The nurse is performing an assessment on a 29-year-old woman who visits the clinic complaining of 'always dropping things and falling down.' While testing rapid alternating movements, the nurse notices that the woman is unable to pat both of her knees. Her response is extremely slow and she frequently misses. What should the nurse suspect?

Correct Answer: C

Rationale: The correct answer is C: Dysfunction of the cerebellum. The cerebellum is responsible for coordinating voluntary movements, including rapid alternating movements. In this case, the woman's inability to pat both of her knees rapidly and accurately suggests a dysfunction in her cerebellum. Vestibular disease (A) would present with issues related to balance and coordination, not specifically rapid alternating movements. Lesion of CN IX (B) would affect the glossopharyngeal nerve, which is not directly related to motor coordination. Inability to understand directions (D) would not explain the physical difficulty observed during the assessment.

Correct Answer: B

Rationale: The correct answer is B: Increased intracranial pressure. The sudden change in pupil size and reactivity indicates a neurological emergency, likely due to increased pressure within the skull. The dilated and nonreactive pupil on the right side (anisocoria) is a sign of uncal herniation, a life-threatening condition where brain structures shift and compress the third cranial nerve. The left pupil's normal size and reaction indicate that it is still functioning properly. This asymmetrical pupil response is a classic sign of elevated intracranial pressure. Choices A, C, and D are incorrect because they do not account for the specific neurological findings observed in this scenario.

Correct Answer: A

Rationale: The correct answer is A: Cerebrum. The cerebrum is responsible for higher brain functions, including cognition, perception, and awareness of surroundings. Orientation to surroundings involves awareness of time, place, and person, which are cognitive functions controlled by the cerebrum. The cerebellum (B) controls coordination and balance, not orientation. The CNS (C) includes the brain and spinal cord, but specifically, the cerebrum is responsible for orientation. The medulla oblongata (D) regulates vital functions like breathing and heart rate, not orientation. Thus, choice A is correct as it directly relates to cognitive functions necessary for orientation.

Correct Answer: C

Rationale: The correct answer is C because discussing the potential impact of the patient's family history of stroke is crucial in understanding her risk factors. By encouraging lifestyle changes, such as maintaining a healthy diet and regular exercise, the nurse can help reduce the patient's risk of stroke. This approach aligns with preventive care and empowers the patient to take control of her health. Choices A and D are incorrect because stopping medications or recommending immediate surgery without proper assessment and consultation with healthcare providers could be harmful and unnecessary. Choice B is incorrect as family history is a known risk factor for stroke, and it is essential to address this risk factor and educate the patient on how it may impact her health.

Correct Answer: A

Rationale: The correct answer is A: Reduced anxiety. GABA is an inhibitory neurotransmitter that helps calm the brain, reducing anxiety. By potentiating GABA's action, the medication would enhance its calming effect, leading to reduced anxiety. Improved memory (B), more organized thinking (C), and fewer sensory perceptual alterations (D) are unlikely because GABA primarily influences anxiety and relaxation, not memory, cognitive organization, or sensory perception.