Nokea
Which of the following nursing interventions is taken as a precautionary measure if shock develops when a client with spinal cord injury is hospitalized?
- A. An IV line is inserted to provide access to a vein.
- B. Head and back are immobilized mechanically with a cervical collar and back support.
- C. Traction with weights and pulleys is applied.
- D. A turning frame is used.
Correct Answer: A
Rationale: IV access is critical for administering fluids and medications in shock.
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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.
Which signaling molecule is most likely responsible for an increase in digestive activity?
- A. epinephrine
- B. norepinephrine
- C. acetylcholine
- D. adrenaline
Correct Answer: C
Rationale: The correct answer is C: acetylcholine. Acetylcholine is the primary neurotransmitter responsible for stimulating digestive activity by increasing the secretion of digestive enzymes and promoting smooth muscle contractions. Epinephrine, norepinephrine, and adrenaline are stress hormones that inhibit digestive activity by diverting blood flow away from the digestive system and prioritizing other physiological responses. Therefore, acetylcholine is the most likely signaling molecule to increase digestive activity compared to the other choices.
What kind of loss does the nurse recognize this to be?
- A. Delirium
- B. Memory loss in AD
- C. Normal forgetfulness
- D. Memory loss in mild cognitive impairment
Correct Answer: C
Rationale: Forgetting names and birthdays is typical of normal forgetfulness
Dopamine is an important neurotransmitter. Which disease or disorder results when the neurons in the brain that produce dopamine die?
- A. Multiple sclerosis
- B. Lou Gehrig disease (amyotrophic lateral sclerosis)
- C. Parkinson disease
- D. Seizure disorder
Correct Answer: C
Rationale: Parkinson disease is caused by the degeneration of dopamine-producing neurons in the brain, leading to motor symptoms such as tremors and rigidity. Multiple sclerosis and ALS involve different neurological mechanisms, while seizure disorders are related to abnormal electrical activity in the brain. Dopamine's role in motor control is critical to understanding Parkinson disease.
You are providing care for a patient with an acute hemorrhagic stroke. The patient's husband has been reading a lot about strokes and asks why his wife did not receive alteplase. What is your best response?
- A. Your wife was not admitted within the time frame that alteplase is usually given.
- B. This drug is used primarily for patients who experience an acute heart attack.
- C. Alteplase dissolves clots and may cause more bleeding into your wife's brain.
- D. Your wife had gallbladder surgery just 6 months ago and this prevents the use of alteplase.
Correct Answer: C
Rationale: Alteplase increases the risk of bleeding, making it contraindicated in hemorrhagic stroke.