Nokea
A patient is having a fight or flight response after receiving bad news about his prognosis. What affect will this have on the patients sympathetic nervous system?
- A. Constriction of blood vessels in the heart muscle
- B. Constriction of bronchioles
- C. Increase in the secretion of sweat
- D. Constriction of pupils
Correct Answer: C
Rationale: Sympathetic activation during fight or flight increases sweat secretion, dilates heart muscle vessels, bronchodilates, and dilates pupils.
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The nurse caring for an 80 year-old patient knows that she has a pre-existing history of dulled tactile sensation. The nurse should first consider what possible cause for this patients diminished tactile sensation?
- A. Damage to cranial nerve VIII
- B. Adverse medication effects
- C. Age-related neurologic changes
- D. An undiagnosed cerebrovascular accident in early adulthood
Correct Answer: C
Rationale: Aging reduces sensory receptor density, dulling tactile sensation. Cranial nerve VIII affects hearing, medications may cause other effects, and an old CVA is less likely without evidence.
A trauma patient was admitted to the ICU with a brain injury. The patient had a change in level of consciousness, increased vital signs, and became diaphoretic and agitated. The nurse should recognize which of the following syndromes as the most plausible cause of these symptoms?
- A. Adrenal crisis
- B. Hypothalamic collapse
- C. Sympathetic storm
- D. Cranial nerve deficit
Correct Answer: C
Rationale: Sympathetic storm, triggered by brain injury, causes altered consciousness, elevated vital signs, diaphoresis, and agitation due to sympathetic overstimulation. Other options do not fully explain these symptoms.
The nurse is caring for a patient who exhibits abnormal results of the Weber test and Rinne test. The nurse should suspect dysfunction involving what cranial nerve?
- A. Trigeminal
- B. Acoustic
- C. Hypoglossal
- D. Trochlear
Correct Answer: B
Rationale: The Weber and Rinne tests assess hearing, mediated by cranial nerve VIII (acoustic). Trigeminal affects facial sensation, hypoglossal moves the tongue, and trochlear controls eye movement.
A patient is being given a medication that stimulates her parasympathetic system. Following administration of this medication, the nurse should anticipate what effect?
- A. Constricted pupils
- B. Dilated bronchioles
- C. Decreased peristaltic movement
- D. Relaxed muscular walls of the urinary bladder
Correct Answer: A
Rationale: Parasympathetic stimulation causes pupil constriction, bronchoconstriction, increased peristalsis, and bladder contraction. The other options reflect sympathetic effects.
When caring for a patient with an altered level of consciousness, the nurse is preparing to test cranial nerve VII. What assessment technique would the nurse use to elicit a response from cranial nerve VII?
- A. Palpate trapezius muscle while patient shrugs should against resistance.
- B. Administer the whisper or watch-tick test.
- C. Observe for facial movement symmetry, such as a smile.
- D. Note any hoarseness in the patients voice.
Correct Answer: C
Rationale: Cranial nerve VII (facial) is assessed by observing facial symmetry during movements like smiling. Trapezius testing assesses XI, whisper tests VIII, and hoarseness tests X.