Nokea
What are the two major divisions of the nervous system?
- A. endocrine and exocrine nervous systems
- B. upper and lower nervous systems
- C. spinal and extremity nervous systems
- D. central and peripheral nervous systems
Correct Answer: D
Rationale: The nervous system is divided into the central nervous system (CNS), which includes the brain and spinal cord, and the peripheral nervous system (PNS), which includes all the nerves outside the CNS. This division is fundamental to understanding how the body processes and responds to information.
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The LPN/LVN, under your supervision, is providing nursing care for a patient with GBS. What observation would you instruct the LPN/LVN to report immediately?
- A. Complaints of numbness and tingling
- B. Facial weakness and difficulty speaking
- C. Rapid heart rate of 102 beats per minute
- D. Shallow respirations and decreased breath sounds
Correct Answer: D
Rationale: Respiratory compromise is a critical concern in GBS and requires immediate attention.
When assessing a patient's level of consciousness, the nurse should:
- A. Evaluate the patient's response to verbal and physical stimuli.
- B. Measure the patient's blood pressure.
- C. Inspect the patient's skin color.
- D. Assess the patient's respiratory rate.
Correct Answer: A
Rationale: Evaluating a patient's response to verbal and physical stimuli is essential for assessing their level of consciousness. Blood pressure, skin color, and respiratory rate are important but do not directly measure consciousness.
A client who is treated for a meniscal injury to the knee is advised prolonged immobility. To help prevent skin breakdown and infections, the nurse should instruct the client to increase the intake of which of the following?
- A. Protein
- B. Fiber
- C. Calcium
- D. Liquid
Correct Answer: A
Rationale: Protein aids in wound healing and preventing skin breakdown.
If an individual suffers a traumatic event and has a neurological disorder that means they may be unable to recall anything from the moment of the injury or to retain memories of recent events. This is known as:
- A. anterograde amnesia
- B. retrograde amnesia
- C. postevent amnesia
- D. antenatal amnesia
Correct Answer: A
Rationale: Anterograde amnesia refers to the inability to form new memories after the onset of amnesia, often due to brain injury or trauma. This condition severely impacts an individual's ability to retain information about recent events, while memories from before the injury may remain intact. It is commonly associated with damage to the hippocampus, a brain region critical for memory formation and consolidation.
A previously healthy 26-year-old male is brought to the emergency department due to muscle weakness. He reports mild weakness in his legs that has progressively worsened over a few days to the point that he can barely move his legs. He has some numbness in his legs and his arms feel weak. He has recently recovered from a respiratory infection. 1/5 muscle strength is noted throughout the lower extremities, as well as absent patellar and ankle reflexes. 3 to 4-/5 muscle strength is appreciated throughout his upper extremities. A lumbar puncture is performed, which shows the following: Cell count: 4 cells/mm3, Glucose: 67 mg/dL, Protein: 187 mg/dL Gram stain: no organisms Spirometry is performed, which shows a forced vital capacity of 0.85 L. Which of the following is the best next step in management?
- A. Intravenous (IV) immunoglobulin
- B. Intubation
- C. IV corticosteroids
- D. Immunomodulating agent
Correct Answer: B
Rationale: The patient's presentation of rapidly progressive weakness, areflexia, and elevated cerebrospinal fluid protein with normal cell count (albuminocytologic dissociation) is classic for Guillain-Barre syndrome (GBS). The forced vital capacity of 0.85 L indicates respiratory failure, necessitating immediate intubation to protect the airway and provide mechanical ventilation. Intravenous immunoglobulin and plasma exchange are treatments for GBS but are secondary to securing the airway in this critically ill patient.