Nokea
The patient with gout will have periodic exacerbations of painful joint inflammation. Acute episodes are treated with
- A. Nonsteroidal anti-inflammatory medications and colchicine.
- B. Allopurinol and aspirin.
- C. Antibiotics and acetaminophen.
- D. Bisphosphonates and calcium.
Correct Answer: A
Rationale: NSAIDs and colchicine are used for acute gout attacks, whereas allopurinol is used for long-term management.
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Which of the following is not a realistic outcome to establish with a client who has multiple sclerosis (MS)? The client will develop:
- A. Joint mobility
- B. Muscle strength
- C. Cognition
- D. Mood elevation
Correct Answer: B
Rationale: While joint mobility, cognition, and mood elevation can be improved or maintained, muscle strength is often progressively affected by MS and may not be fully restored.
Twenty-four hours later Bob is discharged. Which of the following statements would indicate Bob understood your teaching?
- A. Increasing pain in the arm is expected over the next 2 days but if it continues the third day I'll call the physician.
- B. If the fingers of my left hand begin to swell and are colder than those of the right hand, I'll elevate my arm above heart level and call the physician.
- C. Bleeding may appear on the cast today. I'll circle the area and if it continues to increase, I'll call the physician.
- D. I'll immobilize my left hand for 1 week, then begin active flexion-extension exercises and continue until my follow-up visit.
Correct Answer: B
Rationale: Swelling and coldness could indicate impaired circulation, necessitating immediate medical attention.
Brown-Sequard syndrome develops with the following damage of the spinal cord:
- A. complete transversal
- B. anterior horns
- C. half transversal
- D. posterior horns
Correct Answer: C
Rationale: Half transversal is the correct answer because Brown-Sequard syndrome results from damage to one side of the spinal cord. This leads to ipsilateral motor paralysis and loss of proprioception, and contralateral loss of pain and temperature sensation due to the crossing of spinothalamic tract fibers.
A patient has a severed spinal nerve as a result of trauma. Which statement is true in this situation?
- A. Because there are 31 pairs of spinal nerves, no effect results if only one nerve is severed.
- B. The dermatome served by this nerve will no longer experience any sensation.
- C. The adjacent spinal nerves will continue to carry sensations for the dermatome served by the severed nerve.
- D. A severed spinal nerve will only affect motor function of the patient because spinal nerves have no sensory component.
Correct Answer: C
Rationale: Rationale for Correct Answer (C): When a spinal nerve is severed, adjacent spinal nerves can compensate and continue to carry sensations for the dermatome served by the severed nerve. This is possible due to the concept of dermatomes overlapping and the redundancy in sensory innervation. Therefore, the patient may still experience sensation in the affected area despite the specific nerve being severed.
Summary of Incorrect Choices:
A: Incorrect. Even if there are 31 pairs of spinal nerves, severing one nerve can still have a significant impact on sensory and motor functions depending on the location and severity of the injury.
B: Incorrect. Sensory loss would occur in the dermatome served by the severed nerve, but adjacent nerves can still carry sensations.
D: Incorrect. Spinal nerves have both sensory and motor components, so severing a spinal nerve can affect both sensory and motor functions, not just motor function.
A 28-year-old female patient has been diagnosed with occipital lobe damage after a car accident. What should the nurse expect the patient to need help with?
- A. Being able to feel heat
- B. Processing visual images
- C. Identifying smells appropriately
- D. Being able to say what she means
Correct Answer: B
Rationale: The occipital lobe is primarily responsible for processing visual images.