Nokea
When assessing the motor function of a patient, the nurse should:
- A. Observe for muscle strength, coordination, and movement symmetry.
- B. Check the patient's heart rate.
- C. Inspect the patient's joint range of motion.
- D. Measure the patient's blood pressure.
Correct Answer: A
Rationale: Motor function assessment involves evaluating muscle strength, coordination, and symmetry. Heart rate, joint range of motion, and blood pressure are not directly related to motor function.
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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.
The brain and spinal cord are the organs of the ________ .
- A. CNS
- B. PNS
- C. ANS
- D. CSF
Correct Answer: A
Rationale: The brain and spinal cord are the primary organs of the central nervous system (CNS). The CNS is responsible for processing and integrating information received from the peripheral nervous system (PNS). The autonomic nervous system (ANS) is a division of the PNS, and cerebrospinal fluid (CSF) is a protective fluid surrounding the CNS. Therefore, CNS is the correct answer as it directly refers to the brain and spinal cord.
What is another name for the preganglionic sympathetic fibers that project to the heart?
- A. solitary tract
- B. vasomotor nerve
- C. vagus nerve
- D. cardiac accelerator nerve
Correct Answer: D
Rationale: The correct answer is D: cardiac accelerator nerve. Preganglionic sympathetic fibers that project to the heart are part of the cardiac accelerator nerves, which increase heart rate and force of contraction. The other choices are incorrect because:
A: solitary tract - involved in transmitting sensory information related to taste and visceral sensations.
B: vasomotor nerve - regulates blood vessel tone and blood pressure.
C: vagus nerve - part of the parasympathetic nervous system and slows down heart rate and decreases force of contraction.
Which of the following factors should the nurse emphasize while teaching a client with a cast on the lower extremities?
- A. The importance of following a regular diet.
- B. The use of prescribed analgesics to manage the pain.
- C. Instructions about ambulating with the crutches.
- D. The importance of regular exercise.
Correct Answer: C
Rationale: Ambulation instructions are critical to ensure safe movement with casts.
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.