Nokea
To evaluate a patient's intellectual function, the nurse should assess:
- A. The patient's ability to understand, reason, and recall information.
- B. The patient's blood pressure.
- C. The patient's respiratory rate.
- D. The patient's skin texture.
Correct Answer: A
Rationale: Intellectual function is assessed by evaluating the patient's ability to understand, reason, and recall information. Blood pressure, respiratory rate, and skin texture are unrelated to intellectual function.
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Why did the patient's wife's husband not receive clot-busting medication (tPA)?
- A. He didn't arrive within the timeframe for that therapy.
- B. Not everyone is eligible for this drug. Has he had surgery lately?
- C. You should discuss the treatment of your husband with his doctor.
- D. The medication you are talking about dissolves clots and could cause more bleeding in your husband's brain.
Correct Answer: D
Rationale: tPA is contraindicated in hemorrhagic strokes because it can worsen bleeding
A patient who is severely brain damaged has decerebrate posturing with extended extremities. In which area of the brain should the nurse suspect the patient has sustained damage?
- A. Cerebrum
- B. Brain stem
- C. Cerebellum
- D. Hypothalamus
Correct Answer: B
Rationale: Decerebrate posturing, characterized by extended extremities, indicates damage to the brainstem, particularly the midbrain or pons. The cerebrum, cerebellum, and hypothalamus are not directly associated with this type of posturing. Recognizing decerebrate posturing is critical for assessing the severity of brain injury.
Which of the following actions should the nurse perform before a client with impaired physical mobility gets up?
- A. Use parallel bars or a walker
- B. Apply an abdominal binder
- C. Use incontinence pads
- D. Use footboard
Correct Answer: B
Rationale: An abdominal binder supports the trunk and aids stability.
Proteins that are secreted by cells are generally
- A. not synthesized on membrane-bound ribosomes
- B. initially synthesized with a signal peptide or leader sequence at their C terminal
- C. found in vesicles and secretory granules
- D. moved across the cell membranes by endocytosis
Correct Answer: C
Rationale: Secreted proteins are typically synthesized on membrane-bound ribosomes and transported into the endoplasmic reticulum (ER) via a signal peptide at their N-terminal. They are then packaged into vesicles and secretory granules for transport to the cell membrane and release. Endocytosis is not involved in secretion, and proteins are usually processed (e.g., glycosylated) in the ER and Golgi, but they are not secreted in a larger form than in the ER.
The trigeminal nerve
- A. Has five divisions
- B. Mandibular division is purely sensory
- C. Has its motor nucleus in the upper pons
- D. Exits the skull entirely through the foramen ovale
Correct Answer: C
Rationale: The trigeminal nerve has three divisions (ophthalmic, maxillary, mandibular) and a motor nucleus in the upper pons. The mandibular division carries both sensory and motor fibers.