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Sometimes the impairments caused by an infection are minor, but if the sufferer is hosting the virus over many years it may induce multiple symptoms of motor and cognitive dysfunction and create a syndrome of impairment that is known as:
- A. HIV praecox.
- B. HIV dysphasis.
- C. HIV delusion.
- D. HIV dementia.
Correct Answer: D
Rationale: HIV dementia, also known as AIDS dementia complex (ADC) or HIV-associated dementia (HAD), is a syndrome of cognitive and motor dysfunction caused by the long-term effects of HIV infection on the brain. Symptoms include memory loss, difficulty concentrating, slowed thinking, and motor impairments. This condition results from the direct impact of the virus on the central nervous system and the immune system's response to the infection.
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Nurse Davis is about to perform an initial assessment on Mrs. Allen, a 64-year-old woman admitted with advanced Parkinson's Disease. Nurse Davis is aware that certain characteristics are indicative of this stage of the disease. Which of the following does Nurse Davis recognize as a characteristic of a patient with advanced Parkinson's disease?
- A. Disturbed vision.
- B. Mask-like facial expression.
- C. Muscle atrophy.
- D. Forgetfulness.
Correct Answer: B
Rationale: A mask-like facial expression is a common feature of advanced Parkinson's disease due to reduced facial muscle movement.
KL is a 34-year-old male admitted to the hospital (large trauma center) after suffering a traumatic brain injury (TBI) secondary to a serious motor vehicle accident. He was in excellent health prior to the accident. HT: 6'2" WT: 190 pounds (86 kg) What is likely the best way to feed KL while he is in the hospital?
- A. nasogastric tube
- B. nasoenteric tube
- C. parenteral nutrients
- D. baby food orally
Correct Answer: B
Rationale: A nasoenteric tube is often the preferred method for feeding patients with traumatic brain injury (TBI) who cannot safely swallow. It allows for enteral nutrition delivery directly into the small intestine, reducing the risk of aspiration compared to a nasogastric tube.
The nurse is providing care for a client admitted to the hospital after a motor vehicle accident. After being informed by family members that the patient is deaf and mute, which action should the nurse take?
- A. Avoid use of the Glasgow Coma Scale.
- B. Consider the Babinski response invalid.
- C. Utilize a three-point scale to grade muscle strength.
- D. Perform the Romberg test with the patient in a seated position.
Correct Answer: A
Rationale: The Glasgow Coma Scale (GCS) cannot be fully assessed in a patient who is deaf and mute, as verbal responses cannot be evaluated. The Babinski reflex, muscle strength grading, and Romberg test are not affected by the patient's communication abilities. Alternative assessment tools should be used.
Certain metabolic diseases can affect the nervous system. For instance, people with diabetes can develop a nervous system problem called diabetic neuropathy. What are the symptoms of diabetic neuropathy?
- A. Constipation or diarrhea
- B. Rapid heart beat
- C. Pain in feet
- D. All of the above
Correct Answer: D
Rationale: Diabetic neuropathy can cause a wide range of symptoms, including gastrointestinal issues like constipation or diarrhea, cardiovascular symptoms like rapid heart rate, and sensory symptoms like pain in the feet. This condition results from nerve damage due to high blood sugar levels. Recognizing these symptoms is essential for managing diabetes-related complications.
A 44-year-old female presents with weakness. Her weakness becomes apparent when she picks up her youngest daughter, or when placing her nonperishable foods in the top shelf of her kitchen. She also reports difficulty when getting up from a chair. These symptoms began a few months ago, and have since worsened. On physical exam, there is an erythematous eruption on her eyelids, and erythematous papules on the dorsal aspect of her hands. Neurological examination is significant for symmetric muscle weakness of her shoulders and hips. Which of the following is most likely the diagnosis?
- A. Glucocorticoid-induced myopathy
- B. Myasthenia gravis
- C. Dermatomyositis
- D. Polymyositis
Correct Answer: C
Rationale: The patient's presentation of proximal muscle weakness, along with the characteristic skin findings (heliotrope rash on the eyelids and Gottron's papules on the hands), is classic for dermatomyositis. This is an inflammatory myopathy associated with autoimmune processes and often involves both muscle and skin. Glucocorticoid-induced myopathy and myasthenia gravis do not present with skin changes, while polymyositis and systemic lupus erythematosus do not typically cause the specific skin lesions seen in this patient.