Nokea
In counseling patients with spinal cord lesions regarding sexual function, how should the nurse advise a male patient with a complete lower motor neuron lesion?
- A. He is most likely to have reflexogenic erections and may experience orgasm if ejaculation occurs
- B. He may have uncontrolled reflex erections but orgasm and ejaculation are usually not possible
- C. He has a lesion with the greatest possibility of successful psychogenic erection with ejaculation and orgasm
- D. He will probably be unable to have either psychogenic or reflexogenic erections and no ejaculation or orgasm
Correct Answer: B
Rationale: Lower motor neuron lesions result in uncontrolled reflex erections.
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What is the major focus for care today for a patient who is 1 day post-operative after a left below-the-knee amputation?
- A. To attain pain control for phantom pain.
- B. To monitor for signs of sufficient tissue perfusion.
- C. To assist the patient to ambulate as soon as possible.
- D. To elevate the residual limb when the patient is supine.
Correct Answer: B
Rationale: Ensuring adequate tissue perfusion is critical in the immediate post-operative period to prevent complications.
A patient with a spinal cord injury has spinal shock. The nurse plans care for the patient based on what knowledge?
- A. Rehabilitation measures cannot be initiated until spinal shock has resolved.
- B. The patient will need continuous monitoring for hypotension, tachycardia, and hypoxemia.
- C. Resolution of spinal shock is manifested by spasticity, hyperreflexia, and reflex emptying of the bladder.
- D. The patient will have complete loss of motor and sensory functions below the level of the injury but autonomic functions are not affected.
Correct Answer: C
Rationale: Spinal shock resolves with the return of reflex activity.
Cell bodies for the motor supply of the trigeminal nerve lie
- A. Hypothalamus
- B. Midbrain
- C. Posterior to cerebral aqueduct
- D. Cerebral cortex
Correct Answer: B
Rationale: The motor nucleus of the trigeminal nerve is located in the midbrain. It supplies muscles of mastication, such as the masseter and temporalis.
The nurse notes that a patient is not able to voluntarily move the right arm. Which part of the brain should the nurse suspect is affected in this patient?
- A. Cerebellum
- B. Frontal lobe
- C. Parietal lobe
- D. Hypothalamus
Correct Answer: B
Rationale: The frontal lobes contain the motor areas that generate the impulses that bring about voluntary movement. Each motor area controls movement on the opposite side of the body. The cerebellum is responsible for coordination and balance, while the parietal lobe processes sensory information. The hypothalamus regulates autonomic functions and is not directly involved in voluntary movement.
A college student observes a roommate going out wearing uncharacteristically seductive clothing, returning 12 to 24 hours later, and then sleeping for 8 to 12 hours. At other times, the roommate sits on the floor speaking like a young child. Which health problem should be considered?
- A. Functional neurological (conversion) disorder
- B. Dissociative identity disorder
- C. Dissociative amnesia
- D. Body dysmorphic disorder
Correct Answer: B
Rationale: The correct answer is B: Dissociative identity disorder. The roommate displaying different behaviors indicates potential dissociation, where different identities or states of consciousness take control. Seductive clothing and extended absence may indicate a different identity, while childlike speech may suggest another identity. This pattern aligns with the criteria for dissociative identity disorder. Functional neurological disorder (Choice A) involves physical symptoms without a clear organic cause. Dissociative amnesia (Choice C) pertains to memory loss due to psychological trauma. Body dysmorphic disorder (Choice D) involves obsession with perceived flaws in physical appearance. These options do not align with the diverse behaviors and identity shifts observed in the roommate.