Nokea
Mrs. C. has a right hemiplegia secondary to a cerebrovascular accident. To avoid aspiration during meals she would be instructed to avoid
- A. swallowing with her head slightly flexed
- B. placing food in the left side of her mouth
- C. eating in an upright position
- D. lying down immediately after eating
Correct Answer: A
Rationale: Head flexion can impair swallowing mechanics.
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The nurse will document which reflex is present when there is dorsiflexion of the great toe with fanning of other toes?
- A. Brudzinski
- B. Babinski (damage to the corticospinal tracts)
- C. Trousseaus
- D. Kernigs
Correct Answer: B
Rationale: The Babinski reflex, characterized by dorsiflexion of the great toe and fanning of the other toes, is abnormal in adults and indicates damage to the corticospinal tract. This reflex is normal in infants but disappears as the nervous system matures. Its presence in adults suggests neurological pathology.
The wife of a 65-year-old man tells the nurse that she is concerned because she has noticed a change in her husband's personality and ability to understand. He also cries very easily and becomes angry. The nurse recalls that the cerebral lobe responsible for these behaviors is the __________ lobe.
- A. Frontal
- B. Parietal
- C. Occipital
- D. Temporal
Correct Answer: A
Rationale: The correct answer is A: Frontal lobe. The frontal lobe is responsible for personality, emotional expression, decision-making, reasoning, and problem-solving. Changes in personality, emotional instability, and difficulty with understanding can indicate dysfunction in the frontal lobe. The other lobes (parietal, occipital, temporal) are primarily involved in different functions such as sensory processing (parietal), visual processing (occipital), and memory, language, and auditory processing (temporal). In this case, the symptoms described by the wife suggest a problem with the frontal lobe, making it the correct choice.
Injury to which segment of the spine results in damage to the chest and abdominal muscles?
- A. cervical
- B. thoracic
- C. lumbar
- D. sacral
Correct Answer: B
Rationale: Injury to the thoracic spine (T1-T12) can affect the chest and abdominal muscles, as this region of the spinal cord controls motor and sensory functions for the upper body. Damage here can lead to paralysis or weakness in these areas.
In reviewing Mrs. Post's laboratory results, which abnormal test is most likely to confirm the diagnosis?
- A. Sedimentation rate
- B. Rheumatoid factor
- C. LE cells
- D. Antinuclear antibody
Correct Answer: D
Rationale: Antinuclear antibodies are highly indicative of systemic lupus erythematosus.
Following a T2 spinal cord injury, the patient develops paralytic ileus. While this condition is present, what should the nurse anticipate that the patient will need?
- A. IV fluids
- B. Tube feedings
- C. Parenteral nutrition
- D. Nasogastric suctioning
Correct Answer: A
Rationale: IV fluids maintain hydration during ileus.