Nokea
Which type of neuron transmits impulses from the central nervous system to the muscles and glands?
- A. Afferent
- B. Efferent
- C. Affective
- D. Effective
Correct Answer: B
Rationale: Efferent neurons, also known as motor neurons, transmit impulses from the central nervous system (brain and spinal cord) to the muscles and glands in the body. These neurons are responsible for inducing muscle contraction or glandular secretion in response to signals from the brain or spinal cord. In contrast, afferent neurons transmit impulses from sensory receptors to the central nervous system to convey sensory information. Thus, the correct answer is efferent neurons.
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A clinical nurse specialist (CNS) is orienting a new graduate registered nurse to an oncology unit where blood product transfusions are frequently administered. In discussing ABO compatibility, the CNS presents several hypothetical scenarios. A well-informed new graduate would know the greatest likelihood of an acute hemolytic reaction would occur when giving:
- A. A-positive blood to an A-negative client
- B. O-positive blood to an A-positive client
- C. O-negative blood to an O-positive client
- D. B-positive blood to an AB-positive client
Correct Answer: B
Rationale: The greatest likelihood of an acute hemolytic reaction occurs when there is mismatch in the ABO blood group system, specifically when the recipient's plasma contains antibodies against the donor's red blood cells. In this scenario, giving O-positive blood to an A-positive client presents the highest risk because the A-positive client has anti-B antibodies in their plasma, which can attack the B antigens present on the O-positive donor red blood cells. This mismatch can lead to rapid destruction of the transfused red blood cells, causing an acute hemolytic reaction. It is crucial to ensure ABO compatibility to prevent such life-threatening reactions during blood product transfusions.
A client with hypothyroidism (myxedema) is receiving levothyroxine (Synthroid), 25 mcg PO daily. Which finding should the nurse recognize as an adverse effect?
- A. Dysuria
- B. Tachycardia
- C. Leg cramps
- D. Blurred vision
Correct Answer: B
Rationale: Levothyroxine is a synthetic form of thyroid hormone used to treat hypothyroidism. An adverse effect of levothyroxine therapy is the development of tachycardia, which is an abnormally rapid heart rate. This is due to the increased metabolic rate resulting from the thyroid hormone replacement. Dysuria (painful urination), leg cramps, and blurred vision are not typically associated with levothyroxine therapy for hypothyroidism.
Mr. Santos a 59-year old businessman was diagnosed with angina pectoris. The nurse understands that the cause of angina pectoris is:
- A. decrease in the alveolar surface for gas exchange
- B. inadequate supply of oxygen to the myocardium
- C. inadequate blood pressure in the pulmonary circulation
- D. increase in the alveolar surface for gas exchange
Correct Answer: B
Rationale: Angina pectoris is chest pain or discomfort caused by a temporary lack of an adequate blood supply to the heart muscle (myocardium). This lack of blood supply results in a decreased supply of oxygen to the heart muscle, leading to chest pain. This condition is commonly associated with coronary artery disease, where the arteries that supply blood to the heart become narrowed or blocked, reducing the flow of oxygen-rich blood to the myocardium. This oxygen deficit can trigger chest pain, which is characteristic of angina pectoris. Therefore, the cause of angina pectoris is the inadequate supply of oxygen to the myocardium, making option B the correct answer.
After a transsphenoidal adenohypophysectomy, a client is likely to undergo hormone replacement therapy. A transsphenoidal adenohypophysectomy is performed to treat which type of cancer?
- A. Esophageal carcinoma
- B. Laryngeal carcinoma
- C. Pituitary carcinoma
- D. Colorectal carcinoma
Correct Answer: C
Rationale: A transsphenoidal adenohypophysectomy is a surgical procedure performed to remove benign or malignant tumors located in the pituitary gland. Pituitary carcinoma refers to a type of cancer that originates in the pituitary gland. Therefore, this surgery is indicated for treating pituitary carcinoma by removing the tumor from the pituitary gland. After the surgery, hormone replacement therapy may be necessary to replace the hormones that were previously produced by the removed adenohypophysis (anterior pituitary gland).
The client with trigeminal neuralgia tells the nurse that acetaminophen (Tylenol) is taken daily for the relief of generalized discomfort. Which laboratory value would indicate toxicity associated with the medication?
- A. Sodium level of 140 mEq/l.
- B. Direct bilirubin level of 2 mg/dl
- C. Prothrombin time of 12 seconds
- D. Platelet count of 400,000/mm3
Correct Answer: B
Rationale: Acetaminophen toxicity can lead to hepatic injury, resulting in elevated liver enzymes, including bilirubin levels. Direct bilirubin is a specific marker for liver function and is typically elevated in cases of acetaminophen overdose or toxicity. Therefore, a direct bilirubin level of 2 mg/dl would indicate toxicity associated with acetaminophen use. Monitoring liver function tests, including bilirubin levels, is crucial when using acetaminophen long-term to prevent toxicity and liver damage.