Nokea
Regarding the cutaneous nerve supply to arm and forearm
- A. C3/4 supply pectoral and upper shoulder
- B. Branches of the brachial plexus supply arm and forearm
- C. C4/5/6/T1 supply the majority of the arm
- D. ?
Correct Answer: B
Rationale: The brachial plexus, formed from C5-T1, supplies the cutaneous innervation of the arm and forearm. Specific branches include the median, ulnar, and radial nerves.
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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.
You are preparing to admit a patient with a seizure disorder. Which of the following actions can you delegate to the LPN/LVN?
- A. Complete admission assessment.
- B. Set up oxygen and suction equipment.
- C. Place a padded tongue blade at bedside.
- D. Pad the side rails before patient arrives.
Correct Answer: D
Rationale: Padding the side rails is a safety measure that can be done by an LPN/LVN without requiring complex assessment skills.
The nurse writes the client problem of 'altered sexual functioning' for a male client diagnosed with multiple sclerosis (MS). Which intervention should be implemented?
- A. Encourage the couple to explore alternative ways of maintaining intimacy.
- B. Make an appointment with a psychotherapist to counsel the couple.
- C. Explain daily exercise will help increase libido and sexual arousal.
- D. Discuss the importance of keeping physically calm during sexual intercourse.
Correct Answer: A
Rationale: Exploring alternative ways to maintain intimacy can help the client and their partner adapt to changes in sexual functioning caused by MS.
In the initial nursing assessment of Mr. Singer it is important to remember that malignant rheumatoid arthritis
- A. is limited to the synovial joints
- B. may also involve the heart, lungs, and other body systems
- C. is primarily an episodic disease
- D. affects primarily the proximal joints
Correct Answer: B
Rationale: Malignant rheumatoid arthritis can affect multiple organ systems beyond the joints.
A 30-year-old female presents with muscle weakness in the lower extremities and palpitations. Her symptoms have been progressively worse over the course of a 2 weeks. She reports to be in great health, but had a period of abdominal pain and diarrhea approximately 5 weeks ago. Her temperature is 98.9 deg F (37.2 deg C), blood pressure 117/82 mmHg, pulse is 102/min, and respirations are 16/min. On physical exam, there is 4-/5 muscle strength throughout the lower extremities. Bilateral patellar reflexes are 1+ and ankle reflexes are absent. Lumbar puncture was performed, and results are pending. Part 2: What is the most appropriate initial treatment?
- A. High dose corticosteroids
- B. Intravenous immunoglobulin
- C. Potassium chloride
- D. Pyridostigmine
Correct Answer: B
Rationale: Intravenous immunoglobulin (IVIG) is the first-line treatment for Guillain-Barre syndrome (GBS). It works by modulating the immune response and reducing the severity of the disease. High-dose corticosteroids are not effective in GBS, and potassium chloride and pyridostigmine are not indicated for this condition.