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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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One of the most common features of neurological disorders are Language deficits and are collectively known as
- A. Dysphasias
- B. Alogias
- C. Anomias
- D. Aphasias
Correct Answer: D
Rationale: Aphasia is a language disorder resulting from damage to the brain's language centers, typically in the left hemisphere. It affects the ability to produce or comprehend speech, read, or write. Aphasia can manifest in various forms, such as Broca's aphasia (difficulty speaking) or Wernicke's aphasia (difficulty understanding language). These deficits are common in neurological disorders like stroke, traumatic brain injury, or neurodegenerative diseases.
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.
Nerve impulses are picked up by a neuron's (nerve cell):
- A. dendrites
- B. axon
- C. neuron cell body
- D. synapse
Correct Answer: A
Rationale: Dendrites are the part of a neuron responsible for receiving nerve impulses from other neurons or sensory receptors. They are branched structures that extend from the cell body and contain receptors for neurotransmitters. When neurotransmitters bind to these receptors, they generate electrical signals that travel toward the cell body, initiating communication between neurons. Dendrites play a crucial role in integrating incoming signals and determining whether the neuron will fire an action potential.
A 25 year-old housewife presents to the urgent care clinic for evaluation of paralysis in her face on the right side. She has a history of an upper respiratory infection 2 weeks before the onset of symptoms. She states that her face on the right is drooping and she is not able to close the right eye. On physical examination, you note that her forehead is smooth on the right, the left palpebral fissure appears wider than the right, and her nasolabial fold on the right is flattened and she is drooling. Based on this information, what is the most likely diagnosis?
- A. Cortical stroke
- B. Bell's palsy
- C. Horner's syndrome
- D. Stress reaction
Correct Answer: B
Rationale: Bell's palsy is a condition characterized by sudden, unilateral facial paralysis due to inflammation or compression of the facial nerve (CN VII). It often follows a viral infection and presents with drooping of the face, inability to close the eye, and flattening of the nasolabial fold. A cortical stroke typically spares the forehead, and Horner's syndrome involves ptosis and miosis.
A client who has a musculoskeletal problem is being discharged after a few days of hospital care. Why should the nurse consider factors related to the home environment while determining a plan for the continued rehabilitation of the client?
- A. To include additional care for clients who lack the basic amenities at home.
- B. To determine the client's access to the nearest drugstore.
- C. To modify the client's living arrangements or other accommodation changes.
- D. To determine if the client would continue with the self-care.
Correct Answer: D
Rationale: Understanding the home environment ensures the client can continue their rehabilitation effectively.