A patient presents with progressive weakness, muscle atrophy, and fasciculations, primarily involving the upper and lower extremities. Over time, the patient develops dysphagia and dysarthria. Which of the following neurological conditions is most likely responsible for these symptoms?

Correct Answer: C

Rationale: The symptoms described, including progressive weakness, muscle atrophy, fasciculations, dysphagia, and dysarthria primarily involving the upper and lower extremities, are classic features of amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease. ALS is a progressive neurodegenerative disorder that affects the motor neurons in the brain and spinal cord, leading to muscle weakness and atrophy. As the disease progresses, patients may develop difficulty swallowing (dysphagia) and speaking (dysarthria). In contrast, Parkinson's disease primarily involves movement-related symptoms such as tremors, muscle stiffness, and slow movements. Guillain-Barré syndrome (GBS) is an acute inflammatory demyelinating polyneuropathy that typically presents with ascending weakness and sensory abnormalities, often preceded by an infection. Myasthenia gravis is characterized by muscle weakness exacerbated by

Correct Answer: C

Rationale: The most commonly associated adverse effect with ACE inhibitors is a dry cough. This cough is non-productive and can be quite bothersome for patients, often leading to non-compliance with the medication. The cough is thought to be due to the accumulation of bradykinin and substance P, which are vasodilatory and bronchoconstrictive peptides that are normally degraded by ACE. When ACE is inhibited, these peptides accumulate and can lead to irritation of the respiratory tract, resulting in the dry cough. It's important for healthcare providers to be aware of this common side effect and consider alternative medications if the cough becomes problematic for the patient.

Correct Answer: D

Rationale: The most appropriate oxygen delivery device for a patient with chronic respiratory failure secondary to severe restrictive lung disease requiring continuous supplemental oxygen is a non-rebreather mask. A non-rebreather mask is designed to deliver high-flow oxygen and is typically used for short-term medical treatment in emergency situations or for critically ill patients. It is ideal for providing the highest concentration of oxygen available for inhalation, making it suitable for patients with severe hypoxemia.

Correct Answer: D

Rationale: The patient's presentation of central obesity, moon face, buffalo hump, purple striae, and elevated cortisol levels strongly suggest Cushing's syndrome. Cushing's syndrome is a disorder characterized by excessive levels of cortisol, either due to an endogenous (e.g., adrenal tumor) or exogenous (e.g., prolonged steroid use) source. The classic physical features of Cushing's syndrome include central obesity with thin extremities (truncal obesity), moon face (rounding and reddening of the face), buffalo hump (accumulation of fat between the shoulders), and purple striae (stretch marks that are wide and purple in color). In the context of the elevated cortisol levels, these clinical signs are highly indicative of Cushing's syndrome. Hyperthyroidism, hypothyroidism, and diabetes mellitus would not typically present with the specific combination of symptoms described.

Correct Answer: C

Rationale: Calcium is essential for maintaining strong and healthy bones. Osteoporosis is a condition characterized by weakened bones, making them more prone to fractures. Consuming calcium-rich foods such as dairy products, leafy greens, and fortified foods can help prevent osteoporosis development. Additionally, incorporating calcium supplements under the guidance of a healthcare provider can further support bone health and reduce the risk of osteoporosis. Regular intake of adequate calcium is considered a crucial preventive measure for osteoporosis.

Correct Answer: C

Rationale: The correct response for the nurse in this situation would be to offer the victim a shower after evidence is collected. It is essential to preserve any physical evidence that may be present from the assault during the forensic examination. Allowing the victim to shower before evidence is collected could potentially compromise the evidence and hinder the investigation. The nurse should provide support to the victim during this difficult time and assure them that they will have the opportunity to shower once the necessary evidence is obtained. It is also crucial for the nurse to offer empathy and understanding while explaining the importance of preserving any evidence related to the assault.

Correct Answer: E

Rationale: All of the statements (A-D) are true when discussing the testing of vision in infants and children separately from testing in adults. However, statement E is NOT true. The course of visual and cognitive development MUST be taken into account in evaluating infants and children's visual abilities. It is crucial to consider the stage of development a child is in when evaluating their vision, as their visual abilities can change rapidly during early childhood. Ignoring the course of development could lead to incorrect assessments and misunderstandings about the child's visual capabilities.

Correct Answer: C

Rationale: The barrier to goal setting between the nurse and the family in this scenario is the failure of the family to perceive the existence of the problem. Goal setting in healthcare generally requires mutual agreement and understanding between the healthcare provider (nurse) and the patient/family. If the family does not perceive that there is an existing problem that needs to be addressed, there will likely be resistance or lack of motivation to set goals and work towards resolving the issue. This barrier can hinder effective communication, collaboration, and ultimately, the successful achievement of healthcare goals. It is important for the nurse to address this barrier through education, communication, and building trust to ensure that all parties are on the same page and actively participate in goal setting and care planning.

Correct Answer: A

Rationale: The nurse should prioritize ensuring proper zeroing and calibration of the ICP monitoring system to ensure procedural accuracy and reliability of the measurements obtained. Proper zeroing involves setting the transducer at the level of the patient's external auditory meatus (ear), which serves as a reference point for accurate ICP readings. Calibration is necessary to establish accurate pressure measurements. Incorrect zeroing or calibration can lead to inaccurate ICP readings, which can impact clinical decision-making for patients with traumatic brain injury. Positioning the patient in a high-Fowler's position, administering prophylactic antibiotics, or placing the ICP monitor in the subarachnoid space via lumbar puncture are not directly related to ensuring the accuracy of the ICP monitoring procedure.