Nokea
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.
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A patient learns that abdominal pain is originating from the liver. The nurse should explain to the patient that the impulses from receptors in the internal organs to the central nervous system are transmitted from which type of neurons?
- A. Interneurons
- B. Efferent neurons
- C. Somatic sensory neurons
- D. Visceral sensory neurons
Correct Answer: D
Rationale: Visceral sensory neurons transmit impulses from internal organs, such as the liver, to the central nervous system. Somatic sensory neurons transmit impulses from the skin and skeletal muscles, while efferent neurons carry motor impulses. Interneurons are found entirely within the central nervous system. This distinction is important for understanding pain pathways.
Dysphagia, dyphonia, dysarthria together with tongue atrophy & depressed "gag" reflex is called like following:
- A. bulbar palsy
- B. Bell's palsy
- C. pseudobulbar palsy
- D. bulbus olfactorius
Correct Answer: A
Rationale: Bulbar palsy is the correct answer because it results from damage to the lower motor neurons of the cranial nerves IX, X, and XII, which are located in the medulla oblongata. This condition leads to dysphagia, dysphonia, dysarthria, and tongue atrophy due to the loss of motor control in the muscles of the pharynx, larynx, and tongue.
Which structure allows communication between the hemispheres?
- A. reticular formation
- B. temporal lobe
- C. contralateral bridge
- D. corpus callosum
Correct Answer: D
Rationale: The corpus callosum is a thick bundle of nerve fibers that connects the left and right hemispheres of the brain, allowing for communication and coordination between them. It enables the integration of information from both sides of the brain, facilitating complex cognitive processes and motor coordination. Damage to the corpus callosum can result in disconnection syndromes, where the hemispheres cannot communicate effectively.
Which gland is often abnormal in patients with myasthenia gravis?
- A. thymus gland
- B. thyroid gland
- C. adrenal gland
- D. pituitary gland
Correct Answer: A
Rationale: The thymus gland, which plays a role in immune system development, is often abnormal in patients with myasthenia gravis. Thymic hyperplasia or thymoma is commonly associated with the condition, and thymectomy (surgical removal of the thymus) can improve symptoms in some cases.
What does an abnormal finding in the assessment of cranial nerve VII (Facial nerve) indicate?
- A. Facial asymmetry or difficulty with facial expressions.
- B. Clear and symmetric facial movements.
- C. Normal taste sensation.
- D. Equal and reactive pupils.
Correct Answer: A
Rationale: Facial asymmetry or difficulty with facial expressions indicates dysfunction of cranial nerve VII (Facial nerve). Clear facial movements, normal taste sensation, and equal pupils are normal findings.