Nokea
A 70-year-old patient is admitted after falling from his roof. He has a spinal cord injury at the C7 level. What findings during the assessment identify the presence of spinal shock?
- A. Paraplegia with a flaccid paralysis
- B. Tetraplegia with total sensory loss
- C. Total hemiplegia with sensory and motor loss
- D. Spastic tetraplegia with loss of pressure sensation
Correct Answer: A
Rationale: Flaccid paralysis below the level of injury indicates spinal shock.
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Following a T2 spinal cord injury, the patient develops paralytic ileus. While this condition is present, what should the nurse anticipate that the patient will need?
- A. IV fluids
- B. Tube feedings
- C. Parenteral nutrition
- D. Nasogastric suctioning
Correct Answer: A
Rationale: IV fluids maintain hydration during ileus.
Mrs. Rollo has been instructed to check her urine with a multiple test stick. For which abnormal finding should she be particularly alert and report to you when the test is positive?
- A. Glucose
- B. pH of 5
- C. Protein
- D. Ketones
Correct Answer: C
Rationale: Proteinuria can indicate kidney damage, a potential side effect of gold therapy.
Which of these physiological changes would not be considered part of the sympathetic fight-or-flight response?
- A. increased heart rate
- B. increased sweating
- C. dilated pupils
- D. increased stomach motility
Correct Answer: D
Rationale: The correct answer is D: increased stomach motility. In the sympathetic fight-or-flight response, the body prioritizes blood flow to essential organs and muscles, leading to decreased activity in non-essential functions like digestion (stomach motility). This is to conserve energy for immediate action. Increased heart rate, sweating, and dilated pupils are all part of the fight-or-flight response as they prepare the body for quick action and heightened awareness.
At the scene of the accident in which position should Joe be placed before being transported by ambulance to the emergency room?
- A. The position in which he was found
- B. Lateral position with arms flexed
- C. Supine position with head in neutral position
- D. Supine position with head flexed
Correct Answer: C
Rationale: Neutral head position prevents further spinal injury.
What central fiber tract connects forebrain and brain stem structures with the hypothalamus?
- A. cardiac accelerator nerve
- B. medial forebrain bundle
- C. dorsal longitudinal fasciculus
- D. corticospinal tract
Correct Answer: B
Rationale: The correct answer is B: medial forebrain bundle. This tract connects the forebrain and brain stem structures with the hypothalamus, playing a crucial role in regulating various physiological functions. It is involved in the control of emotions, reward pathways, and feeding behaviors. The other choices are incorrect because: A) cardiac accelerator nerve is involved in regulating heart rate, not connecting forebrain structures with the hypothalamus; C) dorsal longitudinal fasciculus is associated with eye movements and visual processing, not connecting forebrain with the hypothalamus; D) corticospinal tract is responsible for voluntary motor movements, not involved in connecting forebrain structures with the hypothalamus.