During an assessment of a 32-year-old patient with a recent head injury, the nurse notices that the patient responds to pain by extending, adducting, and internally rotating his arms. His palms pronate, and his lower extremities extend with plantar flexion. Which statement concerning these findings is most accurate? This patient's response:

Correct Answer: D

Rationale: The correct answer is D. These decerebrate posturing responses are indicative of dysfunction in the brainstem. Specifically, the abnormal posturing seen in the patient suggests damage to the midbrain or pons. This type of response is considered a more severe sign compared to decorticate posturing, which typically indicates damage to the cerebral cortex. Decerebrate posturing is associated with a poorer prognosis and can be a sign of significant neurological injury. The other choices are incorrect: A: Indicates a lesion of the cerebral cortex - This is incorrect because the patient's response is indicative of brainstem, not cortical, dysfunction. B: Indicates a completely nonfunctional brainstem - This is an extreme and inaccurate statement. The patient is exhibiting specific posturing responses, indicating some brainstem function. C: Is normal and will go away in 24 to 48 hours - This is incorrect as the described response is a pathological sign, not a normal one, and requires medical attention.

Correct Answer: B

Rationale: The correct answer is B because it provides a clear and accurate definition of neurotransmitters as chemicals that pass messages between brain cells. This response addresses the patient's question directly and in a simple, understandable manner. The other choices are incorrect because: A: This choice assumes the patient's emotional state without addressing the question about neurotransmitters. C: This choice deflects the question back to the doctor without providing any useful information to the patient. D: This choice provides incorrect information about neurotransmitters, as they are not substances we eat daily but rather chemicals in the brain.

Correct Answer: A

Rationale: The correct answer is A: parasympathetic nervous system. Anticholinergic medications block acetylcholine, affecting the parasympathetic nervous system which controls rest and digest functions. Other choices are incorrect because anticholinergics do not directly affect sympathetic nervous system (B), reticular activating system (C), or medulla oblongata (D).

Correct Answer: D

Rationale: The correct answer is D. Phenothiazine medications have a strong dopaminergic effect, which can lead to extrapyramidal side effects like muscle stiffness. This is due to the dopamine blockade by the drug. Therefore, the nurse should instruct the patient to report any muscle stiffness promptly to monitor for potential adverse effects. Choices A, B, and C are incorrect because they do not directly address the specific side effect related to the drug's dopaminergic effect. Chew sugarless gum and increase dietary fiber are more related to gastrointestinal side effects, while arising slowly from bed is typically advised for orthostatic hypotension, not muscle stiffness from dopaminergic effects.

Correct Answer: C

Rationale: The correct answer is C: orthostatic hypotension. Blocking norepinephrine attachment to alpha1 receptors can lead to vasodilation, causing a sudden drop in blood pressure upon standing (orthostatic hypotension). This is a common side effect of alpha1 receptor blockers like some psychotropic medications. Increased psychotic symptoms (A) would not be a direct result of blocking norepinephrine attachment to alpha1 receptors. Severe appetite disturbance (B) is not typically associated with this mechanism of action. Hypertensive crisis (D) would be unlikely since blocking norepinephrine attachment to alpha1 receptors would lead to decreased blood pressure, not increased.