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The client newly diagnosed with multiple sclerosis (MS) states, 'I don't understand how I got multiple sclerosis. Is it genetic?' On which statement should the nurse base the response?
- A. Genetics may play a role in susceptibility to MS, but the disease may be caused by a virus.
- B. There is no evidence suggesting there is any chromosomal involvement in developing MS.
- C. Multiple sclerosis is caused by a recessive gene, so both parents had to have the gene for the client to get MS.
- D. Multiple sclerosis is caused by an autosomal dominant gene on the Y chromosome, so only fathers can pass it on.
Correct Answer: A
Rationale: MS has a genetic component that increases susceptibility, but environmental factors, such as viral infections, also play a significant role in its development.
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The Schwann cells form a myelin sheath around the:
- A. dendrites
- B. cell body
- C. nucleus
- D. axon
Correct Answer: D
Rationale: Schwann cells are responsible for forming the myelin sheath around axons in the peripheral nervous system (PNS). Dendrites, cell bodies, nuclei, and nodes of Ranvier are not directly myelinated by Schwann cells. Therefore, D is the correct answer.
An interneuron has _____________.
- A. long dendrites and a short axon
- B. long dendrites and a long axon
- C. short dendrites and a long axon
- D. short dendrites and a long or short axon
Correct Answer: D
Rationale: Interneurons, which are found within the CNS, typically have short dendrites and either a long or short axon. These neurons act as connectors between sensory and motor neurons, integrating and processing information to generate appropriate responses. The structure of interneurons allows them to facilitate communication within the CNS, enabling complex reflexes and higher-order cognitive functions.
At a visit to the provider's office, an older adult patient's partner reports that the patient has nausea, diarrhea, and a loss of appetite. He has a history of Alzheimer's disease and is taking donepezil (Aricept). The provider should advise which of the following?
- A. Take the drug with food.
- B. Stop taking the drug right away.
- C. Take a reduced dosage of the drug.
- D. Undergo liver function tests right away.
Correct Answer: A
Rationale: Cholinesterase inhibitors such as donepezil commonly cause nausea, vomiting, anorexia, and other gastrointestinal symptoms. This is due to the increase of acetylcholine in all parts of the body, and its subsequent effect on the gastrointestinal tract and other systems of the body. The provider should explain to the patient and his caregiver that taking the drug with food and at bedtime will help minimize uncomfortable gastrointestinal effects. The provider also should instruct the partner to report vomiting, severe diarrhea, weight loss, or signs of gastrointestinal bleeding, such as dark stools or coffee-ground emesis, especially if the patient is also taking a nonsteroidal anti-inflammatory drug. At this point, it is not necessary to stop taking the drug, reduce the dosage, or undergo liver function tests.
What kind of stain is most commonly used to visualize the capsule of cryptococcus?
- A. Gram stain
- B. simple stain
- C. negative stain
- D. fluorescent stain
Correct Answer: C
Rationale: The correct answer is C: negative stain. Negative staining technique uses acidic stains which are repelled by the capsule of cryptococcus, making it visible as a clear halo around the stained cell. Gram stain (A) is used for bacterial cell wall visualization, simple stain (B) colors all cells uniformly, and fluorescent stain (D) requires a fluorescent microscope and specific dyes. Negative stain is the most effective method for visualizing cryptococcus capsules due to its unique structure and composition.
Central paresis, loss of proprioceptive sensation on one side & loss of exteroceptive sensation on the opposite form the following syndrome:
- A. Lambert-Iton
- B. Matskevich-Shtrumpel
- C. Argile-Robertson
- D. Brown-Sequard
Correct Answer: D
Rationale: Brown-Sequard syndrome is the correct answer because it is characterized by ipsilateral motor paralysis and loss of proprioception, and contralateral loss of pain and temperature sensation. This syndrome results from damage to one side of the spinal cord, typically due to trauma or tumors.