Nursing Elites

1. During a late-night study session, a pathophysiology student reaches out to turn the page of her textbook. Which component of her nervous system contains the highest level of control of her arm and hand action?

• A. Cerebral cortex
• B. Basal ganglia
• C. Brainstem
• D. Cerebellum

Correct answer: A

Rationale: The correct answer is A: Cerebral cortex. The cerebral cortex, particularly the motor cortex, is responsible for the voluntary control of precise movements such as turning a page. The cerebral cortex plays a crucial role in the highest level of control of motor functions, including those of the arm and hand. Choice B, Basal ganglia, is more involved in motor planning and coordination, while choice C, Brainstem, is responsible for basic life functions and reflexes. Choice D, Cerebellum, is primarily involved in coordination, precision, and accurate timing of movements, rather than the highest level of control for specific actions like page-turning.

2. When a Tae Kwon Do (TKD) master applies downward pressure just above the elbow joint on an attacker who immediately collapses to the ground, which reflex is applicable to this example?

• A. Golgi tendon reflex
• B. Myotatic reflex
• C. Withdrawal reflex
• D. Crossed-extensor reflex

Correct answer: A

Rationale: The Golgi tendon reflex is the correct answer. This reflex protects the muscle and tendons from excessive force by causing the muscle to relax. In this scenario, the downward pressure applied just above the elbow joint triggers the Golgi tendon reflex, resulting in the attacker's collapse. The other options are incorrect: - The myotatic reflex (also known as the stretch reflex) is responsible for contracting a muscle in response to its stretch, not relaxing it. - The withdrawal reflex is a spinal reflex that moves a body part away from a painful stimulus, not directly related to the scenario described. - The crossed-extensor reflex is a reflex that occurs on the opposite side of the body in response to a withdrawal reflex, which is not the case in this situation.

3. A client with diabetes mellitus has just undergone a right, below-the-knee amputation following gangrene infection. A few days after the amputation, the client confides in the nurse that he still feels his right foot. Knowing the pathophysiologic principles behind this, the nurse can:

• A. administer a psychotropic medication to help the client cope with the sensation of his amputated leg.
• B. explain that many amputees have this sensation and that one theory surmises the end of a regenerating nerve becomes trapped in the scar tissue of the amputation site.
• C. call the physician and request an order for a psychological consult.
• D. educate the client that this area has an unusually abnormal increase in sensitivity to sensation but that it will go away with time.

Correct answer: B

Rationale: The correct answer is B. The sensation of feeling the amputated limb is known as phantom limb pain, which is common after amputation. One theory suggests that it occurs because the end of a regenerating nerve becomes trapped in the scar tissue at the amputation site. Administering psychotropic medication (choice A) is not the first-line treatment for phantom limb pain. Requesting a psychological consult (choice C) is premature without first addressing the known pathophysiological basis of phantom limb pain. Educating the client that the sensitivity will go away with time (choice D) is not entirely accurate as phantom limb pain can persist long-term.

4. A female patient is prescribed medroxyprogesterone acetate (Provera) for dysfunctional uterine bleeding. What should the nurse include in the patient education?

• A. This medication may cause breakthrough bleeding or spotting.
• B. This medication may cause weight gain.
• C. This medication may increase your risk of developing diabetes.
• D. This medication may increase your risk of breast cancer.

Correct answer: A

Rationale: The correct answer is A. Medroxyprogesterone acetate (Provera) can cause breakthrough bleeding or spotting, which is a common side effect of this medication. Choices B, C, and D are incorrect because weight gain, increased risk of diabetes, and increased risk of breast cancer are not commonly associated side effects of medroxyprogesterone acetate. Therefore, the nurse should focus on educating the patient about the potential for breakthrough bleeding or spotting.

5. A patient is being treated for a severe fungal infection with amphotericin B. What is the expected length of treatment for this patient?

• A. 1 to 2 weeks
• B. 3 to 6 weeks
• C. 4 to 12 weeks
• D. 15 to 18 weeks

Correct answer: C

Rationale: The correct answer is C: '4 to 12 weeks.' Amphotericin B treatment duration for severe fungal infections typically ranges from 4 to 12 weeks. This extended period is necessary to ensure complete eradication of the fungal infection and prevent relapse. Choices A, B, and D provide durations that are either too short or too long for treating severe fungal infections effectively, making them incorrect.

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