Priority Decision: The patient was in a traffic collision and is experiencing loss of function below C4. Which effect must the nurse be aware of to provide priority care for the patient?

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Loss of all respiratory muscle function. When a patient experiences loss of function below C4 after a traumatic event like a traffic collision, it can lead to impaired respiratory muscle function. The nurse must be aware of this effect as it poses an immediate threat to the patient's life due to the potential for respiratory failure. Option A) Respiratory diaphragmatic breathing is not the priority concern in this situation because the patient is experiencing loss of function below C4, which would impact the function of the respiratory muscles, not just the diaphragm. Option C) Decreased response of the sympathetic nervous system is not the priority because the immediate threat to the patient's life is the potential loss of respiratory muscle function leading to respiratory compromise. Option D) GI hypomotility with paralytic ileus and gastric distention is not the priority concern in this case as the patient's respiratory status takes precedence over gastrointestinal issues. In an educational context, understanding the hierarchy of priorities in assessing and managing patients with neurological injuries is crucial for nurses. Rapid identification of respiratory compromise in patients with spinal cord injuries is essential to prevent further complications and ensure timely interventions to maintain adequate oxygenation and ventilation.

Correct Answer: C

Rationale: In this question, the correct answer is C) Shortening of a muscle or ligament. A contracture refers to a condition where there is a permanent shortening of a muscle or joint, leading to limited movement in that area. This is commonly seen in patients with neurological conditions or prolonged immobility. Option A) A fluid-filled cyst is incorrect because a contracture does not involve a cyst but rather a structural change in the muscle or ligament. Option B) Generalized muscle pain is incorrect as it does not accurately describe a contracture, which is specifically related to the shortening of a muscle or ligament. Option D) Grating sensation between bones with movement is incorrect as it describes a symptom commonly associated with conditions like osteoarthritis, not a contracture. In an educational context, understanding the term "contracture" is crucial for nurses assessing patients with neurological conditions, musculoskeletal issues, or those at risk for immobility-related complications. Recognizing a contracture allows nurses to implement appropriate interventions to prevent further limitations in movement and promote optimal patient outcomes.

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.