Nokea
The following occur in response to a major surgery:
- A. increased potassium loss
- B. increased protein breakdown
- C. sodium and water retention
- D. all above
Correct Answer: D
Rationale: Major surgery triggers a stress response, leading to potassium loss, protein catabolism, and sodium/water retention due to hormonal changes.
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The patient with apraxia cannot:
- A. name his fingers
- B. carry out an imagined act
- C. draw simple diagrams
- D. speak fluently
Correct Answer: B
Rationale: Carry out an imagined act is the correct answer because apraxia is a motor disorder characterized by the inability to perform purposeful movements, despite having the physical ability and desire to do so. This condition results from damage to the parietal lobe or other areas involved in motor planning.
Which of the following activity-related strategies would a nurse teach a client who is going home?
- A. Avoid fatigue and take frequent rest periods if needed
- B. Take deep breaths every 4 hours while awake
- C. Make your daily routine rigid so that you can remember what to do
- D. Avoid exposure to the outdoors
Correct Answer: A
Rationale: Rest periods help prevent exacerbation of symptoms.
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 1: What is the most likely diagnosis?
- A. Polymyositis
- B. Guillain-Barre syndrome
- C. Hypokalemia
- D. Myasthenia gravis
Correct Answer: B
Rationale: The patient's presentation of progressive weakness, areflexia, and a history of recent gastrointestinal infection is classic for Guillain-Barre syndrome (GBS). GBS is an autoimmune disorder that often follows an infection and leads to demyelination of peripheral nerves. Polymyositis and myasthenia gravis do not typically cause areflexia, and hypokalemia would present with generalized weakness rather than a ascending paralysis.
What are the two branches of the autonomic nervous system?
- A. endocrine and exocrine
- B. upper and lower
- C. sympathetic and parasympathetic
- D. central and peripheral
Correct Answer: C
Rationale: The autonomic nervous system (ANS) regulates involuntary bodily functions and is divided into the sympathetic nervous system, which activates the 'fight or flight' response, and the parasympathetic nervous system, which promotes 'rest and digest' activities. These two branches work in opposition to maintain homeostasis.
On observation of the patient, the nurse notes the presence of a gait disturbance. How should the nurse further evaluate the patient?
- A. Palpate the hips for crepitation
- B. Measure the length of the limbs
- C. Evaluate the degree of leg movement
- D. Compare the muscle mass of one leg with the other
Correct Answer: D
Rationale: Muscle asymmetry may indicate underlying issues.