A patient has a lesion on their left cerebral lobe.
Which of the following would you expect to see during assessment?

Left leg weakness.

Right arm weakness.

Left arm weakness.

Right pupil is fully dilated.

Answer and Explanation

The Correct Answer is B

Choice A rationale

A lesion on the left cerebral lobe, specifically the motor cortex, would affect the contralateral side of the body due to the decussation of corticospinal tracts in the brainstem. Therefore, a left cerebral lesion would typically result in motor deficits, such as weakness, on the right side of the body, not the left leg.

Choice B rationale

The motor pathways from the cerebral cortex descend and cross over (decussate) in the brainstem. Consequently, a lesion in the left cerebral hemisphere will manifest as motor deficits, such as weakness or paralysis, on the contralateral or right side of the body. This includes the right arm, consistent with the expected neurological deficit.

Choice C rationale

As explained by the principle of decussation, a lesion in the left cerebral lobe would impact the motor function of the right side of the body. Therefore, left arm weakness would typically be associated with a lesion in the right cerebral hemisphere, not the left.

Choice D rationale

Pupil dilation is primarily controlled by the oculomotor nerve (cranial nerve III) and sympathetic nervous system pathways. While certain brain lesions can affect pupillary responses, a lesion on the cerebral lobe itself is less likely to directly cause unilateral, fully dilated pupils as a primary motor symptom. Pupillary changes often indicate brainstem involvement or increased intracranial pressure.

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Correct Answer is ["A","B","D"]

Explanation

Choice A rationale

Suctioning should be performed only when clinically indicated, such as in the presence of visible secretions, adventitious breath sounds, or a decline in oxygen saturation. Routine, unnecessary suctioning can cause mucosal trauma, hypoxemia, and increased risk of infection. This "as needed" approach minimizes potential complications and preserves airway integrity.

Choice B rationale

Hyperoxygenating the patient with 100% oxygen for 30-60 seconds prior to suctioning helps to create an oxygen reserve in the lungs and minimize the risk of hypoxemia during the procedure. Suctioning can transiently reduce lung volumes and gas exchange, and pre-oxygenation mitigates this by saturating hemoglobin and dissolved plasma oxygen.

Choice C rationale

Suctioning for longer than 10-15 seconds on each pass significantly increases the risk of hypoxemia, atelectasis, and vagal stimulation leading to bradycardia. Prolonged suctioning depletes oxygen from the airways and can cause physiological distress. Brief passes allow for reoxygenation between attempts and minimize adverse events.

Choice D rationale

Performing hand hygiene prior to suctioning is a critical infection control measure. This practice reduces the transmission of microorganisms from the healthcare provider's hands to the patient's airway, thereby preventing healthcare-associated infections like ventilator-associated pneumonia. Adherence to strict aseptic technique is paramount in airway management.

Choice E rationale

Suctioning should never be performed while inserting the catheter into the artificial airway. Applying negative pressure during insertion can cause significant mucosal trauma, bleeding, and increased risk of infection by pulling tissue into the catheter lumen. Suction should only be applied intermittently and during withdrawal of the catheter, to remove secretions effectively and safely.

A. Position patient sitting on the edge of the bed, leaning on a pillow that is on top of the bedside table. B. Place the patient in prone position and open the back of their gown. C. Have the patient lying supine with arms folded across their chest. D. No particular positioning is required.

Correct Answer is A

Explanation

Choice A rationale

Positioning the patient sitting on the edge of the bed, leaning on a pillow on the bedside table, is the optimal position for a thoracentesis. This position maximizes the intercostal spaces, allowing for easier access to the pleural cavity while keeping the diaphragm in a lowered position. This widens the spaces between the ribs, facilitating needle insertion and minimizing the risk of injury to surrounding structures like the lungs or diaphragm.

Choice B rationale

Placing the patient in a prone position is contraindicated for a thoracentesis. This position would make accessing the posterior pleural space extremely difficult and unsafe, increasing the risk of accidental organ puncture. It offers no anatomical advantage for the procedure and significantly impedes proper visualization and access to the typical insertion site.

Choice C rationale

Lying supine with arms folded across the chest is not an appropriate position for a thoracentesis. This position would flatten the intercostal spaces, making needle insertion more challenging and increasing the risk of lung puncture. It does not provide optimal access to the pleural cavity for fluid drainage and limits respiratory excursion.

Choice D rationale

Stating no particular positioning is required for a thoracentesis is incorrect and potentially dangerous. Proper positioning is critical for patient safety and procedural success, as it optimizes access to the pleural space, minimizes risks, and enhances patient comfort during the procedure. Incorrect positioning can lead to complications.

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A patient has a lesion on their left cerebral lobe. Which of the following would you expect to see during assessment?

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Naxlex Comprehensive Predictor Exams

Which of the following are appropriate while suctioning a patient with an artificial airway on mechanical ventilation?

Correct Answer is ["A","B","D"]

Explanation

Your patient comes into the Emergency Room with a chief complaint of dyspnea which is worse upon inspiration. The patient is diagnosed with a pleural effusion, and the medical doctor wants to do a Thoracentesis. How should you position the patient?

Correct Answer is A

Explanation

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A patient has a lesion on their left cerebral lobe.
Which of the following would you expect to see during assessment?