The nurse cares for a client who has had a left-sided intracerebral hemorrhage. The client is unable to detect light and pain touch on the right arm. Which explanation best describes these observations?

Compression of white matter in the brain and spinal cord

Decreased levels of gamma-aminobutyric acid (GABA) in the brain stem

Decreased levels of neurotransmitters in the pons and medulla

Edema and necrosis of the parietal lobe neurons

Answer and Explanation

The Correct Answer is D

Choice A reason: Compression of white matter in the brain and spinal cord is not the best explanation because it is a condition that affects the transmission of nerve impulses, not the perception of sensory stimuli. White matter is the part of the nervous system that consists of myelinated axons, which are the extensions of nerve cells that carry electrical signals from one cell to another. Compression of white matter can be caused by various factors, such as tumors, trauma, or inflammation, and can result in symptoms such as weakness, numbness, or paralysis.

Choice B reason: Decreased levels of gamma-aminobutyric acid (GABA) in the brain stem is not the best explanation because it is a condition that affects the regulation of muscle tone, not the perception of sensory stimuli. GABA is a neurotransmitter, which is a chemical messenger that transmits signals between nerve cells. GABA is an inhibitory neurotransmitter, which means that it reduces the activity of the nerve cells that it binds to. GABA is mainly found in the brain stem, which is the part of the brain that connects the spinal cord to the cerebrum and cerebellum, and controls vital functions such as breathing, heart rate, and blood pressure. Decreased levels of GABA in the brain stem can cause symptoms such as spasticity, rigidity, or tremors.

Choice C reason: Decreased levels of neurotransmitters in the pons and medulla is not the best explanation because it is a condition that affects the coordination of movements, not the perception of sensory stimuli. Neurotransmitters are chemical messengers that transmit signals between nerve cells. The pons and the medulla are parts of the brain stem that are involved in the control of voluntary and involuntary movements, such as chewing, swallowing, coughing, sneezing, and blinking. Decreased levels of neurotransmitters in the pons and the medulla can cause symptoms such as ataxia, dysarthria, dysphagia, or nystagmus.

Choice D reason: Edema and necrosis of the parietal lobe neurons is the best explanation because it is a condition that affects the processing of sensory stimuli, such as touch, pain, temperature, and position. The parietal lobe is the part of the cerebrum that is responsible for integrating and interpreting sensory information from different parts of the body. The parietal lobe is divided into two hemispheres, each corresponding to the opposite side of the body. A left-sided intracerebral hemorrhage is a condition where a blood vessel in the left parietal lobe ruptures, causing bleeding and swelling in the brain tissue. This can damage the neurons, which are the nerve cells that communicate with each other and form the basis of the nervous system. Edema and necrosis of the parietal lobe neurons can cause symptoms such as loss of sensation, neglect, or agnosia on the right side of the body.

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Correct Answer is C

Explanation

Choice A reason: Enlargement of the spleen is not a common sign of non-Hodgkin lymphoma, but it may occur in some cases. It is more likely to be associated with chronic lymphocytic leukemia or Hodgkin lymphoma.

Choice B reason: Confusion and agitation are not typical symptoms of non-Hodgkin lymphoma, but they may indicate central nervous system involvement or metabolic disturbances. They are more common in patients with brain tumors or infections.

Choice C reason: Frequent respiratory infections are a possible manifestation of non-Hodgkin lymphoma, as the disease affects the immune system and makes the client more susceptible to infections. The respiratory tract is one of the most common sites of infection in patients with non-Hodgkin lymphoma.

Choice D reason: Painful lesions of the lips and oral mucosa are not characteristic of non-Hodgkin lymphoma, but they may be caused by other conditions such as herpes simplex virus, aphthous ulcers, or oral cancer. They are more common in patients with immunodeficiency or poor oral hygiene.

A. Bronchial constriction after inhalation of an irritant B. Damage to the mucociliary lining of the segmental bronchi C. Infiltration of bacteria and inflammatory exudates into the alveoli D. Enlargement of the alveoli with destruction of the alveolar walls

Correct Answer is D

Explanation

Choice A reason: Bronchial constriction after inhalation of an irritant is a possible trigger for an asthma attack, not emphysema. It causes wheezing, coughing, and dyspnea, but it does not affect the alveolar structure or function.

Choice B reason: Damage to the mucociliary lining of the segmental bronchi is a consequence of chronic bronchitis, not emphysema. It impairs the clearance of mucus and pathogens from the airways, leading to recurrent infections and inflammation.

Choice C reason: Infiltration of bacteria and inflammatory exudates into the alveoli is a sign of pneumonia, not emphysema. It causes fever, chills, productive cough, and chest pain, but it does not cause permanent damage to the alveoli.

Choice D reason: Enlargement of the alveoli with destruction of the alveolar walls is the hallmark of emphysema. It reduces the surface area for gas exchange, increases the dead space, and decreases the elastic recoil of the lungs. It causes tachypnea, use of accessory muscles, and hypoxia, which can lead to decreased mental alertness.

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The nurse cares for a client who has had a left-sided intracerebral hemorrhage. The client is unable to detect light and pain touch on the right arm. Which explanation best describes these observations?

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The nurse provides care for a client diagnosed with non-Hodgkin lymphoma. Which observation does the nurse expect to find during assessment of the client?

Correct Answer is C

Explanation

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Correct Answer is D

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