A client has expressive aphasia. Which part of the brain is likely affected?
Occipital lobe.
Wernicke's area.
Broca's area.
Parietal lobe.
The Correct Answer is C
Choice A rationale
The occipital lobe is primarily responsible for visual processing and interpretation. It contains the primary visual cortex, which receives and decodes information from the retinas. Damage to this area typically results in visual field deficits, cortical blindness, or visual hallucinations rather than language production issues. Expressive aphasia is a linguistic and motor speech deficit, which is not anatomically localized to the posterior region of the brain where visual sensory integration occurs during normal function.
Choice B rationale
Wernicke's area is located in the posterior temporal lobe of the dominant hemisphere and is responsible for language comprehension and processing. Damage here leads to receptive aphasia, where the patient can speak fluently but the words lack meaning or form a word salad. While it is a critical language center, it does not control the motor aspects of speech production. Therefore, impairment in this region does not result in the fragmented, effortful speech seen in expressive aphasia.
Choice C rationale
Broca's area is situated in the left frontal lobe and is the primary center for motor speech production and articulation. Damage to this specific region leads to expressive aphasia, characterized by the inability to produce fluent speech or form complete sentences despite understanding what others say. Patients often struggle to find words and speak in short, telegraphic phrases. This area coordinates the complex muscle movements of the mouth and larynx necessary for verbalizing coherent thoughts.
Choice D rationale
The parietal lobe is involved in processing sensory information such as touch, temperature, and pain, as well as spatial orientation and mathematical calculations. It helps integrate various sensory modalities to create a cohesive perception of the environment. Damage to the parietal lobe might cause agnosia or apraxia but does not typically cause expressive aphasia. It lacks the specific motor-associative circuits required for the physical generation of speech that are housed within the frontal lobe structures.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Multiple sclerosis is a chronic autoimmune disease that specifically targets the central nervous system, which includes the brain and spinal cord. It does not primarily affect the peripheral nervous system, which consists of the nerves outside these structures. Peripheral nerve issues are more characteristic of conditions like Guillain-Barre syndrome or peripheral neuropathy. Understanding that MS is a central nervous system disorder is vital for recognizing the types of neurological deficits and imaging findings expected during diagnosis.
Choice B rationale
There is no single definitive blood test that can confirm a diagnosis of multiple sclerosis. Diagnosis is usually based on clinical findings, magnetic resonance imaging showing lesions disseminated in time and space, and sometimes cerebrospinal fluid analysis for oligoclonal bands. Blood tests are primarily used to rule out other conditions that mimic MS, such as systemic lupus erythematosus or vitamin B12 deficiency. Relying solely on a blood test suggests a misunderstanding of the diagnostic process.
Choice C rationale
Multiple sclerosis is characterized by an immune-mediated attack on the myelin sheath, which is the protective insulation surrounding nerve fibers in the central nervous system. This process of demyelination disrupts the normal transmission of electrical impulses, leading to various neurological symptoms. By correctly identifying that the disease involves the loss of myelin within the central nervous system, the client demonstrates an accurate understanding of the underlying pathophysiology and the reason for their varied physical and cognitive symptoms.
Choice D rationale
The clinical course of multiple sclerosis is typically characterized by unpredictable relapses and remissions or a steady progression of symptoms. It is very rare for symptoms to remain exactly the same every day; instead, patients often experience fluctuations in fatigue, motor strength, and sensory perception depending on disease activity and external factors like heat or stress. Believing that symptoms will be identical daily shows a lack of awareness regarding the episodic and variable nature of MS.
Correct Answer is C
Explanation
Choice A rationale
The frontal lobe is primarily responsible for motor function, problem-solving, spontaneity, memory, language, initiation, judgement, impulse control, and social and sexual behavior. A stroke in the frontal lobe would more likely cause hemiparesis, Broca's aphasia (difficulty speaking), or profound changes in personality. It does not contain the primary centers for auditory processing. Therefore, the patient's specific symptoms of hearing difficulty do not align with the functional specializations of the frontal cortex.
Choice B rationale
The occipital lobe is the visual processing center of the brain. It handles visual recognition, color perception, and depth perception. A stroke affecting the occipital lobe would result in visual field cuts or total blindness in specific areas of the visual field. It has no role in hearing or the regulation of emotional behaviors. Since the patient is presenting with auditory and emotional disturbances rather than sight issues, the occipital lobe is an unlikely site for the lesion.
Choice C rationale
The temporal lobe contains the primary auditory cortex and is heavily involved in processing sensory input into derived meanings for the retention of visual memory, language comprehension, and emotional association. The limbic system structures, such as the amygdala, are located within or near the temporal lobe and govern emotional behavior. Damage here frequently causes hearing deficits and emotional instability. This perfectly matches the patient's presentation of difficulty with hearing and altered emotional states following a stroke.
Choice D rationale
The parietal lobe is responsible for integrating sensory information from various parts of the body, specifically touch, pressure, and spatial awareness. It houses the somatosensory cortex. Damage to the parietal lobe typically results in hemispatial neglect, difficulty with mathematics (acalculia), or loss of sensation on one side of the body. It is not the primary site for auditory or emotional regulation. Thus, a parietal stroke would not explain the patient's hearing loss and behavioral changes.
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