Questions and Answers
PART IV · QUESTIONS
1. What is the role of myelin that surrounds the axon of the neuron?
a. Protection from injury
b. Nourish the cell body
c. Provide energy
d. Speed transmission of impulse
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1. The correct answer is d. The myelin sheath insulates the axon and is interrupted periodically at the nodes of Ranvier, which enables the impulse to “jump” more quickly.
2. Where do motor fibers originating in the precentral gyrus cross to the other side of the body?
a. At the level of the spinal segment at which they emerge from the spinal cord
b. At the level of the medulla
c. One or two segments above the level at which they emerge
d. One or two segments below the level at which they emerge
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2. The correct answer is b. Motor fibers cross at the level of the medulla; thus, the left hemisphere controls all the activities on the right side of the body and vice versa.
3. From what area of the brain do the cell bodies of the third cranial nerve originate?
a. Medulla
b. Cerebellum
c. Midbrain
d. Frontal lobe
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3. The correct answer is c. The midbrain is at the level of the tentorial notch; thus, third cranial nerve function/pupillary function is compromised with herniation through the tentorial notch with increased intracranial pressure.
a. Acetylcholine is the neurotransmitter of the sympathetic nervous system.
b. β1 Receptors are found in the myocardium.
c. Stimulation of α1 receptors causes vasodilation of the arterioles.
d. Pupil dilation is a result of parasympathetic stimulation.
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4. The correct answer is b. β1 Receptors on the heart are stimulated by the sympathetic nervous system, resulting in increased impulse formation, conduction, and myocardial contraction. Acetylcholine is the neurotransmitter of the parasympathetic nervous system. Stimulation of α1 receptors causes vasoconstriction. Pupillary dilation is a result of sympathetic stimulation.
5. Which of the following is the earliest compensatory mechanism for increasing intracranial pressure?
a. Increased systemic blood pressure due to systemic arterial vasoconstriction
b. Displacement of cerebrospinal fluid (CSF) into the spinal column
c. Vasodilation of intracranial arteries
d. Herniation of brain tissue
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5. The correct answer is b. Movement of CSF is easiest to accomplish; thus, it is the earliest compensatory mechanism mobilized. According to the Monro-Kellie hypothesis, when one of the components of the cranium (i.e., brain tissue, blood, and CSF) expand, another component must contract to maintain the normal level of intracranial pressure. The other mechanisms mentioned occur at stages when the earlier mechanisms are exceeded.
6. The nurse is caring for a patient who sustained a head injury in a motor vehicle accident. In her assessment of the patient, the nurse should keep in mind that one of the earliest signs of increased intracranial pressure in a supratentorial lesion is what?
a. Pupillary changes
b. Changes in the level of consciousness
c. Respiratory pattern alterations
d. Widened pulse pressure and tachycardia
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6. The correct answer is b. The cerebral cortex and the reticular activating system are involved in consciousness, and these areas are the first to be affected by increased intracranial pressure. The other functions are regulated in the brainstem at a lower level and, therefore, are not affected until later.
7. Which of the following changes in vital signs occurs in the late decompensation stage of increased intracranial pressure?
a. Rapid respirations
b. Slow pulse
c. Widening pulse pressure
d. Rapid pulse
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7. The correct answer is b. As the severity of the increased cranial pressure increases, the perfusion to the vital center in the brainstem diminishes, functions of the cardiovascular and the respiratory system slow down, and regulation of blood pressure is disrupted. The pulse rate slows, the respiratory rate slows, and the pulse pressure narrows as the systolic blood pressure falls.
8. What does a loss of consciousness during a seizure indicate?
a. An infection is causing the seizure
b. That the locus of seizure activity is in the frontal lobe
c. That the seizure activity involves both hemispheres of the brain
d. The individual has status epilepticus
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8. The correct answer is c. A pathological process must involve both cerebral hemispheres for a loss of consciousness to occur.
9. The individual with bacterial meningitis may present with which of the following manifestations?
a. Decreased body temperature
b. Decreased blood pressure
c. Edema of the eyelids
d. Stiff neck
View Answer
9. The correct answer is d. Irritation of the meninges due to inflammation causes stiff neck or nuchal rigidity.
10. Clinical manifestations of bacterial meningitis include which of the following?
a. Fever, swollen tongue, and diminished level of consciousness
b. Photophobia, elevated blood pressure, and skin rash
c. Fever, stiff neck, and diminished level of consciousness
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