the most appropriate initial nursing intervention by the
nurse to take action?
a. Have the patient lie down for at least 5 minutes
b. Take Blood Pressure and pulse rate measurements after standing 1-3 minutes.
c. Notify the Healthcare provider
d. Comfort the patient by trying her to calm down
e. Assess for a full bladder
12. Nurse Angel is taking care of a newly arrived patient with a C7 spinal cord injury who is
feeling anxious, with profuse sweating and flushing, suddenly telling you “ Why can’t I
feel my legs? Am I gonna be disabled forever?” What would the nurse’s appropriate
response be?
a. Prepare the patient for an emergency surgery
b. Immediately call the Healthcare provider
c. Try to calm the patient, as her condition is worsening
d. Explain to the patient that it is just a common temporary effect from the
injury
13. You are a nurse assessing a patient with an SCI. Throughout the assessment you’ve
noticed signs of Increased Intracranial Pressure (IICP), such as a sudden change of
mental status and increased respiratory effort. The nurse knows that taking care of a
patient with ICP is critical, therefore there are actions that are contraindicated with ICP.
Which nursing action should you avoid?
a. Immediately provide continuous oxygen
b. Suction the airways q 2 hrs
c. Position the patient in High-fowlers
d. Position the patient in Trendelenburg
14. You saw an unconscious patient across the street and immediately received emergency
care at the scene. As a student nurse you know that immediate management at the
scene of the injury is critical, because improper handling of the patient can cause further
damage and loss of neurologic function. What proper guidelines of emergency
interventions should be followed.
a. At the scene of the injury, the patient must be immobilized on a spinal
board, with the head and neck maintained in a neutral position
b. Elevate the patient’s head immediately to prevent cord damage
c. Turn the patient carefully to the otherside before placing to the spinal board
d. Immediately provide continuous oxygen to the injured patient
15. Ischemia and edema develop when the spinal cord is damaged. How should the nurse
explain to the patient why the degree of the injury can't be established for a few days to
a week?
a. “Gray and white matter necrosis does not occur until a few days after the
damage."
 b. “Because neurons take time to heal, declaring the injury early does not
always mean the patient will recover”.
c. “Tissue repair usually does not begin immediately”.
d. “Two cord segments above and below the affected level are affected by edema,
which increases the severity of the injury”.
16. A conscious patient with spinal cord lesion is under your care suddenly complains of
acute pain in the back or neck. What would be the appropriate nursing intervention?
a. Notify Healthcare provider and get an order of X-ray and other imaging tests
b. Assessing the patient’s sense of touch
c. Maintain adequate protein
d. Do not turn patient frequently
17. A newly admitted patient in the ER due to sustained injuries from a fall, during the first
assessment of the nurse immediately upon admission, the findings are the ff: BP:
90/50mmHg, altered sensory response, flaccid paralysis on the left, absent bowel
sounds, and no urine output. Moreover, the patient manifested consistent signs every
assessment. These consistent signs?
a. Hypovolemia
b. T3 spinal cord injury
c. Partial paralysis
d. Spinal shock
18. Nurse Dante is caring for a patient with SCI, the nurse elevates the patient's head of
bed, removes compression stockings, and continues to monitor vital signs every two to
three minutes while looking for the origin of the injury to ensure that the patient does not
lose consciousness or die. The nurse avoids the most hazardous complication of
autonomic dysreflexia by performing these procedures, which of the following?
a. Tachycardia
b. Bradypnea
c. Hypoxia
d. Elevated BP
e. Orthostatic hypotension
19. Nurse Odette is taking care of a patient with a C7 spinal cord injury 9 days ago who has
decreased breath sounds, bibasilar crackles, and cough effort. As a nurse taking care of
this type of patient, what is the most appropriate initial nursing action?
a. Teach patient to use incentive spirometry q hourly
b. Place your hands on the patient’s epigastric area and push upward as the
patient coughs
c. Suction the patient’s oral-pharyngeal airways
d. Administer low flow oxygen immediately
20. You are a nurse taking care of a patient with a C7 spinal cord injury. You are discussing
the long-term goals of the patient outcome. An appropriate patient outcome that a nurse
should highlight to the patient is?
a. Encourage patient to exercise every other day
b. Do not encourage patient to drive a car alone
c. How to turn properly in bed without injuring the affected area of the spinal cord
 d. Encourage patient push manual wheelchair in a smooth surface only
21. The nurse is taking her 8am shift assessment of the patient with acute spinal cord injury.
How do the nurse assess the patient’s spinal cord function at the minimum?
a. Measure patient’s blood pressure
b. Assess the patient’s bowel and urine output
c. Palpate the lower abdomen
d. Let patient stand for 1-3 minutes
22. After an automobile accident in which the car collided with a tree, the patient arrives at
the emergency room. The windshield was smashed because the patient was not wearing
a seat belt. As a nurse, what is the most crucial thing you need to do right now?
a. Assess immediately the patient’s GCS score
b. Immediately obtain Vital Signs
c. Use a logroll technique when moving patient
d. Immediately evaluate by gently pinching the skin or touching it lightly with an
object
23. Nurse Odette is taking care of a patient with a C7 spinal cord injury 9 days ago who has
decreased breath sounds, bibasilar crackles, and cough effort. What would be the
appropriate nursing diagnosis?
a. Ineffective airway clearance related to weakness of intercostal muscles
and inability to clear secretions
b. Disturbed sensory perception related to motor and sensory impairment
c. Ineffective breathing patterns related to weakness or paralysis of abdominal and
intercostal muscles and inability to clear secretions
d. Acute pain and discomfort related to treatment and prolonged immobility
24. Autonomic dysreflexia is a common symptom in people who have had a spinal cord
injury. To reduce the likelihood of recurrence, which measure should the nurse avoid?
a. Put pressure on the lower limbs
b. Limiting bladder
c. Strict adherence to bowel elimination
d. Turn patient q 2 hrs to avoid skin breakdown
25. Nurse Kyla is taking care of a 60 year old patient with a spinal cord lesion above the mid
thoracic level. Patients with this injury have a loss of sympathetic control of peripheral
vasoconstrictor activity. What would Nurse Kyla take note of?
a. Practice patient to have ROM exercises every morning at least 15 mins
b. Allow patient to move gradually to an erect position
c. Monitor blood pressure when positions are change
d. Teaching the patient strategies to compensate for or cope with sensory deficits

MULTIPLE SCLEROSIS
1. A patient with multiple sclerosis and a fresh baclofen prescription is being taught by the
nurse. In teaching the patient, which of the following statements should the nurse
include?
a. “Your skin may turn yellow as a result of this drug”.
b. "You'll be able to control your bladder function with this drug."
 c. "You'll be able to control your tremors with this drug."
d. "Your skin may bruise readily as a result of this drug."
2. The student Nurse Joanna is giving a talk for the yearly Nursing Congress of the whole
nursing batch 2021-2022 of Cebu, for a case study on multiple sclerosis (MS), whose
client would be a suitable fit?
a. 62 year old man who has smoked 25 yrs of his life
b. 30 year old woman with colonized methicillin resistant Staphylococcus Aureus
c. Single Mother in her 20s with vitamin deficiency
d. 50 year old man with chronic parasitic infection
3. You are assigned to a patient with relapsing-remitting multiple sclerosis under your care
and tell you that she always feels tired in doing her activities of daily living (ADL). Which
diagnosis should you identify as a current priority of the patient?
a. Self-care deficit
b. Impaired Physical Mobility
c. Disturbed Sensory Perception
d. Fatigue
4. 18 year old Nam-ra is a patient admitted with an exacerbation of multiple sclerosis and
displays resentment about her condition, as verbalized “Even just by simply holding my
utensils, why can’t I be able to do that! I hate my life!” What should a nurse do to assist
Nam-ra in this situation?
a. Counsel the client to have her mother assist her while eating
b. Consult with Physical Therapist on hand exercise
c. Counsel client about Tube Feeding
d. Consult with Occupational Therapy to about assistive devices
5. Newly diagnosed patient with multiple sclerosis has symptoms of vision loss, and loss of
power and numbness in her legs. What would be the pathophysiology behind it?
a. The uncoupling of the bone-remodeling process.
b. Atypical plasma cell develops in the bone marrow and reproduces quickly.
c. Demyelination interrupts the flow of nerve impulses
d. Cancer cells overtake healthy blood cells, and your body becomes unable to
produce disease-fighting antibodies
6. Nurse Solomon is reading the results from the CT scan of his patient with Multiple
Sclerosis. What does Nurse Solomon see in a CT scan to support the findings of the
patient’s condition?
a. Flame-shaped area of demyelination within the mid cervical region of the spinal
cord
b. An area of demyelination in the periventricular white matter of the right
frontal lobe
c. The plaque is perpendicular to the ventricle
d. Stained samples of brain tissue in the image
7. The nurse observes Mr. Tan before entering the bathroom to complete morning self-care,
a client with multiple sclerosis is shown shifting from bed to a motorized wheelchair and
putting splints to the lower extremities. What conclusion could the nurse draw from this
observation?
 a. The client demonstrates reliance to assistive devices
b. The client still needs further instruction to conduct morning care before applying
splints to lower extremities.
c. The client uses assistive devices to maximize independence
d. The client is clearly dependent upon assistive devices.
8. During your assessment of your patient, visual abnormalities, weariness, and limb
weakness are the first symptoms of a person with multiple sclerosis. According to the
patient, recuperation took a few weeks the last time this happened. What type of multiple
sclerosis is the customer suffering from?
a. Primary-progressive
b. Secondary-progressive
c. Relapsing remitting
d. Progressive relapsing
9. A 50 year old man with multiple sclerosis reports “I've been nauseated and tired since
I've begun taking my medication. I'm also having a high fever”. You notice in the patient's
chart that she is taking Interferon beta 1b, which is an anti-inflammatory drug
(Betaseron). What is the best response from the nurses?
a. "Taking a Tylenol at bedtime with your medications may help you feel better
and reduce symptoms."
b. "This is a symptom of a bad reaction and we're going to withdraw your
medication right now."
c. "It's only a side effect of your medication, and it'll go away eventually."
d. "It's definitely best if you go to the hospital because your MS is relapsing and
we'll need to start you on a corticosteroid regimen right away."
10. Dante Zogratis is a newly diagnosed patient with Multiple Sclerosis. What should be the
nurse’s appropriate plan?
a. Avoid all forms of weight-bearing exercise in the patient's life.
b. It's best to avoid wearing an eyepatch because it could irritate your eyes even
more.
c. Teach patient how to properly inject medications as al MS medications
should be administered via SQ or IM injections
d. Encourage the patient to eat a low-residue diet as much as possible.
11. You're teaching your patient how to lessen muscle stiffness after she's been diagnosed
with MS. Which of the following statements, if made by the patient would indicate the
need for further teaching?
a. Spasms can be relieved by my stretching exercise.
b. Taking a pleasant hot bath at the end of the day can help to ease muscle
spasms.
c. Spasticity can be relieved by daily exercise, especially weight bearing.
d. Taking Baclofen may help relieve these painful spasms in my legs
12. Nurse Jingle is taking care of a patient with Multiple Sclerosis, what should be the
medications prescribed for MS include those for disease modification and those for
symptom management. The disease-modifying therapies available to treat MS include:
a. bisphosphonates pamidronate (Aredia)
 b. Interferon beta-1a (Rebif)
c. zoledronic acid (Zometa)
d. Radiation therapy
13. Nurse Jingle is taking care of a patient with apparent symptoms of relapsing MS, what
should be the medications prescribed for this type of MS?
a. IV methylprednisolone
b. IV mitoxantrone
c. IM Copaxone
d. IM Avonex
14. A patient with Multiple Sclerosis has been under your care for quite some time. The
patient demonstrates tremendous anxiety, discomfort, rage, and frustration towards his
condition, as verbalized “I don’t want this? What have I done wrong for having this kind
of illness?”. What would be the appropriate nursing diagnosis?
a. Impaired home maintenance management related to physical, psychological, and
social limits imposed by MS
b. Disturbed thought processes (loss of memory, dementia, euphoria) related to
cerebral dysfunction
c. Ineffective individual coping related to uncertainty of course of MS
d. Risk for depression related to condition
15. A patient with Multiple Sclerosis has been under your care for quite some time. The
patient demonstrates tremendous anxiety, discomfort, rage, and frustration towards his
condition, as verbalized “I don’t want this? What have I done wrong for having this kind
of illness?”. What would be the appropriate nursing intervention to be done?
a. Progressive resistive exercises
b. Encouraged to work and exercise to a point just short of fatigue
c. Gait training may require assistive devices
d. Individualized program of physical therapy, rehabilitation, and education
16. You are planning care for a patient with multiple sclerosis. You know that patients having
MS have an inability to store urine (hyperreflexic, uninhibited), inability to empty the
bladder (hyporeflexic, hypotonic); anda mixture of both types. What would be your most
priority and appropriate nursing intervention?
a. The bedpan or urinal should be readily available
b. Time schedule is set up
c. Drink a measured amount of fluid every 30 minutes
d. Take the prescribed medications
17. Jane Doe, a patient with multiple sclerosis is being taught how to use corticosteroids as
a treatment. If the patient makes one of the following comments, if made by the patient
indicates correct understanding?
a. While using this drug, I should be aware of possible side effects such as
euphoria and insomnia.
b. I had flu-like symptoms while taking this drug
c. Before I begin to observe changes in my health, I will need to take this drug for at
least two weeks.
d. My likelihood of relapsing in the future will be reduced by the corticosteroids.
18. Nurse Lily is taking care of a patient with MS, as a nurse it is essential to know the
disease process of the patient’s condition and help improve care in handling the patient.
What would be the correct pathologic sequence of Multiple Sclerosis?
a. Some B-cell involvement with autoantibodies on degenerating myelin sheaths
—> Gliosis —>Some remyelination —>Partial or total axonal destruction
—>Inflammation (T-cells and macrophages) —> BBB disruption
b. Inflammation (T-cells and macrophages) —> BBB disruption —> Some
B-cell involvement with autoantibodies on degenerating myelin sheaths
—> Gliosis —>Some remyelination —>Partial or total axonal destruction
c. Some remyelination —>Inflammation (T-cells and macrophages) —> BBB
disruption —> Some B-cell involvement with autoantibodies on degenerating
myelin sheaths —> Gliosis —>Partial or total axonal destruction
d. BBB disruption —> Some B-cell involvement with autoantibodies on
degenerating myelin sheaths —> Gliosis —>Partial or total axonal destruction
—> Some remyelination —>Inflammation (T-cells and macrophages)
19. Student Nurse Kiara is reviewing for her midterm test in Medical-Surgical Nursing
subject specifically the topic Multiple Sclerosis. What should she consider and take note
about the characteristic/s of this kind of Autoimmune Disorder?
a. Abnormalities in plasma cells, a type of white blood cell
b. Pathologic fractures, weakness, anemia, infection
c. Recurrent symptom episodes or progressive neurological decline
d. Back pain persisting more than one month
20. Nurse Solomon Park is assessing a 53 year old client diagnosed with Multiple Sclerosis.
Which clinical symptom merits prompt attention?
a. The patient has dysphagia and a congested cough.
b. The patient suffers spasticity and muscle weakness.
c. The patient has apparent signs of scotomas and dysarthria.
d. The client manifests diplopia and scanning speech.
21. A group of clients is being cared for by a nurse and a licensed practical nurse (LPN).
Which nursing task should not be delegated to the LPN?
a. The client with multiple sclerosis should be taught how to self-catheterize.
b. For the client who is on a tight bed rest schedule, discuss to the HCP about
gastrointestinal medicines.
c. A skeletal muscle relaxant should be given to a client who has been diagnosed
with low back pain.
d. Perform a morning blood test on a client who has been diagnosed with bacterial
meningitis.
22. Nurse Linda is taking care of a patient diagnosed with Primary-progressive Multiple
Sclerosis. Based on the diagnosis, the nurse drew the conclusion as the patient’s
nursing diagnosis “anticipatory grieving related to progressive loss." Which Intervention
should be implemented by the nurse?
a. Ask if the client would would like a legal power of Attorney
b. Consult a physical therapist for assistive devices
c. Determine if client needs supporting decisions with the family
 d. Discuss end of life care
23. A high-dose intravenous injection of corticosteroid medicine is given to a client who has
been diagnosed with an acute exacerbation of multiple sclerosis. What type of nursing
intervention should be used?
a. Hold off on taking the drug until all of the cultures have been collected.
b. Include salt supplements in the client's diet.
c. Monitor the client's blood sugar levels on a regular basis.
d. Thoroughly discuss the possibility of stopping the proton pump inhibitor.
24. 39 year old male has altered sexual function diagnosed with Multiple Sclerosis. Which
nursing intervention should be implemented?
a. Discuss the necessity of staying physically calm when having a sexual
relationship.
b. Discuss how increasing libido and sexual desire by exercising on a daily basis
might help.
c. Make an appointment with a therapist to discuss the situation with the couple.
d. Allow the couple to think of other methods to keep their relationship alive.
25. Which of the following outcomes would a healthcare provider expect from a patient with
multiple sclerosis (MS) when examining their cerebrospinal fluid?
a. Increased Red Blood Cells
b. Cloudy with increased turbidity
c. Clear with increased WBCs
d. Clear with increased protein

Amyotropic Lateral Sclerosis

1. Patient R with Amyotropic Lateral Sclerosis is under your care. Which problem would like
to occur with your patient’s condition?
a. Altered body image
b. Disuse Syndrome
c. Fluid and ELectrolyte Imbalance
d. Alteration in Pain
2. Nurse Delilah is taking care of a patient with a newly diagnosed ALS. The patient is
being evaluated to rule out ALS. Which S/S would the Nurse note to be able to confirm
such diagnosis?
a. Fatigue and Malnutrition
b. Dysphagia and slurred speech
c. Flaccidity and Muscle atrophy
d. Weakness and Paralysis
3. Patient R displayed frustration to the nurse, according to the patient who has been
diagnosed with ALS, "I'm well aware that this disease will kill me. What will happen to me
at the end of the day? "Which of the nurse's statements would be true and the most
suitable?
a. Most ALS die of respiratory failure
b. You need to stay positive always
c. You will not die because there are treatments for this
 d. You are afraid that you will die?
4. A 59 year old woman with ALS is a newly admitted patient displaying shortness of breath
and dyspnea. Which intervention should the nurse take first?
a. Administer oxygen via nasal cannula
b. Elevate 30 degrees the head of bed
c. Obtain oxygen saturation
d. Assess the patient’s lung sounds
5. Nurse Zyra was given an order by the physician for a 100 mL intravenous antibiotic over
30 minutes via an intravenous pump. At what rate should the nurse set the IVpump?
a. 20 ml/hr
b. 100 ml/hr
c. 200 ml/hr
d. 300 ml/hr
6. On a medical ward, the nurse is taking care of the following patients. In which case
should a client be referred to first based on the nurse's assessment?
a. The client who is unsatisfied with the fact that he or she is not getting any pain
relief.
b. A patient with pneumonia who has a 90% reading on a pulse oximeter.
c. The client who is nauseous and has abdominal pain.
d. The ALS patient who refuses to change every two hours.
7. You are caring for a patient diagnosed with ALS. Which intervention should be used as
the condition progresses? What should the nurse perform?
a. Teach the client how to utilize a motorized wheelchair
b. Assist the client in preparing a living will.
c. Discuss whether the patient should be admitted to a long-term care facility.
d. Explain how a sigmoid colostomy should be cared for properly.
8. Nurse Maria is asked by the son of a client with ALS: "How likely am I to get this
disease? Is it possible to contract this illness "Which of the nurse's statements would be
the most appropriate?
a. "It's possible that you'll contract the disease if you're exposed to the same virus."
b. "It must be terrifying to think of contracting this condition."
c. "This disease is not infectious or inherited."
d. "ALS does have a hereditary disease that runs in families."
9. You are taking care of a patient with end stage ALS. Therefore, a gastrostomy tube
feeding is required for a patient with this kind of condition. Which finding would require
the nurse to hold the feeding through a bolus tube?
a. 4 episodes of diarrhea
b. The abdomen is soft
c. Potassium level is 3.4 mEq/L
d. Residual of 125 ml
10. Mrs D, a patient diagnosed with ALS is prescribed antiglutamate, riluzole (Rilutek).
Which instruction should the nurse discuss with the patient?
a. Report if febrile
b. Avoid eating green, leafy vegetables
 c. Use SPF 30 when going out
d. Take the medication before breakfast
11. A nurse is taking care of a patient with suspected ALS. Which diagnostic test should the
nurse use to confirm the diagnosis of ALS?
a. Serum Creatine Kinase
b. Muscle Biopsy
c. Electromyogram
d. Pulmonary function test
12. A nurse is taking care of a patient with suspected ALS. Which assessment data make
the nurse suspect the patient has ALS.
a. Progressive, muscle weakness, and fatigue
b. Loss of sensation in the lower extremities
c. Complaints of double vision
d. GI upset for a month
13. Nurse Jay is taking care of a recently diagnosed patient with ALS. Which intervention
should the nurse take first?
a. Discuss how a fistula is accessed
b. Refer patient to a PT
c. Discuss advance directives
d. Discuss a percutaneous gastrostomy tube
14. Nurse Muzan is caring for four patients. Which patient is the first priority?
a. A patient with ALS who has an RR of 26 and exhibits muscle weakness.
b. A patient with pneumonia has Huntington's disease who is coughing up yellow
sputum.
c. A patient with a major depressive episode, and a Huntington's patient is
experiencing a severe depressive episode.
d. A patient with ALS who is requesting treatment.
15. Nurse June is teaching a female patient about her recent diagnosis of amyotrophic
lateral sclerosis (ALS). What is the patient's statement that shows that further education
is required?
a. “In order to minimize constipation, I should use stool softeners."
b. "I'm going to have trouble eating because of limb weakness, muscle twitching."
c. "I don't have to be concerned about preventing skin deterioration."
d. "I should sit up and swallow with my chin to my chest when eating."
16. A patient comes to the hospital with a history of Amyotrophic Lateral Sclerosis (ALS).
You are the charged nurse of this patient and a new nurse is assigned to his care. The
charge nurse knows to intervene if she sees the new nurse implementing what with this
patient?
a. Applying a strict bed rest regime to the client
b. While the client is eating, raise the head of the bed.
c. Regularly check the patient's oxygen saturation and respiratory rate.
d. Keeping the bed in the lowest position and the call light within reach
17. A patient with ALS who was diagnosed a year ago is being observed by the nurse. His
dysarthria is becoming more noticeable upon assessment of the nurse. What measures
may the nurse take to help the patient?
a. Elevate the head of the bed to prevent aspiration.
b. Encourage the patient to begin voice banking.
c. Assess what their current pain level is.
d. Encourage the patient to increase ROM exercises.
18. Nurse Jenny is caring for a client with ALS. As a nurse, you know that Muscle spasticity
is a problem for a client who has been diagnosed with ALS. Which of the following drugs
is the most likely to be prescribed in the future?
a. Methylprednisolone (Solu-Medrol)
b. Baclofen (Lioresal)
c. Lidocaine (Xylocaine)
d. Hydralazine
19. Amyotrophic lateral sclerosis (ALS) was diagnosed in a client six months ago (ALS). The
disease has been aggressive in its progression. Without help, he is unable to maintain
his personal hygiene. The most difficult part is ambulation, which necessitates the use of
a wheelchair and the assistance of others. He has recently developed severe dysphagia.
The goal of nursing interventions for dysphagia would be to prevent the following:
a. Secondary infection resulting from poor oral hygiene
b. Aspiration and weight loss
c. Loss of ability to speak and communicate effectively
d. Drooling
20. Patient M.A. is diagnosed with ALS. Which action should the nurse use as the sickness
progresses?
a. Teach the client how to utilize a motorized wheelchair
b. Assist the client in preparing an advance directives.
c. Discuss whether the patient should be admitted to a long-term care facility.
d. Explain how a sigmoid colostomy should be cared for properly.
21. You are taking care of a patient with a terminal stage of ALS. Which intervention should
the nurse implement?
a. Maintain a negative nitrogen balance.
b. Turn the client and let him cough and deep breathe every shift.
c. Encourage a low-protein, soft-mechanical diet.
d. Perform passive ROM every two (2) hours.
22. The nurse is taking care of a patient with a terminal stage of ALS based on the client's
medical history, his affected neuron location is the Anterior horns. What S/S that the
nurse anticipated that the client could possibly have?
a. Dysphagia
b. Difficulty breathing
c. Slurred speech
d. Spasticity
 23. Patient L.A., a 16 year old patient with ALS verbalizes frustration to her physical
condition “Why am I having this? I can't have fun like any other typical teenager does!”
What nursing etiology is right for the patient?
a. Ineffective coping
b. Risk for depression
c. Self care deficit
d. Disturbed body image
24. Based on your answer above, what would be the appropriate nursing management for
patient L.A.?
a. Provide intellectual stimulating activities, because the client typically experiences
no cognitive deficits and retains mental abilities.
b. Provide client and family teaching.
c. Promote measures to enhance body image.
d. Promote client and family coping as the client and his family deal with the
poor prognosis and the grieving process
25. A 48 year old man was rushed to the ER. Upon assessment you’ve suspected ALS on
his current condition. He is a construction worker working late on a daily basis to feed his
family. Upon several diagnostic tests, your suspicion of having ALS is true. To help
minimize the risks of complication of the disease, what risk factor should you discuss
with the patient?
a. Oxidative stress
b. Work Pollution
c. Autoimmune
d. Free radical damage

Guillain Barre Syndrome

1. The nurse is receiving a client from the emergency department who has a diagnosis of
Guillain-Barré syndrome. The client’s chief sign/symptom is an ascending paralysis that
has reached the level of the waist. Which items should the nurse plan to have available
for emergency use?
a. Nebulizer and pulse oximeter
b. Blood pressure cuff and flashlight
c. Flashlight and incentive spirometer
d. Cardiac monitor and intubation tray
2. Nurse Dina is caring for a male client with Guillain-Barre Syndrome. Which assessment
finding is the most significant?
a. Soft, non distended abdomen
b. Urine output of 50 ml/hr
c. Warm skin
d. Unlabored and even respiration
3. Client Yuno with Guillain-Barré syndrome develops respiratory acidosis due to
insufficient alveolar ventilation. Which findings of arterial blood gas (ABG) values
confirms respiratory acidosis?
a. pH, 5.0; PaCO2 30 mm Hg
 b. pH, 7.40; PaCO2 35 mm Hg
c. pH, 7.35; PaCO2 40 mm Hg
d. pH, 7.25; PaCO2 50 mm Hg
4. Jessy is a female client with Guillian-Barre syndrome. Client is critical with ascending
paralysis and is intubated and receiving mechanical ventilation. Which of the following
strategies would the nurse incorporate in the plan of care to help the client cope with this
illness?
a. Provide and intravenous sedatives
b. Let patient take over care decisions and restricting visitors
c. Encourage patient to perform active range of motion
d. Discuss patient and give positive feedback and supportive environment
5. You are a nurse taking care of a patient in the ICU, due to quadriplegia, a client with
Guillain-Barré disease has been on a ventilator for three weeks and can only
communicate with eye blinks. This time-consuming communication method is sometimes
inconvenient for the nursing staff in intensive care units. Because they own a
family-owned restaurant that does not close until beyond visiting hours, the client's family
arrives infrequently. What should the nurse do if the family asks for a break from visiting
hours?
a. Because of the long-term complexity of the client's treatment and the
necessity for family support, make an exemption to the visiting rules.
b. Make arrangements for a volunteer to stay with the client during the day to help
with socialization and staff communication.
c. Since the client needs to sleep at night, suggest that the family visit in turns
during normal visiting hours.
d. Explain to the family that enforcing rules consistently is critical to avoiding
complaints from other clients' families.
6. You are caring for a female client with Guillain-Barré syndrome who has paralysis
specifically affecting the respiratory muscles, therefore the patient requires mechanical
ventilation. You are asked by the patient about the paralysis, how should you respond?
a. “ Don’t worry you’ll be able to regain your legs then the arms.”
b. “I understand that it's hard to accept this paralysis.”
c. “You are now forever be paralyzed”
d. “This is just temporary, I know it's hard to believe”
7. Nurse Mikee is caring for a patient with Guillain-Barré Syndrome, as a nurse assigned to
this case, which assessment data should be obtained by Nurse Mikee that require most
immediate action?
a. Consistent drooling of saliva
b. BP: 120/40 mmHg
c. Absence of triceps reflex
d. Complains tingling pain in the feet
8. Patient R who manifested numbness and weakness of both feet is admitted with
Guillain-Barré syndrome. What should the nurse anticipate collaborative interventions at
this time?
a. start IV infusion of immunoglobulin (Sandoglobulin).
 b. administration of methylprednisolone (Solu-Medrol).
c. intubation and mechanical ventilation
d. insertion of a nasogastric (NG)
9. The charged nurse of the patient with Guillain Barre Syndrome delegates a novice
nursing assistant? What is the most appropriate action for the nursing assistant?
a. Assessment for bladder distention
b. NGT feeding
c. Passive ROM
d. Give medication with prescription from physician
10. The client is newly admitted to the hospital with a diagnosis of Guillain-Barré syndrome.
The nurse reviewed the past medical history findings of the patient. What significant
findings make the client most at risk in developing for this disease?
a. Seizures or past trauma to the brain for 3 months
b. Encephalitis in the last 3 years
c. Gastrointestinal infection a month ago
d. Spinal cord injury in the last 5 years
11. Nurse Lilah is endorsed to care for a Guillain Barre Syndrome. As the nurse in charge,
you know that this disease is apparent with:
a. S/S are symmetrical and ascending that start in the upper extremities
b. S/S are asymmetrical and ascending that start in the upper extremities
c. S/S are descending that start in the lower extremities
d. S/S are ascending that start in the lower extremities
12. A 25-year-old man goes to the emergency room with unexplained paralysis as
verbalized "I can't feel my hips and legs". The patient states that her feet were feeling
strange a few days ago and she was having problems walking, and that she is now
unable to move her lower extremities. The patient claims to have been sick for roughly
two weeks and has no previous medical history. The doctor suspects that the patient has
Guillain-Barré Syndrome and recommends getting some tests done. Which of the
following findings from your assessment warrants immediate nursing intervention?
a. The patient have absence of reflexes in the lower extremities
b. The patient has a weak cough
c. The patient reports headache
d. The patient have absence of reflexes in the upper extremities
13. You're discussing a patient under your care with GBS upon several treatments available
for Guillain-Barré Syndrome (GBS). Which of the patient's statements needs you
re-educating the patient on treatment?
a. "Immunoglobulin therapy is when a patient receives IV immunoglobulin from a
donor in order to prevent nerve damage caused by antibodies.
b. "A machine will filter my blood to remove antibodies from my plasma that are
attacking the myelin sheath when I start plasmapheresis treatment."
c. "Although there are no cures for this syndrome, there are treatments that can
help you heal faster."
 d. "This syndrome can be treated with plasmapheresis or immunoglobin
treatments, although they are best successful when given within four
weeks of the onset of symptoms."
14. Mr. L.P. is under your care you're preparing to perform a lumbar puncture on a patient in
order to rule out Guillain-Barré Syndrome. Should you have the patient before sending
it?
a. Let him wash his hair
b. Drink contrast dye first thing in the morning
c. Clean back with antiseptic
d. Void
15. Patient M.D., a 28 year old female patient is hospitalized due to the onset Guillain Barre
Syndrome symptoms. In this patient’s phase of her illness, what would be the most
critical assessment for the nurse to carry out?
a. Constant respiratory function evaluation
b. Assess GCS every 2 hrs
c. Monitor the cardiac rhythm carefully every hour
d. Assess sensation and reflexes of the lower extremities
16. A patient with Guillain Barre Syndrome is under your care and monitoring, you know that
caring for this type of condition is critical for the patient’s life. Which assessment data
should the nurse obtained will warrant the most immediate care?
a. The patient’s upper extremities reflexes are absent
b. Patient reports pins and needles with tingling sensation in the feet
c. The patient is drooling
d. BP of 100/40 mmHg
17. Patient M.P. is just recently diagnosed with GBS in your ward and is under your care.
The client reports “I can’t move my legs and there's pins and needles above my navel!”
As a nurse, you know that complications of the disorder may arise anytime, what should
you bring the most essential items in the client’s room?
a. Incentive spirometer
b. Nasal Cannula
c. Pulse Oximeter
d. Intubation tray
18. A 35-year-old patient has no relevant information in their medical history other than that
they had a GI ailment around two weeks ago. They've since recovered, but now they're
experiencing tingling, numbness, and weakness in their feet (paresthesia), which makes
walking difficult. They claim they haven't been hurt, but the sensation is getting worse.
What would the nurse expect to find in ruling out GBS conditions to the patient?
a. Facial actions, such as speaking, chewing, or swallowing, are difficult for
the patient .
b. Muscle problems, such as rigidity or muscle contracture
c. Involuntary jerking or writhing movements
d. Slow or abnormal eye movements.
19. Patient W.A. GBS is under your care for several weeks already. You have noticed during
your morning assessment that the patient has presenting symptoms of Altered breathing
 pattern. Knowing this kind of sign is dangerous to the patient’s condition. What order will
you anticipate for the physician to give you?
a. Prepare client for Tracheostomy
b. Oxygenate client immediately
c. Elevate client in 30 degrees
d. Notify the family that the client is in critical condition
20. A 50 year old client is in for Lumbar Puncture. What is the nurse’s role during the
procedure?
a. Do not elevate head
b. Empty bladder
c. Position lateral recumbent
d. Give fluids to patient to replenish
21. A 68 year old patient with GBS has an NGT for feeding. What will the nurse do first
before starting the scheduled feeding?
a. Checks for gastric residual
b. Keeps head of bed less than 30 degrees
c. Weighs the patient
d. Assess LOC
22. A 50 year old client had Lumbar Puncture.2 days ago. The patient’s results are now
available. What significant finding correlates with the GBS?
a. high glucose with normal white blood cells
b. high protein with low white blood cells
c. high protein with normal white blood cells
d. low protein with high white blood cells
23. You are caring for a patient with acute phase Guillain Barre Syndrome, in the acute
phase it is very important to assess?
a. Gag reflex
b. Breathing pattern
c. Motor function
d. LOC
24. The nurse is suspecting the client is presenting symptoms of GBS in the ER. What would
be the etiology of acquiring the said syndrome?
a. Usually begins 10 days after a banal infections
b. Attacks the peripheral nerves causing inflammation
c. Condition is not rapid
d. Abnormal mutation of the gene
25. The spouse of a client with Guillain-Barré syndrome expresses concern that the client is
growing gloomy and refusing to leave the house. What is the best way for the nurse to
react?
a. "Let your spouse be alone for a while”
b. "For more information, please contact the International Guillain-Barré
Syndrome Foundation."
c. "Invite a few people over so the client doesn't have to leave the house."
d. "This is a common occurrence for people with GBS."
MYASTHENIA GRAVIS
1. The nurse is caring for a client with Myasthenia Gravis, the patient is prescribed
cholinesterase inhibitor neostigmine (Prostigmin). Which data assessment would indicate the
prescribed medication is effective?
a. Without straining his eyes, the client is able to blink them.
b. The client is able to feed herself on her own.
c. When conducting ROM, the client denies any pain.
d. When the client eats, he denies it and nauseous or vomits.
2. Mr. Arranguez, the husband of the client diagnosed with MG, is crying and shares
frustration “ I can’t do this anymore. I don’t know what I should do?!”
a. Refer the client to an MG support group in your area.
b. Discuss advance directives
c. Hear out the his frustration
d. Ask patient if he wants some professional counseling
3. A 29 year old patient with MG is admitted to the ER with presenting symptoms of
exacerbation of motor weakness and shallow breaths. Which significant finding during
the assessment of the nurse indicates the patient is experiencing a cholinergic crisis.
a. The client's muscle strength does not improve after the tensilon test.
b. When a cholinesterase inhibitor is given to the client, the client's symptoms
improve.
c. Injecting IV fluid improves the client's blood pressure (BP), pulse, and respiration
(RR).
d. The amount of ACH receptor antibodies in the blood is enhanced in the serum
assay.
4. The nurse is caring for a female client with MG and discusses discharge instructions.
Which of the ff indicates the client needs further teaching?
a. I should stay away from folks who have respiratory problems.
b. I'm going to drink at least 2,500 cc of water per day.
c. Because of this condition, I won't have a menstrual period.
d. I should not swim in cold water or take a hot bath.
5. Nurse Jan caring for a 65 year old male client with MG is undergoing plasmapheresis at
the bedside. Which significant finding during the assessment warrants the nurse's
immediate attention?
a. Positive Chvosteks & Trousseaus
b. Serum potassium 3.5
c. Visible ecchymosis at vascular site access
d. Client's BP is 94/60 and AP is 112
6. The client P.T., who has been diagnosed with myasthenia gravis, has been sent home.
When it comes to teaching the client's significant others, which is the most important?
a. discuss strategies to assist in the prevention of choking episodes
b. Demonstrate how to do ROM exercises that are not active.
c. Explain how a patient on a ventilator should be cared for.
d. Discuss and demonstrate in taking care of his feeding tube.
7. You are taking care of a client with MG, the client is being evaluated to rule out
myasthenia gravis & being administered the Tensilon test. Which response to the test
indicates the client has MG?
a. The client's assessment data does not appear to have changed.
b. Muscle strength has significantly improved in the client.
c. This refers to the muscle's electrical stimulation amplitude being increased.
d. The amount of acetylcholine receptor antibodies in the blood has reduced.
8. A 30 year old female was rushed in the ER. Upon assessment, MG is suspected in the
patient’s condition with signs of muscle weakness. What would the nurse anticipate the
first line of therapy for symptomatic relief?
a. Tetrabenazine
b. Deutetrabenazine
c. Mestinon
d. Austedo
9. Patient L.J. is a 20 year old patient with MG. Which of the following statements from a
20-year-old female client who has been diagnosed with MG indicates that she is aware
of the discharge instruction?
a. "To help with expenses, I've taken a new job at a daycare center for youngsters."
b. "I may be able to have children, but I will have to look after my own children
before I can have them.
c. "I'm going to drink at least 1000 mL of water or something else.
d. “A daily dose of liquid"
10. The nurse is caring for a patient with suspected MG that is rushed to the ER. Which
statement by the client supports the diagnosis of myasthenia gravis (MG)?
a. "This week, I gained 3 pounds and am spitting out pink frothy sputum."
b. "I have double vision and involuntarily eyelids droop."
c. "My feet and legs are weak and fatigued."
d. "When I walk down the corridor, I have chest tightness and faint."
11. Patient M.L. is under your care diagnosed with MG and has been prescribed with
Mestinon. Every week, the dosage is frequently changed. Everytime the dosage is
adjusted, what would be your priority nursing management?
a. Always administer the medication on time
b. Monitor V/S every 15 minutes
c. Administer the medication before breakfast
d. Assess client’s muscle strength every 6 hours
12. Your client Mr. Rosell is taking up Methylprednisolone medication for his MG. What side
effects would you monitor while taking up his medication?
a. Euphoria
b. Respiratory Depression
c. Hypervolemia
d. Orthostatic Hypotension
13. Patient N.T. has just been recently diagnosed with MG. Knowing this condition could
easily exacerbate his current presenting symptoms. Which of the ff orders that you
should question?
 a. Pyridostigmine bromide (Mestinon) 3 times daily PO
b. Procaine (Novocain) SQ stat to reduce pain in lower limbs
c. Prednisolone OD daily
d. Eyepatch to be worn every night
14. You are caring for a patient with MG. During assessment what nursing diagnosis would
you conclude for a patient w/ MG experiencing a cholinergic crisis?
a. Altered mental status
b. Acute Fatigue
c. Impaired Gas exchange
d. Ineffective airway clearance
15. Patient M.J. is about to be discharged, Nurse Lily is teaching the client about his
condition. Which statement would indicate that the patient needs further education?
a. Any indicators of infection should be reported to my physician.
b. My beta blocker will be discontinued by the doctor since it may worsen my
symptoms.
c. I should stay away from physical endurance exercise
d. I can take an ibuprofen if I'm having trouble sleeping because of the spasms.
16. You are caring for a patient with MG who’s experiencing a myasthenic crisis. Which of
the ff priority actions below needs to be taken action immediately?
a. Stop anticholinesterase medication regimen
b. Insert Nasogastric Tube
c. Monitor I/O q 2hrs
d. Administer Novocaine
17. Patient N.D. with MG reports “this is so tiring, I don't have any strength in muscles
anymore”. Which of the following could the nurse do for this patient?
a. I can take an ibuprofen if I'm having trouble sleeping because of the spasms.
b. Assist the patient in creating a schedule for taking medications on time.
c. Educate the patient on the importance of avoiding all forms of physical activity as
much as possible when possible.
d. To improve muscle strength, teach the patient to exercise for several hours each
day
18. R.T. a 35 year old male client with MG arrives in the ER and complains of nausea and
diarrhea. His BP is 130/85 mmHg, HR 80bpm, 38.4 deg, O2 sat 96%. Based on the
assessment, what would be the priority of the nurse?
a. Intubate the patient as soon as possible. He's about to have a myasthenic crisis.
b. Educate students on the impacts of medications.
c. Examine patient for any symptoms of infection.
d. Examine for any other thymectomy-related issues.
19. A newly diagnosed patient was educated by the nurse about the pathology of
Myasthenia Gravis. You know that the thymus gland is involved in the disease process of
MG, the patient asks where the thymus gland is located, how will you state that the
patient so that he can easily understand?
a. behind the thyroid gland
b. anterior to the hypothalamus
 c. within the adrenal glands
d. behind the breastbone in between the lungs
20. Patient G.G. MG will be eating lunch at 12 noon. The time now is 10am and the patient
is scheduled to take Pyridostigmine. What time should the nurse in charge administer
the medication to the patient so he will have the maximum benefit of the prescribed
medication?
a. 1 hour after the patient eats
b. As soon as possible
c. 1 hour before the patient eats
d. at 12:00 noon right before the patient eats
21. Nurse Aubrey is caring for a patient with MG. The patient has inexplicable muscle
weakness, double vision, breathing difficulties, and ptosis, upon assessment through
Tensilon test (Edrophonium) by a neurologist. What signs and symptoms might indicate
that the patient has myasthenia gravis after taking Edrophonium?
a. A tingling sensation in the eyelids and a sudden ringing in the ears are reported
by the patient.
b. Muscle strength has improved in the patient.
c. Wheezing and flushing of the face are both experienced
d. The patient's muscle weakness worsens as a result of the condition
22. Which of the following patients is the most susceptible to a cholinergic episode?
a. A patient with MG who claims to be taking too much anticholinesterase medicine.
b. A patient with MG who has recently had left hip surgery and is suffering from a
respiratory infection.
c. A patient with MG who says he hasn't taken Pyridostigmine for the past two
weeks.
d. A patient with MG is one who is taking too much anticholinesterase medication.
23. You're a student nurse who’s providing teaching to a group of patients with myasthenia
gravis in Vicente Sotto Hospital. Which of the following below is not a treatment option
for this condition?
a. Corticosteroids
b. Thymectomy
c. Lumbar Puncture
d. Cholinesterase Medication
24. A client with myasthenia gravis is treated with a thymectomy through a median
sternotomy technique. Which intervention should be included in the nurse's
postoperative care plan for the client?
a. Inject lactated Ringer's solution intravenously as needed.
b. Assess chest tube drainage
c. To avoid respiratory depression, do not provide pain medication.
d. Post-operatively, keep visitation to a minimum for 24 hours.
25. Patient A.D., w/ MG is having difficulty with maintaining an effective breathing pattern
and airway clearance. What should the nurse keep at the bedside of the patient to
always be readily available?
a. Pulse oximeter and cardiac monitor
 b. Low flow oxygen and metered-dose inhaler
c. Incentive spirometer
d. Ambu bag and suction equipment

ALZHEIMER’S DSE
1. You are caring for a patient with Alzheimer Disease. The spouse of the client Mr.A does
not understand why the client was able to develop the disorder, as verbalized “ Why did
my wife develop this? It did not run in the family. How will the nurse respond?
a. The progression of Alzheimer's disease differs from person to person.
b. Alzheimer's disease is caused by a combination of genetic and environmental
factors.
c. It's likely that someone in your family hasn't been properly diagnosed with the
disease.
d. Smoking and drinking lead to the development of Alzheimer's disease.
2. Patient R.J. is a client with AD with a history of receptive aphasia. Which area of the
brain is likely damaged from Alzheimer’s?
a. Occipital Lobe
b. Frontal Lobe
c. Limbic System
d. Temporal Lobe
3. Patient R.B. has been in your care for 1 year already who’s a terminally ill patient. The
family members of the patient still haven't been able to cope and are still in the grieving
process, as verbalized “He will not die, We will do anything to make him alive”. What
would be appropriate nursing dx for the family of the px?
a. Caregiver role strain
b. Risk for depression
c. Anger related to situation crisis
d. Anticipatory grieving
4. A 79 year old patient is admitted with presenting S/S of early AD. What would the nurse
utilize to confirm the client’s diagnosis?
a. Physical exam and client hx
b. Neuritic plaques findings from CT Scan
c. Amyloid plaques and neurofibrillary tangles can be detected in blood testing.
d. Tests for beta-amyloid and tau proteins in the blood tested positive.
5. Nurse Angel is discussing roles and responsibilities of the caregiver of the AD patient.
Which statement indicates that Nurse Angel’s teaching has been effective?
a. There aren't any drugs that can help you get rid of this condition.
b. The stronger and the efficacy of the effect of the medications on the disease the
earlier they are started.
c. For many years, there have been medications that can help you manage your
symptoms.
d. There are medications that work well in the late stages of the disease.
6. An 80 -year-old patient’s husband reports that his wife is unable to solve common
problems encountered at home. At this time, you know that obtaining the current mental
status of the patient is essential. Which question should you ask the patient with AD?
a. “Where were you born?”
b. “What is your name?”
c. “What did you do today?”
d. “What did you eat for breakfast?”
7. You are a nurse working at the long term facility, during the morning change of shift
reports that the px with dementia has had sundowning. Which action should the nurse
take while caring for this kind of patient?
a. Provide an hourly schedule for the day's events.
b. Open the blinds and provide frequent activities.in the client’s room
c. In the evenings, move the patient to a quieter room.
d. Allow the patient to take a short nap in the middle of the day.
8. Patient N.R. with Alzheimer's disease is under your care in a long term facility, upon
several assessments the nurse was able to know that the patient had several episodes
of sudden wandering away from home. Which appropriate nursing action the nurse will
include the patient’s plan of care.
a. Inquire as to why the patient's wandering episodes have occurred.
b. Several times a day, reorient the patient to the new living arrangement.
c. Ensure that the patient is in a room that is close to the nursing station.
d. Bring along objects from the patient's house that the family is familiar with.
9. Patient D.P. with AD is admitted in the hospital due to Urinary Tract Infection. The
significant other reports the nurse, “I'm just worn out by the constant anxiety and
concern. As a result, we are unable to afford a care facility. I'm not sure what to do
anymore”. What would be the appropriate nursing dx for the spouse?
a. caregiver role strain related to limited resources for caregiving.
b. social isolation related to unrelieved caregiving responsibilities.
c. ineffective health maintenance related to stress.
d. anxiety related to limited financial resources.
10. You are caring for a patient with late stage AD, you have identified the nursing diagnosis
of Disturbed thought process related to effects of Dementia. What is the appropriate
nursing intervention for this patient’s current condition?
a. Ensure that the patient has access to current newspapers and magazines.
b. Ensure that the patient's care is carried out on a daily basis.
c. Every several hours, refocus the patient to the date and time.
d. Encourage the patient to recall past occurrences.
11. You are caring for a patient who is about to be discharged. Risperidone (Risperdal) is a
medication that is given to an outpatient with mild Alzheimer's disease (AD). Which
evidence does the nurse have at the next clinic appointment to support the medication's
efficacy?
a. There is less restlessness in the patient.
b. The patient's voice is more distinct.
c. A tablet can be swallowed by the patient.
 d. The patient is well-dressed and well-groomed.
12. Nurse Rose Jane is caring for a patient in a long term facility. A new prescription for
donepezil has been issued to a home-health patient with Alzheimer's disease (AD) and
mild dementia (Aricept). Which nursing measure will be the most effective in ensuring
that the medication is taken as directed?
a. In a medication container, set up the medications on a weekly basis.
b. Reminding the patient to take their medication on a daily basis
c. Having the medication administered by the patient's spouse
d. In the patient's home, posting reminders to take the meds is essential
13. The nurse explains to the spouse of a patient who is being evaluated for Alzheimer's
disease (AD) that the disease is caused by a combination of factors. What is the correct
statement of the nurse?
a. In patients with dementia, the presence of MRI-detected brain atrophy confirms
the diagnosis of Alzheimer's disease.
b. In certain cases, new medications have been demonstrated to drastically reverse
Alzheimer's disease.
c. In patients with dementia, the presence of MRI-detected brain atrophy confirms
the diagnosis of Alzheimer's disease.
d. Only until alternative causes of dementia have been ruled out can a diagnosis of
Alzheimer's disease be made.
14. A family member brings a 70-year-old patient to the clinic because they are concerned
about the patient's increased sleep difficulties and inability to manage basic concerns at
home. Which question should the nurse ask the patient to find out about his or her
current mental state?
a. "Where did you grow up?"
b. “ When is your Birthday?”
c. “How are you feeling today?”
d. "What day of the week is it today?"
15. You are taking care of an 82-year-old patient who is diagnosed with moderate dementia
due to multiple strokes. What would the nurse expect to find during the assessment of
the patient?
a. Recent loss of short and long term memory
b. eating and swallowing problems
c. ability to complete simple tasks in a variety of ways
d. extreme fatigue at night
16. When examining a delirious patient's mental state, should the nurse follow the following
guidelines?
a. When the patient is well-rested, perform the examination.
b. During the examination, readjust the patient as needed.
c. Choose a location that is free of distractions from the environmental stimuli
d. To alleviate anxiety, medicate the px first
17. Nurse Lucy is taking care of a patient with mild dementia. Which action will the nurse
include in a treatment plan for a hospitalized patient with this particular condition?
a. Reminding the patient on a regular basis that he or she is in the hospital
 b. To reduce the danger of aspiration, place suction near the bedside.
c. Taking adequate service care of the patient's personal hygiene
d. To avoid skin deterioration, the patient should be repositioned on a regular basis.
18. Nurse Myka is taking care of a patient with suspected AD. What would she expect for a
patient with suspected AD to present such symptoms?
a. The behavior has remained the same.
b. minor confusion and memory issues
c. more time in bed or sleeping
d. wandering behavior, incontinence, and agitation
19. You are caring for a patient with AD. As the nurse in charge, what is the major goal of
treatment for this patient?
a. maintain patient safety.
b. maintain or increase body weight.
c. return to a higher level of self-care.
d. enhance functional motor ability over time.
20. The nurse is caring for a patient with delirium. The nurse is identifying patients
susceptible to having delirium. Which patient is most at risk for developing delirium
below?
a. A 55-year-old woman with cholecystitis
b. A 22-year-old man with a fractured femur
c. A 40-year-old woman having an elective hysterectomy
d. A 80-year-old man admitted to the medical unit with complications related to
heart failure
21. A 62-year-old man with early-stage Alzheimer's disease keeps on taking ginkgo biloba
in spite of the fact that he believes it will halt the disease's progression. The patient's
reply to the nurse demonstrates that he or she is aware of the ginkgo's side effects.
a. "Ginkgo has a side effect of ringing in the ears."
b. "It's not a good idea to quit taking ginkgo all at once."
c. "While walking, ginkgo may induce soreness in the legs."
d. "The risk of bruising may be increased by ginkgo."
22. Patients in the community are visited by you as the home care nurse. Which patient is
showing signs of an early stage of Alzheimer's disease ?
a. A 67-year-old male does not recognize his family members and close friends.
b. A 60-year-old female misplaces her purse and jokes about having memory loss.
c. A 80-year-old male is incontinent and not able to perform hygiene independently.
d. A 74-year-old female is unable to locate the address where she has lived for 10
years.
23. Nurse Abby is caring for a 72 year old man with severe dementia in the long term care
facility. The patient is malnourished and has dysphagia. What should be the nurse’s plan
of care for the patient?
a. During meals, turn on the television to keep him occupied.
b. Provide thickened fluids and moist foods in small pieces.
c. To avoid aspiration, keep his fluid intake limited during planned meals.
d. Allow the patient to choose his or her favorite dishes from the menu.
 24. The nurse is caring for a px with Alzheimer’s Disease, the nurse administered a dose of
risperidone due to presenting symptoms of delirium. What is the intended effect of the
medication?
a. To decrease blood pressure
b. Alleviation of depression
c. Quietly lying in bed
d. Relief of confusion
25. You are a nurse caring for patient with dementia. When it comes to caring for people with
dementia, what kind of nurse intervention is most effective?
a. Treat the patient in a way that is appropriate for his or her age.
b. Focusing on one thing at a time, and giving straightforward instructions.
c. Call the patient "honey" or "sweetie" with affection.
d. Avoid direct contact with patient

Parkinson’s Disease
1. Nurse Jo is caring for a client who is newly diagnosed with Parkinson’s Disease. What
should the nurse understand about his patient’s condition?
a. Communication skills may have come back
b. Mood fluctuations
c. Diverse interest
d. Intellectual competence is diminished
2. A client with a recent diagnosis of Parkinson's disease is expected to report which sign
or symptom while getting a health history.
a. Slow movement
b. Rapid weight loss
c. Motor tremors
d. Depression
3. You are caring for a patient with PD. Anorexia and vomiting are common symptoms of
Parkinson's disease in a patient. Levodopa is being used by the patient. What will be the
first thing you do as a nurse?
a. Examine your client's eating preferences.
b. Always monitor the client's blood pressure.
c. Hold the client's medicines and contact the HCP.
d. Administer medication with food
4. A care plan for a client who has been diagnosed with Parkinson's disease is being
developed by the nurse. For the client diagnosed with Parkinson's disease, what
statement shows the purpose of drug therapy?
a. It will cure the PD
b. Will maintain functional ability
c. The client will be able to take the ordered medication properly
d. Decrease symptoms of PD
5. The nurse is assessing patients with PD. Which patient with Parkinson's disease should
the nurse be concerned about administering benztropine to?
a. Undergoing hip replacement surgery
 b. Diagnosed with glaucoma
c. Client with MI
d. Client with CHF
6. You are caring for a client with PD and given an order to let the client have levodopa
therapy. What area would improve the effectiveness of the said therapy?
a. Alertness
b. Muscle spasm
c. Mood
d. Muscle rigidity
7. Nurse Maria is caring for a patient with PD. Knowing the symptoms of the disease,
Nurse Maria made a collaborative care plan for the patient with the physical therapist.
Which goals are collaboratively established?
a. Improve muscle strength
b. Reduce muscle spasm
c. Reduce ataxia
d. Maintain joint flexibility
8. The nurse is planning care for the patient with PD. Which of the ff goals below has the
most realistic view for a px diagnosed with PD?
a. begin preparation for terminal care
b. maintain optimal body function
c. stop the fast progression of the disease
d. cure the disease
9. The nurse is caring for the patient with PD, she is preparing a plan to minimize the
effects of hypokinesia. When would be the right time for the nurse to encourage the
patient to schedule the most demanding physical activities?
a. When family members are available at the said time
b. Coincide with the peak action of the drug therapy
c. Early in the morning
d. Immediately after a good rest
10. Nurse Linda is observing a client with PD unbuttons his shirt, she notices that the upper
arm tremors disappear. Which of the statements below conclude the observation of the
nurse on tremors?
a. Tremors are psychological which can be controlled in a forceful will
b. Tremors disappear when client attention is been diverted to other things
c. There is no explanation in the observation
d. tremors sometimes disappears through purposeful event and voluntary
movement
11. You are a nurse developing a teaching plan for a patient who has been recently
diagnosed with PD. Which topic should you include in the plan of care?
a. Enhancing immune system
b. Maintaining safe environment
c. Engaging in diversional activities
d. Maintaining a balanced diet
12. Mr. Park is rushed into the ER, upon assessment the Physician suspected Mr.Park to
have initial signs of PD. What do the nurse expect for Mr. Park to have such signs?
a. Akinesia
b. Tremor
c. Bradykinesia
d. Rigidity
13. Mr. Park is diagnosed with PD and reports freezing gait and has the difficulty to initiate
upon movements. Which appropriate nursing approach is the most helpful to the
patient?
a. Instruct the client to remain still
b. Support the client while initiating walking
c. Have the client to remain still
d. Have the client to march in place
14. The nurse is caring for a patient with PD, and identifies the nursing dx of the patient is
impaired physical mobility related to bradykinesia. Based on the nursing dx, what would
be the appropriate actions of the nurse to safely help the px to ambulate?
a. Teach the patient to slide forward while keeping their feet in contact with the floor.
b. Take tiny steps in a straight line immediately in front of the patient's feet.
c. Allow the patient to only ambulate with help if necessary.
d. To get the patient's legs moving, rock them from side to side