Nokea
When performing a neurologic assessment, the nurse should prioritize:
- A. Observing for any sudden changes in mental status or physical function.
- B. Measuring the patient's body temperature.
- C. Checking the patient's blood pressure.
- D. Assessing the patient's respiratory rate.
Correct Answer: A
Rationale: Sudden changes in mental status or physical function are critical in neurologic assessments. Temperature, blood pressure, and respiratory rate are secondary considerations.
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Following a knee arthroplasty, a patient has a continuous passive motion machine for the affected joint. The nurse explains to the patient that this device is used for what purpose?
- A. To relieve edema and pain at the incision site
- B. To promote early joint mobility and increase knee flexion
- C. To prevent venous stasis and the formation of a deep venous thrombosis
- D. To improve arterial circulation to the affected extremity to promote healing
Correct Answer: B
Rationale: Continuous passive motion enhances joint mobility.
Which of the following is not a typical clinical manifestation of multiple sclerosis (MS)?
- A. Double vision
- B. Sudden bursts of energy
- C. Weakness in the extremities
- D. Muscle tremors
Correct Answer: B
Rationale: Sudden bursts of energy are not associated with MS. Fatigue, weakness, and muscle tremors are common symptoms.
A 44-year-old female presents with weakness. Her weakness becomes apparent when she picks up her youngest daughter, or when placing her nonperishable foods in the top shelf of her kitchen. She also reports difficulty when getting up from a chair. These symptoms began a few months ago, and have since worsened. On physical exam, there is an erythematous eruption on her eyelids, and erythematous papules on the dorsal aspect of her hands. Neurological examination is significant for symmetric muscle weakness of her shoulders and hips. Which of the following is most likely the diagnosis?
- A. Glucocorticoid-induced myopathy
- B. Myasthenia gravis
- C. Dermatomyositis
- D. Polymyositis
Correct Answer: C
Rationale: The patient's presentation of proximal muscle weakness, along with the characteristic skin findings (heliotrope rash on the eyelids and Gottron's papules on the hands), is classic for dermatomyositis. This is an inflammatory myopathy associated with autoimmune processes and often involves both muscle and skin. Glucocorticoid-induced myopathy and myasthenia gravis do not present with skin changes, while polymyositis and systemic lupus erythematosus do not typically cause the specific skin lesions seen in this patient.
Bradycardia can occur in response to:
- A. elevated intraocular pressure
- B. ocular massage
- C. pulling of the extraocular muscle
- D. all above
Correct Answer: D
Rationale: Bradycardia can be triggered by elevated intraocular pressure, ocular massage, or extraocular muscle manipulation due to the oculocardiac reflex.
Cell bodies for the motor supply of the facial nerve lie
- A. Hypothalamus
- B. Midbrain
- C. Floor of the third ventricle
- D. Pons
Correct Answer: D
Rationale: The motor nucleus of the facial nerve is located in the pons. It controls muscles of facial expression, such as the orbicularis oculi and buccinator.