Pathophysiology Practice Questions

Pathophysiology Practice Questions Related

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During the home visit of a client with dementia, the nurse notes that an adult daughter persistently corrects her father's misperceptions of reality, even when the father becomes upset and anxious. Which intervention should the nurse teach the caregiver?

  • A. Anxiety-reducing measures
  • B. Positive reinforcement
  • C. Reality orientation techniques
  • D. Validation techniques
Correct Answer: D

Rationale: The correct answer is D: Validation techniques. In dementia care, using validation techniques involves acknowledging the person's feelings and reality, even if it differs from actual events or facts. It helps in reducing the client's anxiety and distress. In this scenario, the daughter persistently correcting her father's misperceptions can escalate his anxiety. Teaching the daughter validation techniques will encourage her to validate her father's feelings and perceptions, ultimately promoting a more supportive and less confrontational environment. Choices A, B, and C are incorrect in this context. While anxiety-reducing measures can be beneficial, the primary issue here is the father's misperceptions being consistently corrected. Positive reinforcement focuses on rewarding desired behaviors, which is not directly related to the situation described. Reality orientation techniques involve constantly reminding the person of the correct time, place, and other details, which may not be suitable for someone with dementia experiencing distress.

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A 70-year-old woman has difficulty with driving, and she has been frequently getting lost. Her husband said she has also been acting strangely and seems to want to sleep a lot. He said the other night she kept saying she was seeing animals such as lions in her room. He says her memory is not too bad, but he is very concerned about her health. Physical examination reveals an alert woman with stable vital signs. Bradykinesia and limb rigidity are noted. These findings are consistent with:

  • A. Alzheimer's disease.
  • B. vascular dementia.
  • C. dementia with Lewy bodies.
  • D. frontotemporal dementia.
Correct Answer: C

Rationale: The correct answer is dementia with Lewy bodies (DLB). Hallucinations, parkinsonian symptoms (like bradykinesia and limb rigidity), and fluctuating cognition are characteristic of DLB. Alzheimer's disease (Choice A) typically presents with memory loss as a prominent feature. Vascular dementia (Choice B) is associated with a history of strokes and step-wise cognitive decline. Frontotemporal dementia (Choice D) often presents with changes in behavior and personality rather than the parkinsonian symptoms seen in this case.

Multiple sclerosis manifests as asymmetrical and in different parts of the body because:

  • A. Autoreactive lymphocytes are causing diffuse patchy damage to the myelin sheath in the central nervous system.
  • B. Acetylcholine receptors are destroyed by immunoglobulin G.
  • C. Autoreactive T lymphocytes cause progressive loss of neurons in the substantia nigra.
  • D. Cortical motor cells degenerate.
Correct Answer: A

Rationale: The correct answer is A. Multiple sclerosis is characterized by the immune system attacking the myelin sheath in the central nervous system. This attack leads to patchy damage on the myelin sheath, resulting in asymmetrical neurological symptoms. Choices B, C, and D are incorrect because they do not accurately describe the pathophysiology of multiple sclerosis. In multiple sclerosis, it is the autoreactive lymphocytes that target and damage the myelin sheath, not acetylcholine receptors, T lymphocytes, or cortical motor cells.

Which ability should Nurse Rebecca expect from a client in the mild stage of dementia of the Alzheimer's type?

  • A. Remembering the daily schedule
  • B. Recalling past events
  • C. Coping with anxiety
  • D. Solving problems of daily living
Correct Answer: B

Rationale: In the mild stage of dementia of the Alzheimer's type, clients can often recall past events but may have difficulty with new information. Therefore, Nurse Rebecca should expect the client to have the ability to recall past events. Choice A is incorrect because remembering the daily schedule may become challenging as the disease progresses. Choice C is incorrect as clients in the mild stage may experience anxiety, but coping with anxiety is not a specific ability associated with this stage of dementia. Choice D is incorrect as solving problems of daily living becomes more challenging as the disease advances, not in the mild stage.

After a generalized seizure, a 27-year-old woman with epilepsy feels tired and falls asleep. This is:

  • A. an ominous sign.
  • B. normal and termed the postictal period.
  • C. a reflection of an underlying brain tumor.
  • D. only worrisome if there are focal neurologic deficits after.
Correct Answer: B

Rationale: Choice B is the correct answer. The postictal period is the phase following a seizure, characterized by symptoms like fatigue, confusion, and sleepiness. It is a normal part of the seizure process and does not necessarily indicate a serious underlying issue. Choice A is incorrect because feeling tired and falling asleep after a seizure is expected and not an ominous sign. Choice C is incorrect as there is no indication in the scenario provided to suggest an underlying brain tumor. Choice D is incorrect because the presence of focal neurologic deficits would indeed be concerning, but the postictal state itself is a common and expected occurrence post-seizure.

A hemoglobin electrophoresis is done to evaluate for sickle cell disease. The report reveals the person has HbAS, which means the person:

  • A. is normal with no sickle cell disease.
  • B. is a sickle cell carrier.
  • C. has sickle cell anemia.
  • D. has thalassemia.
Correct Answer: B

Rationale: HbAS indicates sickle cell trait, not full-blown sickle cell anemia. Choice A is incorrect because HbAS indicates the presence of the sickle cell trait. Choice C is incorrect as sickle cell anemia is characterized by HbSS, not HbAS. Choice D is incorrect as thalassemia is a different type of hemoglobin disorder not indicated by HbAS.

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