Nokea
A patient reports nearly having a motor vehicle crash and states that his heart was pounding and he was breathing heavy and fast. Currently, the patient's heart rate and breathing are within normal limits. Which neurotransmitter has resumed control after the patient's incident?
- A. Serotonin
- B. Prostaglandin
- C. Acetylcholine
- D. Norepinephrine
Correct Answer: C
Rationale: Acetylcholine is the neurotransmitter responsible for mediating parasympathetic (rest-and-digest) functions, which resume control after a sympathetic (fight-or-flight) response. Norepinephrine mediates the sympathetic response, while serotonin and prostaglandins are involved in mood and pain regulation. Understanding neurotransmitter roles is key to explaining autonomic nervous system function.
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Patients with a history of osteoporosis have an increased risk for
- A. Infection in the bone.
- B. Peripheral blood clot formation.
- C. Painful joint inflammation.
- D. Fracture formation.
Correct Answer: D
Rationale: Osteoporosis weakens bones making them more prone to fractures.
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.
To prevent strain on Mr. Tucker's back muscles, which nursing action is INAPPROPRIATE?
- A. To place him on bed pan, logroll using a turning sheet
- B. When lying on his side, flex upper leg and place a pillow between his knees
- C. When lying on his back, place pillows under entire length of his knees
- D. To turn him on his side, gently turn his shoulders and upper trunk first, prop with a pillow, then turn his pelvis and lower limbs
Correct Answer: D
Rationale: Turning the pelvis and lower limbs last can strain back muscles.
What causes an initial incomplete spinal cord injury to result in complete cord damage?
- A. Edematous compression of the cord above the level of the injury
- B. Continued trauma to the cord resulting from damage to stabilizing ligaments
- C. Infarction and necrosis of the cord caused by edema, hemorrhage, and metabolites
- D. Mechanical transection of the cord by sharp vertebral bone fragments after the initial injury
Correct Answer: C
Rationale: Secondary injury due to ischemia and inflammation can lead to complete cord damage.
KL is a 34-year-old male admitted to the hospital (large trauma center) after suffering a traumatic brain injury (TBI) secondary to a serious motor vehicle accident. He was in excellent health prior to the accident. HT: 6'2" WT: 190 pounds (86 kg) What is the best means of determining KL's caloric needs while in the hospital?
- A. Mifflin-St Jeor equation
- B. Harris-Benedict equation
- C. WHO standards
- D. Indirect calorimetry
Correct Answer: D
Rationale: Indirect calorimetry is the gold standard for determining caloric needs in critically ill patients, including those with traumatic brain injury (TBI). It measures oxygen consumption and carbon dioxide production to provide an accurate assessment of energy expenditure.