Nurse Anderson is preparing to conduct an initial assessment of Mrs. Green, a 63-year-old woman admitted with Parkinson's Disease. She collaborates with the dietician to tailor Mrs. Green's diet, especially considering her medication, levodopa. Nurse Anderson discusses with the dietician about which type of food should be limited or avoided for a patient taking levodopa. What type of food should they focus on?
- A. Food rich in Vitamin B6.
- B. Food rich in Thiamine.
- C. Food rich in Vitamin E.
- D. Food rich in Vitamin C.
Correct Answer: A
Rationale: Vitamin B6 can interfere with the effectiveness of levodopa, so it should be limited in the diet of PD patients.
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Which of the following findings would indicate a change in a patient's mental status?
- A. Sudden onset of confusion or disorientation.
- B. Steady gait and normal speech.
- C. Clear and coherent communication.
- D. Stable vital signs and regular breathing.
Correct Answer: A
Rationale: A sudden onset of confusion or disorientation is a key indicator of a change in mental status. Steady gait, clear communication, and stable vital signs are normal findings.
You are providing care for a patient with an acute hemorrhagic stroke. The patient's husband has been reading a lot about strokes and asks why his wife did not receive alteplase. What is your best response?
- A. Your wife was not admitted within the time frame that alteplase is usually given.
- B. This drug is used primarily for patients who experience an acute heart attack.
- C. Alteplase dissolves clots and may cause more bleeding into your wife's brain.
- D. Your wife had gallbladder surgery just 6 months ago and this prevents the use of alteplase.
Correct Answer: C
Rationale: Alteplase increases the risk of bleeding, making it contraindicated in hemorrhagic stroke.
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.
Babinsky response usually develops with damage in:
- A. upper motor neuron
- B. lower motor neuron
- C. cerebellar
- D. thalamus
Correct Answer: A
Rationale: Upper motor neuron is the correct answer because the Babinski sign is a pathological reflex indicative of damage to the corticospinal tract. It is characterized by the extension of the big toe and fanning of the other toes upon stimulation of the sole, which is abnormal in adults and suggests a loss of inhibitory control from the brain.
When an edrophonium (Tensilon) test is carried out, which of the following drugs must be available as an antidote?
- A. Atropine sulfate
- B. Diazepam (Valium)
- C. Ephedrine
- D. Corticosteroids
Correct Answer: A
Rationale: Atropine sulfate is used as an antidote for cholinergic crisis.