Nokea
Percutaneous cervical cordotomy:
- A. Is performed under general anaesthesia.
- B. Occurs by entry of a needle into the intervertebral foramen between cervical vertebrae C4 and C5.
- C. Involves thermoablation of the anterior spinothalamic tract.
- D. Is performed on the same side as the pain.
Correct Answer: C
Rationale: Percutaneous cervical cordotomy (PCC) relieves cancer pain via targeted nerve destruction. It's done under local anesthesia with sedation, not general, to monitor patient response (e.g., pain relief, side effects) during stimulation. The needle enters at C1-C2, not C4-C5, targeting the lateral spinothalamic tract contralateral to the pain not the anterior tract explicitly, though terminology varies. Thermoablation destroys pain fibers, confirmed by test stimulation. It's performed opposite the pain side due to crossed spinothalamic pathways. Complete numbness isn't typical; sensory loss is partial. Thermoablation's specificity using radiofrequency to interrupt pain transmission defines PCC's efficacy, minimizing damage to adjacent motor tracts while achieving analgesia.
You may also like to solve these questions
Heart failure with preserved ejection fraction is caused by:
- A. Ventricular hypertrophy reducing contractility of muscles
- B. Decreased perfusion of the myocardium
- C. Dilated cardiomyopathy
- D. Impaired ventricular relaxation resulting in the lack of ability of ventricles to fill with blood
Correct Answer: D
Rationale: HFpEF stiff ventricles won't relax, slashing fill-up, not pump-out. Hypertrophy aids, doesn't cause; perfusion dips hurt supply; dilated's HFrEF. Nurses target this, a chronic fill flaw.
A nurse is caring for a client diagnosed with peripheral artery disease. Which of the following is a common assessment finding?
- A. 4+ pedal pulses
- B. 3+ pedal pulses
- C. Bounding pulses in all 4 extremities
- D. 1+ pedal pulses
Correct Answer: D
Rationale: Peripheral artery disease (PAD) clogs arteries, slashing flow 1+ pedal pulses (weak, thready) are typical, reflecting ischemia below blockages. 4+ or 3+ pulses (strong) contradict PAD's hypoperfusion; bounding pulses suggest hyperdynamic states, not occlusion. Nurses expect weak pulses, checking for pain or pallor, key to tracking PAD's limb-threatening march, guiding interventions like revascularization.
A nurse is caring for a client recently diagnosed with pericarditis. Which of the following is a common assessment finding with this disorder?
- A. Elevated troponin
- B. Pericardial friction rub
- C. Heart failure
- D. ST-segment depression
Correct Answer: B
Rationale: Pericarditis rubs the sac pericardial friction rub, a scratchy sound, marks inflammation, a common find as layers grate. Troponin rises with muscle damage, not here. Heart failure or ST depression hints tamponade or ischemia, not direct. Nurses auscultate this rub, tying it to pericarditis's irritated core, a diagnostic bellwether.
Fatty liver disease is more common in people with metabolic syndrome or type 2 diabetes. The pathogenesis of fatty liver disease is not yet completely known. Question: What does current research suggest with respect to the pathogenesis?
- A. Steatosis correlates with inflammation
- B. Inflammation correlates with fibrosis
- C. Steatosis correlates with liver damage
- D. Steatosis correlates with insulin resistance
Correct Answer: D
Rationale: Fatty liver's tale steatosis ties to insulin resistance, a metabolic syndrome root, not just inflammation, fibrosis, or vague damage. Nurses see this, a chronic fat-glucose knot.
A 75-year-old lady is listed for an anterior resection to treat a cancer in the descending hemicolon. She has never previously been in hospital. She gives no history of shortness of breath or angina, but admits that she does not take part in strenuous activity. Apart from painkillers, she takes no medications. Appropriate statements regarding preoperative testing include:
- A. Resting echocardiography is a useful test of her functional capacity.
- B. Coronary angiography is indicated.
- C. Cardiopulmonary exercise testing is a useful test of functional capacity.
- D. Brain natriuretic peptide level is a useful test that indicates heart failure.
Correct Answer: C
Rationale: Preoperative assessment evaluates surgical risk. Resting echocardiography assesses cardiac structure, not functional capacity, which requires dynamic testing. Coronary angiography is invasive and unwarranted without symptoms like angina or ischemia evidence. Cardiopulmonary exercise testing (CPET) measures aerobic capacity (e.g., VOâ‚‚ peak), directly assessing functional reserve for surgical stress ideal for this asymptomatic but inactive patient. Brain natriuretic peptide (BNP) indicates heart failure if elevated but doesn't test capacity; it's a biomarker, not a stress test. Dobutamine stress echocardiography detects ischemia, useful but less comprehensive than CPET for overall fitness. CPET's ability to quantify cardiopulmonary reserve makes it the most appropriate choice for optimizing perioperative management in this elderly patient.