A 16-year-old's level of arousal was altered after taking a ...

[Collmarie]

A 16-year-old's level of arousal was altered after taking a recreational drug. Physical exam re-vealed a negative Babinski sign, equal and reactive pupils, and roving eye movements.
 
  Which of the following diagnoses will the nurse most likely see on the chart?
  a. Psychogenic arousal alteration
  b. Metabolically induced coma
  c. Structurally induced coma
  d. Structural arousal alteration

Question 2

A 20-year-old experiences a severe closed head injury as a result of a motor vehicle accident. Which of the following structures is most likely keeping the patient in a vegetative state (VS) 1 month after the accident?
 
  a. Cerebral cortex
  b. Brainstem
  c. Spinal cord
  d. Cerebellum

[k.lashomb]

Answer to Question 1

ANS: B
Persons with metabolically induced coma generally retain ocular reflexes even when other signs of brainstem damage are present. Psychogenic arousal activation demonstrates a general psychi-atric disorder. Structurally induced coma is manifested by asymmetric responses. Structural arousal alteration does not have drug use as its etiology.

Answer to Question 2

ANS: B
When a person loses cerebral function, the reticular activating system and brainstem can maintain a crude waking state known as a VS. Cognitive cerebral functions, however, cannot occur with-out a functioning reticular activating system. A VS is not associated with the cerebral cortex, spinal cord, or cerebellum.