Nokea
The area of the nervous system that is responsible for mediating reflexes is the:
- A. Medulla.
- B. Cerebellum.
- C. Spinal cord.
- D. Cerebral cortex.
Correct Answer: C
Rationale: The correct answer is C: Spinal cord. The spinal cord is responsible for mediating reflexes due to its role in transmitting sensory information to the brain and coordinating motor responses without involving higher brain centers. Reflex actions are quick, involuntary responses to stimuli that help protect the body. The medulla (A) controls vital functions like breathing and heartbeat, the cerebellum (B) coordinates movement and balance, and the cerebral cortex (D) is involved in higher cognitive functions like thinking and decision-making, but not reflex actions.
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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 level of energy intake per day is the most appropriate for KL?
- A. 1,800 kcal
- B. 2,100 kcal
- C. 2,400 kcal
- D. 2,700 kcal
Correct Answer: C
Rationale: For a patient with traumatic brain injury (TBI), an energy intake of approximately 2,400 kcal/day is often appropriate to meet increased metabolic demands while avoiding overfeeding, which can exacerbate complications like hyperglycemia or respiratory issues.
A patient with a spinal cord injury has spinal shock. The nurse plans care for the patient based on what knowledge?
- A. Rehabilitation measures cannot be initiated until spinal shock has resolved.
- B. The patient will need continuous monitoring for hypotension, tachycardia, and hypoxemia.
- C. Resolution of spinal shock is manifested by spasticity, hyperreflexia, and reflex emptying of the bladder.
- D. The patient will have complete loss of motor and sensory functions below the level of the injury but autonomic functions are not affected.
Correct Answer: C
Rationale: Spinal shock resolves with the return of reflex activity.
You are providing care for a patient with an acute hemorrhagic stroke. The patient's husband has been reading a lot about strokes and asks why his wife did not receive alteplase. What is your best response?
- A. Your wife was not admitted within the time frame that alteplase is usually given.
- B. This drug is used primarily for patients who experience an acute heart attack.
- C. Alteplase dissolves clots and may cause more bleeding into your wife's brain.
- D. Your wife had gallbladder surgery just 6 months ago and this prevents the use of alteplase.
Correct Answer: C
Rationale: Alteplase increases the risk of bleeding, making it contraindicated in hemorrhagic stroke.
All of the following are branches of the ophthalmic division of the trigeminal nerve EXCEPT:
- A. Lacrimal nerve
- B. Infraorbital nerve
- C. Supraorbital nerve
- D. Infratrochlear nerve
Correct Answer: B
Rationale: The infraorbital nerve is a branch of the maxillary division (V2) of the trigeminal nerve, not the ophthalmic division (V1). It supplies sensation to the lower eyelid, cheek, and upper lip.
A college student observes a roommate going out wearing uncharacteristically seductive clothing, returning 12 to 24 hours later, and then sleeping for 8 to 12 hours. At other times, the roommate sits on the floor speaking like a young child. Which health problem should be considered?
- A. Functional neurological (conversion) disorder
- B. Dissociative identity disorder
- C. Dissociative amnesia
- D. Body dysmorphic disorder
Correct Answer: B
Rationale: The correct answer is B: Dissociative identity disorder. The roommate displaying different behaviors indicates potential dissociation, where different identities or states of consciousness take control. Seductive clothing and extended absence may indicate a different identity, while childlike speech may suggest another identity. This pattern aligns with the criteria for dissociative identity disorder. Functional neurological disorder (Choice A) involves physical symptoms without a clear organic cause. Dissociative amnesia (Choice C) pertains to memory loss due to psychological trauma. Body dysmorphic disorder (Choice D) involves obsession with perceived flaws in physical appearance. These options do not align with the diverse behaviors and identity shifts observed in the roommate.