A patient reports weakness of the extremities and diplopia. The nurse knows that these symptoms are characteristic of which condition?

Myasthenia gravis (MG)

Multiple sclerosis (MS)

Cerebral palsy (CP)

Parkinson disease (PD)

Answer and Explanation

The Correct Answer is A

A) Myasthenia gravis (MG):
Weakness of the extremities and diplopia (double vision) are hallmark symptoms of myasthenia gravis, an autoimmune disorder that affects the neuromuscular junction. In MG, antibodies attack acetylcholine receptors, leading to muscle weakness that worsens with activity and improves with rest. The weakness typically affects voluntary muscles, including those responsible for eye movement, which leads to symptoms such as diplopia and ptosis (drooping eyelids).

B) Multiple sclerosis (MS):
Multiple sclerosis involves the demyelination of neurons in the central nervous system, leading to a variety of neurological symptoms. While MS can cause weakness and visual disturbances, the typical symptoms of MS include fatigue, muscle spasticity, ataxia, and sensory deficits. Diplopia can occur in MS but is usually accompanied by other neurological signs such as numbness, tingling, or loss of coordination.

C) Cerebral palsy (CP):
Cerebral palsy is a group of disorders affecting movement and posture due to non-progressive brain injury or abnormal brain development, often occurring in early childhood. While CP can cause muscle weakness and coordination issues, it does not typically present with diplopia. Instead, it often involves spasticity, motor impairment, and difficulty with fine motor tasks.

D) Parkinson disease (PD):
Parkinson disease is characterized by tremors, bradykinesia (slowness of movement), rigidity, and postural instability. While PD can lead to muscle weakness and visual issues like blurred vision, it is not typically associated with diplopia as a primary symptom. The hallmark motor symptoms are primarily related to tremor and difficulty initiating movements rather than generalized weakness and double vision.

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Correct Answer is C

Explanation

A) Hypothalamus and the medulla: While the hypothalamus and medulla play critical roles in regulating autonomic functions and overall sympathetic nervous system activity, the primary origin of the sympathetic nervous system's neural impulses comes from the spinal cord, specifically in the thoracic and lumbar regions. The hypothalamus and medulla are involved in coordinating and regulating sympathetic activity rather than being the origin of the impulses themselves.

B) Cranium and sacral area of the spinal cord: The cranium and sacral regions are primarily associated with the parasympathetic nervous system, not the sympathetic nervous system. The parasympathetic nervous system's nerve fibers arise from the brainstem and the sacral region, while the sympathetic fibers originate from the thoracic and lumbar areas.

C) Thoracic and lumbar section of the spinal cord: The sympathetic nervous system originates in the thoracolumbar region of the spinal cord, which includes the thoracic and lumbar segments (T1-L2). These regions house the preganglionic neurons whose axons exit the spinal cord and synapse in sympathetic ganglia, leading to the sympathetic effects on organs and tissues. This makes the thoracic and lumbar sections the correct location for the origin of SNS impulses.

D) Nerve membrane: The nerve membrane, or the cellular membrane of individual neurons, is not the location where impulses originate. The origin of the impulses is in the central nervous system (CNS), specifically in the spinal cord for the sympathetic system, not at the level of the individual nerve membranes.

A. Irritable bowel disease B. Glaucoma C. Asthma D. Hypertension

Correct Answer is B

Explanation

A) Irritable bowel disease: Benztropine is an anticholinergic medication that can reduce gastrointestinal motility, which might exacerbate constipation. However, irritable bowel disease (IBD) is not a contraindication for using benztropine. The drug is more likely to cause concern in conditions where smooth muscle relaxation could worsen symptoms of constipation, but it is not typically withheld due to IBD alone.

B) Glaucoma: Glaucoma, particularly narrow-angle glaucoma, is a contraindication for benztropine use. Benztropine, as an anticholinergic agent, can cause pupil dilation (mydriasis), which can increase intraocular pressure and worsen glaucoma. This is a critical concern for patients with glaucoma, and the healthcare provider should be notified before administering the drug.

C) Asthma: While benztropine can have mild anticholinergic effects that may cause dryness of the respiratory tract, it is not a contraindication for asthma. Beta-agonist inhalers are more commonly prescribed to manage bronchospasm, but the use of benztropine in asthma is not typically harmful unless the patient is experiencing severe respiratory distress. Asthma would not be a primary concern when administering this medication.

D) Hypertension: Benztropine does not directly affect blood pressure in a way that would be a concern for someone with hypertension. While it may cause some mild autonomic changes (like dry mouth or dizziness), hypertension is not a contraindication for the medication. Therefore, there is no specific need to notify the healthcare provider due to a history of hypertension.

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A patient reports weakness of the extremities and diplopia. The nurse knows that these symptoms are characteristic of which condition?

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Naxlex Comprehensive Predictor Exams

The central nervous system (CNS) cells, where the impulses for the sympathetic nervous system (SNS) originate, are located where?

Correct Answer is C

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Correct Answer is B

Explanation

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