Nokea
Vasodilators produced by the endothelium include:
- A. endothelium-derived relaxing factor (EDRF)
- B. nitric oxide (NO)
- C. prostacyclin (PGL2)
- D. all above
Correct Answer: D
Rationale: The endothelium produces vasodilators such as EDRF (which includes NO) and prostacyclin (PGL2). These substances help regulate vascular tone and blood flow.
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Which finding may suggest a problem with the patient's proprioception?
- A. Difficulty standing with eyes closed or swaying when standing still.
- B. Steady gait and normal balance.
- C. Clear, intact sensation in all extremities.
- D. Normal muscle strength and coordination.
Correct Answer: A
Rationale: Proprioception issues are indicated by difficulty standing with eyes closed or swaying. Steady gait, intact sensation, and normal strength are normal findings.
Meningitis refers to that class of infections that cause inflammation of the meninges. Which Part of the brain does this refer to?
- A. Spinal fluid.
- B. Membranous covering of the brain and spinal cord.
- C. Main part of a neurone.
- D. Axon terminal.
Correct Answer: B
Rationale: Meningitis is an infection that causes inflammation of the meninges, the protective membranes covering the brain and spinal cord. Symptoms include fever, headache, neck stiffness, and cognitive impairments. The inflammation can lead to serious complications, such as brain damage or sepsis, if not treated promptly. Meningitis can be caused by bacterial, viral, or fungal infections, with bacterial meningitis being the most severe form.
An elderly patient presents with a right-sided headache and acute loss of vision on the same side. Tenderness is noted to the right temporal region as well as to the scalp. To obtain a definitive diagnosis, the nurse practitioner will order:
- A. Erythrocyte sedimentation rate (ESR)
- B. C-reactive protein (CRP)
- C. Temporal artery biopsy
- D. CT scan of the head
Correct Answer: C
Rationale: The correct answer is C: Temporal artery biopsy. This is the gold standard for diagnosing giant cell arteritis, which presents with symptoms such as headache, vision loss, and tenderness to the temporal region and scalp. The biopsy will show characteristic inflammatory changes in the artery wall.
A: ESR and B: CRP are nonspecific markers of inflammation and can be elevated in various conditions, including giant cell arteritis, but they do not provide a definitive diagnosis.
D: CT scan of the head may show signs of inflammation in the temporal artery, but it is less sensitive than a biopsy for diagnosing giant cell arteritis.
A client with a subdural hematoma becomes restless and confused, with dilation of the ipsilateral pupil. The physician orders mannitol for which of the following reasons?
- A. To reduce intraocular pressure
- B. To prevent acute tubular necrosis
- C. To promote osmotic diuresis to decrease ICP
- D. To draw water into the vascular system to increase blood pressure
Correct Answer: C
Rationale: Mannitol is an osmotic diuretic that draws fluid from the brain tissue into the vascular system, reducing intracranial pressure (ICP). This is critical in cases of subdural hematoma, where increased ICP can lead to brain herniation and further neurological damage. The drug works by creating an osmotic gradient, pulling water from the extracellular space of the brain into the bloodstream, which is then excreted by the kidneys. This mechanism helps alleviate symptoms like restlessness, confusion, and pupil dilation caused by increased ICP.
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.