pathophysiology exam 5

What is the low parameter for arterial blood pressure before cerebral blood flow becomes severely compromised?

60 mm Hg

Much like brain death, there are criteria for the diagnosis of a persistent vegetative state, and the criteria have to have lasted for more than 1 month. Which of these is not a criteria for the diagnosis of persistent vegetative state?

Ability to open the eyes

Hypoglycemia has a sudden onset with a progression of symptoms. What are the signs and symptoms of hypoglycemia?

Altered cerebral function and headache

Global and focal brain injuries manifest differently. What is almost always a manifestation of a global brain injury?

Altered level of consciousness

Manifestations of brain tumors are focal disturbances in brain function and increased intercranial pressure (ICP). What causes the focal disturbances manifested by brain tumors?

Brain edema and disturbances in blood flow

Herniated disks occur when the nucleus pulposus is compressed enough that it protrudes through the annulus fibrosus, putting pressure on the nerve root. This type of injury occurs most often in the cervical and lumbar region of the spine. Which of the following is not an important assessment technique for a herniated disk in the lumbar region?

Ankle rotation test

The pancreas is an endocrine organ that is composed of acini and the islets of Langerhans. The islets of Langerhans have alpha, beta, and delta cells as well as the PP cell. Which cells secrete insulin?

Beta cells

Using surgery to relieve severe, intractable pain has been successful to a degree. What can surgery be used for when a person is in pain?

Block transmission of phantom limb pain

Diabetic ketoacidosis (DKA) is a condition that mostly occurs in type 1 diabetics. What are the definitive diagnostic criteria for DKA

Blood glucose level greater than 250 mg/dL; bicarbonate less than 15 mEq/L and pH less than 7.3

Intracranial aneurysms that rupture cause subarachnoid hemorrhage in the client. How is the diagnosis of intracranial aneurysms and subarachnoid hemorrhage made?

CT scan

What is it that is distinctive in a person with acromegaly?

Broad bulbous nose and a protruding lower jaw

When the suspected diagnosis is bacterial meningitis, what assessment techniques can assist in determining if meningeal irritation is present?

Brudzinski sign and Kernig sign

A 14-year-old girl has been thrown from the back of a pick-up truck. MRI shows complete cord injury at the level of C2. What is the main significance of an injury at this level of the spinal column?

Cannot breathe on own, needs ventilator assistance

Peripheral nerve disorders are not uncommon. What is an example of a fairly common mononeuropathy?

Carpal tunnel syndrome

Peripheral neuropathies occur in people with diabetes mellitus. With the loss of sensation in the lower extremities, diabetics become predisposed to what?

Clawing of toes and denervation of the small muscles of the foot

A severe type of headache that occur more frequently in men than women and is described as having unrelenting, unilateral pain located most frequently in the orbit is called what?

Cluster headache

Which type of seizure begins in a localized area of the brain but may progress rapidly to involve both hemispheres?

Complex partial

The nurse is caring for a 31-year-old trauma victim admitted to the neurologic intensive care unit. While doing the initial assessment, the nurse finds that the client is flexing the arms, wrists, and fingers. There is adduction of plantar flexion of the lower extremities. How would the nurse describe this in the notes?

Decorticate posturing

In describing the ideal analgesic, what factor should not be included?

Decrease the level of consciousness

Type 2 diabetes is caused by metabolic abnormalities in the presence of insulin. Which of these is not an example of those metabolic abnormalities?

Decreased glucose production by the liver

Growth hormone exerts its effects on the body in many ways. Which of these is not an effect of GH?

Decreases ATCH production

Brain death is the term that is used when the loss of function of the entire brain is irreversible. A clinical examination must be done and repeated 6 hours later with the same findings for brain death to be declared. What is not assessed in the clinical examination for brain death?

Electrocardiogram

A man is brought into the emergency department by paramedics who state that the client passed out on the street. The man smells of alcohol, and when roused says he has not eaten since yesterday. He is wearing a medic alert bracelet that says he is a diabetic. What would the nurse suspect as a diagnosis?

Hypoglycemia

When giving pain medicine for acute pain, health care workers are reluctant to provide much needed opioid pain medicine. What is the major concern of health care workers when providing opioid pain relief?

Fear of addiction

Approximately 6 months after a spinal cord injury, a 29-year-old man has an episode of autonomic dysreflexia. Which of the following is not characteristic of autonomic dysreflexia?

Fever

The spinal cord contains the basic factors necessary to coordinate function when a movement is planned. It is the lowest level of function. What is the highest level of function in planning movement?

Frontal cortex

Type 1A diabetes is now considered an autoimmune disorder. What factors are considered necessary for type 1A diabetes to occur?

Genetic predisposition, environmental triggering event, and a T-lymphocyte-mediated hypersensitivity reaction against some beta-cell antigen

Growth hormone is secreted by adults as well as by children. Growth hormone deficiency in children is treated by injections of GH on a daily basis. When teaching a family or child to give injections of GH, what is important to teach them?

Give the injections at bedtime to produce the greatest effect at night, like the body does.

When the assessment of thyroid autoantibodies is performed, what is the suspected diagnosis?

Hashimoto thyroiditis

What disease is thought to be related to the destruction of the cholinergic interneurons?

Huntington disease

In Addison disease, the majority of the adrenal cortex has been destroyed. This causes a lack of mineralocorticoids and glucocorticoids. Therapy consists of oral replacement with what drug?

Hydrocortisone

In an acute adrenal crisis, the onset of symptoms is sudden and in the case of Addison disease, can be precipitated by exposure to a minor illness or stress. Which of these is not a manifestation of acute adrenal crisis?

Hypertension

There are several types of brain injuries that can occur. Which of these is not a primary (or direct) brain injury?

Hypoxic

What is the first-line drug of choice to treat status epilepticus?

Intravenous lorazepam

Diabetics are at higher risk than are the majority of the population for injury to organ systems in the body. Which organs are most at risk?

Kidneys and eyes

What fetal abnormalities are associated with gestational diabetes mellitus?

Macrosomia and hypocalcemia

Hormones that counteract insulin's storage function when regulating blood glucose during times when glucose intake is limited, or glucose stores are depleted are called counterregulatory hormones. Which of these is not a counterregulatory hormone?

Mineralocorticoids

Migraine headaches affect millions of people worldwide. What are first-line agents for the treatment of migraine headaches?

Naproxen sodium and metoclopramide

It is often necessary to assess a client's pain. What factors would you assess when assessing pain?

Nature and severity of pain

Which of the following types of pain is characterized by severe, brief, often repetitive pain?

Neuralgia

Which of the following will conduct injurious stimuli to alert the body of potential damage?

Nociceptors

What disease results from the degeneration of the dopamine nigrostriatal system of the basal ganglia?

Parkinson disease

What are the hallmark signs of diabetes mellitus?

Polyuria, polydipsia, and polyphagia

When testing nociceptive stimuli to elicit a withdrawal reflex in the body, what stimuli are commonly used?

Pressure from a sharp object

Amyotrophic lateral sclerosis is considered a disease of the upper motor neurons. What is the most common clinical presentation of amyotrophic lateral sclerosis?

Slowly progressive weakness and atrophy in distal muscles of one upper extremity

Research has identified a cycle of insulin-induced post hypoglycemic episodes. What is this phenomenon called?

Somogyi effect

Phantom limb pain is a little understood pain that is difficult to treat, even though the client is experiencing severe pain. What are the treatments for phantom limb pain?

Sympathetic blocks and hypnosis

The hallmark manifestation of Cushing syndrome is a moon face, a "buffalo hump" between the shoulder blades, and a protruding abdomen. What other manifestation of Cushing syndrome occur?

Thin extremities and muscle weakness

Children feel pain just as much as adults do. What is the major principle in pain management in the pediatric population.

Treat on individual basis and match analgesic agent with cause and level of pain.

Hyperthyroidism that is inadequately treated can cause a life-threating condition known as thyroid storm. Which of these is not a manifestation of thyroid storm?

Very low fever

In myasthenia gravis, periods of stress can produce myasthenia crisis. When does myasthenia crisis occur?

When muscle weakness becomes severe enough to compromise ventilation