Nokea
Which of these diseases does NOT require the introduction of foreign nucleic acid?
- A. kuru
- B. polio
- C. rabies
- D. St. Louis encephalitis
Correct Answer: A
Rationale: The correct answer is A (kuru) because kuru is a prion disease caused by misfolded proteins, not foreign nucleic acid. Polio, rabies, and St. Louis encephalitis are caused by viruses, which contain foreign nucleic acid. Prions do not contain nucleic acid and replicate by inducing misfolding of normal cellular proteins. Therefore, kuru does not require the introduction of foreign nucleic acid for its transmission and development.
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A client with subdural hematoma was given mannitol to decrease intracranial pressure (ICP). Which of the following results would best show the mannitol was effective?
- A. Urine output increases
- B. Pupils are 8 mm and nonreactive
- C. Systolic blood pressure remains at 150 mm Hg
- D. BUN and creatinine levels return to normal
Correct Answer: A
Rationale: An increase in urine output is the most direct indicator of mannitol's effectiveness. Mannitol works by promoting osmotic diuresis, which increases urine production. This reduces fluid volume in the brain, thereby decreasing ICP. While other signs like pupil reactivity and blood pressure are important, they are secondary indicators and may not directly correlate with the drug's immediate effect.
Which type of drug would be an antidote to atropine poisoning?
- A. nicotinic agonist
- B. anticholinergic
- C. muscarinic agonist
- D. α-blocker
Correct Answer: C
Rationale: The correct answer is C: muscarinic agonist. Atropine is an anticholinergic drug that blocks muscarinic receptors. Therefore, the antidote for atropine poisoning would be a muscarinic agonist, which competes with atropine for binding to muscarinic receptors and reverses its effects. Nicotinic agonist (A) would not be effective as atropine acts on muscarinic receptors, not nicotinic receptors. Anticholinergic (B) is the same class as atropine, so it would not counteract its effects. α-blocker (D) works on a different receptor system and would not be effective in treating atropine poisoning.
Which of these cranial nerves contains preganglionic parasympathetic fibers?
- A. optic, CN II
- B. facial, CN VII
- C. trigeminal, CN V
- D. hypoglossal, CN XII
Correct Answer: B
Rationale: The correct answer is B: facial nerve, CN VII. The facial nerve contains preganglionic parasympathetic fibers that innervate the lacrimal, submandibular, and sublingual glands. These fibers originate from the superior salivatory nucleus in the pons. Option A (optic nerve) is involved in vision and not related to parasympathetic function. Option C (trigeminal nerve) is primarily involved in sensory innervation of the face and motor function of the muscles of mastication. Option D (hypoglossal nerve) is responsible for motor control of the tongue and is not associated with parasympathetic fibers.
After a demonstration of isometric (muscle-setting) exercises, which of the following comments by the patient tells you he has understood how to do the exercises?
- A. I pull on the traction rope to release the tension for 5 seconds and release.
- B. I draw the kneecap toward the thigh, hold for 5 seconds and relax.
- C. I lift myself up off the bed for 5 seconds by using the trapeze and relax.
- D. I turn to my right side, hold for 5 seconds and relax.
Correct Answer: B
Rationale: Isometric exercises involve contracting muscles without movement; drawing the kneecap demonstrates correct technique.
While gathering equipment after an injection, a nurse accidentally received a prick from an improperly capped needle. To interpret this sensation, which of these areas must be intact?
- A. Corticospinal tract, medulla, and basal ganglia
- B. Pyramidal tract, hypothalamus, and sensory cortex
- C. Lateral spinothalamic tract, thalamus, and sensory cortex
- D. Anterior spinothalamic tract, basal ganglia, and sensory cortex
Correct Answer: C
Rationale: The correct answer is C: Lateral spinothalamic tract, thalamus, and sensory cortex. The lateral spinothalamic tract carries pain and temperature sensations to the thalamus, which then relays it to the sensory cortex for interpretation. In this scenario, the nurse's sensation of being pricked by the needle is a pain sensation, so the intactness of the lateral spinothalamic tract, thalamus, and sensory cortex is crucial for interpreting this sensation.
Choices A, B, and D are incorrect because they do not involve the specific pathways responsible for transmitting pain sensations. The corticospinal tract (choice A) is involved in motor function, the pyramidal tract (choice B) is involved in voluntary movement, and the anterior spinothalamic tract (choice D) is not associated with pain and temperature sensations. Therefore, the correct answer is C as it directly relates to the interpretation of the pain sensation experienced by the nurse.