Nokea
A client with multiple sclerosis (MS) is frustrated by tremors associated with the disease. How should the nurse explain why these tremors occur? Due to the demyelination of neurons that occurs in MS:
- A. there is an imbalance in acetylcholine and dopamine, leading to tremors.
- B. there is a disruption in nerve impulse conduction, causing tremors.
- C. muscles are unable to receive impulses, resulting in tremors.
- D. the reflex arc is disrupted, leading to muscle tremors.
Correct Answer: B
Rationale: In multiple sclerosis (MS), demyelination of neurons disrupts nerve impulse conduction. This disruption in nerve impulses can lead to tremors, explaining why the client experiences tremors in MS. Choice A is incorrect because tremors in MS are primarily due to nerve conduction issues, not an imbalance in acetylcholine and dopamine. Choice C is incorrect as it oversimplifies the process; the issue lies in nerve impulses, not the muscle's ability to receive them. Choice D is incorrect as the primary cause of tremors in MS is the disruption in nerve impulse conduction, not the reflex arc being disrupted.
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What is the distinguishing feature of Hodgkin disease noted on histologic exam?
- A. Reed-Sternberg cells
- B. Red-stained cells
- C. Human Papillomavirus
- D. B-cells and T-cells
Correct Answer: A
Rationale: The correct answer is A: Reed-Sternberg cells. Reed-Sternberg cells are large, abnormal B-cells that are characteristic of Hodgkin's lymphoma. These cells are identified on histologic examination of lymph node biopsies from patients with Hodgkin disease. Choice B, 'Red-stained cells,' is vague and does not describe a specific feature of Hodgkin disease. Choice C, 'Human Papillomavirus,' is incorrect as Hodgkin disease is not caused by HPV. Choice D, 'B-cells and T-cells,' is incorrect as Hodgkin disease is characterized by the presence of Reed-Sternberg cells, which are abnormal B-cells.
Which of the following accurately describes the pathophysiology of asthma?
- A. Chronic inflammation of the bronchial lining
- B. Narrowing of the airway due to bronchoconstriction
- C. Damage to alveoli reducing lung elasticity
- D. Overproduction of mucus by the goblet cells
Correct Answer: B
Rationale: The correct answer is B: "Narrowing of the airway due to bronchoconstriction." In asthma, there is an inflammatory response that leads to bronchoconstriction, causing the airways to narrow and making it difficult to breathe. Choice A is incorrect as chronic inflammation is a feature of asthma but not the primary pathophysiological mechanism. Choice C is incorrect as damage to alveoli is more characteristic of conditions like emphysema. Choice D is incorrect as overproduction of mucus is a feature of chronic bronchitis, not asthma.
Peritonitis is a condition that can result in serious complications. Identify one of the complications.
- A. Increased peristalsis
- B. Dizziness and malaise
- C. Sepsis and shock
- D. Nausea and vomiting
Correct Answer: C
Rationale: Corrected Rationale: Peritonitis can lead to severe complications such as sepsis and shock due to the infection spreading in the abdominal cavity. Sepsis is a systemic inflammatory response to infection, and shock is a life-threatening condition where the body's organs are not receiving enough blood flow. Choices A, B, and D are incorrect. Increased peristalsis is not a typical complication of peritonitis; dizziness and malaise, as well as nausea and vomiting, are symptoms rather than complications of the condition.
A client on an acute medicine unit of a hospital with a diagnosis of small bowel obstruction is reporting intense, diffuse pain in her abdomen. Which physiologic phenomenon is most likely contributing to her complaint?
- A. Somatic pain resulting from pressure on the parietal peritoneum
- B. Referred pain from her small bowel
- C. Visceral pain resulting from distension and ischemia
- D. Neuropathic pain resulting from autonomic dysfunction
Correct Answer: C
Rationale: Visceral pain is associated with distension, ischemia, and inflammation of internal organs. In the case of a small bowel obstruction, the intense, diffuse pain reported by the client is likely due to the distension and ischemia of the small bowel. Somatic pain (Choice A) would be more localized and sharp, typically arising from the parietal peritoneum. Referred pain (Choice B) is pain perceived at a site distant from the actual pathology. Neuropathic pain (Choice D) involves dysfunction or damage to the nervous system and is not typically associated with the described physiologic phenomenon of distension and ischemia in the context of a small bowel obstruction.
In emphysema, what features result in impaired oxygenation?
- A. The bronchioles are inflamed and filled with mucus
- B. The alveoli have lost surfactant and collapse
- C. Enlarged, permanently inflated alveoli
- D. The accumulation of purulent fluid in the bronchioles
Correct Answer: C
Rationale: The correct answer is C. In emphysema, impaired oxygenation results from enlarged and permanently inflated alveoli, leading to reduced surface area for gas exchange. Choices A, B, and D are incorrect. In emphysema, bronchioles are not typically filled with mucus, alveoli losing surfactant and collapsing is more characteristic of conditions like atelectasis, and purulent fluid accumulation in the bronchioles is commonly seen in conditions like pneumonia, not emphysema.