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When caring for the patient with CREST syndrome (calcinosis, Raynaud's phenomenon, esophageal dysfunction, sclerodactyly, and telangiectasia) associated with scleroderma, what should the nurse teach the patient to do?
- A. Maintain a fluid intake of at least 3000 mL/day.
- B. Avoid exposure to the sun or other ultraviolet light.
- C. Monitor and keep a log of daily blood pressure (BP).
- D. Protect the hands and feet from cold exposure and injury.
Correct Answer: D
Rationale: Cold protection prevents Raynaud's episodes.
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To assess cranial nerve VIII (Vestibulocochlear nerve), the nurse should:
- A. Perform a hearing test and assess balance.
- B. Evaluate the patient's ability to swallow.
- C. Inspect the patient's throat.
- D. Palpate the patient's neck.
Correct Answer: A
Rationale: Cranial nerve VIII (Vestibulocochlear nerve) is responsible for hearing and balance. A hearing test and balance assessment evaluate its function. Swallowing, throat inspection, and neck palpation are unrelated.
What gland produces a secretion that causes fight-or-flight responses in effectors?
- A. adrenal medulla
- B. salivatory gland
- C. reproductive gland
- D. thymus
Correct Answer: A
Rationale: The correct answer is A: adrenal medulla. The adrenal medulla is part of the adrenal gland and secretes adrenaline and noradrenaline in response to stress, leading to fight-or-flight responses. The salivary gland produces saliva, the reproductive gland produces sex hormones, and the thymus produces T-cells for the immune system, none of which are related to fight-or-flight responses.
The 30-year-old female client is admitted with complaints of numbness, tingling, a crawling sensation affecting the extremities, and double vision which has occurred two(2) times in the month. Which question is most important for the nurse to ask the client?
- A. Have you experienced any difficulty with your menstrual cycle?
- B. Have you noticed a rash across the bridge of your nose?
- C. Do you get tired easily and sometimes have problems swallowing?
- D. Are you taking birth control pills to prevent conception?
Correct Answer: C
Rationale: Fatigue and swallowing difficulties are common symptoms of MS and can indicate disease progression or exacerbation.
Mr. K., aged 60 years, has a diagnosis of transient ischemic attack. An essential aspect of his history that needs to be documented is
- A. sudden, brief loss of sensory, motor, or visual function
- B. determining if he has any allergies
- C. any history of neurologic disease
- D. his medication history, both prescribed and over-the-counter
Correct Answer: A
Rationale: Sudden neurological deficits are hallmark symptoms of TIA.
The mechanism of action for entacapone is:
- A. COMT inhibition
- B. MAO-B inhibition
- C. D2-receptor inhibition
- D. Dopa-decarboxylase inhibition
Correct Answer: A
Rationale: Entacapone works by inhibiting catechol-O-methyltransferase (COMT), which prolongs the effect of levodopa by preventing its breakdown.