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In obtaining the history for the patient with carpal tunnel syndrome, you would expect to note a history of
- A. Pain and numbness or tingling sensation in the hand (over the palmar surface of the thumb, index finger, middle finger, and lateral aspect of the ring finger) that is worse at night.
- B. Crepitus (grating feeling on palpation over joint during range of motion) due to loss of articular cartilage and bony overgrowth in joint.
- C. Excessive forward curvature of the thoracic spine (kyphosis) owing to pathologic vertebral fractures, and collapsing of the anterior portion of the vertebral bodies in the thoracic area.
- D. Acute onset of excruciating pain in joint because of accumulation of uric acid within the joint.
Correct Answer: A
Rationale: Carpal tunnel syndrome symptoms include nocturnal pain and paresthesia in the median nerve distribution.
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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.
Meningitis refers to that class of infections that cause inflammation of the meninges. Which Part of the brain does this refer to?
- A. Spinal fluid.
- B. Membranous covering of the brain and spinal cord.
- C. Main part of a neurone.
- D. Axon terminal.
Correct Answer: B
Rationale: Meningitis is an infection that causes inflammation of the meninges, the protective membranes covering the brain and spinal cord. Symptoms include fever, headache, neck stiffness, and cognitive impairments. The inflammation can lead to serious complications, such as brain damage or sepsis, if not treated promptly. Meningitis can be caused by bacterial, viral, or fungal infections, with bacterial meningitis being the most severe form.
The nurse is caring for a client with ICP. Why will the nurse position the client in bed with HOB elevated to 30 degrees?
- A. Makes it easier for the client to breathe
- B. Prevents the Valsalva maneuver
- C. Promotes venous drainage
- D. Reduces pain
Correct Answer: C
Rationale: Elevating the head of the bed to 30 degrees promotes venous drainage from the brain, reducing intracranial pressure (ICP). This position helps improve cerebral perfusion and prevents complications associated with increased ICP, such as brain herniation.
The nurse is providing care for an 87-year-old woman who is recovering from a cerebral vascular accident. Which precaution should the nurse take after noting the patient has a positive Romberg test?
- A. Institute fall-risk precautions.
- B. Provide small, frequent meals.
- C. Request a footboard and splints.
- D. Darken the room and reduce stimuli.
Correct Answer: A
Rationale: A positive Romberg test indicates impaired balance and proprioception, increasing the risk of falls. Fall-risk precautions, such as using a gait belt and ensuring a safe environment, are essential. Small meals, footboards, and reducing stimuli are not directly related to balance issues.
Nervous System consists of:
- A. Brain
- B. Spinal Cord
- C. Nerves
- D. All the above
Correct Answer: D
Rationale: The nervous system is composed of the brain, spinal cord, and nerves, which work together to control and coordinate the body's activities. The brain processes information, the spinal cord transmits signals, and the nerves connect the central nervous system to the rest of the body, making 'All the above' the correct answer.