Deck 16: Disorders of Brain Function

Question 1

The nurse knows which of the following phenomena listed below is an accurate statement about axonal transport?

A) Anterograde and retrograde axonal transport allow for the communication of nerve impulses between the neuron and the central nervous system (CNS).
B) Materials can be transported to the nerve terminal by either a fast or slow component.
C) The unidirectional nature of the axonal transport system protects the CNS against potential pathogens.
D) Axonal transport facilitates the movement of electrical impulses but precludes the transport of molecular materials.

Answer 1

Materials can be transported to the nerve terminal by either a fast or slow component.

Question 2

An adult male has a new diagnosis of Guillain-Barré syndrome. The nurse knows which of the following pathophysiological processes underlie the deficits that accompany the degeneration of myelin in his peripheral nervous system (PNS)?

A) The destruction of myelin causes fewer Schwann cells to be produced in the client's PNS.
B) The axonal transport system is compromised by the lack of myelin surrounding nerve cells.
C) Unless remyelination occurs, the axon will eventually die.
D) A deficit of myelin predisposes the client to infection by potential pathogens.

Answer 2

Unless remyelination occurs, the axon will eventually die.

Question 3

While assessing a critically ill patient in the emergency department, the nurse notes on the cardiac monitor an R-on-T premature ventricular beat that develops into ventricular tachycardia (VT). Immediately, the patient became unresponsive. The nurse knows that based on pathophysiologic principles, the most likely cause of the unresponsiveness is

A) metabolic acidosis that occurs spontaneously following any dysrhythmias.
B) interruption of the blood/oxygen supply to the brain.
C) massive cerebrovascular accident (CVA) resulting from increased perfusion.
D) a blood clot coming from the heart and occluding the carotid arteries.

Answer 3

interruption of the blood/oxygen supply to the brain.

Question 4

When educating a patient about to undergo a pacemaker insertion, the nurse explains the normal phases of cardiac muscle tissue. During the repolarization phase, the nurse will stress that membranes must be repolarized before they can be reexcited. Within the cell, the nurse understands that

A) potassium channels open while sodium channels close, causing repolarization to the resting state.
B) the influx of calcium is the primary stimulus for the repolarization of cardiac tissue.
C) only the electrical activity within the heart will determine when repolarization occurs.
D) the cell membranes need to stay calm resulting in muscle tissue becoming refractive.

Question 5

A client with a diagnosis of depression has been prescribed a medication that ultimately increases the levels of the neurotransmitter serotonin between neurons. Which of the following processes will accompany the actions of the neurotransmitter in a chemical synapse?

A) Two-way communication between neurons is permitted in contrast to the one-way communication in electrical synapses.
B) Communication between a neuron and the single neuron it is connected with will be facilitated.
C) The neurotransmitter will cross gap junctions more readily.
D) More neurotransmitters will cross the synaptic cleft and bond with postsynaptic receptors.

Question 6

The neurotransmitter GABA mainly functions to trigger inhibitory postsynaptic potentials (IPSPs). Therefore, when explaining this to a group of nursing students, the nurse will state that

A) it takes at least three chemical substances (amino acids, neuropeptides, and monoamines) to stimulate any activity between the cells.
B) there is a symbiotic relationship; therefore, the end result will be depolarization of the postsynaptic membrane.
C) the combination of GABA with a receptor site is inhibitory since it causes the local nerve membrane to become hyperpolarized and less excitable.
D) the neurotransmitters will interact with cholinergic receptors to bind to acetylcholine in order to produce hypopolarization within the cell.

Question 7

When reviewing the purpose/action of neurotransmitters as they interact with different receptors, the nursing instructor gives an example using acetylcholine. When acetylcholine is released at the sinoatrial node in the right atrium of the heart, it is

A) positively charged.
B) inhibitory.
C) overstimulated.
D) dormant.

Question 8

A male newborn infant has been diagnosed with spina bifida occulta. Which of the following pathophysiological processes has most likely contributed to the infant's health problem?

A) The neural groove failed to fuse and completely close across the top of the neural plate.
B) The infant's spinal cord and meninges protrude through his skin.
C) The child's central and peripheral nervous systems have insufficiently differentiated during embryonic development.
D) The infant's soma and viscera are underdeveloped.

Question 9

A child is experiencing difficulty with chewing and swallowing. The nurse knows that which of the following cells may be innervating specialized gut-related receptors that provide taste and smell?

A) Special somatic afferent fibers
B) General somatic afferents
C) Special visceral afferent cells
D) General visceral afferent neurons

Question 10

A nursing student having trouble moving his head from side to side is likely experiencing a problem with which type of neurons?

A) General visceral efferent neurons
B) Preganglionic neurons
C) Parasympathetic postganglionic neurons
D) Pharyngeal efferent neurons

Question 11

Following a spinal cord injury suffered in a motor vehicle accident, a 22-year-old male has lost fine motor function of his fingers and thumb but is still able to perform gross motor movements of his hand and arm. Which of the following components of his white matter has most likely been damaged?

A) The inner layer (archilayer)
B) The middle layer (paleolayer)
C) The outer layer (neolayer)
D) The reticular formation

Question 12

Not realizing that its surface was hot, a woman has quickly withdrawn her hand from the surface of a bowl that she was removing from a microwave. Which of the following phenomena has facilitated the rapid movement of her hand in response to the painful stimulus?

A) Her midbrain has rapidly responded to the nociceptive stimuli and induced arm flexion.
B) The withdrawal reflex of her peripheral nervous system has quickly mediated between afferent and effector neurons.
C) The forebrain has mediated a protective spiral cord reflex.
D) Her CNS has enacted a protective response received by neurons that innervate her arm muscles.

Question 13

A Tae Kwon Do (TKD) master is applying downward pressure just above the elbow joint on an attacker who immediately collapses to the ground. The TKD master knows the elbow joint can bend inward toward the body but not in the opposite direction. Which of the following reflexes is applicable to this example?

A) Knife-clasp
B) Withdrawal
C) Myotatic
D) Inverse myotatic

Question 14

During a clinical assessment of a 68-year-old client who has suffered a head injury, a neurologist suspects that a client has a sustained damage to her vagus (CN X) nerve. Which of the following assessment findings is most likely to lead the physician to this conclusion?

A) The client has difficulty swallowing and has had recent constipation and hypoactive bowel sounds.
B) The client is unable to turn her head from side to side, and her tongue is flaccid.
C) The client has a unilateral facial droop, dry eyes, and decreased salivary production.
D) The client is unable to perform any fine motor movements of her tongue.

Question 15

A 9-year-old girl has a diffuse collection of symptoms that are indicative of deficits in endocrine and autonomic nervous system control. She also suffers from persistent fluid and electrolyte imbalances. The nurse knows which of the following aspects of the nervous system listed below would her health care providers focus their diagnostic efforts on?

A) Her afferent and efferent cranial nerve function
B) Possible damage to her pons and medulla
C) Impaired function of her hypothalamus
D) Potential damage to the girl's cerebellum

Question 16

A badly burned firefighter has been in an induced coma for 3 weeks. When he awakens, he thanks his son for singing Happy Birthday to him a week earlier. Which part of the brain is responsible for allowing him to hear and comprehend while comatose?

A) Thalamus
B) Hypothalamus
C) Corpus callosum
D) Basal ganglia

Question 17

Which of the following statements best conveys an aspect of the role of cerebrospinal fluid (CSF)?

A) It provides physical protection for the brain and ensures that leukocytes and erythrocytes are evenly distributed in the CNS.
B) CSF cushions the brain and provides a near-water medium for diffusion of nutrients.
C) CSF distributes plasma proteins throughout the superficial gray matter of the CNS.
D) It ensures that the high metabolic and oxygenation needs of the brain are met, as well as absorbing physical shocks.

Question 18

A 21-year-old male is brought to the ED following a night of partying in his fraternity. His friends found him "asleep" and could not get him to respond. They cannot recall how many alcoholic beverages he drank the night before. While educating a student nurse and the roommates in the fraternity, the nurse begins by explaining that alcohol is

A) water-soluble compound that is easily absorbed by the gastric lining of the stomach.
B) very lipid soluble and rapidky crosses the blood-brain barrier.
C) able to reverse the transport of some substances to remove them from the brain.
D) very likely to cause sedation, and therefore the patient just needs to sleep it off.

Question 19

A 45-year-old diabetic male is experiencing erectile dysfunction. If his erectile dysfunction is caused by the nervous system, then the nurse can educate the patient that the venous blood supply to the penis is controlled by

A) sacral parasympathetic fibers.
B) the hypothalamus.
C) the vagus nerve.
D) postganglionic sympathetic neurons.

Question 20

As you are walking in the park, a huge black Labrador (dog) runs up to you and places his paws on your shoulders. Immediately your heart starts racing, you feel palpations and anxiety, and your hands become a little shaky. The nurse knows that this response is primarily caused by

A) fear of dogs that make you feel like your chest is being tightened and that you have lost control of the situation.
B) increased levels of glucocorticoids by the adrenal glands that result in an increase in epinephrine level.
C) response of the cholinergic muscarinic receptors on innervational targets of postganglionic fibers.
D) ^{stimulation of the release of ?}2^{-adrenergic receptors, which will open the airway} and increase oxygenation.