Nokea
Following discharge teaching, the nurse realizes that additional instruction is needed when the patient says what?
- A. It is important for me to avoid exposure to people with upper respiratory infections.
- B. When I begin to feel better
- C. I should stop taking the prednisone to prevent side effects.
- D. I plan to use vitamin supplements and a high-protein diet to help manage my condition.
Correct Answer: B
Rationale: Prednisone should not be stopped abruptly due to the risk of adrenal insufficiency
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The area of the nervous system that is responsible for mediating reflexes is the:
- A. Medulla.
- B. Cerebellum.
- C. Spinal cord.
- D. Cerebral cortex.
Correct Answer: C
Rationale: The correct answer is C: Spinal cord. The spinal cord is responsible for mediating reflexes due to its role in transmitting sensory information to the brain and coordinating motor responses without involving higher brain centers. Reflex actions are quick, involuntary responses to stimuli that help protect the body. The medulla (A) controls vital functions like breathing and heartbeat, the cerebellum (B) coordinates movement and balance, and the cerebral cortex (D) is involved in higher cognitive functions like thinking and decision-making, but not reflex actions.
A 30-year-old female presents with muscle weakness in the lower extremities and palpitations. Her symptoms have been progressively worse over the course of a 2 weeks. She reports to be in great health, but had a period of abdominal pain and diarrhea approximately 5 weeks ago. Her temperature is 98.9 deg F (37.2 deg C), blood pressure 117/82 mmHg, pulse is 102/min, and respirations are 16/min. On physical exam, there is 4-/5 muscle strength throughout the lower extremities. Bilateral patellar reflexes are 1+ and ankle reflexes are absent. Lumbar puncture was performed, and results are pending. Part 2: What is the most appropriate initial treatment?
- A. High dose corticosteroids
- B. Intravenous immunoglobulin
- C. Potassium chloride
- D. Pyridostigmine
Correct Answer: B
Rationale: Intravenous immunoglobulin (IVIG) is the first-line treatment for Guillain-Barre syndrome (GBS). It works by modulating the immune response and reducing the severity of the disease. High-dose corticosteroids are not effective in GBS, and potassium chloride and pyridostigmine are not indicated for this condition.
Which of these diseases can be prevented with a vaccine for humans?
- A. eastern equine encephalitis
- B. western equine encephalitis
- C. West Nile encephalitis
- D. Japanese encephalitis
Correct Answer: D
Rationale: Step 1: Identify the disease - Japanese encephalitis is caused by a virus transmitted by mosquitoes.
Step 2: Understand the role of a vaccine - a vaccine stimulates the immune system to produce antibodies to fight the virus.
Step 3: Vaccines prevent future infections - by administering a vaccine for Japanese encephalitis, individuals can develop immunity and prevent the disease.
Step 4: Therefore, the correct answer is D because a vaccine is available to prevent Japanese encephalitis.
Summary: A, B, and C are incorrect because there are no vaccines available for eastern equine encephalitis, western equine encephalitis, and West Nile encephalitis, respectively.
Which finding may suggest a problem with the patient's proprioception?
- A. Difficulty standing with eyes closed or swaying when standing still.
- B. Steady gait and normal balance.
- C. Clear, intact sensation in all extremities.
- D. Normal muscle strength and coordination.
Correct Answer: A
Rationale: Proprioception issues are indicated by difficulty standing with eyes closed or swaying. Steady gait, intact sensation, and normal strength are normal findings.
A patient diagnosed with depersonalization disorder tells the nurse, It's starting again. I feel as though I'm going to float away. The nurse should help the patient by:
- A. encouraging meditation.
- B. administering an anxiolytic medication.
- C. helping the patient visualize a pleasant scene.
- D. helping the patient focus on the here and now.
Correct Answer: D
Rationale: The correct answer is D: helping the patient focus on the here and now. This is appropriate for depersonalization disorder as it helps the patient ground themselves in reality and reduce dissociative symptoms. Encouraging meditation (A) may exacerbate dissociation by further disconnecting the patient from reality. Administering an anxiolytic medication (B) may provide temporary relief but does not address the underlying issue. Helping the patient visualize a pleasant scene (C) may be soothing but may not be effective in addressing the dissociative symptoms.