Nokea
What does an abnormal response in the assessment of the plantar reflex indicate?
- A. Possible neurological dysfunction, such as an upper motor neuron lesion.
- B. Normal reflex response.
- C. Absence of reflex abnormalities.
- D. Clear, coordinated movements.
Correct Answer: A
Rationale: An abnormal plantar reflex, such as toe extension (Babinski sign), suggests possible upper motor neuron dysfunction. A normal reflex involves toe flexion.
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You are caring for a patient with a recurrent glioblastoma who is receiving dexamethasone (Decadron) 4 mg IV every 6 hours to relieve symptoms of right arm weakness and headache. Which assessment information concerns you the most?
- A. The patient does not recognize family members.
- B. The blood glucose level is 234 mg/dL.
- C. The patient complains of a continued headache.
- D. The daily weight has increased 1 kg.
Correct Answer: A
Rationale: Changes in recognition could indicate neurological deterioration requiring immediate attention.
In evolutionary terms, which is the oldest part of the brain?
- A. the limbic system
- B. the cortex
- C. the right hemisphere
- D. the brain stem
Correct Answer: D
Rationale: The brainstem is the oldest part of the brain in evolutionary terms, as it is responsible for basic life-sustaining functions such as breathing, heart rate, and blood pressure. It includes structures like the medulla oblongata, pons, and midbrain. The brainstem has been conserved throughout evolution and is present in all vertebrates, making it a fundamental component of the central nervous system. In contrast, the cortex and limbic system evolved later and are more developed in higher mammals.
Following administration of 1.5 g of methocarbamol (Robaxin), which of the following statements by Mrs. Iris would inform the nurse that the medication was effective?
- A. I was thirsty after that medication.
- B. I have been urinating a lot today.
- C. Those awful muscle spasms have let up.
- D. The swelling in my leg seems to have gone down.
Correct Answer: C
Rationale: Methocarbamol is a muscle relaxant; relief from muscle spasms indicates effectiveness.
Apraxia involves an inability to undertake learned and purposeful activities such as dressing, cooking etc., and means that sufferers must rely increasingly on caregivers to help with these activities. Limb apraxia is a common symptom of left hemisphere damage and consists of a deficit in performing gestures to verbal command or imitation. One form of rehabilitation training for limb apraxia is:
- A. Gestural training.
- B. Mime training.
- C. Motor training.
- D. Replication training.
Correct Answer: A
Rationale: Gestural training is a rehabilitation technique used to improve limb apraxia, a condition characterized by difficulty in performing purposeful movements. This training involves teaching individuals to recognize and execute appropriate gestures and postures, enhancing their ability to perform daily activities. By focusing on the coordination of movements and the context in which they are used, gestural training helps individuals regain functional independence and reduce reliance on caregivers.
A patient arrived in the ER with a head injury. She is unconscious. The physician and a fellow nurse are the only staff members near the patient. Her husband begins to criticize the attending physician and suggest that a different physician should care for this patient. What is the best response?
- A. Report the nurse to the attending physician.
- B. Call the nurse away from the patient and remind him that the patient can still hear even if unconscious.
- C. Ask the nurse why he has such feelings.
- D. Simply nod your head in agreement.
Correct Answer: B
Rationale: Unconscious patients can still perceive their surroundings; thus, maintaining professional communication is important.