Portage Pathophysiology Module 6 Exam Questions and Complete Solutions, Exams of Nursing

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Portage Pathophysiology Module 6

Exam Questions and Complete

Solutions

A patient experiences a seizure that manifests with repetitive hand rubbing and reports of hallucinations right before the seizure occurred. They have experienced which type of seizure? - Correct Ans: focal seizure with impairment of consciousness or awareness A patient is having difficulty tracking their eye laterally. Which cranial nerve is affected? - Correct Ans: CN VI You are seeing a patient with Parkinson's disease in your office. You notice they have difficulty turning themselves around to sit in the chair, freezing in the process. This is an example of what physical manifestation of the disease? - Correct Ans: bradykinesia Delta waves appear in which stage of sleep? - Correct Ans: stage 3 A person reports feelings of anhedonia, guilt, and worthlessness that seem to be worse in the morning. They also exhibit excessive weight loss and experience insomnia. What type of depression are they experiencing? - Correct Ans: melancholic depression Each of the following statements is true regarding the organization of the nervous system except: - Correct Ans: the CNS has an afferent and efferent division Each of the following statements is true regarding Alzheimer's disease except: - Correct Ans: Tau protein is broken down when the neuron that produced it dies Each of the following are modifiable factors related to stroke except: - Correct Ans: obesity Primary insomnia is characterized by each of the following except: - Correct Ans: can also be called comorbid insomnia (comorbid is secondary)

What type of seizure manifests with a blank stare, lasts only for a few seconds, and often goes unnoticed? - Correct Ans: absence seizure Sleep disturbances associated with narcolepsy include each of the following except: - Correct Ans: sleep apnea Each of the following statements is true of Parkinson's disease except: - Correct Ans: Environmental factors alone lead to disease development Efferent neurons deliver _______ input from the CNS to the periphery. - Correct Ans: motor _______ work by blocking membrane receptors and the subsequent reuptake of serotonin and norepinephrine. - Correct Ans: tri-cyclic anti-depressants _______ is sleep disordered breathing caused by airway obstruction. - Correct Ans: obstructive sleep apnea ________ utilizes electric impulses to inhibit or stop the abnormal nerve activity that causes tremor and other unwanted movement patterns associated with Parkinson's disease. - Correct Ans: deep brain stimulation Connective tissue sheaths that surround the brain and spinal cord providing protection are called the _______. - Correct Ans: meninges T/F - Make true if False Astrocytes help to form the blood-brain barrier which prevents toxins from the blood from entering the brain. - Correct Ans: true T/F - Make true if False

The average age of onset for major depressive disorder is mid-30s; however, the age of onset is increasing in recent times. - Correct Ans: False; average age of onset is DECREASING in recent times. T/F - Make true if False Vital signs increase during stage 1 of NREM sleep. - Correct Ans: false, vital signs DECREASE during stage 1 of NREM sleep T/F - Make true if False Wandering episodes are characteristic of severe Alzheimer's disease. - Correct Ans: False, wandering episodes increase in moderate Alzheimer's disease. Explain how a chemical synapse produces an excitatory or inhibitory signal. - Correct Ans: The presynaptic neuron will secrete neurotransmitters which diffuse into the synaptic cleft and bind to excitatory or inhibitory receptors on the postsynaptic membrane eliciting an excitatory or inhibitory signal in one direction. You are babysitting a 7-year-old child with a known history of seizure activity. You notice they appear flushed and seem unresponsive. You ask if they are feeling alright and they stare at you blankly. After a few seconds they act as if nothing happened and return to play. Is this a generalized or focal seizure? Based upon this description, what specific type of seizure did this individual experience? - Correct Ans: generalized absence seizure Describe the importance of brain activity that occurs during REM sleep. - Correct Ans: During this phase of sleep, incoming sensory input is blocked; the brain cannot process it. However, internalized sensory tracts are stimulated allowing previously formed memories to replay in one's mind. Studies have shown that adequate time spent in REM sleep is necessary for normal physiologic and psychologic functioning during periods of wakefulness. A patient reports to the emergency department where you are working at 7 pm. They report that earlier that morning they began to experience numbness in their right leg. They had walked more than usual the day before, so they ignored their symptoms. As the day went on, they noticed that the numbness got worse, and they began to slur their words. By the time they are evaluated, their symptoms begin to subside. The numbness disappears, and their speech returns to normal. What do you suspect this patient has experienced? What is the clinical significance? - Correct Ans: This patient has experienced a TIA as their symptoms subsided in less than 24 hours without intervention. However, this should not be

ignored as TIAs serve as a warning sign that a stroke can occur in the future. Underlying pathology such as atherosclerosis, etc. must be addressed for prevention. A 75-year-old male is brought to the emergency department by their spouse at 8 pm. The spouse reports that they were cleaning up after dinner at approximately 6:30 pm, and she noticed that her husband's speech was very unclear. When she asked him what was going on, he said that he didn't know and that the entire right side of his face felt numb. She reports that he is very active, but he has a past medical history of atrial fibrillation. Based upon these symptoms and past medical history, what do you suspect this patient is experiencing? How would you confirm this diagnosis? What treatment should be administered? Explain why you chose that treatment. - Correct Ans: This patient is more than likely experiencing an ischemic stroke. A CT scan and MRI would be needed to determine if a clot was blocking blood flow to the brain tissue and to rule out a hemorrhagic stroke. If a clot is found, this patient should receive tPA drugs as they are within the 3-4.5 hour treatment window. A patient is being seen in your office with a primary complaint of daytime fatigue that has lasted for the past 2 months. They go on to tell you that they are having difficulty with work performance and are constantly on edge. You suspect they have chronic insomnia. What are the 4 primary symptoms of insomnia? Describe a nonpharmacologic treatment plan that you can prescribe for this patient. - Correct Ans: The 4 primary symptoms of insomnia are: Difficulty initiating sleep Difficulty maintaining sleep Waking up too early Chronic nonrestorative or poor sleep You would educate the patient on proper sleep hygiene and encourage them to evaluate possible stressors that may need to be removed from their daily routine. Sleep hygiene involves the establishment of consistent sleep patterns (going to bed at the same time each night and only sleeping as long as one needs to feel refreshed during the day), creating a comfortable sleeping environment (optimal room temperature), avoidance of screens and excessive light right before bed, and finally, avoidance of stimulants (caffeine) several hours prior to normal bedtime.