A patient has a lesion involving the fasciculus gracilis and fasciculus cuneatus of the spinal cord. What should the nurse expect the patient to experience the loss of?

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Touch, deep pressure, vibration, and position sense. The fasciculus gracilis and fasciculus cuneatus are ascending pathways in the spinal cord responsible for transmitting sensory information such as touch, deep pressure, vibration, and position sense from the body to the brain. If there is a lesion affecting these pathways, the patient would likely experience a loss of these specific sensory modalities. Option A) Pain and temperature sensations are carried by the spinothalamic tract, which is separate from the fasciculus gracilis and fasciculus cuneatus. Therefore, this option is incorrect. Option C) Subconscious information about body position and muscle tension is primarily mediated by the spinocerebellar tracts, not the fasciculus gracilis and fasciculus cuneatus. Hence, this option is incorrect. Option D) Voluntary muscle control from the cerebral cortex to the peripheral nerves involves the corticospinal tracts, which are also distinct from the pathways affected by a lesion in the fasciculus gracilis and fasciculus cuneatus. Therefore, this option is incorrect. Understanding the specific functions of different spinal cord pathways is crucial for healthcare professionals, especially nurses, in assessing and interpreting sensory deficits in patients. This knowledge helps in providing appropriate care and interventions to address the patient's needs effectively.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Heart rate of 42 bpm. When a patient sustains a spinal cord injury at the level of T2, it can lead to autonomic dysreflexia, a potentially life-threatening condition. A sudden increase in blood pressure can stimulate the vagus nerve, causing bradycardia (slow heart rate). This response is a critical indication of autonomic dysreflexia. Option A) SpO2 of 92% is suboptimal but does not pose an immediate threat compared to a bradycardia. Option C) Blood pressure of 88/60 mm Hg is low but can be a normal response to the injury and not as concerning as the bradycardia. Option D) Loss of motor and sensory function in arms and legs, while significant, is an expected outcome of a spinal cord injury at T2 and is not as acutely dangerous as bradycardia in this context. Educationally, understanding the specific complications of spinal cord injuries, such as autonomic dysreflexia, is crucial for nurses caring for these patients. Recognizing the signs and symptoms of autonomic dysreflexia promptly is vital to prevent severe complications and provide timely interventions. This question highlights the importance of prioritizing assessments based on the potential for immediate harm in patients with spinal cord injuries.

Correct Answer: C

Rationale: In this NCLEX question related to the neurological system, the correct answer is C) Osteoblast. Osteoblasts are bone-forming cells responsible for bone formation through the process of osteogenesis. They play a crucial role in bone remodeling and repair. Osteocytes (A) are mature bone cells that maintain bone tissue but do not actively form new bone. Osteoclasts (B) are responsible for bone resorption, breaking down bone tissue. Sarcomere (D) is a structural unit of myofibrils in muscle cells, not related to bone formation. Understanding the function of each type of bone cell is essential in the context of the neurological system as bones provide support and protection for the nervous system. Knowing the roles of osteoblasts, osteocytes, and osteoclasts is fundamental for nurses and healthcare professionals in managing patients with neurological conditions that may affect bone health. This knowledge is crucial for providing holistic care and understanding the implications of neurological disorders on bone integrity.

Correct Answer: B

Rationale: In the case of a patient diagnosed with torticollis, the correct action for the nurse to provide is option B) Exercises to increase the strength of the muscles. Torticollis, also known as wry neck, is a condition characterized by a twisted or tilted neck due to involuntary muscle contractions. By engaging in specific exercises, the patient can help improve muscle strength and flexibility, which can alleviate the symptoms of torticollis over time. Option A) An immobilizer to hold the bones in place is incorrect because torticollis is primarily a muscular issue rather than a problem with bones that need immobilization. Using an immobilizer would not address the underlying cause of the condition. Option C) A pillow to use to support the knees while sleeping and Option D) Enough pillows to support the patient's head comfortably are also incorrect as they do not directly target the muscles of the neck that are affected in torticollis. While supportive pillows may provide some comfort, they do not address the need for muscle strengthening to improve the condition. From an educational standpoint, understanding the rationale behind the correct answer not only reinforces knowledge of torticollis but also highlights the importance of non-pharmacological interventions such as exercises in managing musculoskeletal conditions. Nurses play a vital role in educating patients on self-care strategies like exercises, empowering them to actively participate in their treatment and recovery process.

Correct Answer: D

Rationale: In the emergency department, the priority intervention for a patient with a stroke is option D, which is the maintenance of respiratory function with a patent airway and oxygen administration. This is crucial because adequate oxygenation is essential for brain function and to prevent further damage in a patient experiencing a stroke. The other options are not the priority interventions for a stroke patient in the emergency department. Option A, intravenous fluid replacement, may be necessary but is not the immediate priority in a stroke situation. Option B, administration of osmotic diuretics, is not the first-line intervention and is typically used later in stroke management. Option C, initiation of hypothermia, is not a standard intervention for stroke in the acute setting. Educationally, it is important for healthcare providers to understand the critical nature of maintaining respiratory function in stroke patients to optimize oxygen delivery to the brain. This knowledge is essential for providing effective care and improving patient outcomes in stroke management. It is vital for nurses and other healthcare professionals to prioritize interventions based on the immediate needs of the patient to ensure the best possible outcome.