A man who was found wandering in a park at 2 AM has been brought to the emergency department for an examination; he said he fell and hit his head. During the examination, the nurse asks him to use his index finger to touch the nurse's finger, then his own nose, then the nurse's finger again (which has been moved to a different location). The patient is clumsy, unable to follow the instructions, and overshoots the mark, missing the finger. The nurse should suspect which of the following?

Correct Answer: C

Rationale: The correct answer is C: Acute alcohol intoxication. The patient's inability to follow the finger-to-nose test and clumsiness are classic signs of cerebellar dysfunction, which is commonly seen in individuals under the influence of alcohol. Alcohol affects the cerebellum, leading to impaired coordination and balance. This is confirmed by the patient overshooting the mark and missing the target. The other choices (A, B, D) are less likely as they do not explain the patient's specific presentation and symptoms, which are indicative of acute alcohol intoxication.

Correct Answer: A

Rationale: The correct answer is A: increased concentration of neurotransmitters in the synaptic gap. MAOIs inhibit the enzyme monoamine oxidase, which breaks down neurotransmitters like serotonin, norepinephrine, and dopamine. By blocking this enzyme, MAOIs increase the levels of these neurotransmitters in the synaptic gap, enhancing their effects. This results in improved mood and decreased symptoms of depression or anxiety. Choice B is incorrect because MAOIs do not directly affect the concentration of neurotransmitters in the serum. Choice C is incorrect as MAOIs do not cause destruction of receptor sites. Choice D is incorrect because MAOIs do not directly stimulate the limbic system; rather, they modulate neurotransmitter levels to improve symptoms.

Correct Answer: D

Rationale: The correct answer is D: fluphenazine (Prolixin). Fluphenazine is a typical antipsychotic medication that exerts its effects by blocking dopamine receptors in the brain. This action leads to an increase in dopamine levels, which can cause anticholinergic side effects such as dry mouth, constipation, blurred vision, and urinary retention. The other choices, lithium (A), buspirone (B), and risperidone (C), do not typically exhibit significant anticholinergic side effects. Lithium is used to treat bipolar disorder, buspirone is an anxiolytic medication, and risperidone is an atypical antipsychotic that has a lower risk of causing anticholinergic effects compared to typical antipsychotics like fluphenazine.

Correct Answer: A

Rationale: The correct answer is A: Parkinson disease. Patients with Parkinson's disease are at increased risk of developing extrapyramidal side effects when taking antipsychotic medications. The nurse should closely monitor the patient for symptoms such as tremors, muscle rigidity, and bradykinesia. This is crucial to prevent worsening of Parkinson's symptoms. Incorrect options: B: Graves disease - Antipsychotic medications do not directly interact with Graves disease, so additional monitoring is not necessary. C: Osteoarthritis - Antipsychotic medications do not have a significant impact on osteoarthritis, so additional monitoring is not required. D: Epilepsy - While some antipsychotic medications can lower the seizure threshold, epilepsy is not directly related to the need for additional monitoring in this context.

Correct Answer: C

Rationale: The correct answer is C because acupuncture involves the insertion of needles to modulate the flow of energy along body meridians. This is based on the traditional Chinese medicine belief that the body has channels or meridians through which energy flows. By inserting needles at specific points, practitioners aim to correct imbalances in energy flow. Choice A is incorrect as acupuncture does not drain toxic energies. Choice B is incorrect as it mentions pressure on meridian points rather than needle insertion. Choice D is incorrect as it refers to a different concept, which is the principle of homeopathy, not acupuncture.