While making a home visit she complains to you of experiencing increasing joint stiffness. You learn she has been doing a lot of reading lately. Based on these data you conclude she
- A. needs to exercise involved joints periodically
- B. needs to take long walks twice a day
- C. is a chronic complainer
- D. needs to rest involved joints for one hour at a time
Correct Answer: A
Rationale: Regular exercise maintains joint flexibility and reduces stiffness.
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Nurse Carter observes that Mr. Adams, a 73-year-old patient in her care, has a distinctive shuffling walk as he moves down the hallway. Recognizing this unique pattern, Nurse Carter reflects on which neurological condition is typically associated with such a gait. Which disease should Nurse Carter associate with a shuffling gait?
- A. Raynaud's disease
- B. Multiple sclerosis
- C. Myasthenia gravis
- D. Parkinson's disease
Correct Answer: D
Rationale: A shuffling gait is a hallmark feature of Parkinson's disease, caused by bradykinesia and postural instability.
When assessing a patient for signs of increased intracranial pressure (ICP), the nurse should look for:
- A. Changes in level of consciousness, headache, and vomiting.
- B. Normal pupil size and reaction.
- C. Absence of nausea or vomiting.
- D. Clear and coordinated movements.
Correct Answer: A
Rationale: Increased intracranial pressure (ICP) is associated with changes in consciousness, headache, and vomiting. Normal pupil size, absence of nausea, and clear movements are not indicative of ICP.
A patient has a severed spinal nerve as a result of trauma. Which statement is true in this situation?
- A. Because there are 31 pairs of spinal nerves, no effect results if only one nerve is severed.
- B. The dermatome served by this nerve will no longer experience any sensation.
- C. The adjacent spinal nerves will continue to carry sensations for the dermatome served by the severed nerve.
- D. A severed spinal nerve will only affect motor function of the patient because spinal nerves have no sensory component.
Correct Answer: C
Rationale: Rationale for Correct Answer (C): When a spinal nerve is severed, adjacent spinal nerves can compensate and continue to carry sensations for the dermatome served by the severed nerve. This is possible due to the concept of dermatomes overlapping and the redundancy in sensory innervation. Therefore, the patient may still experience sensation in the affected area despite the specific nerve being severed.
Summary of Incorrect Choices:
A: Incorrect. Even if there are 31 pairs of spinal nerves, severing one nerve can still have a significant impact on sensory and motor functions depending on the location and severity of the injury.
B: Incorrect. Sensory loss would occur in the dermatome served by the severed nerve, but adjacent nerves can still carry sensations.
D: Incorrect. Spinal nerves have both sensory and motor components, so severing a spinal nerve can affect both sensory and motor functions, not just motor function.
A Neurological disorder that is characterised by impairments in motor performance and coordination are known as
- A. Dyspraxia
- B. Apraxia
- C. Anapraxia
- D. Amotoria
Correct Answer: B
Rationale: Apraxia is a neurological disorder that affects the ability to perform purposeful movements, despite having the physical ability and desire to do so. Individuals with apraxia may struggle with tasks like dressing, cooking, or using tools. This condition is often caused by damage to the parietal lobe or other areas of the brain involved in motor planning and execution.
You are instructing a patient who has multiple sclerosis about how dantrolene (Dantrium) will help control spasticity. Through which of the following pharmacologic actions is this drug effective in treating this manifestation?
- A. Blocks acetylcholine at the neuromuscular junction
- B. Interrupts nerve signals from the spinal cord to the muscles
- C. Inhibits destruction of acetylcholine by acetylcholinesterase
- D. Alters intracellular calcium exchange at the muscles
Correct Answer: D
Rationale: Dantrolene, a peripherally acting muscle relaxant, acts directly on spastic muscles and inhibits muscle contraction by preventing the release of calcium in skeletal muscles. Anticholinergic drugs or muscarinic antagonist block acetylcholine at the neuromuscular junction. Baclofen, a centrally acting muscle relaxant, relieves spasticity by interrupting nerve signals from the spinal cord. Most drugs used to treat myasthenia gravis act by preventing the destruction of acetylcholine at the neuromuscular junction.