Nokea
Treatment of the patient with antidepressants will most likely do what?
- A. Improve cognitive function
- B. Not alter the course of either condition
- C. Cause interactions with the drugs used to treat the dementia
- D. Be contraindicated because of the central nervous system (CNS)€“depressant effect of antidepressants
Correct Answer: B
Rationale: Antidepressants do not alter the progression of dementia
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In a patient with a stable vertebral fracture, what should the nurse teach the patient to do?
- A. Remain on bed rest until the pain is gone.
- B. Logroll to keep the spine straight when turning.
- C. How to use bone cement to correct the problem.
- D. Take as much analgesic as needed to relieve the pain.
Correct Answer: B
Rationale: Logrolling minimizes further injury to the spine.
The presence of Parkinsonism suggests damage to the following:
- A. caudate nucleus
- B. black substance
- C. cerebellar
- D. frontal lobe
Correct Answer: B
Rationale: Black substance (substantia nigra) is the correct answer because Parkinsonism is characterized by the degeneration of dopaminergic neurons in the substantia nigra. This leads to the classic symptoms of tremor, bradykinesia, and rigidity due to the loss of dopamine in the basal ganglia, which regulates movement.
A 38-year-old female presents with muscle fatigue that is worse by the end of the day. She reports to have myalgias in the back of her neck, and at times her head "drops." She also states to sees "double" when watching television, or reading for a prolonged period of time. On physical examination, ptosis is produced when asking the patient to look at the ceiling without blinking. Pupillary function is intact. Appropriate serologic testing is obtained. On repetitive nerve stimulation, the amplitude of the compound muscle action potential progressively declines. Which of the following is most likely the diagnosis?
- A. Botulism
- B. Lambert-Eaton myasthenic syndrome
- C. Acute inflammatory demyelinating polyradiculopathy
- D. Myasthenia gravis
Correct Answer: D
Rationale: The patient's symptoms of fatigable weakness, ptosis, and diplopia, along with the decremental response on repetitive nerve stimulation, are classic for myasthenia gravis. This autoimmune disorder is caused by antibodies against acetylcholine receptors at the neuromuscular junction, leading to impaired muscle contraction. Botulism and Lambert-Eaton syndrome also cause weakness but have different clinical and electrophysiological features. Multiple sclerosis and acute inflammatory demyelinating polyradiculopathy do not typically present with fatigable weakness.
If a nurse observes a sudden change in a client's vital signs, what immediate step should the nurse take?
- A. Inform the physician
- B. Change the environmental settings of the client
- C. Alter the diet intake of the client
- D. Decrease the physical activity of the client
Correct Answer: A
Rationale: Immediate medical attention is necessary for significant changes in vital signs.
Which finding should the nursing assistant report immediately for a patient with a fractured femur?
- A. The patient complains of pain.
- B. The patient appears confused.
- C. The patient's blood pressure is 136/88.
- D. The patient voided using the bedpan.
Correct Answer: B
Rationale: Confusion could indicate a more serious underlying issue, such as reduced cerebral perfusion.