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A 63-year-old patient with PD has done well on rasagiline 1 mg once a day and ropinirole 4 mg three times a day for several years. In the past, higher doses of ropinirole resulted in excessive drowsiness. He now needs more symptom relief. The best recommendation would be to:
- A. Add carbidopa/levodopa.
- B. Add entacapone.
- C. Add pramipexole.
- D. Consider DBS surgery.
Correct Answer: A
Rationale: Adding carbidopa/levodopa can provide additional symptom relief without increasing the risk of drowsiness associated with higher doses of ropinirole.
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You are preparing to admit a patient with a seizure disorder. Which of the following actions can you delegate to the LPN/LVN?
- A. Complete admission assessment.
- B. Set up oxygen and suction equipment.
- C. Place a padded tongue blade at bedside.
- D. Pad the side rails before patient arrives.
Correct Answer: D
Rationale: Padding the side rails is a safety measure that can be done by an LPN/LVN without requiring complex assessment skills.
When positioning the patient after a total hip arthroplasty with a posterior approach, it is important that the nurse maintain the affected extremity in what position?
- A. Adduction and flexion
- B. Abduction and extension
- C. Abduction and internal rotation
- D. Adduction and external rotation
Correct Answer: B
Rationale: Abduction and extension prevent dislocation.
The action potential is measured in millivolts (mV) and is ranged from:
- A. -90mV to +20mV
- B. -70mV to +30mV
- C. -65mV to +40mV
- D. -30mV to +60mV
Correct Answer: C
Rationale: The action potential involves a rapid change in membrane potential, typically ranging from -65mV (resting potential) to +40mV (peak depolarization). This change is driven by the influx of sodium ions and the subsequent efflux of potassium ions. The action potential is a key mechanism for transmitting information within the nervous system, enabling neurons to communicate over long distances.
Vasodilators produced by the endothelium include:
- A. endothelium-derived relaxing factor (EDRF)
- B. nitric oxide (NO)
- C. prostacyclin (PGL2)
- D. all above
Correct Answer: D
Rationale: The endothelium produces vasodilators such as EDRF (which includes NO) and prostacyclin (PGL2). These substances help regulate vascular tone and blood flow.
What do we call the layer of fatty tissue surrounding the axon of some neurons?
- A. cutaneous coating
- B. myelin sheath
- C. dendritic barrier
- D. synaptic sleeve
Correct Answer: B
Rationale: The myelin sheath is a layer of fatty tissue that surrounds the axons of some neurons, providing insulation and increasing the speed of electrical signal transmission. Myelin is produced by glial cells, such as oligodendrocytes in the central nervous system and Schwann cells in the peripheral nervous system. Damage to the myelin sheath, as seen in conditions like multiple sclerosis, can impair neural communication and lead to neurological symptoms.