NU 578 UNIT 4 EXAM A MASTERY 150 CORRECT VERIFIED ANSWERS WITH DETAILED RATIONALES INSTANT DOWNLOAD

NU 578 UNIT 4 EXAM A MASTERY 150
CORRECT VERIFIED ANSWERS WITH
DETAILED RATIONALES INSTANT
DOWNLOAD


NU 578 UNIT 4 EXAM
Comprehensive Study Guide with Detailed Rationales
Question 1: A nurse practitioner is evaluating a patient with suspected
acute bacterial meningitis; the patient presents with fever, nuchal
rigidity, and altered mental status. Which diagnostic procedure is
considered the gold standard for confirming the diagnosis and
identifying the causative organism? A) Computed Tomography (CT) of
the head. B) Lumbar Puncture (LP) with cerebrospinal fluid
(CSF) analysis. C) Blood cultures alone. D) Electroencephalogram
(EEG).
The lumbar puncture allows for the direct analysis of cerebrospinal
fluid, including cell count, glucose, protein, Gram stain, and culture.
This is the definitive method for diagnosing meningitis and determining
whether it is bacterial, viral, or fungal. CT is used to rule out mass
effect before LP but does not diagnose the infection itself.


Question 2: In a patient with bacterial meningitis, which of the
following CSF findings is most characteristic? A) Normal glucose,
normal protein, lymphocytic pleocytosis. B) Low glucose, high
protein, and neutrophilic pleocytosis. C) High glucose, low
protein, and red blood cells. D) Normal glucose, high protein, and
xanthochromia.
Bacterial meningitis typically presents with low CSF glucose (due to
bacterial consumption), elevated protein (due to blood-brain barrier
disruption and inflammation), and a predominance of neutrophils
(polymorphonuclear leukocytes). Viral meningitis usually shows
normal glucose and lymphocytic pleocytosis.

,Question 3: A patient is admitted with signs of increased intracranial
pressure (ICP); the nurse observes Cushing’s Triad. Which of the
following sets of vital sign changes constitutes Cushing’s Triad? A)
Tachycardia, hypotension, and irregular respirations. B) Bradycardia,
hypertension (with widened pulse pressure), and irregular
respirations. C) Tachycardia, hypertension, and tachypnea. D)
Bradycardia, hypotension, and Cheyne-Stokes respirations.
Cushing’s Triad is a late and ominous sign of severely increased ICP
indicating brainstem herniation. It consists of bradycardia (due to
vagal stimulation), systolic hypertension with widening pulse pressure
(to maintain cerebral perfusion), and irregular or depressed
respirations.


Question 4: A patient with a history of atrial fibrillation suddenly
develops right-sided weakness and aphasia; a CT scan rules out
hemorrhage. What is the most likely etiology of this ischemic stroke? A)
Thrombotic stroke due to atherosclerosis. B) Embolic stroke due to a
clot from the heart. C) Lacunar stroke due to small vessel disease. D)
Hemorrhagic stroke due to aneurysm rupture.
Atrial fibrillation causes stasis of blood in the atria, leading to
thrombus formation. These clots can dislodge and travel to the brain,
causing an embolic stroke. The sudden onset of focal deficits like
aphasia and hemiparesis is classic for embolic events. Thrombotic
strokes often have a more gradual progression or stuttering course.


Question 5: Which medication is the primary pharmacological
intervention for reducing cerebral edema in patients with increased
intracranial pressure? A) Furosemide. B) Mannitol. C) Lisinopril. D)
Dexamethasone.
Mannitol is an osmotic diuretic that draws water out of the brain tissue
into the vascular space, thereby reducing cerebral edema and lowering
intracranial pressure. While dexamethasone is used for vasogenic
edema associated with tumors, mannitol is the standard for acute
traumatic or cytotoxic edema.

,Question 6: A patient presents with a sudden, severe "thunderclap"
headache described as the worst headache of their life, accompanied by
photophobia and neck stiffness. What is the most likely diagnosis? A)
Migraine with aura. B) Tension-type headache. C) Subarachnoid
Hemorrhage (SAH). D) Cluster headache.
A subarachnoid hemorrhage, often caused by a ruptured aneurysm,
classically presents with a sudden, explosive headache ("thunderclap").
Meningeal irritation from blood in the subarachnoid space causes
photophobia and nuchal rigidity. This is a medical emergency
requiring immediate neuroimaging.


Question 7: In the management of status epilepticus, what is the first-
line benzodiazepine typically administered intravenously? A) Oral
diazepam. B) IV Lorazepam (Ativan). C) IV Phenytoin. D) IV
Levetiracetam.
IV Lorazepam is the preferred first-line agent for stopping active
seizures in status epilepticus due to its rapid onset and longer duration
of action in the CNS compared to diazepam. Phenytoin and
levetiracetam are second-line agents used for maintenance after the
seizure is controlled.


Question 8: A patient with Parkinson’s Disease is prescribed
Levodopa/Carbidopa; the nurse explains that Carbidopa is added to the
regimen for a specific purpose. What is the role of Carbidopa? A) It
increases the production of dopamine in the brain. B) It inhibits
peripheral decarboxylation of Levodopa, allowing more to
reach the brain. C) It acts as a direct dopamine agonist. D) It prevents
the breakdown of acetylcholine.
Levodopa is converted to dopamine by the enzyme dopa-decarboxylase.
If this happens in the periphery, it causes side effects like nausea and
reduces the amount reaching the brain. Carbidopa is a peripheral
decarboxylase inhibitor that prevents this conversion outside the CNS,
increasing the bioavailability of Levodopa in the brain and reducing
systemic side effects.

, Question 9: Which clinical feature distinguishes Parkinson’s Disease
from other movement disorders? A) Intention tremor. B) Resting
tremor, rigidity, bradykinesia, and postural instability. C)
Chorea and athetosis. D) Flaccid paralysis.
The cardinal motor signs of Parkinson’s Disease are resting tremor
(often "pill-rolling"), rigidity (cogwheel or lead-pipe), bradykinesia
(slowness of movement), and postural instability. Intention tremor is
seen in cerebellar disorders, and chorea is seen in Huntington’s Disease.


Question 10: A patient with Multiple Sclerosis (MS) experiences a
temporary worsening of symptoms when exposed to heat or during
exercise; what is this phenomenon called? A) Uhthoff’s Phenomenon. B)
Lhermitte’s Sign. C) Charcot’s Triad. D) Raynaud’s Phenomenon.
Uhthoff’s Phenomenon is the temporary worsening of neurological
symptoms in MS patients due to an increase in body temperature. Heat
slows nerve conduction in already demyelinated fibers. Lhermitte’s
Sign is an electric shock sensation down the spine upon neck flexion.


Question 11: Which diagnostic test is most sensitive for detecting the
plaques and demyelination associated with Multiple Sclerosis? A) CT
scan of the head. B) MRI of the brain and spinal cord with
gadolinium contrast. C) Lumbar puncture. D) Electromyography
(EMG).
MRI is the gold standard for diagnosing MS, revealing characteristic
white matter plaques (lesions) in the brain and spinal cord. Gadolinium
contrast helps identify active, inflammatory lesions. Lumbar puncture
may show oligoclonal bands, but MRI is more sensitive for structural
diagnosis.


Question 12: A patient presents with unilateral facial droop, inability to
close the eye on the affected side, and loss of taste on the anterior two-
thirds of the tongue; there are no other neurological deficits. What is the
most likely diagnosis? A) Stroke (CVA). B) Bell’s Palsy (Idiopathic
Facial Paralysis). C) Trigeminal Neuralgia. D) Myasthenia Gravis.
Bell’s Palsy is a lower motor neuron lesion of Cranial Nerve VII (Facial
Nerve). It affects the entire half of the face (including the forehead),