Nokea
Cerebellar function is assessed by which of the following tests?
- A. Muscle size and strength
- B. Cranial nerve examination
- C. Coordination - hop on one foot
- D. Spinothalamic tract
Correct Answer: C
Rationale: Cerebellar function is assessed by testing coordination, balance, and fine motor skills. Asking the patient to hop on one foot evaluates their balance and coordination, which are controlled by the cerebellum. Muscle size and strength, cranial nerve examination, and the spinothalamic tract are not specific to cerebellar function.
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A 33-year-old female presents with drooping of her eyelid that seem to occur while reading or watching television. This appears to get worse later in the day. She also reports that at times she sees "double." A few weeks ago, she was prescribed an antibiotic medication for a urinary tract infection. She does not recall the name of the antibiotic. On physical exam, bilateral ptosis, with the left affected more than the right is seen. Pupillary function intact. A glove is filled with ice, and subsequently applied to the patient's eyelid. After two minutes, the patient's ptosis has improved. Which of the following is most likely to yield rapid symptom improvement?
- A. Corticosteroids
- B. Plasma exchange
- C. Acetylcholinesterase inhibitor
- D. Thymectomy
Correct Answer: C
Rationale: The patient's symptoms of ptosis and diplopia that worsen with activity and improve with rest are classic for myasthenia gravis. The ice pack test, which improves ptosis, further supports this diagnosis. Acetylcholinesterase inhibitors, such as pyridostigmine, are the first-line treatment for symptomatic improvement in myasthenia gravis. Corticosteroids and plasma exchange are used for long-term management or severe cases, while thymectomy is a surgical option for thymoma-associated myasthenia gravis.
The home health nurse is caring for the client newly diagnosed with multiple sclerosis. Which client issue is of most importance?
- A. The client refuses to have a gastrostomy feeding.
- B. The client wants to discuss if she should tell her fiancé.
- C. The client tells the nurse life is not worth living anymore
- D. The client needs the flu and pneumonia vaccines.
Correct Answer: C
Rationale: Expressing feelings of hopelessness or suicidal ideation requires immediate intervention to ensure the client's safety and provide emotional support.
A patient reports sudden weakness on one side of their body. The nurse should:
- A. Perform a neurologic assessment focusing on motor function and sensation.
- B. Measure the patient's oxygen saturation.
- C. Inspect the patient's skin color.
- D. Check the patient's blood glucose levels.
Correct Answer: A
Rationale: Sudden weakness on one side of the body may indicate a neurological issue, such as a stroke. A focused neurologic assessment is essential. Oxygen saturation, skin color, and blood glucose levels are secondary considerations.
Which of the following is the most common cause of neonatal meningitis?
- A. Haemophilus influenzae b
- B. Streptococcus agalactiae
- C. Neisseria meningitidis
- D. Streptococcus pneumoniae
Correct Answer: B
Rationale: The correct answer is B: Streptococcus agalactiae. This bacterium is the most common cause of neonatal meningitis due to its ability to colonize the maternal genital tract and be transmitted to the newborn during delivery. It is a leading cause of early-onset neonatal sepsis and meningitis. Haemophilus influenzae b, Neisseria meningitidis, and Streptococcus pneumoniae are more commonly associated with meningitis in older children and adults, rather than in neonates. Therefore, choice B is the most appropriate answer based on the specific context of neonatal meningitis.
What region of the limbic lobe is responsible for generating stress responses via the hypothalamus?
- A. hippocampus
- B. amygdala
- C. mammillary bodies
- D. prefrontal cortex
Correct Answer: B
Rationale: The correct answer is B: amygdala. The amygdala is responsible for generating stress responses through its connections with the hypothalamus. It plays a crucial role in processing emotions, including fear and anxiety. The hippocampus (A) is involved in memory formation, not stress responses. The mammillary bodies (C) are part of the hypothalamus but are not directly responsible for generating stress responses. The prefrontal cortex (D) is involved in decision-making and impulse control, not stress responses. Thus, the amygdala is the correct choice for its specific role in triggering stress responses via the hypothalamus.