The ability that humans have to perform very skilled movements such as writing is controlled by the:

Correct Answer: B

Rationale: The correct answer is B: Corticospinal tract. The corticospinal tract is responsible for controlling voluntary skilled movements like writing. It carries motor commands from the primary motor cortex to the spinal cord, enabling precise movements of the hands and fingers. The basal ganglia (A) are involved in motor planning and coordination but not direct control of skilled movements. The spinothalamic tract (C) is responsible for transmitting sensory information related to pain and temperature, not motor control. The extrapyramidal tract (D) is involved in involuntary movements and posture regulation, not skilled movements like writing.

Correct Answer: D

Rationale: The correct answer is D because dissociative identity disorder (DID) is often linked to unresolved childhood abuse issues, leading to fragmentation of identity as a coping mechanism. This is supported by research showing a high prevalence of childhood trauma among individuals with DID. Option A is incorrect because it relates more to anxiety disorders. Option B is incorrect as it describes traits more associated with personality disorders. Option C is incorrect as it pertains to mood disorders like depression, which are not the primary etiology of DID.

Correct Answer: A

Rationale: In this scenario, option A, "I will avoid exercise because the pain gets worse," is the correct answer that indicates a need for additional teaching. This statement demonstrates a lack of understanding regarding the importance of exercise in managing chronic low back pain. Regular, appropriate exercise is actually beneficial in strengthening muscles, improving flexibility, and reducing pain. Option B, "I will use heat or ice to help control the pain," is a correct statement as both heat and ice can be used as part of a pain management plan for low back pain. Option C, "I will not wear high-heeled shoes at home or work," is also a correct statement as wearing high-heeled shoes can exacerbate back pain by altering posture and putting strain on the lower back. Option D, "I will purchase a firm mattress to replace my old one," is a correct statement as a firm mattress can provide better support for the back, especially for individuals with low back pain. Educationally, it is important to emphasize the role of exercise in managing chronic low back pain, along with other lifestyle modifications and therapies. Providing evidence-based information about the benefits of exercise and dispelling myths or misconceptions can empower patients to take an active role in their pain management and overall well-being.

Correct Answer: B

Rationale: In this scenario, the most crucial intervention is option B) Infuse ceftriaxone (Rocephin) 2000 mg IV to treat the infection. Bacterial meningitis is a life-threatening infection that requires urgent treatment with appropriate antibiotics to prevent serious complications and reduce mortality. Prompt initiation of antibiotics is essential to target the causative organism and halt the progression of the infection within the central nervous system. Option A) Administer codeine 15 mg orally for the patient's headache is incorrect because although pain management is important, addressing the underlying infection takes precedence in this situation. Option C) Give acetaminophen (Tylenol) 650 mg orally to reduce the fever is also incorrect as reducing fever alone does not treat the underlying cause of bacterial meningitis, which is the infection. Option D) Give furosemide (Lasix) 40 mg IV to decrease intracranial pressure is not the priority intervention as reducing intracranial pressure may be necessary in some cases of meningitis, but addressing the infection with antibiotics is the primary focus in bacterial meningitis management. Educationally, this question emphasizes the importance of understanding the urgent nature of treating bacterial meningitis with appropriate antibiotics to prevent serious neurological complications and improve patient outcomes. It highlights the necessity of prioritizing interventions based on the urgency of the patient's condition and the underlying pathophysiology.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) problems in reading. Nystagmus and diplopia are visual disturbances that can occur as side effects of anticonvulsants. Nystagmus is an involuntary eye movement that can cause difficulty in focusing on objects, leading to problems in reading. Diplopia, or double vision, can also make reading challenging as the individual sees two images instead of one. Option A) drowsiness is a common side effect of anticonvulsants, but it is not directly related to nystagmus and diplopia. Drooping eyelids (Option B) could indicate ptosis, which is not typically associated with nystagmus and diplopia caused by anticonvulsants. Excessive tearing (Option D) is more commonly associated with conditions like allergies or eye irritation, rather than nystagmus and diplopia. In an educational context, understanding the side effects of medications is crucial for nurses to provide safe and effective care to their patients. Recognizing symptoms like nystagmus and diplopia can help nurses intervene early, prevent complications, and improve the quality of care provided to patients taking anticonvulsants.