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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Diabetes mellitus is a metabolic disorder characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. It typically presents with polyuria, polydipsia, and polyphagia, which contrasts with the patient's current presentation of decreased urine output and hyponatremia. The underlying pathophysiology involves pancreatic beta cell dysfunction or insulin resistance, not directly related to brain tumor removal.
Choice B rationale
Hypertonic agonism is not a recognized medical term or complication. The concept of tonicity relates to the osmotic pressure of a solution, and an "agonist" refers to a substance that binds to a receptor and initiates a physiological response. This option does not align with the patient's symptoms of decreased urine output and hyponatremia following brain surgery.
Choice C rationale
Diabetes insipidus (DI) is a condition characterized by the inability of the kidneys to conserve water, leading to excessive urination (polyuria) and thirst (polydipsia). This is often due to insufficient production of antidiuretic hormone (ADH) or renal insensitivity to ADH. The patient's presentation of *decreased* urine output directly contradicts the hallmark symptom of DI.
Choice D rationale
Syndrome of inappropriate antidiuretic hormone (SIADH) is characterized by excessive secretion of ADH, leading to water retention, dilutional hyponatremia (serum sodium 124 mEq/L, normal range 135-145 mEq/L), and decreased urine output. Brain surgery can stimulate ADH release. This aligns with the patient's symptoms of decreased urine output and low serum sodium.
Correct Answer is ["C","D"]
Explanation
Choice A rationale
Patient self-extubation would typically trigger a low-pressure alarm, not a high-pressure alarm, because the ventilator circuit would no longer be connected to the patient's airway, resulting in a sudden drop in airway pressure and a loss of positive pressure ventilation.
Choice B rationale
Disconnection of the tubes, similar to self-extubation, would lead to a low-pressure alarm due to the loss of a closed circuit. The ventilator would detect a rapid decrease in pressure within the system as air escapes, indicating a leak or complete disconnection.
Choice C rationale
Tube displacement, particularly if the endotracheal tube is pushed deeper into the bronchus or becomes kinked, increases airway resistance. This heightened resistance requires the ventilator to exert more pressure to deliver the set tidal volume, thus triggering a high-pressure alarm.
Choice D rationale
The patient biting the endotracheal (ET) tube creates an occlusion within the airway, significantly increasing airway resistance. This increased resistance makes it harder for the ventilator to deliver breaths, leading to a rapid rise in peak inspiratory pressure and activating the high-pressure alarm.
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