Nokea
After receiving a change-of-shift report at 7:00 am, which of these patients will you assess first?
- A. A 23-year-old with a migraine headache who is complaining of severe nausea associated with retching
- B. A 45-year-old who is scheduled for a craniotomy in 30 minutes and needs preoperative teaching
- C. A 59-year-old with Parkinson's disease who will need a swallowing assessment before breakfast
- D. A 63-year-old with multiple sclerosis who has an oral temperature of 101.8°F and flank pain
Correct Answer: B
Rationale: Preoperative teaching is time-sensitive and critical for surgical preparation.
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One of the most widely used tests of executive functioning is the:
- A. Manhattan card sorting test.
- B. Quebec number sorting task.
- C. Wisconsin card sorting test.
- D. Minnesota number ordering test.
Correct Answer: C
Rationale: The Wisconsin Card Sorting Test (WCST) is a widely used neuropsychological test designed to assess executive functions, such as problem-solving, cognitive flexibility, and the ability to adapt to changing rules. During the test, individuals must sort cards based on different criteria (e.g., color, shape) and adjust their strategy when the sorting rules change. This test is particularly useful for evaluating frontal lobe function and identifying deficits in executive functioning.
A person who is drunk may have difficulty walking in a straight line because the alcohol has impacted their:
- A. thalamus
- B. reticular formation
- C. amygdala
- D. cerebellum
Correct Answer: D
Rationale: The cerebellum is responsible for coordinating voluntary movements, balance, and posture. Alcohol impairs the cerebellum's function, leading to difficulties in walking, balance, and fine motor control. This is why individuals who are drunk often exhibit unsteady movements and have trouble walking in a straight line. The cerebellum's role in motor coordination makes it particularly sensitive to the effects of alcohol.
What type of diet is recommended for people with seizures or epilepsy?
- A. high carbohydrate diet
- B. fruit-only diet
- C. ketogenic diet
- D. low-fat diet
Correct Answer: C
Rationale: The ketogenic diet is a high-fat, low-carbohydrate diet that has been shown to reduce seizure frequency in some individuals with epilepsy, particularly those who do not respond well to medication. It works by altering the body's metabolism to produce ketones, which may have anticonvulsant effects.
With regard to myotomal nerve supply
- A. opponens pollicis is C8
- B. shoulder abduction is C5, 6
- C. ankle plantar flexion is L4, 5
- D. elbow extension is C7, 8
Correct Answer: B
Rationale: Shoulder abduction is primarily controlled by the C5 and C6 nerve roots, which innervate the deltoid and supraspinatus muscles.
Meningeal syndrome suggests any of the following, EXCEPT:
- A. neck stiffness
- B. headache
- C. photophobia
- D. Babynsky response
Correct Answer: D
Rationale: Babinski's response is the correct answer because it is a pathological reflex indicative of upper motor neuron damage, not meningeal irritation. Meningeal syndrome, which includes neck stiffness, headache, and photophobia, is typically caused by inflammation of the meninges, as seen in meningitis or subarachnoid hemorrhage.