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Which motor symptom, visible in the hands, is characteristic of Parkinson's disease?
- A. blue discoloration
- B. red discoloration
- C. tremor
- D. severe edema
Correct Answer: C
Rationale: Tremor, particularly a resting tremor, is a hallmark symptom of Parkinson's disease. It often begins in the hands and can progress to other parts of the body as the disease advances.
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The limbic system includes the:
- A. amygdala, hypothalamus, hippocampus
- B. hypothalamus, medulla, hippocampus
- C. hippocampus, pons, thalamus
- D. cerebellum, pons, hypothalamus
Correct Answer: A
Rationale: The limbic system is a group of brain structures involved in emotion, memory, and motivation. It includes the amygdala, which processes fear and emotional responses; the hypothalamus, which regulates hormones and homeostasis; and the hippocampus, which is essential for forming and retrieving memories. These structures work together to integrate emotional and cognitive processes, playing a key role in behavior and survival.
An elderly patient presents with a right-sided headache and acute loss of vision on the same side. Tenderness is noted to the right temporal region as well as to the scalp. To obtain a definitive diagnosis, the nurse practitioner will order:
- A. Erythrocyte sedimentation rate (ESR)
- B. C-reactive protein (CRP)
- C. Temporal artery biopsy
- D. CT scan of the head
Correct Answer: C
Rationale: The correct answer is C: Temporal artery biopsy. This is the gold standard for diagnosing giant cell arteritis, which presents with symptoms such as headache, vision loss, and tenderness to the temporal region and scalp. The biopsy will show characteristic inflammatory changes in the artery wall.
A: ESR and B: CRP are nonspecific markers of inflammation and can be elevated in various conditions, including giant cell arteritis, but they do not provide a definitive diagnosis.
D: CT scan of the head may show signs of inflammation in the temporal artery, but it is less sensitive than a biopsy for diagnosing giant cell arteritis.
In helping Mr. Hall to maintain proper body alignment in bed to prevent dislocation of the prosthetic head and hip contracture, the nurse should assist the patient to lie
- A. straight in bed alternating head position from flat to 30° elevation and left leg abducted
- B. diagonally toward the right side of the bed with legs together
- C. flat on back in bed for first 48 hours with legs adducted
- D. on the right side only with the left leg in front of the right leg
Correct Answer: A
Rationale: This position minimizes stress on the new hip joint.
True statements about aldosterone include:
- A. it increases the amount of Na+-K+ ATPase in the target cells
- B. it reduces the sodium content of the sweat
- C. it increases the acidity of urine
- D. all above
Correct Answer: D
Rationale: Aldosterone increases Na+-K+ ATPase activity in target cells, promoting sodium reabsorption and potassium excretion. It also reduces sodium loss in sweat and increases urine acidity by promoting hydrogen ion excretion. These actions help regulate electrolyte balance and blood pressure.
A 63-year-old patient with PD has done well on rasagiline 1 mg once a day and ropinirole 4 mg three times a day for several years. In the past, higher doses of ropinirole resulted in excessive drowsiness. He now needs more symptom relief. The best recommendation would be to:
- A. Add carbidopa/levodopa.
- B. Add entacapone.
- C. Add pramipexole.
- D. Consider DBS surgery.
Correct Answer: A
Rationale: Adding carbidopa/levodopa can provide additional symptom relief without increasing the risk of drowsiness associated with higher doses of ropinirole.