A client has idiopathic parkinsonism. Her physician prescribed benztropine mesylate (Cogentin) 1 mg po daily. The nurse explains to her that the pathophysiological defect is an imbalance between:

Estrogen and progesterone

An autosomal dominant genetic defect

Dopamine and acetylcholine

Atherosclerosis and lack of blood supply

Answer and Explanation

The Correct Answer is C

A. Estrogen and progesterone. These hormones regulate the reproductive system and do not play a direct role in Parkinsonism. While some studies suggest estrogen may have a neuroprotective effect, an imbalance between estrogen and progesterone is not the primary defect in Parkinson’s disease.
B. An autosomal dominant genetic defect. Parkinson’s disease can have a genetic component, but idiopathic Parkinsonism occurs without a clear genetic cause. Most cases are sporadic and result from dopamine depletion, rather than an inherited genetic mutation.
C. Dopamine and acetylcholine. Parkinsonism results from a deficiency of dopamine in the basal ganglia, leading to an imbalance between dopamine (inhibitory) and acetylcholine (excitatory). This imbalance causes motor symptoms such as tremors, rigidity, and bradykinesia. Benztropine (Cogentin) is an anticholinergic medication that helps reduce acetylcholine activity, restoring balance and improving symptoms.
D. Atherosclerosis and lack of blood supply. While vascular issues can contribute to stroke-related movement disorders, idiopathic Parkinsonism is caused by neurodegeneration, not blood flow problems. Atherosclerosis is not the primary cause of the dopamine-acetylcholine imbalance seen in Parkinsonism.

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Correct Answer is D

Explanation

A. "Are you taking a multivitamin?" GBS is an autoimmune disorder, not a nutritional deficiency. While vitamin B12 deficiency can cause neuropathy, it is not a known trigger for GBS.
B. "Have you traveled overseas recently?" Travel history is not a common risk factor for GBS. While some infections acquired during travel could trigger an immune response, GBS is most often linked to common viral or bacterial infections rather than international exposure.
C. "Do you have a history of chronic alcohol abuse?" Chronic alcohol use can cause peripheral neuropathy, but it does not trigger GBS. GBS is caused by an abnormal immune response following an infection, not alcohol-related nerve damage.
D. "Have you had a recent influenza infection?" GBS is often preceded by a respiratory or gastrointestinal infection, such as influenza, Epstein-Barr virus, or Campylobacter jejuni. The immune system mistakenly attacks the peripheral nervous system, leading to progressive muscle weakness and paralysis. Asking about recent infections helps identify a key trigger for GBS onset.

A. Hemorrhagic strokes result in brain tissue death due to lack of blood flow, whereas ischemic strokes result from bleeding in the brain. B. Hemorrhagic strokes are typically treated with clot-busting medications, while ischemic strokes are treated with surgery to repair the ruptured vessel. C. Ischemic strokes are generally more common than hemorrhagic strokes. D. Ischemic strokes are caused by a rupture of a blood vessel, while hemorrhagic strokes are caused by a blockage in a blood vessel.

Correct Answer is C

Explanation

A: "Hemorrhagic strokes result in brain tissue death due to lack of blood flow, whereas ischemic strokes result from bleeding in the brain." Ischemic strokes occur when a blood vessel becomes blocked, often due to a clot, preventing blood flow and leading to brain tissue damage from lack of oxygen. In contrast, hemorrhagic strokes involve bleeding into or around the brain, which increases pressure and can cause immediate brain injury.
B: "Hemorrhagic strokes are typically treated with clot-busting medications, while ischemic strokes are treated with surgery to repair the ruptured vessel." Ischemic strokes are often treated with thrombolytic agents, or clot-busting medications, aimed at dissolving the clot and restoring blood flow to the affected area of the brain. Hemorrhagic strokes, on the other hand, may require surgical interventions, such as clipping or coiling of aneurysms, or other measures to stop the bleeding and relieve pressure on the brain.
C: "Ischemic strokes are generally more common than hemorrhagic strokes." Ischemic strokes account for approximately 87% of all strokes, making them significantly more prevalent compared to hemorrhagic strokes. The higher incidence can be attributed to factors such as atherosclerosis, hypertension, and diabetes, which increase the risk of clots forming in the arteries supplying the brain.
D: "Ischemic strokes are caused by a rupture of a blood vessel, while hemorrhagic strokes are caused by a blockage in a blood vessel." Ischemic strokes result from a blockage in a blood vessel, typically due to a clot, which disrupts blood flow to the brain. Hemorrhagic strokes arise from the rupture of a blood vessel, leading to bleeding in or around the brain.

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A client has idiopathic parkinsonism. Her physician prescribed benztropine mesylate (Cogentin) 1 mg po daily. The nurse explains to her that the pathophysiological defect is an imbalance between:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has a suspected diagnosis of Guillain-Barré syndrome (GBS). Which of the following questions should the nurse ask the client?

Correct Answer is D

Explanation

Which of the following is a key difference between ischemic and hemorrhagic strokes?

Correct Answer is C

Explanation

A nurse is preparing to perform a cranial nerve examination on a client. Which of the following actions should the nurse take to check cranial nerve XII?

A nurse is assessing a client who has multiple sclerosis. The client reports that, since the onset of the disease, there are times when their symptoms are active and then followed by a period with no symptoms. Which of the following types of multiple sclerosis does this pattern indicate?

A nurse is preparing to administer aspirin 650 mg PO every 12 hr. The amount available is aspirin 325 mg tablets. How many tablets should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

A nurse is preparing to perform a cranial nerve examination on a client. Which of the following actions should the nurse take to check cranial nerve VII?

A nurse is teaching a group of nursing students about spinal cord injuries in clients who are aged 65 years and older. Which of the following should the nurse identify as the most common cause of spinal cord injuries for this age group?

A nurse is reviewing the medical record of a client who is experiencing delirium. Which of the following medications should the nurse identify as a cause of this disorder?

A nurse is assessing a client's cranial nerves. Which of the following methods should the nurse use to assess cranial nerve II?

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