PORTAGE LEARNING NURS 231: Pathophysiology 2022 MODULE 6

PORTAGE LEARNING NURS 231: Pathophysiology 2022 MODULE 6 Question 1 2.5 / 2.5 pts Multiple Choice: A patient has experienced a seizure affecting the left temporal lobe. The family reports that the patient exhibited repetitive lip smacking and hand rubbing followed by a period of great fear and insecurity. They have experienced which type of seizure? Focal seizure without impairment of consciousness or awareness Correct! Focal seizure with impairment of consciousness or awareness Generalized tonic/clonic seizure Question 2 2.5 / 2.5 pts Multiple Choice: A patient is having difficulty tracking their eye laterally. Which cranial nerve is affected? CN II. CN III. CN IV. Correct! CN VI. Question 3 2.5 / 2.5 pts Multiple Choice: You are seeing a patient with Parkinson’s disease in your office. You notice they are repetitively rubbing their right thumb and forefinger. This is an example of what physical manifestation of the disease? Correct! Pill-rolling Cogwheeling Bradykinesia Rigidity Question 4 2.5 / 2.5 pts Multiple Choice: Sleep spindles are characteristic of which stage of sleep? Stage 1 Correct! Stage 2 Stage 3 Stage 4 Question 5 2.5 / 2.5 pts Multiple Choice: A person reports feelings of worthlessness and guilt as well as difficulty sleeping. As they are speaking, you notice a repetitive, accentuated blinking of their eyes. What type of depression are they experiencing? Melancholic depression Atypical depression Depression with psychotic features Correct! Depression with catatonic features Question 6 2.5 / 2.5 pts Multiple Choice: Each of the following statements is true regarding the organization of the nervous system except: The PNS has an afferent and efferent division Correct! The somatic nervous system can be further divided into the sympathetic and parasympathetic divisions The CNS contains the hindbrain, midbrain, and forebrain The PNS contains the cranial nerves Question 7 2.5 / 2.5 pts Multiple Choice: Each of the following statements is true regarding Alzheimer’s disease except: Correct! Neurofibrillary tangles are a result of an abnormal accumulation of amyloid in the blood vessels Neuritic plaques are composed of deteriorating nerve pieces that arrange themselves around a sticky protein core called amyloid beta (Aβ) Cerebral amyloid angiopathy contributes to the pathogenesis of Alzheimer’s disease Question 8 2.5 / 2.5 pts Multiple Choice: Each of the following are modifiable behaviors related to stroke except: Obesity Smoking Correct! Hypercholesteremia Immobility Question 9 2.5 / 2.5 pts Multiple Choice: Adjustment insomnia is characterized by each of the following except: Correct! More than 30 days of insomnia symptomology Disrupted sleep is in response to physical or emotional stressor Resolves on its own once an adjustment is made/stressor is removed Question 10 2.5 / 2.5 pts Multiple Choice: A “drop attack” is another term for which type of seizure? Myoclonic seizure Clonic seizure Tonic seizure Correct! Atonic seizure Question 11 2.5 / 2.5 pts Multiple Choice: Narcolepsy appears to be linked to an abnormal regulation of which stage of sleep? stage 1 stage 2 stage 4 Correct! REM Question 12 2.5 / 2.5 pts Multiple Choice: Each of the following statements is true of Parkinson’s disease except: Correct! Environmental factors alone lead to disease development It affects the substantia nigra of the brain It is characterized by a loss of dopaminergic neurons Incidence increases with age Question 13 2 / 2 pts Fill in the blank: Efferent neurons deliver input from the CNS to the periphery. Your Answer: motor Answer: Motor Question 14 2 / 2 pts Fill in the blank: work by blocking membrane receptors and the subsequent reuptake of serotonin and norepinephrine. Your Answer: Tricyclic antidepressants, TCAs Answer: Tricyclic antidepressants (TCAs) Question 15 2 / 2 pts Fill in the blank: is sleep disordered breathing due to the brain not properly signaling the respiratory muscles. Your Answer: Central sleep apnea Answer: Central sleep apnea Question 16 2 / 2 pts Fill in the blanks: The aim of drug therapy used for Parkinson’s disease is to increase neuron activity or decrease neuron activity. Your Answer: dopaminergic, cholinergic Answer: dopaminergic, cholinergic Question 17 2 / 2 pts Fill in the blank: Connective tissue sheaths that surround the brain and spinal cord providing protection are called the . Your Answer: meninges Answer: Meninges Question 18 5 / 5 pts T/F – Make true if False Oligodendrocytes produce myelin in the PNS. Your Answer: False Answer: False, oligodendrocytes produce myelin in the CNS. Question 19 5 / 5 pts 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. Your Answer: False Answer: False, the age of onset is decreasing in recent times. Question 20 5 / 5 pts T/F – Make true if False Brain activity is decreased during REM sleep. Your Answer: False Answer: False, brain activity is increased during REM sleep. Question 21 5 / 5 pts T/F – Make true if False Complete dependence for activities of daily living is characteristic of severe Alzheimer’s disease. Your Answer: True Answer: True Question 22 5 / 5 pts Short Answer Essay Explain the mechanism of electric synapses and how they contribute to the rapid propagation of an action potential. Your Answer: Electric synapses allow the passage of the current through openings called gap junctions. Gap juntions penetrate the junctions of neighboring cells, which allows the current to move in either direction. This results in the ability of the action potential to move rapidly from neuron to neuron. Answer: Electrical synapses allow the passage of current-carrying ions through small openings called gap junctions. These gap junctions penetrate the cell junction of neighboring cells allowing current to flow in either direction. Question 23 5 / 5 pts Short Answer Essay 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? Your Answer: The specific type of seizure described is an absence seizure, which is considered a subcategory of generalized seizures. Answer: Generalized, Absence seizure Question 24 5 / 5 pts Short Answer Essay Describe the importance of brain activity that occurs during REM sleep. Your Answer: During REM sleep, internalized sensory are stimulated which allows formed memories to replay. REM sleep is necessary for normal physiolgic and psychologic functioning during wake times. REM deprivation can lead to anxiety, decreased concentration, and behavioral changed. Answer: 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. Question 25 5 / 5 pts Short Answer Essay A patient reports to the emergency department where you are working at 10 pm. They report that earlier in the day beginning at approximately 9 am they began to experience tingling in their right arm. They decided to ignore it thinking it was probably a result of all the gardening they did the day before. As the day went on, the tingling sensation got worse, and they started to have difficulty speaking. The patient’s spouse reported that they were slurring their words. Past medical history includes a diagnosis of diabetes and hypercholesteremia. By the time they are evaluated, their symptoms start to subside. The tingling disappears and their speech returns to normal. What do you suspect this patient has experienced? What evidence is there to support that diagnosis? Your Answer: The patient experienced a TIA, transient ischemic attack, or mini stroke. The patient's symptoms, tingling sensation, slurred speech, difficulty speaking, are signs of a stroke. However, with TIA, the symptoms/signs, will resolve within 24 hours. The patient's medical history of diabetes and hypercholesteremia also are risk factors for stroke. Answer: This patient has experienced a TIA. They have experienced symptoms consistent with oxygen deprivation to the brain, however their symptoms subsided within 24 hours of their onset. Question 26 10 / 10 pts Long Answer Essay A 75-year-old male is brought to the emergency department via ambulance at 5 pm. The patient’s spouse reports that when they woke up (approximately at 6 am) he reported to her that he was having some blurred vision but decided to go about his day. As the day progressed, he started experiencing tingling and feelings of weakness on the entire left side of his body. He has a past medical history of diabetes. 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. Your Answer: This patient is experiencing a stroke. A CT scan and MRI will be ordered to determine the type of stroke and rule out possible other disorders. A vasular image will be done to determine source of the block. Since its been over 4 hours since symptom onset, the window to safely administer tPA has passed. A catheter based method is necessary. This will mechanically break the clot and deliver drugs directly to the clot itself. A stent might be place as well. Answer: 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 would need to be re-perfused through catheterbase methods as they are outside of the 3-4.5 treatment window for the use of tPA drugs. Question 27 10 / 10 pts Long Answer Essay 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. Your Answer: The 4 symptoms are: DIfficulty initiating sleep Difficulty maintaining sleep Waking up too early Chronic nonrestorative (poor)sleep For a primary insomnia diagnosis, patient must exhibit at least 3 symptoms from the list above and at least one sympton during wake hours, such as poor work performance and irritability. Nonpharmacologic treatment will be patient education and good sleep hygiene, sleep habits. This includesa comfortable sleeping environmnet, going to bed at the same time each night, avoid caffeine or other stimulants several hours prior to bedtime, avoidance of screens before bed. Answer: The 4 primary symptoms of insomnia are: Difficulty initiating sleep Difficulty maintaining sleepWaking 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.