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Pathophysiology of the Nervous System > Pathophysiology

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Total Questions : 8

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Question 1:

A nurse is teaching a client about the functions of the nervous system. Which of the following statements by the client indicates a need for further teaching?

A. The central nervous system processes sensory information and generates motor commands. B. The peripheral nervous system consists of the brain and spinal cord. C. The autonomic nervous system regulates involuntary functions of smooth muscles, cardiac muscles, and glands. D. The sympathetic nervous system prepares the body for stress or emergency situations.

Answer and Explanation

Choice A:

This is a correct statement. The central nervous system (CNS) is responsible for processing sensory information, generating motor commands, and regulating cognitive and emotional functions.

Choice B:

This is an incorrect statement. The peripheral nervous system (PNS) consists of the cranial nerves, spinal nerves, and ganglia that connect the CNS to the rest of the body.

Choice C:

This is a correct statement. The autonomic nervous system (ANS) regulates involuntary functions of smooth muscles, cardiac muscles, and glands. It has two branches: the sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS).

Choice D:

This is a correct statement. The sympathetic nervous system (SNS) prepares the body for stress or emergency situations by increasing heart rate, blood pressure, respiratory rate, and blood glucose levels. It also dilates the pupils, bronchi, and blood vessels to skeletal muscles.

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Question 2:

A nurse is assessing a client who has a spinal cord injury at the level of T6. Which of the following findings should the nurse expect? (Select all that apply.)

A. Loss of sensation below the waist B. Paralysis of the lower extremities C. Impaired bladder and bowel control D. Difficulty swallowing E. Decreased sweating and shivering

Answer and Explanation

Choice A:

This is a correct answer. A spinal cord injury at the level of T6 affects the sensory nerves that innervate the lower half of the body, resulting in loss of sensation below the waist.

Choice B:

This is a correct answer. A spinal cord injury at the level of T6 affects the motor nerves that innervate the lower half of the body, resulting in paralysis of the lower extremities.

Choice C:

This is a correct answer. A spinal cord injury at the level of T6 affects the autonomic nerves that innervate the bladder and bowel, resulting in impaired bladder and bowel control.

Choice D:

This is an incorrect answer. A spinal cord injury at the level of T6 does not affect the cranial nerves that innervate the pharynx and esophagus, which are responsible for swallowing.

Choice E:

This is a correct answer. A spinal cord injury at the level of T6 affects the autonomic nerves that innervate the sweat glands and thermoregulatory centers, resulting in decreased sweating and shivering.

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Question 3:

A nurse is caring for a client who has a traumatic brain injury. The client says to the nurse, "I don't remember what happened to me." How should the nurse respond?

A. "You have a brain injury that affects your memory." B. "Don't worry, your memory will come back soon." C. "What do you think happened to you?" D. "Tell me more about how you feel right now."

Answer and Explanation

Choice A:

This is an incorrect answer. The nurse should not give information that might overwhelm or distress the client without assessing their readiness to learn.

Choice B:

This is an incorrect answer. The nurse should not give false reassurance or minimize the client's condition.

Choice C:

This is an incorrect answer. The nurse should not ask questions that might confuse or frustrate the client who has memory impairment.

Choice D:

This is a correct answer. The nurse should use therapeutic communication techniques such as exploring feelings, reflecting, and active listening to provide emotional support and establish rapport with the client.

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Question 4:

A nurse is educating a client who has multiple sclerosis about glia cells. Which of the following statements by the client indicates an understanding of the teaching?

A. "Glia cells produce myelin that insulates nerve fibers." B. "Glia cells transmit electrical impulses along nerve fibers." C. "Glia cells secrete neurotransmitters that communicate with other cells." D. "Glia cells destroy pathogens and foreign substances in the nervous system."

Answer and Explanation

Choice A:

This is a correct answer. Glia cells are supportive cells that provide insulation, protection, nutrition, and regulation for neurons. One type of glia cells, called oligodendrocytes, produce myelin that insulates nerve fibers and increases the speed of electrical impulses.

Choice B:

This is an incorrect answer. Glia cells do not transmit electrical impulses along nerve fibers. This is the function of neurons, which are the primary cells of the nervous system.

Choice C:

This is an incorrect answer. Glia cells do not secrete neurotransmitters that communicate with other cells. This is also the function of neurons, which release neurotransmitters at the synapses to transmit signals to other neurons, muscles, or glands.

Choice D:

This is an incorrect answer. Glia cells do not destroy pathogens and foreign substances in the nervous system. This is the function of microglia, which are a type of immune cells that reside in the nervous system and act as macrophages.

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Question 5:

A nurse is monitoring a client who has a seizure disorder. The nurse observes that the client has brief episodes of staring, blinking, and lip smacking. The nurse should document this type of seizure as:

A. Tonic-clonic seizure B. Absence seizure C. Myoclonic seizure D. Atonic seizure

Answer and Explanation

Choice A:

This is an incorrect answer. A tonic-clonic seizure (also known as a grand mal seizure) is characterized by alternating phases of muscle rigidity and jerking movements, along with loss of consciousness and postictal confusion.

Choice B:

This is a correct answer. An absence seizure (also known as a petit mal seizure) is characterized by brief episodes of staring, blinking, lip smacking, or other subtle movements, along with impaired awareness and no postictal confusion.

Choice C:

This is an incorrect answer. A myoclonic seizure is characterized by sudden, brief, and irregular muscle contractions, usually involving the arms, legs, or trunk.

Choice D:

This is an incorrect answer. An atonic seizure (also known as a drop attack) is characterized by sudden loss of muscle tone, resulting in falling or collapsing.

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Question 6:

A nurse is caring for a client who has increased intracranial pressure (ICP) due to a brain tumor. Which of the following actions should the nurse take?

A. Elevate the head of the bed to 30 degrees B. Administer morphine sulfate for pain relief C. Encourage coughing and deep breathing exercises D. Perform passive range of motion exercises

Answer and Explanation

Choice A:

This is a correct answer. Elevating the head of the bed to 30 degrees helps to reduce ICP by facilitating venous drainage from the brain and decreasing cerebral edema.

Choice B:

This is an incorrect answer. Administering morphine sulfate for pain relief can increase ICP by causing vasodilation, respiratory depression, and increased carbon dioxide levels in the blood.

Choice C:

This is an incorrect answer. Encouraging coughing and deep breathing exercises can increase ICP by increasing intrathoracic pressure, which impedes venous drainage from the brain.

Choice D:

This is an incorrect answer. Performing passive range of motion exercises can increase ICP by stimulating the sympathetic nervous system, which increases blood pressure and cerebral blood flow.

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Question 7:

A nurse is reviewing the laboratory results of a client who has Guillain-Barré syndrome (GBS). Which of the following findings should the nurse report to the provider?

A. Elevated cerebrospinal fluid (CSF) protein level B. Decreased serum creatinine kinase (CK) level C. Increased CSF white blood cell (WBC) count D. Decreased serum sodium level

Answer and Explanation

Choice A:

This is an incorrect answer. Elevated CSF protein level is a common finding in clients who have GBS due to demyelination of peripheral nerves. It does not indicate infection or inflammation and does not require immediate intervention.

Choice B:

This is an incorrect answer. Decreased serum CK level is a normal finding in clients who have GBS because CK is released from damaged muscle tissue and GBS does not affect muscle cells directly.

Choice C:

This is a correct answer. Increased CSF WBC count indicates infection or inflammation in the central nervous system (CNS), which can be a complication of GBS or a sign of another condition such as meningitis or encephalitis. The nurse should report this finding to the provider for further evaluation and treatment.

Choice D:

This is an incorrect answer. Decreased serum sodium level can occur.

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Question 8:

A nurse is planning care for a client who has Parkinson's disease. Which of the following interventions should the nurse include in the plan of care? (Select all that apply.)

A. Encourage the client to perform activities of daily living (ADLs) independently B. Provide the client with a high-protein, low-carbohydrate diet C. Administer levodopa-carbidopa as prescribed D. Teach the client to use assistive devices such as a walker or cane E. Monitor the client for orthostatic hypotension

Answer and Explanation

Choice A:

This is a correct answer. Encouraging the client to perform ADLs independently helps to maintain their functional ability, self-esteem, and quality of life. The nurse should provide assistance and supervision as needed, but avoid doing everything for the client.

Choice B:

This is an incorrect answer. Providing the client with a high-protein, low-carbohydrate diet can interfere with the absorption and effectiveness of levodopa-carbidopa, which is the main medication used to treat Parkinson's disease. The nurse should provide the client with a balanced diet that includes adequate fluids and fiber.

Choice C:

This is a correct answer. Administering levodopa-carbidopa as prescribed helps to reduce the symptoms of Parkinson's disease such as tremors, rigidity, bradykinesia, and postural instability. Levodopa is converted to dopamine in the brain, which is deficient in clients who have Parkinson's disease. Carbidopa prevents the breakdown of levodopa in the peripheral tissues, allowing more levodopa to reach the brain.

Choice D:

This is a correct answer. Teaching the client to use assistive devices such as a walker or cane helps to improve their mobility, balance, and safety. The nurse should also teach the client strategies to overcome freezing episodes, such as rocking from side to side or stepping over an imaginary line.

Choice E:

This is a correct answer. Monitoring the client for orthostatic hypotension helps to prevent falls and injuries. Orthostatic hypotension is a common complication of Parkinson's disease and its medications, which can cause a sudden drop in blood pressure when changing positions. The nurse should instruct the client to change positions slowly and report any symptoms such as dizziness, lightheadedness, or fainting.

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