During an interview with a male client who has Parkinson's disease (PD), the nurse notices that he is drooling and mumbling. Which pathophysiological factor contributes to the client's inability to express himself?

Damage to Broca's area in temporal lobe of brain.

Degeneration of dopaminergic neurons of the basal ganglia.

Brain atrophy with diffuse amyloid plaques disposition.

Paralysis of the pharyngeal and epiglottal area.

Answer and Explanation

The Correct Answer is B

Parkinson's disease (PD) is a neurodegenerative disorder characterized by the progressive degeneration of dopaminergic neurons in the substantia nigra of the basal ganglia. This degeneration leads to a deficiency of dopamine, a neurotransmitter involved in the regulation of movement and coordination. The inability to express oneself, as seen in the client's mumbling, can be attributed to the motor symptoms of PD, particularly bradykinesia (slowness of movement) and hypomimia (reduced facial expression), which result from dopaminergic neuron degeneration.

A) Damage to Broca's area in the temporal lobe of the brain:

Damage to Broca's area typically results in expressive aphasia, which is characterized by difficulty speaking and forming coherent sentences. While speech difficulties can occur in PD, they are primarily due to motor dysfunction rather than damage to specific language centers in the brain.

B) Degeneration of dopaminergic neurons of the basal ganglia:

Correct. Degeneration of dopaminergic neurons in the basal ganglia, particularly the substantia nigra, is the primary pathological factor in Parkinson's disease. This degeneration leads to motor symptoms such as bradykinesia, tremor, and rigidity, which can affect the client's ability to speak clearly and express himself.

C) Brain atrophy with diffuse amyloid plaques disposition:

This description is more characteristic of Alzheimer's disease, a different neurodegenerative disorder characterized by brain atrophy and the deposition of amyloid plaques. While cognitive impairment can occur in PD, the primary motor symptoms are related to dopaminergic neuron degeneration rather than amyloid plaque deposition.

D) Paralysis of the pharyngeal and epiglottal area:

Paralysis of the pharyngeal and epiglottal area can lead to dysphagia (difficulty swallowing) rather than difficulty expressing oneself verbally. While dysphagia can occur in PD, it is not typically the primary factor contributing to speech difficulties in this condition.

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Correct Answer is D

Explanation

Pressure injuries, also known as pressure ulcers or bedsores, result from prolonged pressure on the skin, leading to tissue ischemia and damage. Early recognition of the pathophysiological processes involved in pressure injury development is crucial for prevention and timely intervention. Here's why option D is the correct choice:

A) Epidermal fragility and skin excoriation with serous drainage:

This description more closely aligns with the characteristics of a superficial wound or abrasion rather than the early stages of a pressure injury. In pressure injuries, epidermal breakdown may occur later in the process, after prolonged pressure and tissue ischemia.

B) Hypodermal fluid accumulation and blister formation:

While fluid accumulation and blister formation can occur in some types of wounds, such as friction blisters or burns, they are not typically characteristic of the early stages of pressure injury development. Pressure injuries primarily involve tissue ischemia and damage due to pressure and shear forces.

C) Necrotic tissue, purulent exudate, and eschar formation:

This description is more indicative of advanced or severe pressure injuries rather than the early stages. Necrotic tissue, purulent exudate, and eschar formation typically occur in pressure injuries that have progressed to deeper tissue involvement and infection.

D) Ischemic inflammatory response marked by erythemic skin:

Correct. In the early stages of pressure injury development, the affected area may exhibit signs of tissue ischemia and inflammation, which can manifest as erythema (redness) of the skin. This erythema is a result of the body's inflammatory response to tissue damage caused by pressure and may indicate the need for intervention to relieve pressure and prevent further injury.

A. Deposition of crystals in the synovial space of the joints produces inflammation and irritation. B. Chondrocyte injury destroys joint cartilage, producing osteophytes and joint inflammation. C. An immune complex and autoantibody deposition in connective tissue results in inflammation. D. An autoimmune inflammation involving IgG response to an antigen causes joint destruction.

Correct Answer is A

Explanation

Gout is a form of inflammatory arthritis characterized by sudden, severe attacks of pain, redness, and swelling in the joints, commonly affecting the big toe joint (first metatarsophalangeal joint). The primary pathophysiological process underlying gout involves the deposition of monosodium urate crystals in the joints and surrounding tissues. Here's an explanation of why option A is the correct answer:

A) Deposition of crystals in the synovial space of the joints produces inflammation and irritation:

Correct. Elevated levels of uric acid in the blood can lead to the formation of monosodium urate crystals, which then accumulate in the synovial fluid of joints, particularly in the big toe joint in many cases. These crystals trigger an inflammatory response, activating immune cells and causing swelling, redness, warmth, and severe pain in the affected joint. The inflammation and irritation result from the body's response to the presence of these crystals.

B) Chondrocyte injury destroys joint cartilage, producing osteophytes and joint inflammation:

This option describes a process more characteristic of osteoarthritis, where degeneration of joint cartilage leads to inflammation and the formation of osteophytes (bone spurs). Gout does not directly involve chondrocyte injury.

C) An immune complex and autoantibody deposition in connective tissue results in inflammation:

This process describes the pathophysiology of autoimmune diseases such as rheumatoid arthritis, where immune complexes and autoantibodies contribute to inflammation and tissue damage. In gout, the inflammation is primarily triggered by the deposition of urate crystals rather than immune complex deposition.

D) An autoimmune inflammation involving IgG response to an antigen causes joint destruction:

This option describes the autoimmune process seen in diseases like rheumatoid arthritis, where antibodies target specific antigens, leading to joint destruction. Gout is not an autoimmune disease, and joint destruction in gout is primarily due to inflammation caused by urate crystal deposition rather than autoimmune mechanisms.

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During an interview with a male client who has Parkinson's disease (PD), the nurse notices that he is drooling and mumbling. Which pathophysiological factor contributes to the client's inability to express himself?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for an immobilized client who is at risk for breakdown in skin integrity. Which pathophysiological process should the nurse note early in the development of a pressure injury?

Correct Answer is D

Explanation

A client with a sudden onset of big toe joint pain and swelling is diagnosed with gout. Which pathophysiologic process is producing the symptoms of gout?

Correct Answer is A

Explanation

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