neurologic infections, autoimmune disorders + neuropathies - PREP U

Question 1

how does testing serum albumin levels help with determining a patients risk of developing a pressure injury?

Answer 1

low albumin levels can indicate a protein deficiency, which can indicate low nutritional status. Which is an issue because proper nutrition is needed to maintain skin integrity and promote wound healing

Question 2

Interferon beta-1a (Rebif)
Interferon beta-1b (BetaSeron)
Interferon beta-1a (Avonex)
Glatiramer acetate (Copaxone)

these are all drugs used in the treatment of which disease?

Answer 2

MS - Multiple Sclerosis

Question 3

when educating a patient with MS and their caregiver, what information is important to provide about managing MS?

Answer 3

pain and fatigue affect most people with MS and is often the disabling symptoms.

-avoid hot temperatures/ heat
-participate in OT/PT
-effective treatment of anemia to reduce extra fatigue
-treat depression

Question 4

Herpes simplex virus is the most common cause of ______ _________.

Answer 4

acute encephalitis

Question 5

Myasthenia gravis occurs when antibodies attack which receptor sites?

Answer 5

Acetylcholine

Question 6

Bell’s palsy is a paralysis of which of the following cranial nerves?

Answer 6

the facial nerve (#7)

Question 7

tic douloureux is another name for what?

Answer 7

trigeminal neuralgia

Question 8

A disorder in which killer T cells and autoantibodies attack or destroy natural cells—those cells that are “self”
is describing which autoimmune disorder?

Answer 8

MS

Question 9

what are the common clinical manifestation associated with MS?

Answer 9

-pain
-weakness
-numbness
-fatigue
-spasticity
-depression
-difficulty w/ coordination
-loss of balance

Question 10

if you as a nurse are preparing to administer acetylcholinesterase inhibitor test to rule out Myastinia Gravis, why does atropine need to be readily available?

Answer 10

this test can cause severe bradycardia and respiratory distress

Question 11

what interventions can a patient with Bell’s Palsy do to maintain or increase muscle tone?

Answer 11

-massage the face multiple times a day with an upward motion

-wrinkling the forehead, blowing out the cheeks and whistling can be performed to prevent muscle atrophy

Question 12

what clinical manifestations are expected with meningitis?

Answer 12

-nuchal rigidity (neck stiffness)
-positive Kernig’s sign
-positive Brudzinski’s sign
-photophobia
-possible fever

Question 13

Which clinical indicator of meningitis is performed by having the patient lie on their back with hips and knees flexed to 90 degrees and then you slowly extend/ straighten 1 leg at a time. This sign is POSITIVE if the patient experiences resistance, pain or inability to extend the knee. (Pain is usually felt in the lower back)

Answer 13

Kernig’s Sign

Question 14

which clinical indicator of meningitis is performed by having the patient lie flat on their back, the clinician places one hand behind the head and the other on their chest to prevent the patient from rising and the clinician gently flexes their neck. This sign is POSITIVE if the patient responds by involuntarily flexes their hips and knees

Answer 14

Brudzinski’s sign

Question 15

what clinical manifestations are consistent with a n abscess in the frontal lobe?

Answer 15

-hemiparesis (weakness/ inability to move 1 side of the body)

-seizures (initiate seizure precautions)
-expressive aphasia

Question 16

-facial distortion
-increased tearing
-painful sensations in the face, behind the ears, + in the eyes

These are associated with which neurological disorder?

Answer 16

Bell’s Palsy

Question 17

Guillain-Barré syndrome is an autoimmune attack on the peripheral _________ _______. Myelin is what protects nerves, provides insulation and speeds the conduction of impulses.

Answer 17

myelin sheath

Question 18

what is the diagnostic test used to confirm Myasthenia Gravis?

Answer 18

The Tensilon test
injecting a short-acting drug called edrophonium chloride (Tensilon) and observing whether muscle strength temporarily improves. This response indicates a positive result for MG

Question 19

Guillain-Barré syndrome (GBS) AKA acute idiopathic polyneuritis is an autoimmune attack on the peripheral nerve myelin. What most often precedes the GBS attack?

Answer 19

a viral infection

Question 20

what does an acute GBS attack present like?

Answer 20

-sudden bilateral lower extremity weakness

-sudden bilateral dyskinesia
-numbness/ tingling episodes

Question 21

Which diagnostic test is used for MS (multiple sclerosis)? and what are we looking for to diagnose?

Answer 21

MRI - Multiple plaques in the CNS (brain, optic nerves and spinal cord)

Question 22

If a patient is suspected of having meningitis, and their CSF is tested,
-Glucose will be __________, due to the bacteria consuming it

-protein will be __________, due to inflammation and increased permeability through the blood brain barrier

-WBCs will be _________.

Answer 22

glucose will be decreased
protein will be increased
WBCs will be increased

Question 23

if you came into contact with another person who has been diagnosed with ____________ ___________, you will prophylactically be treated with one of the following:

• rifampin
• ciprofloxacin hydrochloride
  -ceftriaxone sodium

Answer 23

meningococcal meningitis

Question 24

Which of the following is standard test for early diagnosis of herpes simplex virus (HSV)-1 encephalitis?

Answer 24

Polymerase chain reaction (PCR) - this test confirms the presence of herpes simplex virus 1

Question 25

what should we possibly be assessing for in a patient who is diagnosed already with GBS?

Answer 25

-weakness, numbness, and tingling in the arms and legs that the patient may perceive as painful

-ARDS (can be from progressive weakness moving into the upper body)

-difficulty, chewing, swallowing and talking if cranial nerves become involved (dysphagia)

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