Nokea
Which of the following pathways is not concerned with posture and movement?
- A. Spinocerebellar
- B. Vestibulospinal
- C. Tractus solitarius
- D. ?
Correct Answer: C
Rationale: The tractus solitarius is involved in taste and visceral sensation, not posture and movement. The spinocerebellar and vestibulospinal tracts are involved in motor coordination and balance.
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While the nurse performs formal patient assessment, assistive personnel often observe changes when obtaining vital signs or assisting patients with ADL's. When discussing care for a patient with back pain, the nurse should particularly alert the assistant to watch for:
- A. Dizziness
- B. Bowel/bladder incontinence
- C. Difficulty swallowing
- D. Arm weakness
Correct Answer: B
Rationale: Bowel and bladder incontinence in a patient with back pain may indicate cauda equina syndrome, a medical emergency caused by compression of the nerve roots in the lower spine. Dizziness, difficulty swallowing, and arm weakness are not typically associated with cauda equina syndrome.
What term refers to an inflammation of brain tissues?
- A. encephalitis
- B. meningitis
- C. sinusitis
- D. meningoencephalitis
Correct Answer: A
Rationale: The correct answer is A: encephalitis. Encephalitis specifically refers to inflammation of the brain tissues. "Meningitis" (B) is inflammation of the meninges, the protective membranes covering the brain and spinal cord. "Sinusitis" (C) is inflammation of the sinuses, not the brain. "Meningoencephalitis" (D) refers to inflammation of both the brain and meninges, but encephalitis is more specific to brain tissue. Therefore, encephalitis is the most accurate term for inflammation of brain tissues.
The tiny space between neurons or a neuron and its target muscle is the:
- A. dendrite
- B. axon
- C. neuron cell body
- D. synapse
Correct Answer: D
Rationale: The synapse is the tiny gap between neurons or between a neuron and its target cell, such as a muscle. It is the site where neurotransmitters are released to transmit signals from one cell to another. When an action potential reaches the axon terminal, neurotransmitters are released into the synapse and bind to receptors on the postsynaptic cell, triggering a response. The synapse is crucial for communication within the nervous system.
The client newly diagnosed with multiple sclerosis (MS) states, 'I don't understand how I got multiple sclerosis. Is it genetic?' On which statement should the nurse base the response?
- A. Genetics may play a role in susceptibility to MS, but the disease may be caused by a virus.
- B. There is no evidence suggesting there is any chromosomal involvement in developing MS.
- C. Multiple sclerosis is caused by a recessive gene, so both parents had to have the gene for the client to get MS.
- D. Multiple sclerosis is caused by an autosomal dominant gene on the Y chromosome, so only fathers can pass it on.
Correct Answer: A
Rationale: MS has a genetic component that increases susceptibility, but environmental factors, such as viral infections, also play a significant role in its development.
The right hand of a client with multiple sclerosis trembles severely whenever she attempts a voluntary action. She spills her coffee twice at lunch and cannot get her dress fastened securely. Which is the best legal documentation in nurses' notes of the chart for this client assessment?
- A. Has an intention tremor of the right hand.
- B. Right-hand tremor worsens with purposeful acts.
- C. Needs assistance with dressing and eating due to severe trembling and clumsiness.
- D. Slight shaking of right hand increases to severe tremor when client tries to button her clothes or drink from a cup.
Correct Answer: D
Rationale: Documenting the specific circumstances under which the tremor worsens provides a clear and accurate description of the client's condition.