A patient with a metastatic tumor of the spinal cord is scheduled for removal of the tumor by a laminectomy. In planning postoperative care for the patient, what should the nurse recognize?

Correct Answer: B

Rationale: In this scenario, option B is the correct answer. Metastatic tumors of the spinal cord are commonly extradural lesions, meaning they are located outside the spinal cord and are typically treated palliatively. This is because complete removal of these tumors may not be possible due to their location and the potential risks involved in trying to remove them entirely. Option A is incorrect because most cord tumors do not cause autodestruction of the cord as in traumatic injuries. Option C is incorrect because radiation therapy is not routinely administered following surgery for all malignant spinal cord tumors; the decision to use radiation therapy would depend on the specific case and treatment plan. Option D is incorrect because while surgery for intramedullary tumors may be considered palliative in some cases, it is not always the case for all spinal cord tumors. Educationally, understanding the nature of spinal cord tumors and their treatment options is crucial for nurses caring for patients undergoing surgeries like laminectomies. It is important for nurses to recognize the differences in treatment approaches for various types of spinal cord tumors to provide optimal postoperative care and support for their patients.

Correct Answer: C

Rationale: In the context of neurological system assessment and stroke prevention, the correct answer to the question is option C) Daily low-dose aspirin. This is because aspirin, specifically in low doses, is a well-established medication for reducing the risk of ischemic stroke in patients with TIAs (transient ischemic attacks) and other risk factors. Aspirin works by inhibiting platelet aggregation, thereby reducing the formation of blood clots that can lead to blockages in the blood vessels supplying the brain, causing an ischemic stroke. Option A) Furosemide (Lasix) is a diuretic often used to manage fluid retention but does not play a role in stroke prevention. Option B) Lovastatin (Mevacor) is a statin medication used to lower cholesterol levels and prevent cardiovascular events but is not specifically indicated for stroke prevention. Option D) Nimodipine (Nimotop) is a calcium channel blocker that is used in certain situations related to subarachnoid hemorrhage but is not the recommended medication for reducing the risk of ischemic stroke in patients with TIAs. In an educational context, understanding the appropriate medications for stroke prevention is crucial for healthcare professionals involved in assessing and managing patients at risk for cerebrovascular events. By knowing the rationale behind the use of daily low-dose aspirin in this population, healthcare providers can make informed decisions to optimize patient care and reduce the incidence of ischemic strokes. It is essential to reinforce the importance of evidence-based practice and staying updated on current guidelines to deliver high-quality care to patients at risk for stroke.

Correct Answer: D

Rationale: The correct answer is D) Specific serotonin receptor agonists such as sumatriptan (Imitrex) for acute migraine and cluster headaches. Sumatriptan works by binding to serotonin receptors in the brain, causing vasoconstriction of the dilated blood vessels that contribute to headache pain. This helps to interrupt the migraine or cluster headache process at the neurochemical level, providing relief. Option A) β-Adrenergic blockers like propranolol are typically used for migraine prevention, not for acute treatment. Option B) Serotonin antagonists like methysergide are not commonly used anymore due to side effects and availability of more effective treatments. Option C) Tricyclic antidepressants such as amitriptyline can be used for migraine prevention, but they do not directly target the pathophysiologic process of acute migraine or cluster headaches. Educationally, understanding the rationale behind specific drug therapies for different types of headaches is crucial for healthcare providers to effectively manage and treat patients with these conditions. This knowledge helps in making informed decisions regarding appropriate medications based on the underlying pathophysiology of the headache disorder.

Correct Answer: B

Rationale: In assessing Parkinson's disease, the correct answer is B) relief of symptoms with administration of dopaminergic agents. This is the gold standard for confirming Parkinson's disease as it is a neurodegenerative disorder characterized by dopamine deficiency in the brain. Dopaminergic agents help alleviate symptoms by increasing dopamine levels. Option A) CT and MRI scans are not typically used to confirm Parkinson's disease as they do not directly show the specific dopamine deficiency that characterizes the disease. These imaging techniques may be used to rule out other conditions that could present with similar symptoms. Option C) the presence of tremors that increase during voluntary movement is a common symptom of Parkinson's disease, but it is not specific enough to confirm the diagnosis on its own as other conditions can also cause tremors. Option D) cerebral angiogram revealing cerebral atherosclerosis is unrelated to Parkinson's disease. Parkinson's is not caused by atherosclerosis, but rather by the degeneration of dopamine-producing cells in the brain. Educationally, understanding the diagnostic criteria for Parkinson's disease is crucial for healthcare providers to accurately identify and manage patients with this condition. Knowing the importance of dopaminergic agents in symptom relief helps in providing appropriate treatment and improving patient outcomes. It is also essential to differentiate Parkinson's disease from other conditions with similar symptoms to ensure proper management and care.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Self-care activities. When assessing the neurological system, the nurse must consider the impact on the patient's ability to perform self-care activities such as grooming, bathing, toileting, and dressing. Neurological conditions can affect motor skills, coordination, and cognitive function, making it challenging for patients to engage in these activities independently. Option A) Eating could be impacted by neurological conditions, but it is not the most comprehensive answer in terms of addressing the patient's overall self-care needs. Option B) Walking focuses on mobility, which is also important but does not encompass the full range of self-care activities. Option C) Dressing is a specific aspect of self-care, but choosing option D) demonstrates a broader understanding of the patient's holistic needs. In an educational context, understanding the impact of neurological conditions on self-care activities is crucial for nurses to provide comprehensive and patient-centered care. By selecting option D), nurses demonstrate their ability to assess the patient's functional abilities comprehensively and identify areas where the patient may require assistance or accommodations. This knowledge is essential for developing individualized care plans and promoting the patient's independence and quality of life.