Nokea
Which of the following would the nurse assess first when Joe arrives in the emergency room?
- A. Movement of fingers
- B. Pain sensation in legs
- C. Respiratory rate
- D. Temperature sensation in arms
Correct Answer: C
Rationale: Respiratory function is prioritized in spinal injuries.
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The resting potential indicates that the inside of the neuron is ________ compared to the outside.
- A. under ionic pressure
- B. positive
- C. negative
- D. inactive
Correct Answer: C
Rationale: The resting potential of a neuron, typically around -65mV, indicates that the inside of the neuron is negatively charged compared to the outside. This charge difference is maintained by the sodium-potassium pump and the selective permeability of the cell membrane to ions. The resting potential is essential for the neuron's ability to generate and transmit nerve impulses, as it provides the electrical gradient necessary for action potentials.
What is another name for the preganglionic sympathetic fibers that project to the heart?
- A. solitary tract
- B. vasomotor nerve
- C. vagus nerve
- D. cardiac accelerator nerve
Correct Answer: D
Rationale: The correct answer is D: cardiac accelerator nerve. Preganglionic sympathetic fibers that project to the heart are part of the cardiac accelerator nerves, which increase heart rate and force of contraction. The other choices are incorrect because:
A: solitary tract - involved in transmitting sensory information related to taste and visceral sensations.
B: vasomotor nerve - regulates blood vessel tone and blood pressure.
C: vagus nerve - part of the parasympathetic nervous system and slows down heart rate and decreases force of contraction.
A 38-year-old female presents with muscle fatigue that is worse by the end of the day. She reports to have myalgias in the back of her neck, and at times her head "drops." She also states to sees "double" when watching television, or reading for a prolonged period of time. On physical examination, ptosis is produced when asking the patient to look at the ceiling without blinking. Pupillary function is intact. Appropriate serologic testing is obtained. On repetitive nerve stimulation, the amplitude of the compound muscle action potential progressively declines. Which of the following is most likely the diagnosis?
- A. Botulism
- B. Lambert-Eaton myasthenic syndrome
- C. Acute inflammatory demyelinating polyradiculopathy
- D. Myasthenia gravis
Correct Answer: D
Rationale: The patient's symptoms of fatigable weakness, ptosis, and diplopia, along with the decremental response on repetitive nerve stimulation, are classic for myasthenia gravis. This autoimmune disorder is caused by antibodies against acetylcholine receptors at the neuromuscular junction, leading to impaired muscle contraction. Botulism and Lambert-Eaton syndrome also cause weakness but have different clinical and electrophysiological features. Multiple sclerosis and acute inflammatory demyelinating polyradiculopathy do not typically present with fatigable weakness.
The diagnostic manual used by clinicians called DSM-IV-TR identifies two broader diagnostic syndromes into which many neurological disorders fall. Dementia is one which is characterised by which of the following:
- A. The impairment of basic cognitive functions.
- B. The impairment of physical abilities.
- C. The impairment of memory.
- D. All of the above.
Correct Answer: D
Rationale: Dementia is a neurological syndrome characterized by the progressive decline of cognitive functions, including memory, reasoning, and the ability to perform daily activities. It is often accompanied by changes in mood, behavior, and personality. Dementia can result from various causes, such as Alzheimer's disease, vascular dementia, or traumatic brain injury, and it significantly impacts an individual's quality of life and independence.
True statements about EOG (electro-oculogram) include:
- A. the EOG light-peak to dark-trough ratio is reduced in central retinal vein occlusion
- B. the light peak of EOG is abnormal in Best's disease
- C. the EOG light rise is produced by depolarization of the basal membrane of the retinal pigment epithelium
- D. all above
Correct Answer: D
Rationale: The EOG light-peak to dark-trough ratio is reduced in retinal vein occlusion, the light peak is abnormal in Best's disease, and the light rise is due to RPE depolarization. All statements are true.