A patient recently started on phenytoin (Dilantin) to control simple complex seizures is seen in the outpatient clinic. Which information obtained during his chart review and assessment will be of greatest concern?
- A. The gums appear enlarged and inflamed.
- B. The white blood cell count is 2300/mm³.
- C. Patient occasionally forgets to take the phenytoin until after lunch.
- D. Patient wants to renew his driver's license in the next month.
Correct Answer: B
Rationale: A low white blood cell count could indicate bone marrow suppression, a serious side effect of phenytoin.
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What hormone is important in milk production and maintaining lactation?
- A. Estrogen
- B. Oxytocin
- C. Prolactin
- D. Adrenaline
Correct Answer: C
Rationale: Prolactin is the correct answer because it is the hormone produced by the pituitary gland that stimulates milk production in the mammary glands. During lactation, prolactin levels remain elevated to ensure a continuous supply of milk. While oxytocin is involved in milk ejection, prolactin is primarily responsible for milk synthesis and maintenance of lactation.
The polyneuropathic pattern of sensory loss suggests presence of the following syndrome:
- A. numbness & pain in distal parts of extremities
- B. numbness & analgesia in half of the body
- C. pain & sensory ataxia in half of the body
- D. analgesia & sensory ataxia in proximal parts of extremities
Correct Answer: A
Rationale: Numbness and pain in distal parts of extremities is the correct answer because polyneuropathy typically affects the longest nerves first, leading to a glove-and-stocking pattern of sensory loss. This condition is often caused by systemic diseases such as diabetes, vitamin deficiencies, or toxic exposures.
When assessing a patient for signs of increased intracranial pressure (ICP), the nurse should look for:
- A. Changes in level of consciousness, headache, and vomiting.
- B. Normal pupil size and reaction.
- C. Absence of nausea or vomiting.
- D. Clear and coordinated movements.
Correct Answer: A
Rationale: Increased intracranial pressure (ICP) is associated with changes in consciousness, headache, and vomiting. Normal pupil size, absence of nausea, and clear movements are not indicative of ICP.
To determine the extent of Mr. Smith's head injury, what baseline nursing assessment is most important?
- A. Respiratory status
- B. Motor strength
- C. Urinary output
- D. Gastrointestinal function
Correct Answer: A
Rationale: Respiratory status is crucial in assessing head injuries due to potential brainstem involvement.
A Neurological disorder that is characterised by impairments in motor performance and coordination are known as
- A. Dyspraxia
- B. Apraxia
- C. Anapraxia
- D. Amotoria
Correct Answer: B
Rationale: Apraxia is a neurological disorder that affects the ability to perform purposeful movements, despite having the physical ability and desire to do so. Individuals with apraxia may struggle with tasks like dressing, cooking, or using tools. This condition is often caused by damage to the parietal lobe or other areas of the brain involved in motor planning and execution.