152) ANSWER

D) Ipsilateral motor loss below lesion

RATIONALE

Hemisection of the anterior and posterior portions of the spinal cord results in loss of position sense (proprioception) on the same side of the body as the trauma, below the level of injury. Option 3 is seen in anterior cord syndrome; option 1 is incorrect. The core issue of the question is knowledge of characteristics of Brown-Séquard syndrome following spinal cord injury. Use nursing knowledge and the process of elimination to make a selection.

151) ANSWER

D) Influenza

RATIONALE

Influenza has been associated with Guillian-Barré syndrome, which causes progressive paralysis. Eliminate options 1, 2, and 3 which have no known association with Guillian-Barré.

150) Answer

C. Nausea

Rationale

•Amantadine (Symmetrel), in addition to its action on the influenza virus, increases the availability of dopamine in certain areas of the brain. Increased dopamine action in the chemoreceptor trigger zone of the brain causes nausea and vomiting.

149) ANSWER

B) 100/60 to 130/76.

RATIONALE

An increase of 30 mmHg systolic and 15 mmHg diastolic on two occasions is diagnostic for PIH. The blood pressures in each of the other options do not meet the criteria for increase in either the systolic or the diastolic blood pressure reading. Specific knowledge of the criteria for PIH is needed to answer this question. Use nursing knowledge and the process of elimination to make your selection. As an alternative, choose option 2 because it has the greatest degree of change in both systolic and diastolic measurements.

148) ANSWER

A) Pain

RATIONALE

Herpetic lesions are very painful, so the first priority is to provide comfort measures for the client. The other diagnoses do not address the client's most immediate concern. Recognize that prioritization is the key to correctly answering this question. The most immediate issue is pain.

147) Answer

C. Albuterol (Ventolin)

Rationale

•Albuterol is a short acting beta agonist administered via nebulizer or metered dose inhaler. Albuterol is the drug of choice for acute bronchospasms and bronchoconstriction.

•Theophylline, salmeterol, and Advair are not indicated for short term bronchospasm or bronchoconstriction relief.

146) ANSWER

A) Swan-neck deformity and ulnar deviation

RATIONALE

Swan-neck deformity occurs at the proximal interphalangeal (PIP) joint and ulnar deviation occurs as a result of joint destruction with disease progression. Heberden’s and Bouchard’s nodes are commonly found in clients with osteoarthritis. Tophi (firm, moveable nodules) are associated with gout. Charcot’s joint is considered a neuropathic disorder that falls under the broader category of rheumatism. It is not specific to RA and is more likely to be seen as a complication in clients with diabetes. The core issue of the question is identification of signs and symptoms of RA. Use nursing knowledge and the process of elimination to make a selection.