ATI LPN
Medical Surgical Nursing Neurological Disorders Quizlet Questions
Question 1 of 5
Which statement best describes the underlying basis of the dark current in the outer segment of the photoreceptors?
Correct Answer: B
Rationale: The dark current is sodium influx via cGMP-dependent channels in low light. TMP13 p. 650
Question 2 of 5
After receiving change-of-shift report on the following four patients, which patient should the nurse see first?
Correct Answer: A
Rationale: tPA needs to be infused within the first few hours after stroke symptoms start in order to be effective in minimizing brain injury. The other medications should also be given as quickly as possible, but timing of the medications is not as critical.
Question 3 of 5
A 58-year-old female, accompanied by her husband, presents with trouble walking. She describes her legs as being heavy and stiff, and at times experiences muscle spasms in her lower extremities. Her husband notices that she has been having trouble writing, and buttoning her shirt. These symptoms have progressively worsened over that past 4-5 months. Neurologic exam is significant for intrinsic hand weakness, and arm fasciculations. The lower extremity is hypertonic, with increased patellar reflexes. On gait testing, the patient has poor balance, moves slowly, and has issues with turning. Which of the following is the best treatment to prolong life?
Correct Answer: D
Rationale: The presentation of upper (hypertonia, hyperreflexia) and lower (weakness, fasciculations) motor neuron signs suggests ALS. Riluzole is the only FDA-approved treatment to slow ALS progression and prolong life by reducing glutamate excitotoxicity. Pyridostigmine treats myasthenia gravis, botulinum toxin manages spasticity symptomatically, prednisone is for inflammatory conditions, and IVIG is for Guillain-Barre.
Question 4 of 5
A 62-year-old male presents with left-sided weakness. He was last seen normal approximately 5 hours ago. Past medical history is significant for coronary artery disease and hypertension. On exam, there is 4+/5 strength in the left upper extremity, and 3/5 strength in the left lower extremity. He is unable to walk. Non-contrast head CT is negative for blood and a large territory infarct, and CT angiography shows an occlusion in the proximal portion of the anterior cerebral artery. Which of the following is the best next step in management?
Correct Answer: B
Rationale: Left-sided weakness with ACA occlusion 5 hours post-onset exceeds the tPA window (4.5 hours) but is within the 24-hour window for thrombectomy if large vessel occlusion is confirmed, offering the best chance for recovery.
Question 5 of 5
A 15-year-old female presents to the emergency department with a seizure. While she was eating her breakfast in the morning, her mother witnessed myoclonic jerks involving the upper extremities. Over a half-hour, the myoclonus became more dramatic, finally evolving into a generalized-tonic clonic seizure lasting 1-2 minutes. The patient reports sleeping 4-5 hours per night for the last few days due to upcoming midterm examinations. She denies alcohol or drug use. She is currently sexually active with her boyfriend and uses condoms as her only form of contraception. On physical exam, there is evidence of recent tongue biting, no focal neurological deficits, and normal intelligence. A sleep-deprived EEG is performed with interictal findings showing generalized 4-5-Hz polyspike and slow-wave discharges, with activation during photic stimulation (photoparoxysmal response). MRI of the brain is normal. Which of the following is the best treatment option for this patient?
Correct Answer: C
Rationale: Myoclonic jerks progressing to tonic-clonic seizures with photoparoxysmal EEG findings suggest juvenile myoclonic epilepsy (JME). Levetiracetam is effective and safe in women of childbearing age, unlike valproic acid (teratogenic).