Unit 5 Chapter 13 Path Flashcards
The nurse is performing a test to determine a client’s neurologic function related to a suspected lesion in the parietal lobe. What would the nurse determine is a normal finding after assessment?
A) The client is able to correctly distinguish visual cues.
B) The client is able to determine correctly that the item placed in his hand is a paper clip.
C) The client is able to stand on both feet and put his finger to his nose.
D) The client is able to hear the words and repeat them to the nurse.
B) The client is able to determine correctly that the item placed in his hand is a paper clip
Rationale:Localized lesions of the parietal lobe can result in the inability to recognize the meaningfulness of an object (a condition called agnosia). With the person’s eyes closed, a screwdriver can be felt and described as to shape and texture. Nevertheless, the person cannot integrate the sensory information required to identify it as a screwdriver.
A client has sustained damage to cranial nerve VIII. The nurse recognizes that the client may experience difficulty with:
A) Smell
B) Motor
C) Taste
D) Hearing
D) Hearing
Rationale:Cranial nerve VIII (vestibulocochlear nerve) is associated with hearing. The other options involve different nerves.
What is the role of a neuromodulator when it acts on a postsynaptic receptor?
A) Produces slower and longer-lasting changes in membrane excitability
B) Rapidly removes a neurotransmitter once it excretes its effects
C) Synthesizes and stores potent neurotransmitters
D) Maintains the long-term survival of the postsynaptic cell
A) Produces slower and longer-lasting changes in membrane excitability
Rationale:The neuromodulators react with presynaptic or postsynaptic receptors to alter the release of or response to neurotransmitters. With postsynaptic receptors, they produce slower and longer-lasting changes in membrane excitability.
The nurse is caring for a client who has damage to the facial nerve (CN VII). What complication related to unilateral loss of a branch of the facial nerve function should the nurse closely assess for?
A) Unilateral, severe pain from inflammation of the nerve
B) Laryngeal obstruction
C) Loss of ability to accomodate
D) Eye dryness with risk for corneal scarring
D) Eye dryness with risk for corneal scarring
Rationale:Loss of this CN VII nerve function or damage to the nerve can result in eye dryness with risk of corneal scarring and blindness. Medial strabismus from loss of eye abduction is due to damage to the abducens nerve (CN VI). This results in loss of blinking control on the affected side. Unilateral, severe pain from inflammation of the nerve results from trigemnial nerve damage. Laryngeal obstruction is a result from damage to the vagus nerve (CN X).
A client had a sleep study performed and was diagnosed with sleep apnea. What part of the brain is the nurse aware is most likely affected, causing this disorder?
A) Parietal lobe
B) Hindbrain
C) Occipital lobe
D) Frontal lobe
B) Hindbrain
Rationale:The hindbrain consists of the metencephalon (cerebellum and pons) and the myelencephalon (medulla oblongata). Sleep disorders and cerebrovascular accidents are disorders that frequently affect the hindbrain. This area of the brain assists in managing motor activity, posture, and major functions such as respirations and circulation of blood.
Activation of the parasympathetic nervous system has occurred. The nurse would assess the client for:
A) Decreased urine output
B) Elevated heart rate
C) Organ function
D) Increased respiratory rate
C) Organ function
Rationale:The parasympathetic nervous system is concerned with conservation of energy, resource replenishment, and maintenance of organ function during periods of minimal activity. The sympathetic division maintains vital functions and responds when there is a critical threat to the integrity of the individual—the “fight-or-flight” response. Conservation of urine is an SNS response/adaptation.
Which types of cells are supporting cells of the peripheral nervous system?
A) Ependymal cells
B) Schwann cells
C) Oligodendrocytes
D) Astrocytes
B) Schwann cells
Rationale:The Schwann cells play an important role in supporting the peripheral nervous system. The other cells support the central nervous system.
A client has developed shock and the physician has instructed the nurse to begin the administration of intravenous dopamine. The nurse anticipates that the medication will:
A) cause vasoconstriction of the splanchnic vessels.
B) cause alteration in the level of consciousness.
C) cause vasodilatation of the coronary blood vessels.
D) cause vasoconstriction of the renal system.
C) cause vasodilatation of the coronary blood vessels.
Rationale:Dopamine, which is an intermediate compound in the synthesis of norepinephrine, also acts as a neurotransmitter. It is the principal inhibitory transmitter of interconnecting neurons in the sympathetic ganglia. It also has vasodilator effects on renal, splanchnic, and coronary blood vessels when given intravenously and is sometimes used in the treatment of shock. Level of consciousness is not affected.
A client has experienced the α1-receptor stimulation. The nurse would assess the client for:
A) Vasoconstriction
B) Vasodilatation
C) Decreased level of consciousness
D) No response
A) Vasoconstriction
Rationale:The α1 receptors are primarily found in postsynaptic effector sites; they mediate responses in vascular smooth muscle. It causes vasoconstriction in many blood vessels, including those of the skin, gastrointestinal tract, kidney, and brain.
In which phases of the action potential are there movement in and out of sodium and potassium? Select all that apply.
A) Repolarization
B) Hyperpolarization
C) Polarization
D) Depolarization
A) Repolarization
D) Depolarization
Rationale:The ion gate is open or closed during the polarization stage of action potential when the threshold potential is met. The other stages allow movements in and out of sodium and potassium.
A client awakes after being in a coma several days following a traumatic head injury. The client is able to give the family a detailed account of what was said at the bedside while theclient was in a coma. The family asks the nurse, “How is this possible?” Which response is most accurate?
A) “The thalamus can interpret highly emotional auditory experiences and remember them.”
B) “The hypothalamus can integrate the homeostatic control of the body’s internal environment.”
C) “The speech center is near where the client’s injury occurred, so it is very sensitive at this time.”
D) “The hypothalamus is part of the ventral horn that has an amazing ability to remember detail.”
A) “The thalamus can interpret highly emotional auditory experiences and remember them.”
Rationale:The thalamus is divided into distinct nuclei, which are the major relay stations for informaton going to and from the cerebral cortex. All sensory pathways have direct projections to thalamic nuclei, which conveys the information to restricted areas of the sensory cortex. Coordination and integration of peripheral sensory stimuli occur in the thalamus, along with some crude interpretation of highly emotional-laden auditory experiences that not only occur but can be remembered. For example, a person can recover from a deep coma in which cerebral cortex activity is minimal and remember some of what is said at the bedside.
Which parts of the brain make up the brain stem?
A) Circle of Willis and hypothalamus
B) Cerebellum and reticular system
C) Pons and medulla oblongata
D) Limbic and diencephalons
C) Pons and medulla oblongata
Rationale:The brain stem consists of the pons and the medul
A client asks the nurse when during embryonic growth the nervous system develops. The best response would be:
A) Week 12
B) Week 6
C) Week 15
D) Week 3
D) Week 3
Rationale:The nervous system appears very early in week 3 of embryonic development, around 22 to 23 days’ gestation. This early development is essential because it influences the development and organization of many other body systems, including the axial skeleton, skeletal muscles, and sensory organs (such as the eyes and ears).
Neuromodulators can produce slower and longer-lasting changes in membrane excitability by acting on postsynaptic receptors. What do neuromodulators do?
A) Alter the metabolic function of Schwann cells
B) Alter the ligand gate response to electrical activity
C) Alter the inhibitory response of postsynaptic electrical receptors
D) Alter the release of, or response to, neurotransmitters
D) Alter the release of, or response to, neurotransmitters
Rationale:Neuromodulator molecules react with presynaptic or postsynaptic receptors to alter the release of, or response to, neurotransmitters.
Which drug, administered by the nurse to a client with a heart rate of 40 and syncope, is a muscarinic blocking drug that will increase the heart rate?
A) Atropine
B) Lidocaine
C) Dopamine
D) Epinephrine
A) Atropine
Rationale:The drug atropine is an antimuscarinic or muscarinic cholinergic blocking drug that prevents the action of acetylcholine at excitatory and inhibitory muscarinic receptor sites. Because it is a muscarinic blocking drug, it exerts little effect at nicotinic receptor sites. Dopamine and epinephrine are both catecholamines, not muscarinic receptors.
