Chapter 15 Pathophysiology NCLEX-Style Review Questions

A client has just been diagnosed with multiple sclerosis (MS). The nurse recognizes that the client's condition is a result of: -An immune-mediated response that is caused by the demyelinization of the myelin sheath of the white matter of the brain, spinal cord, and optic nerve -Circulating antibodies attacking the postsynaptic acetylcholine levels -Degenerative changes in the musculoskeletal system -Degeneration of the lower cell bodies of the lower motor neurons in the gray matter

An immune-mediated response that is caused by the demyelinization of the myelin sheath of the white matter of the brain, spinal cord, and optic nerve

Following his annual influenza vaccination, a client begins to feel achy, like he has developed the flu. An hour later, the client is rushed to the emergency department and diagnosed of Guillain-Barré syndrome based on which assessment findings? Select all that apply. -BP 90/62 -Flaccid paralysis of limbs -Rapid deterioration of respiratory status -Pale, cool, dry skin -Lack of any physical pain

BP 90/62, Flaccid paralysis of limbs, Rapid deterioration of respiratory status

A client diagnosed with early multiple sclerosis (MS) will likely demonstrate which manifestations? Select all that apply. -Bladder dysfunction -Visual clouding -Fatigue -Anxiety -Paresthesia

Bladder dysfunction, Visual clouding, Fatigue, Paresthesia

Select the laboratory blood test that would be a used to suggest a diagnosis of muscular dystrophy (MD). -Amylase levels -Creatine kinase -Serum glucose -Rheumatoid factor

Creatine kinase

Regarding the pathophysiology of Parkinson disease, which statement is true? -Acetylcholine levels rise and inhibit voluntary movement. -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.

Degeneration of the nigrostriatal dopamine neurons occurs.

A sudden, traumatic, complete transection of the spinal cord results in what type of injury below the site? -Deep visceral pain -3+ tendon reflexes -Flaccid paralysis -Vasoconstriction

Flaccid paralysis

In what part of the body does the highest level of motor function occur? -Brain's cerebellum -Brain stem -Spinal cord -Frontal cortex of the brain

Frontal cortex of the brain

The nurse is assessing a client diagnosed with myasthenia gravis (MG). The nurse would expect the assessment to include: -Absent deep tendon reflexes -Loss of hearing on the affected side -Impaired ability to move tongue laterally -Inability to move eyes in multiple positions

Inability to move eyes in multiple positions

A client with an acute spinal cord injury is developing spinal shock. The nurse should perform which priority assessment? -Vasoconstriction causing hypertension -Paresthesia of the extremities below the injury -Loss of tendon reflexes below the injury -Inability to move lower extremities

Loss of tendon reflexes below the injury

The nurse is teaching a client about appropriate interventions for back pain. Select all that apply. -Aerobic exercise -Muscle relaxants -Bed rest -Analgesics -Nonsteroidal anti-inflammatory drugs

Muscle relaxants, Analgesics, Nonsteroidal anti-inflammatory drugs

When assessing the motor system, which area of the assessment should be the focus for the nurse? Select all that apply. -Muscle strength -Presence of muscle pain -Coordination -Body position -Presence of involuntary muscle movement

Muscle strength, Coordination, Body position, Presence of involuntary muscle movement

After being thrown off the back of a bull, a bull rider can move his arms but has loss of motor function in the lumbar and sacral segments of the spinal cord. This is referred to as: -Tetraplegia -Anterior cord syndrome -Quadriplegia -Paraplegia

Paraplegia

Which treatment should take place immediately in a client experiencing autonomic dysreflexia? -Increase the client's blood pressure to allow for adequate perfusion. -Place the client in a supine position, and increase intravenous fluids. -Position the client in upright position, and correct the initiating stimulus. -Apply binders and support hose to shunt the blood to the main organs.

Position the client in upright position, and correct the initiating stimulus.

A client works as a data entry worker for a large company and goes to employee health with pain in the wrist/hand. The nurse suspects that it is carpal tunnel syndrome based on which assessment findings? Select all that apply. -Precision grip weakness in the affected hand -Describes numbness/tingling in the thumb and first digit -Loss of tendon reflexes on the affected extremity -Pain interferes with sleeping -States his forearm feels funny (paresthesia)

Precision grip weakness in the affected hand, Describes numbness/tingling in the thumb and first digit, Pain interferes with sleeping

Which symptom is unique to amyotrophic lateral sclerosis (ALS) and is not observed in multiple sclerosis (MS)? -Fatigue -Dysarthria -Optic nerve dysfunction -Respiratory muscle impairment

Respiratory muscle impairment

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 empty bladder completely, thereby preventing autonomic dysreflexia -Assessment of lower extremities to prevent deep vein thrombosis -Respiratory ventilation assessment and prevention of aspiration pneumonia -Ability to turn from side to side, thereby preventing skin breakdown

Respiratory ventilation assessment and prevention of aspiration pneumonia

Which complication of spinal cord injury is the most preventable in a paraplegic client? -Autonomic dysreflexia -Muscle atrophy -Deep vein thrombosis -Skin breakdown

Skin breakdown

An individual experiencing spinal cord damage (SCD) is at high risk for developing deep vein thrombosis (DVT) and pulmonary emboli (PE) due to which pathophysical cause? Select all that apply. -Impaired pain perception -Stasis of blood flow -Hypercoagulation of blood -Impaired vasomotor tone -Impaired mobility

Stasis of blood flow, Hypercoagulation of blood, Impaired vasomotor tone, Impaired mobility

Coordinated muscular movement requires proper functioning of four areas of the nervous system. Which system controls posture and balance? -The motor system -The vestibular system -The sensory system -The cerebellar system

The vestibular system

A recently injured (3 months ago) client with a spinal cord injury at T4 to T5 is experiencing a complication. He looks extremely ill. The nurse recognizes this as autonomic dysreflexia (autonomic hyperreflexia). His BP is 210/108; skin very pale; gooseflesh noted on arms. The priority nursing intervention would be to: -scan his bladder to make sure it is empty. -check the jugular vein for distention. -assess calves of legs for redness, warmth, or edema. -check the mouth/throat for pustules and redness.

scan his bladder to make sure it is empty.