Nokea
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.
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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.
Epilepsy is considered a diagnosis when there are how many unprovoked seizures?
- A. 2
- B. 3
- C. 4
- D. 5
Correct Answer: A
Rationale: Epilepsy is diagnosed when an individual experiences at least two unprovoked seizures separated by more than 24 hours. This criterion helps distinguish epilepsy from isolated seizure events caused by temporary factors like fever or alcohol withdrawal.
The nurse is assisting a neurologist with assessment of a patient with facial muscle weakness. When the neurologist asks the patient to identify different odors, which nerve is being tested?
- A. II (optic)
- B. X (vagus)
- C. I (olfactory)
- D. VIII (acoustic)
Correct Answer: C
Rationale: Cranial nerve I (olfactory) is responsible for the sense of smell and is tested when a patient is asked to identify odors. Cranial nerves II, VIII, and X are involved in vision, hearing, and autonomic functions, respectively. Assessing the olfactory nerve is important for evaluating cranial nerve function.
A patient exhibits sudden, severe headache and neck stiffness. What should the nurse do first?
- A. Perform a neurologic assessment and evaluate for signs of meningeal irritation.
- B. Measure the patient's blood pressure.
- C. Check the patient's blood glucose levels.
- D. Inspect the patient's throat.
Correct Answer: A
Rationale: Sudden, severe headache and neck stiffness may indicate meningitis. A neurologic assessment and evaluation for meningeal irritation are critical. Blood pressure, glucose levels, and throat inspection are secondary.
A patient learns that abdominal pain is originating from the liver. The nurse should explain to the patient that the impulses from receptors in the internal organs to the central nervous system are transmitted from which type of neurons?
- A. Interneurons
- B. Efferent neurons
- C. Somatic sensory neurons
- D. Visceral sensory neurons
Correct Answer: D
Rationale: Visceral sensory neurons transmit impulses from internal organs, such as the liver, to the central nervous system. Somatic sensory neurons transmit impulses from the skin and skeletal muscles, while efferent neurons carry motor impulses. Interneurons are found entirely within the central nervous system. This distinction is important for understanding pain pathways.