Nokea
Brown-Sequard syndrome develops with the following damage of the spinal cord:
- A. complete transversal
- B. anterior horns
- C. half transversal
- D. posterior horns
Correct Answer: C
Rationale: Half transversal is the correct answer because Brown-Sequard syndrome results from damage to one side of the spinal cord. This leads to ipsilateral motor paralysis and loss of proprioception, and contralateral loss of pain and temperature sensation due to the crossing of spinothalamic tract fibers.
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When is a diagnosis of cholinergic crisis made?
- A. The patient's respiration is impaired because of muscle weakness.
- B. Administration of edrophonium (Tensilon) increases muscle weakness.
- C. Administration of edrophonium (Tensilon) results in improved muscle contractility.
- D. EMG reveals decreased response to repeated stimulation of muscles.
Correct Answer: B
Rationale: Increased muscle weakness after Tensilon indicates cholinergic crisis
A client with rheumatoid arthritis taking hydroxychloroquine (Plaquenil) should be taught that, because of this drug therapy, he should
- A. expect relief of pain and inflammation within 1-2 weeks
- B. have an eye examination every 4-6 months
- C. take the medication before bedtime
- D. be alert for development of a skin rash
Correct Answer: B
Rationale: Hydroxychloroquine can cause retinal damage, requiring regular eye exams.
Twenty-four hours later Bob is discharged. Which of the following statements would indicate Bob understood your teaching?
- A. Increasing pain in the arm is expected over the next 2 days but if it continues the third day I'll call the physician.
- B. If the fingers of my left hand begin to swell and are colder than those of the right hand, I'll elevate my arm above heart level and call the physician.
- C. Bleeding may appear on the cast today. I'll circle the area and if it continues to increase, I'll call the physician.
- D. I'll immobilize my left hand for 1 week, then begin active flexion-extension exercises and continue until my follow-up visit.
Correct Answer: B
Rationale: Swelling and coldness could indicate impaired circulation, necessitating immediate medical attention.
Which of the following is the causative agent of East African trypanosomiasis?
- A. Trypanosoma cruzi
- B. Trypanosoma vivax
- C. Trypanosoma brucei rhodanese
- D. Trypanosoma brucei gambiense
Correct Answer: C
Rationale: The correct answer is C: Trypanosoma brucei rhodanese. East African trypanosomiasis is caused by Trypanosoma brucei, specifically the subspecies Trypanosoma brucei rhodanese. This parasite is transmitted by tsetse flies and infects humans, causing sleeping sickness. Trypanosoma cruzi (Choice A) causes Chagas disease, not East African trypanosomiasis. Trypanosoma vivax (Choice B) causes a different form of animal trypanosomiasis. Trypanosoma brucei gambiense (Choice D) is responsible for West African trypanosomiasis, not the East African form. Therefore, the correct choice is C.
The nurse is evaluating the status of a client who had a craniotomy 3 days ago. The nurse would suspect the client is developing meningitis as a complication of surgery if the client exhibits:
- A. A positive Brudzinski's sign
- B. A negative Kernig's sign
- C. Absence of nuchal rigidity
- D. A Glascow Coma Scale score of 15
Correct Answer: A
Rationale: A positive Brudzinski's sign, where flexion of the neck causes involuntary flexion of the hips and knees, is a classic sign of meningitis. Meningitis is a potential complication after craniotomy due to the breach in the protective meninges, allowing pathogens to enter the central nervous system. Other signs include fever, headache, and nuchal rigidity.