In a person with an upper motor neuron lesion such as a cerebrovascular accident, which of these physical assessment findings should the nurse expect?

Correct Answer: A

Rationale: The correct answer is A: Hyperreflexia. In upper motor neuron lesions like cerebrovascular accidents, there is disruption of inhibitory signals leading to increased reflex activity. This results in hyperreflexia, where reflexes are exaggerated. This occurs due to lack of inhibition from the brain on the spinal reflex arc. The other choices are incorrect because fasciculations (B) are seen in lower motor neuron lesions, loss of muscle tone and flaccidity (C) are characteristics of lower motor neuron lesions, and atrophy and wasting of muscles (D) occur due to disuse or denervation in lower motor neuron lesions, not in upper motor neuron lesions.

Correct Answer: A

Rationale: The correct answer is A: Computed tomography (CT) scan. In this scenario, a CT scan would be most appropriate as it can quickly identify signs of multiple infarctions, such as ischemic strokes, which can present similarly to dementia. A CT scan provides detailed images of the brain's structure, allowing for visualization of infarcts and helping differentiate between Alzheimer's disease and multiple infarctions. Reasons why other choices are incorrect: B: Positron emission tomography (PET) scan - PET scans are used to detect metabolic changes in the brain, which may not be as helpful in distinguishing between Alzheimer's disease and multiple infarctions. C: Functional magnetic resonance imaging (fMRI) - fMRI measures brain activity and may not be as effective in identifying structural abnormalities associated with infarctions. D: Single-photon–emission computed tomography (SPECT) scan - SPECT scans are useful for evaluating blood flow in the brain but may not provide

Correct Answer: B

Rationale: The correct answer is B: Dopamine-blocking effects. Restlessness and an uncontrollable need to be in motion are symptoms of extrapyramidal side effects, commonly caused by dopamine-blocking medications used to treat mental illness. Dopamine blockade can lead to an imbalance in the neurotransmitter system, resulting in movement disorders like akathisia. Anticholinergic effects (choice A) typically cause dry mouth and constipation, not restlessness. Endocrine-stimulating effects (choice C) would not manifest as restlessness. The ability to stimulate spinal nerves (choice D) is not directly related to the symptoms described.

Correct Answer: A

Rationale: The correct answer is A because clozapine can cause agranulocytosis, a serious condition where the body's white blood cell count drops significantly, leading to infections like sore throat and fever. Reporting these symptoms promptly is crucial for timely medical intervention. Choices B, C, and D are incorrect because they are not directly related to potential side effects or complications of clozapine therapy.

Correct Answer: D

Rationale: The correct answer is D: dopamine. Dopamine is implicated in the pathophysiology of schizophrenia, with increased dopamine activity thought to contribute to the positive symptoms of the disorder. This is supported by the effectiveness of antipsychotic medications that block dopamine receptors. GABA (A) is an inhibitory neurotransmitter, and its dysfunction is associated with anxiety disorders, not schizophrenia. Substance P (B) is primarily involved in pain perception and neurokinin receptors, not typically implicated in schizophrenia. Histamine (C) plays a role in the sleep-wake cycle and allergic responses, but is not a primary neurotransmitter involved in schizophrenia.