Nokea
A patient is brought to the emergency department with an injured lower left leg following a fall while rock climbing. The nurse identifies the presence of a fracture based on what cardinal sign of fracture?
- A. Muscle spasms
- B. Obvious deformity
- C. Edema and swelling
- D. Pain and tenderness
Correct Answer: B
Rationale: Obvious deformity is a clear indicator of a fracture.
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Acetylcholine is a neurotransmitter that provides for communication between muscles and nerves. When there is a problem with the interaction between acetylcholine and the acetylcholine receptor sites on the muscles, which condition(s) can occur?
- A. Myasthenia gravis
- B. Botulism
- C. Multiple sclerosis
- D. A and B
Correct Answer: D
Rationale: Myasthenia gravis and botulism are conditions that result from impaired acetylcholine function. Myasthenia gravis is an autoimmune disorder that blocks acetylcholine receptors, while botulism prevents acetylcholine release. Multiple sclerosis affects the myelin sheath, not acetylcholine. Understanding these conditions highlights the importance of acetylcholine in neuromuscular communication.
A drug that affects both divisions of the autonomic system is going to bind to, or block, which type of neurotransmitter receptor?
- A. nicotinic
- B. muscarinic
- C. α-adrenergic
- D. β-adrenergic
Correct Answer: A
Rationale: Rationale for Correct Answer (A):
1. Nicotinic receptors are present in both sympathetic and parasympathetic divisions of the autonomic system.
2. Drugs affecting both divisions target nicotinic receptors to modulate autonomic functions.
3. Binding or blocking nicotinic receptors can impact both sympathetic and parasympathetic activities.
Summary of Incorrect Choices:
B. Muscarinic receptors are specific to the parasympathetic division, not affecting the sympathetic division.
C. α-adrenergic receptors are specific to the sympathetic division, not influencing parasympathetic functions.
D. β-adrenergic receptors are also specific to the sympathetic division, not impacting the parasympathetic division.
Nurse Parker is overseeing the care of a patient with Parkinson's disease who has been consistently taking carbidopa/levodopa (Sinemet) for a year. She is attentively monitoring for any potential adverse reactions associated with this specific medication. Which adverse reaction should Nurse Parker be particularly vigilant about in monitoring this patient?
- A. The occurrence of dyskinesia.
- B. The emergence of respiratory depression.
- C. The onset of glaucoma.
- D. The development of a rash or other signs of an allergic reaction.
Correct Answer: A
Rationale: Dyskinesia, or involuntary movements, is a common adverse reaction to long-term levodopa therapy in PD patients.
During assessment of a patient with dementia, the nurse determines that the condition is potentially reversible when finding out what about the patient?
- A. Has long-standing abuse of alcohol
- B. Has a history of Parkinson's disease
- C. Recently developed symptoms of hypothyroidism
- D. Was infected with human immunodeficiency virus (HIV) 10 years ago
Correct Answer: C
Rationale: Hypothyroidism can cause reversible cognitive impairment
What does a positive Babinski sign in an adult suggest?
- A. Possible upper motor neuron dysfunction.
- B. Normal plantar reflex.
- C. Absence of neurological abnormalities.
- D. Normal function of lower motor neurons.
Correct Answer: A
Rationale: A positive Babinski sign in an adult indicates possible upper motor neuron dysfunction, such as a stroke or spinal cord injury. A normal plantar reflex involves toe flexion, not extension.