A patient presents to the emergency department (ED) with a two-hour history of hemiparesis of the right arm and leg. Also, it is noted during assessment (examination) that the left side of her face moves normally, but the other side droops. Identify the item which helps to explain the connection between the pathophysiology of this illness and the pattern of signs and symptoms (555)
Ischemia of the brain tissue is causing cellular injury, swelling and malfunction of the contralateral side
The functioning of the right cranial nerve controlling facial movement is compromised by cerebral edema
The sensorimotor tracts leading from the brain to the body decussate and control the arm and leg on the same side as the lesion,
The corticospinal tracts leading from the brain to the body decussate and control the ipsilateral arm and leg.
The Correct Answer is A
A. Ischemia of the brain tissue is causing cellular injury, swelling, and malfunction of the contralateral side: Hemiparesis occurs on the side opposite to the brain lesion due to the crossing (decussation) of motor pathways.
B. The functioning of the right cranial nerve controlling facial movement is compromised by cerebral edema: While facial nerve involvement can cause drooping, the hemiparesis suggests a central (brain) rather than peripheral issue.
C. The sensorimotor tracts leading from the brain to the body decussate and control the arm and leg on the same side as the lesion: This is incorrect because the tracts control the contralateral side of the body.
D. The corticospinal tracts leading from the brain to the body decussate and control the ipsilateral arm and leg: This is incorrect; the corticospinal tracts control the contralateral side.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Decreased respirations and CO2 retention: A thyrotoxic crisis (thyroid storm) typically involves increased, not decreased, respiratory rates and CO2 retention due to increased metabolic activity.
B. Seizures and extreme tachycardia: Thyrotoxic crisis is characterized by severe symptoms including extreme tachycardia, fever, and potentially seizures due to excessive thyroid hormone levels.
C. Constipation and a swollen abdomen: Constipation and abdominal swelling are more typical of hypothyroidism rather than a thyrotoxic crisis.
D. Hypotension and bradycardia: Thyrotoxic crisis usually causes tachycardia and hypertension rather than bradycardia and hypotension.
Correct Answer is D
Explanation
A. An increased serum calcitonin level: Calcitonin is involved in lowering blood calcium levels, so increased levels would not indicate hypercalcemia but rather a compensatory mechanism to lower calcium.
B. An increased number of osteocytes: Osteocytes are bone cells, and their number is not a direct indicator of hypercalcemia. Osteoclasts and osteoblasts are more relevant to bone metabolism.
C. Elevated plasma magnesium levels: Elevated magnesium levels are not specifically indicative of hypercalcemia and can be related to other conditions.
D. An increased parathyroid hormone (PTH) level: Hypercalcemia can be associated with increased PTH levels, particularly in primary hyperparathyroidism. Elevated PTH can lead to increased calcium release from bones.
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