Chamberlain NR 325 Exam 2, NR 325
Exam #2 2023
Which sided stroke has impaired speech/language aphasia; impaired right/left
discrimination; slow performance/cautious,; depression/anxiety; impaired
comprehension. - CORRECT ANSWERS Left-Sided
Which sided stroke has spatial perception deficits; denying/minimizing; rapid
performance/short attention; impulsiveness; impaired judgment; impaired time. -
CORRECT ANSWERS Right-sided
_____ are the confirming diagnostic studies for stroke. - CORRECT ANSWERS CT;
CT angiogram; CT/MRI perfusion and diffusion imaging; MRI; Magnetic resonance
angiography (MRA)
_____ are the confirming laboratory studies for stroke. - CORRECT ANSWERS
Prothrombin time, activated partial thromboplastin time; CBC (including
platelets); Electrolyte panel with blood glucose; Lipid profile; Renal and hepatic
studies
Recombinant tissue plasminogen activator (tPA) is used to produce localized fibrinolysis
by binding to the fibrin in the thrombi, and is the immediate treatment for _____ _____. -
CORRECT ANSWERS Ischemic stroke
Aspirin at a dose of 325 mg may be started within 24 to 48 hours after the onset of an
_____ stroke. - CORRECT ANSWERS ischemic
Anticoagulants and platelet inhibitors are contraindicated in patients with _____ strokes.
- CORRECT ANSWERS hemorrhagic
The main drug therapy for patients with _____ stroke is the management of
hypertension. - CORRECT ANSWERS hemorrhagic
The _____ _____ of a spinal cord injury (SCI) is initial physical disruption of the spinal
cord. - CORRECT ANSWERS primary injury
The _____ _____ of a spinal cord injury is from processes, such as ischemia, hypoxia,
hemorrhage, edema - CORRECT ANSWERS secondary injury
_____ _____ may occur shortly after acute SCI. It is characterized by loss of deep
tendon and sphincter reflexes, loss of sensation, and flaccid paralysis below the level of
injury. - CORRECT ANSWERS Spinal shock
,_____ _____ involvement results in total loss of sensory and motor function below the
level of injury. - CORRECT ANSWERS Complete cord
_____ _____ involvement results in a mixed loss of voluntary motor activity and
sensation and leaves some tracts intact. - CORRECT ANSWERS Incomplete cord
SCI at C1-C3 - CORRECT ANSWERS Often fatal; Movement in neck and above,
loss of innervation to diaphragm, absence of independent respiratory function
SCI at C4 - CORRECT ANSWERS Sensation and movement in neck and above;
May be able to breathe without ventilator
SCI at C5 - CORRECT ANSWERS Full neck, partial shoulder, back, biceps; Gross
elbow, inability to roll over or use hands; ↓ Respiratory reserve
SCI at C6 - CORRECT ANSWERS Shoulder and upper back abduction and
rotation at shoulder; Full biceps to elbow flexion, wrist extension, weak grasp of
thumb; ↓ Respiratory reserve
SCI at C7-C8 - CORRECT ANSWERS All triceps to elbow extension, finger
extensors and flexors; Good grasp with some decreased strength; ↓ Respiratory
reserve
SCI at T1-T6 - CORRECT ANSWERS Full innervation of upper extremities; Back,
essential intrinsic muscles of hand; Full strength and dexterity of grasp; ↓ Trunk
stability, decreased respiratory reserve
SCI at T6-T12 - CORRECT ANSWERS Full, stable thoracic muscles and upper
back; Functional intercostal muscles, resulting in ↑ respiratory reserve
SCI at L1-L2 - CORRECT ANSWERS Varying control of legs and pelvis; Instability
of lower back
SCI at L3-L4 - CORRECT ANSWERS Quadriceps and hip flexors; Absence of
hamstring function, flail ankles
CT scan is the preferred imaging study to diagnose the location and degree of injury
and the degree of _____ _____ _____. - CORRECT ANSWERS spinal canal
compromise
_____ is used to assess soft tissue injury, neurologic changes, unexplained neurologic
deficits, or worsening neurologic condition in SCI. - CORRECT ANSWERS MRI
Goals immediately after _____ include maintaining a patent airway, adequate
ventilation/breathing, and adequate circulating blood volume (ABCs) and preventing
extension of spinal cord damage (secondary injury). - CORRECT ANSWERS SCI
, _____ allows the patient to move and ambulate while cervical bones fuse - CORRECT
ANSWERS Halo fixation device
One of the physically demonstrable symptoms of meningitis is _____ _____. Severe
neck stiffness causes a patient's hips and knees to flex when the neck is flexed. -
CORRECT ANSWERS Brudzinski's sign
Positive _____ sign is involuntary flexing of hips and knees (an involuntary reaction to
lessen the stretch on the inflamed meninges) - CORRECT ANSWERS Brudzinski's
sign
_____ _____ is a neuropsychiatric manifestation of liver disease. The pathogenesis is
multifactorial. It includes the neurotoxic effects of ammonia, abnormal
neurotransmission, astrocyte swelling, and inflammatory cytokines. - CORRECT
ANSWERS Hepatic encephalopathy
A characteristic manifestation of hepatic encephalopathy is _____, or flapping tremors,
with the most common involving the arms and hands. - CORRECT ANSWERS asterixis
If the common bile duct is obstructed due to _____, no bilirubin will reach the small
intestine to be converted to urobilinogen. Thus the kidneys will excrete bilirubin, causing
dark amber to brown urine. - CORRECT ANSWERS cholelithiasis
Complications of _____ and cholecystitis include gangrenous cholecystitis, subphrenic
abscess, pancreatitis, cholangitis (inflammation of biliary ducts), biliary cirrhosis,
fistulas, and rupture of the gallbladder, which can cause bile peritonitis. - CORRECT
ANSWERS cholelithiasis
Manifestations of _____ vary from indigestion to moderate to severe pain, fever, chills,
and jaundice. - CORRECT ANSWERS cholecystitis
When a stone is lodged in the ducts or when stones are moving through the ducts,
spasms may result in response to the stone. This sometimes causes severe pain, which
is termed _____ _____. - CORRECT ANSWERS biliary colic
_____ results in the replacement of liver tissue by fibrosis (scar tissue) and regenerative
nodules that occur from the liver's attempt to repair itself - CORRECT ANSWERS
cirrhosis
Hepatic encephalopathy caused by cirrhosis is treated with _____, to prevent
breakdown of blood and the release of ammonia in the intestine. - CORRECT
ANSWERS lactulose
Increased levels of alkaline phosphatase, ALT, and AST are the notable labs present
with _____. - CORRECT ANSWERS cholecystitis
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