Nokea
A nurse is taking care of a client with ptosis (drooping) of the eyelids, difficulty chewing and swallowing, diplopia, voice weakness, masklike facial expression, and weakness of the extremities. Which of the following conditions does the nurse suspect?
- A. Parkinson's disease
- B. Extrapyramidal disorder
- C. Multiple sclerosis
- D. Myasthenia gravis
Correct Answer: D
Rationale: Myasthenia gravis presents with these symptoms, particularly muscle weakness.
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When caring for the patient with CREST syndrome (calcinosis, Raynaud's phenomenon, esophageal dysfunction, sclerodactyly, and telangiectasia) associated with scleroderma, what should the nurse teach the patient to do?
- A. Maintain a fluid intake of at least 3000 mL/day.
- B. Avoid exposure to the sun or other ultraviolet light.
- C. Monitor and keep a log of daily blood pressure (BP).
- D. Protect the hands and feet from cold exposure and injury.
Correct Answer: D
Rationale: Cold protection prevents Raynaud's episodes.
What gland produces a secretion that causes fight-or-flight responses in effectors?
- A. adrenal medulla
- B. salivatory gland
- C. reproductive gland
- D. thymus
Correct Answer: A
Rationale: The correct answer is A: adrenal medulla. The adrenal medulla is part of the adrenal gland and secretes adrenaline and noradrenaline in response to stress, leading to fight-or-flight responses. The salivary gland produces saliva, the reproductive gland produces sex hormones, and the thymus produces T-cells for the immune system, none of which are related to fight-or-flight responses.
The patient with gout will have periodic exacerbations of painful joint inflammation. Acute episodes are treated with
- A. Nonsteroidal anti-inflammatory medications and colchicine.
- B. Allopurinol and aspirin.
- C. Antibiotics and acetaminophen.
- D. Bisphosphonates and calcium.
Correct Answer: A
Rationale: NSAIDs and colchicine are used for acute gout attacks, whereas allopurinol is used for long-term management.
Which of the following is not a realistic outcome to establish with a client who has multiple sclerosis (MS)? The client will develop:
- A. Joint mobility
- B. Muscle strength
- C. Cognition
- D. Mood elevation
Correct Answer: B
Rationale: While joint mobility, cognition, and mood elevation can be improved or maintained, muscle strength is often progressively affected by MS and may not be fully restored.
To assess cranial nerve VIII (Vestibulocochlear nerve), the nurse should:
- A. Perform a hearing test and assess balance.
- B. Evaluate the patient's ability to swallow.
- C. Inspect the patient's throat.
- D. Palpate the patient's neck.
Correct Answer: A
Rationale: Cranial nerve VIII (Vestibulocochlear nerve) is responsible for hearing and balance. A hearing test and balance assessment evaluate its function. Swallowing, throat inspection, and neck palpation are unrelated.