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During assessment of the patient diagnosed with fibromyalgia, what should the nurse expect the patient to report?
- A. Generalized muscle twitching and spasms
- B. Nonrestorative sleep with resulting fatigue
- C. Profound and progressive muscle weakness that limits ADLs
- D. Widespread musculoskeletal pain that is accompanied by inflammation and fever
Correct Answer: B
Rationale: Nonrestorative sleep is a hallmark of fibromyalgia.
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Mr. Jay is receiving levodopa (L-dopa) to control symptoms of Parkinson disease. Which of the following indicates that he is taking his medication properly?
- A. Anorexia, nausea, and vomiting
- B. Transient hypertension
- C. Constipation
- D. Rapid reduction of rigidity
Correct Answer: D
Rationale: Levodopa effectively reduces rigidity when taken correctly.
Gray matter differs from white matter because gray matter _________ and white matter ______.
- A. is in the PNS, is in the CNS
- B. is part of the sympathetic nervous system, is part of the parasympathetic nervous system
- C. contains neuronal cell bodies, contains axons
- D. contains neurons, contains glia
Correct Answer: C
Rationale: Gray matter consists primarily of neuronal cell bodies, dendrites, and unmyelinated axons, while white matter is composed mainly of myelinated axons. This distinction is crucial for understanding the functional and structural organization of the nervous system.
A patient with PD is taking carbidopa/levodopa 25/100 mg three times a day, and reports that he tends to slow down 2 hours before his next carbidopa/levodopa dose. This patient is most likely experiencing:
- A. Delayed onset response
- B. Dyskinesia
- C. Freezing
- D. Wearing off
Correct Answer: D
Rationale: Wearing off refers to the recurrence of PD symptoms before the next dose of medication, indicating the need for dose adjustment or adjunct therapy.
An elderly patient is brought to the clinic for confusion, horizontal eye movement bilaterally, and intermittent disorientation to time and place over the past 3 months. The patient has a history of alcoholism for 30 years. Which dementia type is the patient most likely experiencing?
- A. Wernicke’s encephalopathy
- B. Pick’s disease
- C. Lewy bodies
- D. Parkinson’s disease
Correct Answer: A
Rationale: The correct answer is A: Wernicke's encephalopathy. This patient's history of chronic alcoholism puts them at risk for thiamine deficiency, leading to Wernicke's encephalopathy. Symptoms such as confusion, horizontal eye movement abnormalities (nystagmus), and disorientation are classic features. Pick's disease (B) is a rare form of frontotemporal dementia with distinct pathological features. Lewy bodies (C) are associated with dementia with Lewy bodies, characterized by visual hallucinations and parkinsonism. Parkinson's disease (D) primarily presents with motor symptoms like tremors and rigidity, not cognitive deficits like this patient.
The client diagnosed with multiple sclerosis is scheduled for a magnetic resonance imaging (MRI) scan of the head. Which information should the nurse teach the client about the test?
- A. The client will have wires attached to the scalp and lights will flash off and on.
- B. The machine will be loud and the client must not move the head during the test.
- C. The client will drink a contrast medium 30 minutes to one (1) hour before the test.
- D. The test will be repeated at intervals during a five (5)- to six (6)-hour period.
Correct Answer: B
Rationale: An MRI is a loud procedure, and the client must remain still to ensure clear images. Contrast medium may be used, but it is not always required, and the test does not typically take 5-6 hours.