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 A

Explanation

The atrioventricular (AV) node is an essential component of the cardiac conduction system responsible for transmitting electrical impulses from the atria to the ventricles. The inherent rate of the AV node refers to its intrinsic ability to generate electrical impulses in the absence of external influences.

Here's a breakdown of each option:

A) 40 to 60:

Correct. The inherent rate of the AV node is typically 40 to 60 beats per minute (bpm). This rate is slower than that of the sinoatrial (SA) node, which has an inherent rate of 60 to 100 bpm. The AV node acts as a backup pacemaker, ensuring that the ventricles receive electrical impulses even if the SA node fails to function properly.

B) 20 to 40:

This range is not consistent with the typical inherent rate of the AV node. A rate of 20 to 40 bpm would be unusually slow and could indicate significant conduction system abnormalities rather than the normal functioning of the AV node.

C) 60 to 80:

This range is more characteristic of the inherent rate of the SA node rather than the AV node. The SA node is the primary pacemaker of the heart, and its inherent rate is typically 60 to 100 bpm.

D) 80 to 100:

Similar to option C, this range is more consistent with the inherent rate of the SA node rather than the AV node. The SA node typically has a faster intrinsic rate compared to the AV node.

A. It occurs as a complication of a spinal cord injury. B. Muscle weakness is progressive, degenerative, and fatal. C. Mental status changes occur late in the disease. D. Autonomic nervous system and sensory changes occur.

Correct Answer is B

Explanation

Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease, is a progressive neurodegenerative disorder affecting motor neurons in the brain and spinal cord. Understanding the pathophysiological process of ALS is crucial for providing accurate information about the disease prognosis to the client. Here's why option B is the correct choice:

A) It occurs as a complication of a spinal cord injury:

This statement is incorrect. ALS is not a complication of a spinal cord injury. While both conditions involve motor neuron dysfunction, they have different etiologies and pathophysiological processes. ALS is characterized by the degeneration of motor neurons in the brain and spinal cord, leading to muscle weakness and atrophy, whereas spinal cord injury results from trauma to the spinal cord.

B) Muscle weakness is progressive, degenerative, and fatal:

Correct. ALS is characterized by progressive degeneration of motor neurons, leading to muscle weakness, atrophy, and eventual paralysis. The disease is relentless and fatal, typically within 2 to 5 years of diagnosis, although survival can vary widely among individuals. As motor neurons degenerate, voluntary muscle control is lost, eventually affecting the ability to speak, swallow, breathe, and move. Respiratory failure is the most common cause of death in ALS patients.

C) Mental status changes occur late in the disease:

While cognitive and behavioral changes can occur in some individuals with ALS, particularly in the later stages of the disease, they are not universal. ALS primarily affects motor neurons, leading to progressive muscle weakness and paralysis. However, some individuals may experience frontotemporal dementia (FTD), a type of cognitive impairment characterized by changes in behavior, personality, and language.

D) Autonomic nervous system and sensory changes occur:

ALS primarily affects motor neurons rather than sensory neurons or the autonomic nervous system. Sensory symptoms such as numbness, tingling, or loss of sensation are not typical features of ALS. Autonomic dysfunction, including changes in heart rate, blood pressure, or bowel and bladder function, is not a prominent feature of ALS.

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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

What is the inherent rate of the AV (atrioventricular) node area?

Correct Answer is A

Explanation

A client is diagnosed with amyotrophic lateral sclerosis (ALS). Which pathophysiological process should the nurse use when providing the client with information about this disease prognosis?

Correct Answer is B

Explanation

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