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
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Correct Answer is B
Explanation
A. High unconjugated, low direct: In liver disease, both conjugated (direct) and unconjugated bilirubin levels are typically elevated.
B. High conjugated, high direct: In cirrhosis and alcoholic liver disease, the liver's ability to process bilirubin is impaired, leading to elevated levels of both conjugated (direct) and unconjugated bilirubin, causing jaundice.
C. High direct, high unconjugated: Both direct (conjugated) and unconjugated bilirubin levels are elevated, but this does not clarify the direct relationship with jaundice.
D. Low indirect, normal unconjugated: In liver disease, bilirubin levels are elevated, not low or normal.
Correct Answer is A
Explanation
A. Esophageal varices: Coffee-ground emesis suggests upper gastrointestinal bleeding, which is often due to ruptured esophageal varices in patients with cirrhosis.
B. Colorectal cancer: This condition typically presents with lower gastrointestinal symptoms such as changes in bowel habits or blood in the stool, not coffee-ground emesis.
C. Inflammatory bowel disease: This condition can cause gastrointestinal bleeding but is more commonly associated with symptoms like diarrhea and abdominal pain rather than coffee-ground emesis.
D. Appendicitis: This condition typically presents with right lower quadrant pain, not upper GI bleeding.
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