ATI LPN
Neurological Disorders in Medical Surgical Nursing Questions
Question 1 of 5
Which neurotransmitter is released by both rods and cones at their synapses with bipolar cells?
Correct Answer: C
Rationale: Rods and cones release glutamate to synapse with bipolar cells. TMP13 p. 655
Question 2 of 5
A female patient who had a stroke 24 hours ago has expressive aphasia. An appropriate nursing intervention to help the patient communicate is to
Correct Answer: A
Rationale: Communication will be facilitated and less frustrating to the patient when questions that require a 'yes' or 'no' response are used. When the language areas of the brain are injured, the patient might not be able to read or recite words, which will frustrate the patient without improving communication. Expressive aphasia is caused by damage to the language areas of the brain, not by the areas that control the motor aspects of speech. The nurse should allow time for the patient to respond.
Question 3 of 5
A patient has had a cerebral hemorrhage and is unconscious. Which of the following is the priority intervention?
Correct Answer: C
Rationale: In an unconscious patient with cerebral hemorrhage, airway protection is the priority. Suctioning saliva prevents aspiration, which could worsen the condition. Passive ROM, electrolyte monitoring, and documentation are secondary to maintaining a patent airway.
Question 4 of 5
A 38-year-old female presents with muscle fatigue that is worse by the end of the day. She reports to have myalgias in the back of her neck, and at times her head 'drops.' She also states to sees 'double' when watching television, or reading for a prolonged period of time. On physical examination, ptosis is produced when asking the patient to look at the ceiling without blinking. Pupillary function is intact. Appropriate serologic testing is obtained. On repetitive nerve stimulation, the amplitude of the compound muscle action potential progressively declines. Which of the following is most likely the diagnosis?
Correct Answer: D
Rationale: Fatiguable weakness, ptosis, diplopia, and declining CMAP amplitude on repetitive stimulation are classic for myasthenia gravis, a postsynaptic neuromuscular junction disorder. Botulism involves descending paralysis, Lambert-Eaton improves with repetition, AIDP (Guillain-Barre) is acute with areflexia, and MS involves CNS demyelination.
Question 5 of 5
A 69-year-old male presents with abnormal speech and right-sided weakness. While eating lunch with his wife, he suddenly could not move his right arm or leg, and was unable to speak. They arrived to the emergency department within minutes. His wife currently reports improvement from when the symptoms first began, and he is almost back to normal when examined 1 hour later. Past medical history is significant for hypertension and type 2 diabetes mellitus. He has smoked 1 pack of cigarettes daily for 45 years. Non-contrast head CT is shown. Diffusion-weighted image MRI shows no sign of infarction. CT angiogram of the neck shows 72% stenosis of the left internal carotid artery. Which of the following is most likely etiology of his transient ischemic attack?
Correct Answer: A
Rationale: Transient symptoms resolving within 1 hour with significant carotid stenosis (72%) suggest TIA from artery-to-artery embolization. Cardioembolism requires atrial fibrillation, small vessel disease causes lacunar syndromes, and hypoperfusion lacks focal deficits.