Ch 15 patho
Which statement accurately reflects the typical person afflicted with multiple sclerosis (MS)? A 25-year-old woman A 50-year-old man A 6-year-old girl A 26-year-old man
A 25-year-old woman
Which cardinal assessment finding would lead the nurse to suspect a client has developed Parkinson disease? Hypotonia Bradykinesia Paresthesia Lack of sweating
Bradykinesia
Neurotoxins such as the botulism organism can produce paralysis by what mechanism? Causing a recessive gene defect on the X chromosome Loss of acetylcholine receptors Demyelination of multiple peripheral nerves By blocking release of acetylcholine
By blocking release of acetylcholine
The nurse expects that loss of respiratory effort occurs with a spinal injury at which level? C1-3 C7-T1 T9-T12 S1-S5
C1-3
An older adult has had a recent decrease in coordination, with gait being described as wide-based, unsteady, and lacking in fluidity, although the client's muscle tone appears normal. This client requires further assessment for which condition that is involved with coordination of movement? Muscle atrophy Cerebellar disorder Impaired spinal reflexes Lower motor neuron lesions
Cerebellar disorder
Regarding the pathophysiology of Parkinson disease, which statement is true? Degeneration of the nigrostriatal dopamine neurons occurs. The dopamine receptors increase from an alteration in neuronal basal ganglia. Failure of the cerebral cortex interferes with the use of acetylcholine. Acetylcholine levels rise and inhibit voluntary movement.
Degeneration of the nigrostriatal dopamine neurons occurs.
Which statement best describes the pathophysiology of Parkinson disease? Degeneration of the nigrostriatal dopamine system Increase in the number of dopamine receptors by an alternate basal ganglion Failure of the cerebral cortex, which does not allow the use of acetylcholine Rise in acetylcholine levels, causing an inhibition of voluntary movement
Degeneration of the nigrostriatal dopamine system
A client with Parkinson disease presents with bradykinesia and an altered gait. These symptoms arise in response to the progressive deterioration of which structure in the brain? Limbic system Dopamine nigrostriatal system Serotonergic system Cerebellum
Dopamine nigrostriatal system
A nurse is assessing a client with symptoms of botulism. The nurse will question the client regarding ingestion of which food? Dairy products Unrefrigerated meat Home-grown and canned vegetables Fresh fish
Home-grown and canned vegetables
A client with an acute spinal cord injury is developing spinal shock. The nurse should perform which priority assessment? Inability to move lower extremities Loss of tendon reflexes below the injury Vasoconstriction causing hypertension Paresthesia of the extremities below the injury
Loss of tendon reflexes below the injury
Antibiotics such as gentamicin can produce a disturbance in the body that is similar to botulism by preventing the release of acetylcholine from nerve endings. In persons with preexisting neuromuscular transmission disturbances, these drugs can be dangerous. What disease falls into this category? Multiple sclerosis Duchenne muscular dystrophy Becker muscular dystrophy Myasthenia gravis
Myasthenia gravis
Which disease is thought to be caused by antibody-mediated loss of acetylcholine receptors in the neuromuscular junction? Parkinson syndrome Guillain-Barré syndrome Myasthenia gravis Huntington disease
Myasthenia gravis
Disorders of the pyramidal tracts, such as a stroke, are characterized by which physical finding? Hypotonia Muscle rigidity Paralysis Involuntary movements
Paralysis
What disease results from the degeneration of the dopamine nigrostriatal system of the basal ganglia? Parkinson disease Huntington disease Guillain-Barré syndrome myasthenia gravis
Parkinson disease
Guillain-Barré syndrome is characterized by which form of neuron damage? Mononeuropathy Polyneuropathy Peripheral neuropathy Transneuropathy
Polyneuropathy
Which treatment should take place immediately in a client experiencing autonomic dysreflexia? Position the client in upright position, and correct the initiating stimulus. Increase the client's blood pressure to allow for adequate perfusion. Place the client in a supine position, and increase intravenous fluids. Apply binders and support hose to shunt the blood to the main organs.
Position the client in upright position, and correct the initiating stimulus.
Throwing a ball or picking up a fork are movements controlled by which portion of the frontal lobe? Premotor cortex Primary motor cortex Reflexive circuitry Supplementary motor cortex
Premotor cortex
The parent of a toddler with Duchenne muscular dystrophy reports that the child has an increase in muscle size but a decrease in strength. The nurse documents this using which medical term? Pseudohypertrophy Fasciculations Dysdiadochokinesia Chorea
Pseudohypertrophy
Nystagmus due to cerebellar dysfunction would most likely interfere with which activity? Walking Speech Fine motor skills Reading
Reading
A client is devastated to receive a diagnosis of amyotrophic lateral sclerosis (ALS). The symptomatology of this disease is a result of its effects on upper and lower motor neurons. The health care provider caring for this client will focus on which priority intervention for this client? Ability to turn from side to side, thereby preventing skin breakdown Ability to empty bladder completely, thereby preventing autonomic dysreflexia Respiratory ventilation assessment and prevention of aspiration pneumonia Assessment of lower extremities to prevent deep vein thrombosis
Respiratory ventilation assessment and prevention of aspiration pneumonia
Which complication of spinal cord injury is the most preventable in a paraplegic client? Skin breakdown Muscle atrophy Deep vein thrombosis Autonomic dysreflexia
Skin breakdown
During physiology class, the instructor asks students to explain the pathology behind development of multiple sclerosis. Which student gave the most accurate description? The demyelination and subsequent degeneration of nerve fibers and decreased oligodendrocytes, which interfere with nerve conduction Muscle necrosis with resultant increase in fat/connective tissue replacing the muscle fibers Atherosclerotic destruction of circulation to the brain, resulting in lactic acid buildup that affects nerve transmission Autoimmune disease where antibody loss of acetylcholine receptors at the neuromuscular junction causes decreased motor response
The demyelination and subsequent degeneration of nerve fibers and decreased oligodendrocytes, which interfere with nerve conduction
What do deep tendon reflexes assess? Functioning of the "motor strip" Basic brain stem functions such as breathing The stretch reflex at different spinal cord segments Regulation of brain stem and cortical areas
The stretch reflex at different spinal cord segments
A client comes to the clinic and informs the nurse that he believes he is suffering from Parkinson disease. What objective data assessed by the nurse would correlate with the client's concern? Select all that apply. Tachycardia Tremor Rigidity Bradykinesia Rapid speech
Tremor Rigidity Bradykinesia
Autonomic dysreflexia (autonomic hyperreflexia) is characterized by which of the following? Severe spinal shock Tachycardia and pale skin Lack of sweat above injury level Vasospasms and hypertension
Vasospasms and hypertension
Herniated disks put pressure on the nerve root. This type of injury occurs most often in the cervical and lumbar region of the spine. What is an important assessment technique(s) for a herniated disk in the lumbar region? Select all that apply. hip flexion test computed tomography (CT) scan straight-leg test electroencephalography
hip flexion test computed tomography (CT) scan straight-leg test
Death caused by muscular dystrophy in early adulthood is usually due to: respiratory and cardiac muscle involvement. severe skeletal muscle weakness. severe long bone fractures. malnutrition.
respiratory and cardiac muscle involvement.
The nurse has just completed an assessment on a client admitted with Guillain-Barré syndrome. The nurse determines that a priority of care will be: ventilatory assessment and support. emotional support. administration of antibiotics. feeding the client.
ventilatory assessment and support.