Nokea
A client with a history of chronic alcoholism presents to the emergency department with a complaint of double vision. Which cranial nerve is most likely involved?
- A. Cranial nerve I (Olfactory)
- B. Cranial nerve III (Oculomotor)
- C. Cranial nerve VI (Abducens)
- D. Cranial nerve VII (Facial)
Correct Answer: C
Rationale: The correct answer is Cranial nerve VI (Abducens). Chronic alcoholism can lead to damage to the abducens nerve, which controls the lateral movement of the eye. This damage can result in symptoms like double vision. Cranial nerve I (Olfactory) is responsible for the sense of smell and is not related to eye movement. Cranial nerve III (Oculomotor) controls most of the eye movements but is less likely to be affected in chronic alcoholism than the abducens nerve. Cranial nerve VII (Facial) is responsible for facial movements and is not associated with double vision.
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A group of prison inmates developed tuberculosis following exposure to an infected inmate. On examination, tissues were soft and granular (like clumped cheese). Which of the following is the most likely cause?
- A. Coagulative necrosis
- B. Liquefactive necrosis
- C. Caseous necrosis
- D. Autonecrosis
Correct Answer: C
Rationale: The correct answer is C. Caseous necrosis is characteristic of tuberculosis, where the tissue has a soft, cheese-like appearance. Coagulative necrosis involves protein denaturation, liquefactive necrosis is seen in brain infarcts and abscesses, and autonecrosis is not a recognized term in pathology, making them incorrect choices in this scenario.
Which of the following mediators of inflammation causes increased capillary permeability and pain?
- A. Serotonin
- B. Histamine
- C. Bradykinin
- D. Nitric oxide
Correct Answer: C
Rationale: Bradykinin is the correct answer. It is a potent mediator of inflammation that causes increased capillary permeability and is responsible for the pain associated with inflammation. Serotonin and histamine are also mediators of inflammation, but they are not primarily known for increasing capillary permeability or inducing pain. Nitric oxide is involved in various physiological processes but is not a primary mediator of inflammation that causes increased capillary permeability and pain.
A 50-year-old female was diagnosed with sideroblastic anemia. Which of the following assessment findings would most likely occur?
- A. Bronze-colored skin
- B. Decreased iron
- C. Normochromic erythrocytes
- D. Aplastic bone marrow
Correct Answer: A
Rationale: The correct answer is A: 'Bronze-colored skin.' Sideroblastic anemia is characterized by excess iron deposition, leading to bronze-colored skin. This occurs due to the abnormal accumulation of iron in tissues. Choices B, C, and D are incorrect because sideroblastic anemia does not typically present with decreased iron levels, normochromic erythrocytes, or aplastic bone marrow.
A patient is prescribed tadalafil (Cialis) for erectile dysfunction. What condition would contraindicate the use of this medication?
- A. History of hypertension
- B. Use of nitrates
- C. Use of antihypertensive medications
- D. History of peptic ulcer disease
Correct Answer: B
Rationale: The correct answer is B: 'Use of nitrates.' Tadalafil (Cialis) is contraindicated in patients using nitrates due to the risk of severe hypotension. Nitrates and tadalafil both cause vasodilation, leading to a synergistic effect that can result in a dangerous drop in blood pressure. Choices A, C, and D are incorrect because a history of hypertension, the use of antihypertensive medications, and a history of peptic ulcer disease are not direct contraindications for tadalafil use.
Which manifestation of stress reflects the non-specific fight or flight response?
- A. Decreased pupillary light response
- B. Increased GI motility
- C. Decreased short-term memory
- D. Increased cardiopulmonary rates
Correct Answer: D
Rationale: The correct answer is D, 'Increased cardiopulmonary rates.' The fight or flight response, activated by stress, is a non-specific physiological reaction that prepares the body to deal with perceived threats. In this response, the heart rate and breathing rate increase to supply more oxygen to muscles and vital organs, enabling a rapid response in dangerous situations. Choices A, B, and C are incorrect because decreased pupillary light response, increased GI motility, and decreased short-term memory are not typical manifestations of the fight or flight response.