Nokea
The nurse is checking the deep tendon reflexes of a patient who has compression of the fifth and sixth cervical nerves on the right. Which deep tendon reflex is diminishes?
- A. Right biceps reflex
- B. Left brachioradialis reflex
- C. Right triceps reflex
- D. Left patellar reflex
Correct Answer: A
Rationale: Compression of the C5 and C6 nerve roots affects the biceps reflex. The brachioradialis, triceps, and patellar reflexes are controlled by different nerve roots (C6, C7, and L2-L4, respectively). A diminished biceps reflex indicates a lesion at C5-C6.
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A patient reports sudden weakness on one side of their body. The nurse should:
- A. Perform a neurologic assessment focusing on motor function and sensation.
- B. Measure the patient's oxygen saturation.
- C. Inspect the patient's skin color.
- D. Check the patient's blood glucose levels.
Correct Answer: A
Rationale: Sudden weakness on one side of the body may indicate a neurological issue, such as a stroke. A focused neurologic assessment is essential. Oxygen saturation, skin color, and blood glucose levels are secondary considerations.
Which of the following is the most common cause of neonatal meningitis?
- A. Haemophilus influenzae b
- B. Streptococcus agalactiae
- C. Neisseria meningitidis
- D. Streptococcus pneumoniae
Correct Answer: B
Rationale: The correct answer is B: Streptococcus agalactiae. This bacterium is the most common cause of neonatal meningitis due to its ability to colonize the maternal genital tract and be transmitted to the newborn during delivery. It is a leading cause of early-onset neonatal sepsis and meningitis. Haemophilus influenzae b, Neisseria meningitidis, and Streptococcus pneumoniae are more commonly associated with meningitis in older children and adults, rather than in neonates. Therefore, choice B is the most appropriate answer based on the specific context of neonatal meningitis.
The lateral spinothalamic tract:
- A. carries fibres which terminate in the thalamus
- B. contains mainly the second-order neurones.
- C. carries fibres that carry information on temperature and pain
- D. all above
Correct Answer: D
Rationale: The lateral spinothalamic tract carries second-order neurons transmitting pain and temperature information to the thalamus. It is a critical pathway for sensory perception and is involved in relaying these sensations to higher brain centers.
Which is the most common neurotransmitter in the brain?
- A. serotonin
- B. glutamate
- C. dopamine
- D. GABA
Correct Answer: B
Rationale: Glutamate is the most abundant excitatory neurotransmitter in the brain and is involved in nearly all excitatory brain functions. It plays a key role in synaptic plasticity, learning, and memory. Glutamate binds to receptors on postsynaptic neurons, promoting the transmission of signals. However, excessive glutamate activity can lead to excitotoxicity, causing neuronal damage and contributing to conditions like stroke and neurodegenerative diseases.
A 63-year-old patient taking carbidopa/levodopa 25/100 mg four times a day for PD is experiencing end-of-dose wearing off. The best recommendation is to:
- A. Add tolcapone.
- B. Add entacapone.
- C. Consider deep-brain stimulation (DBS).
- D. Change carbidopa/levodopa to three times a day.
Correct Answer: B
Rationale: Entacapone, like tolcapone, is a COMT inhibitor that can help manage wearing-off symptoms by extending the duration of levodopa's effect.