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Chamberlain College of Nursing NURSING NR 509 APEA
Question: A transient ischemic attack is: a transient episode of neurologic dysfunction by focal brain, spinal cord, or retinal ischemia, without acute inf... [Show More] arction. Correctan infarction of the centr al nervous system tissue that may be silent or symptomatic.the abrupt onset of motor or sensory deficits. Incorrectfocal or asymmetric weaknesses caused by central and peripheral nerve damage. Explanation: TIA is now defined as “a transient episode of neurological dysfunction caused by focal brain, spinal cord, or retinal ischemia, without acute infarction.” Ischemic stroke is “an infarction of central nervous system tissue” that may be symptomatic or silent. The other terms are not related to the new definitions. Question: A patient is asked to visually follow a finger through the cardinal fields of gaze. Which cranial nerves are being assessed? III, IVIII, IV, VI CorrectV, VI, VII Explanation: Visually following a finger through the cardinal fields of gaze is one way to assess the oculomotor (CN III), trochlear (CN IV) and abducens (CN VI) nerves. CN I is the olfactory nerve and assesses smell. CN II is the optic nerve and assesses visual acuity. CN V is the trigeminal nerve and assesses both sensory and motor functions. Question: Uncontrolled electrical activity in the brain, which may produce minor physical signs, thought disturbances, or disturbed motor activity is: dystonia.bradykinesia.tremor.seizure. CorrectExplanation: A seizure is an uncontrolled electrical activity in the brain which may produce minor physical signs, thought disturbances, or disturbed motor activity, or a combination of symptoms. Dystonia is a neurological disorder that causes involuntary muscle spasms and twisting of the limbs. Bradykinesia is the term used to describe the impaired ability to adjust to one's body position. This symptom is noted in patients who have Parkinson's disease. A rhythmic oscillatory movement of a body part resulting from the contraction of opposing muscle groups is a tremor. Question: When evaluating the sensory system, testing the posterior columns tract would include assessing sensations of: position and vibration. Correctpain and temperature.deep touch. Incorrectdiscriminative sensations. Explanation: When evaluating the sensory system, testing the spinothalamic tracts would include assessing sensations of pain and temperature. Assessing position and vibration evaluate the posterior columns. Light touch assesses both the spinothalamic and posterior column tracts. To assess discriminative sensation, both the spinothalamic and posterior columns tracts as well as the cortex would be assessed. Question: Physical exam of a well two-week-old infant reveals a little dimple with a small amount of hair just above the sacral area. This could be: an unusual finding but within normal limits. Incorrecthirsutism.Arnold -Chiari malformation. spina bifida occulta. Correct Explanation: There are four types of spina bifida: occulta, closed neural tube defects, meningocele, and myelomeningocele. Occulta is the mildest and most common form in which one or more vertebrae are malformed. The name “occulta,” which means “hidden,” indicates that a layer of skin covers the malformation, or opening in the vertebrae. This form of spina bifida, present in 10-20 percent of the general population, rarely causes disability or symptoms. Closed neural tube defects are often recognized early in life due to an abnormal tuft or clump of hair or a small dimple or birthmark on theskin at the site of the spinal malformation. Meningocele and myelomeningocele generally involve a fluidfilled sac—visible on the back—protruding from the spinal canal. In meningocele, the sac may be covered by a thin layer of skin. In most cases of myelomeningocele, there is no layer of skin covering the sac and an area of abnormally developed spinal cord tissue is usually exposed. Hirsutism is an excessive amount of hair on the body usually caused by a hormonal imbalance. An Arnold-Chiari malformation is a cyst-like formation in the fourth ventricle, cerebellum or brainstem. Question: A female patient complains of weakness in her arm when combing her hair. This finding could be suggestive of which type of weakness pattern? Proximal CorrectDistal IncorrectSymmetricAsymmetric Explanation: To identify proximal weakness, ask about difficulty with movements such as combing hair, reaching up to a shelf, getting up out of a chair, or climbing a high step. Question: What geriatric condition is characterized by normal alertness but progressive global deterioration of cognition in multiple domains? DeliriumCognitive impairmentParkinson's diseaseAlzheimer's disease Correct Explanation: Alzheimer's disease is a geriatric condition in which normal alertness is present but progressive global deterioration of cognition occurs in multiple domains, including short-term memory, but with sparing of memory for remote events, subtle language errors, visuospatial perceptual difficulties, and changes in executive function, or the ability to perform sequential tasks such as instrumental activities of daily living (IADLs). Delirium is a serious disturbance in a person's mental abilities that results in a decreased awareness of one's environment and confused thinking. Cognitive impairment is an intermediate stage between the expected cognitive decline of normal aging and the more serious decline of dementia. Parkinson's disease is a progressive disorder of the nervous system that affects movement. Question:When assessing coordination of muscle movement, four areas of the nervous system function in an integrated way. These areas include the motor, cerebellar, the vestibular, and the sensory systems. Which system coordinates position sense? Motor systemCerebellar systemVestibular system IncorrectSensory system Correct Explanation: Coordination of muscle movement requires that four areas of the nervous system function in an integrated way: motor system for muscle strength, cerebellar system for rhythmic movements and steady posture, vestibular system for balance and coordinating eye, head, and body movements, and sensory system for position sense. Question: A band of skin innervated by the sensory root of a single spinal nerve is termed a: peripheral nerve field.dermatome. Correctsynapseasterixis. Explanation: A band of skin innervated by the sensory root of a single spinal or dorsal nerve root is termed a dermatome. A peripheral nerve field refers to an area of the skin innervated by a single nerve and is described as cutaneous nerve distribution. A synapse is a structure that permits a neuron to pass an electrical or chemical signal to another cell. Asterixis refers to an abnormal tremor consisting of involuntary jerking movements, especially in the hands, frequently occurring with impending hepatic coma and other forms of metabolic encephalopathy. This is also known as flapping tremor. Question: An 8-month-old with a significant head lag would suggest the need for: exercises that strengthen the neck muscles.a follow-up visit in 2 months.a neurological evaluation. Correctan orthopedic referral. Explanation:A baby typically should be able to control the neck muscles by around 4 months of age, so that when pulling from a lying to a sitting position the head should remain in line with the torso and not flop back. Delays in reaching this developmental milestone have been observed in premature babies and in those with cerebral palsy; all others should be referred to a pediatric neurologist for further evaluation. The other choices do not address the issue or the cause. Early interventions result in better outcomes. Question: Hyperalgesia refers to: decreased sensitivity to pain.increased sensitivity to pain. Correctabsence of pain sensation.absence of touch sensation. Explanation: Analgesia refers to absence of pain sensation; hypalgesia to decreased sensitivity to pain; hyperalgesia to increased sensitivity; and anesthesia to absence of touch sensation. Question: Brief, repetitive, stereotyped, coordinated movements occurring at irregular intervals are consistent with: facial tics. Correctdystonic movements.athetoid movements.oral-facial dyskinesias. Incorrect Explanation: Facial tics are brief, repetitive, stereotyped, coordinated movements occurring at irregular intervals. Examples include repetitive winking, grimacing, and shoulder shrugging. Dystonic movements are similar to athetoid movements, but often involve larger portions of the body, including the trunk. Grotesque, twisted postures may result. Athetoid movements are slower and more twisting and writhing than choreiform movements, and have a larger amplitude. They most commonly involve the face and the distal extremities. Oral–facial dyskinesias are rhythmic, repetitive, bizarre movements that chiefly involve the face, mouth, jaw, and tongue: grimacing, pursing of the lips, protrusions of the tongue, opening and closing of the mouth, and deviations of the jaw. These are involuntary movements. Question:When a patient complains of severe headaches that have worsened over the last few weeks but she has no other symptoms, a most likely diagnosis would be: sinusitis.a tumor. Correctsubarachnoid hemorrhage. Incorrectan abscess. Explanation: The most important attributes of headaches are chronologic pattern and severity. Changing or progressively severe headaches increase the likelihood of tumor, abscess, or other masses. Extremely severe headaches suggest subarachnoid hemorrhage or meningitis and these headaches require immediate intervention because they worsen rapidly, not over a "few weeks". Sinusitis does cause headache but these headaches are not usually severe. Question: While assessing the cranial nerves, the nurse practitioner touches the cornea lightly with a wisp of cotton. This maneuver assesses which cranial nerve? Cranial Nerve II (CN II)Cranial Nerve IV (CN IV) IncorrectCranial Nerve V (CN V) CorrectCranial Nerve X (CN X) Explanation: Touching the cornea and assessing for a reflex assesses cranial nerve V. Question: The patient has his eyes closed and an area on his right leg is briefly touched by the nurse practitioner. The patient is instructed to open his eyes and point to the area that was touched. This is an example of the discriminative sensation known as: graphesthesia.stereognosis.two point discrimination. Incorrectpoint localization. Correct Explanation:Graphesthesia, or number identification is the ability to identify a number when drawn in the hand of a patient whose eyes are closed. A discriminative sensation, stereognosis, is the ability to identify an object by feeling. The ability to identify an object touching 2 areas simultaneously is termed two-point discrimination. Point localization refers to the ability of the patient to identify the area of the body that was touched when his eyes were closed. Question: When assessing the cranial nerves, the nurse practitioner observes that the soft palate does not rise when the patient is instructed to say "ah". This finding could be suggestive of a bilateral lesion in which cranial nerve? Cranial Nerve V (CN V)Cranial Nerve VII (CN VII)Cranial Nerve IX (CN IX)Cranial Nerve X (CN X) Correct Explanation: Failure of the soft palate to rise when the patient is instructed to say "ah" or yawn could be suggestive of a bilateral lesion in cranial nerve X (CN X)-vagus nerve. Question: The level of consciousness that refers to the patient that remains unarousable with eyes closed without evidence of response to inner need or external stimuli is said to be in: an obtunded state.a comatose state. Correcta lethargic state.a stuporous state. Explanation: A patient that remains unarousable with eyes closed without evidence of response to inner need or external stimuli is a comatose patient. An obtunded patient opens his eyes, looks at the person speaking to him but responds slowly and appears confused. Lethargy refers to the patient that appears drowsy but can open his eyes, respond to questions, then fall back to sleep. A stuporous patient arouses from sleep only after painful stimuli. Question: Having the patient shrug his shoulders and elicit neck movements would be testing Cranial Nerve:VI.VII.IX.XI. Correct Explanation: Cranial Nerve XI is the spinal accessory nerve and is responsible for proper functioning of the shoulder and neck muscles. When the trapezius is paralyzed, the shoulder droops and the scapula is displaced downward and laterally. Weakness with atrophy and fasciculations indicates a peripheral nerve disorder. CN VI tests extraocular movements; CN VII tests hearing; and CN IX and X test swallowing and the gag reflex. Question: The Glasgow coma scale assesses: cranial nerve response.pupillary response.motor response. Correctauditory response. Explanation: Based on motor responsiveness, verbal performance, and eye opening to appropriate stimuli, the Glasgow Coma Scale was designed and should be used to assess the depth and duration of coma and impaired consciousness. This scale helps to gauge the impact of a wide variety of conditions such as acute brain injury due to traumatic and/or vascular injuries or infections, metabolic disorders such as hepatic or renal failure, hypoglycemia, or diabetic ketoacidosis. Cranial nerve, auditory, and pupillary responses are not included in the come scale assessment. Question: Discriminative sensations include all of the following except: astereognosis.stereognosis.graphesthesia.deep tendon reflexes Correct Explanation: Discriminative sensations test the ability of the sensory cortex to correlate, analyze, and interpret sensations. These include: stereognosis, graphesthesia, two-point identification, point localization, and extinction. Deep tendon reflexes evaluate the spinal nerve roots and usually include C5, C6, C7, L4, and S1.Question: Symmetric weakness of the distal muscles of the legs suggests a: polyneuropathy. Correctmyopathy.sensory neuropathy.cerebellar disease. Incorrect Explanation: Polyneuropathy would present as symmetric weakness in the distal muscles. Symmetric weakness of the proximal muscles of the legs suggests a myopathy. Nystagmus, dysarthria, hypotonia, and ataxia would be characteristic of cerebellar disease. Sensory neuropathy usually presents as numbness, tingling, and pain. Question: The thalamus and the basal ganglion are located in the: spinal cord.peripheral nervous system.white matter.gray matter. Correct Explanation: Deep in the brain lie additional clusters of gray matter. These include the basal ganglia, which affect movement, and the thalamus and the hypothalamus structures in the diencephalon. The thalamus processes sensory impulses and relays them to the cerebral cortex. Question: The most common cause of viral encephalitis in children is: Herpes simplex virus Type IIPicornavirusEnteroviruses IncorrectHerpes simplex virus Type I Correct Explanation: Herpes simplex Type I is the most common cause of viral encephalitis in children. The other choices are incorrect. [Show Less]
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South University NSG 6440 APEA QUESTIONS
APEA QUESTIONS NEUROLOGY The level of consciousness that refers to the ability of the patient to respond fully and appropriately to stimuli is known as... [Show More] : alertness When assessing the patien t’s sense of position, instruct the patient to first stand with his feet together and eyes open, then instruct him to close both eye for 30- 60 seconds. If he loses his balance with his eyes closed, this is: suggestive of ataxia related to dorsal column disease When comparing two sides of the body for symmetric sensation a symmetrical distal sensory loss would be suggestive of: polyneuropathy A female patient complains of weakness in her arm when combing her hair. This finding could be suggestive of which type of weakness pattern? Proximal Having the patient shrug his shoulders and elicit neck movements would be testing cranial nerve: XI It is imperative to assess for suicidality and bipolar disorder in patients suspected of experiencing: depression Which one of the following procedures should NOT be performed in a comatose patient? Dilate the pupils With the adult patient laying supine, the nurse practitioner flexes that patient’s leg at both the hip and the knee and the straightens the knee. Pain and increased resistance to extending the knee is noted. This is a positive: Kernig’s sign The part of the brain that controls most functions in the body and is responsible for breathing, heart rate, and articulate speech is the: brainstem The patient has his eyes closed and an area on his right leg is briefly touched by the nurse practitioner. The patient is instructed to open his eyes and point to the area that was touched. This is an example of the discriminative sensation known as: point localization What geriatric condition is characterized by normal alertness but progressive global deterioration of cognition in multiple domains? Alzheimer’s disease Which one of the following assesses pain, temperature, and sensation using the distal and proximal areas testing pattern? Test the sensation in the thumbs and little fingers An 8-month-old with a significant head lag would suggest the need for: a neurological evaluation A form of aphasia in which the speech is confluent, slow, with few words and laborious effort and inflection and articulation are impaired but words are meaningful, is termed: Broca’s aphasia With the patient lying supine, the nurse practitioner places her hands behind the patient’s head while flexing the neck forward until his chin touches his chest. Neck stiffness with resistance to flexion is noted. This is a positive: nuchal rigidity sign When assessing coordination of muscles movement, four areas of the nervous system function in a integrate way. These areas include the motor, cerebellar, the vestibular, and the sensory systems. Which system coordinates a steady posture? Cerebellar system The level of consciousness that refers to the patient that remains unarousable with eyes closed without evidence of response to inner need or external stimuli is said to be in: a comatose state Hypesthesia refers to: decreased sensitivity to touch A female patient complaint of weakness in both arms when transferring the wet clothes from the washer and placing them in the dryer. This finding could be suggestive of which type of weakness pattern? Symmetric A 80-year-old male visits the nurse practitioner for an annual well exam. History reveals two falls in the prior 12 months and difficulty with balance. The next step the nurse practitioner should take is: obtain cognitive and functional assessment Fasciculations in atrophic muscles suggests: a lower motor neuron disease A tension headache presents with pain in the: frontotemporal region of the head An example of tandem walking is having the patient: walk heel-to-toe By placing the patient in the supine position, the nurse practitioner raises the patient’s relaxed and straightened leg while flexing the leg at the hip, and the dorsiflexes the foot. This maneuver is known as: the straight-leg raise A discriminative sensation that described that ability to identify an object by feeling it is: stereognosis The best method of detecting cognitive impairment or intellectual disability at an early age is by: assessment of the achievement of development milestones Symptoms of a subdural hematoma include: noticeable bleeding between the dura and the cerebrum on x-ray The part of the brain tissue that rims the surfaces of the cerebral hemispheres, forming the cerebral cortex is known as the: gray matter The patient experiences a sudden loss of consciousness with falling without movements and injury may occur. This type of seizure is consistent with: a myoclonic seizure A patient is noted as lying supine with the jaws clenched and the neck extended with the arms adducted and stiffly extended at the elbows. His forearms are pronated, wrists and fingers flexed. The legs are extended at the knees and the feet are plantar flexed. This position is consistent with: decerebrate rigidity When assessing abdominal cutaneous reflexes, the nurse practitioner strokes the lower abdomen, the localized twitch is absent. This finding could be suggestive of a pathologic lesion in which segmented level of the spine? Thoracic 10, 11, and 12 An older adult presenting with signs of undernourishment, slowed motor performance, and loss of muscle mass or weakness suggests: frailty Symmetric weakness of the proximal muscles of the legs suggests a: myopathy Aphasia refers to: the inability to produce or understand language The part of the peripheral nervous system that regulates muscle movement and response to the sensations of pain and touch is the: somatic nervous system Assessment findings in an infant with increased intracranial pressure would include: drowsiness What is an example of a disease or condition that appears in a dermatomal pattern? Shingles Common physical findings in a young child with cerebral palsy include which one of the following? Presence of crossed or touching knees The part of the peripheral nervous system that controls involuntary actions is known as the: autonomic nervous system Ptosis of the left eye would be suggestive of damage to which cranial nerve? Cranial nerve III (CN III) A patient who is being evaluated for frequent headaches, mentions that the headache worsens with coughing, sneezing, or when changing positions. Increasing pain with these maneuvers may be suggestive of: a brain tumor An infant presents with an inappropriately increasing head circumference and hydrocephalus confirmed by CT scan. In addition to these findings, which one of the following would also be consistent with hydrocephalus? Tense, bulging fontanels A 40-year-old male presents with complaints of headaches. History revels headaches that occurred daily for about 4-6 weeks. He had relief for 6 months but now they are recurring. These are most likely: cluster headaches Assessing the neurological status of a child with a ventriculoperitoneal shunt should include: use of the Glasgow coma scale During this type of seizure activity, the patient appears confused. Automatisms include automatic motor behaviors such as chewing, smacking the lips, walking about, and unbuttoning clothes. This type of seizure activity is referred to as a: focal seizure with impairment of consciousness Which of the following neurological assessment findings indicate the need for further evaluations? Weak and ineffective sucking movements To evaluate a patient’s response to light touch sensation, the nurse practitioner would as the patient to identify: a touch on the skin in response to touching the skin with a cotton wisp A patient is instructed to stand, close both eyes, and extend both arms forward with the palms facing upward for 20-30 seconds. If the forearm drifts downward, this would indicate: corticospinal tract lesion A term used to describe an increase in the muscular bulk with diminished strength is: pseudohypertrophy Most peripheral nerves contain afferent and efferent fibers. The term efferent refers to: motor nerve fibers The Glasgow coma scale assesses: motor response When observing the thenar atrophy of hands, a typical observation is: furrowing in the spaces between the metacarpals When evaluating a patient for weakness of the upper extremities, bilateral distal weakness is noted. This finding could be suggestive of: polyneuropathy Disorders of speech fall into three groups that affect all of the following except the: written language During this type of seizure activity, the patient loses consciousness suddenly, sometimes with a cry, and the body stiffens into tonic extensor rigidity. Breathing stops, and the person becomes cyanotic. A clonic phase of rhythmic muscularcontraction follows. This type of seizure activity is referred to as a: grand mal seizure Persistent blinking after glabellar tap and difficulty walking heel-to-toe are common in: Parkinson’s disease An indication that there is a malfunction of a ventriculoperitoneal (VP) shunt in an older child would be the presence of a: headache upon awakening When assessing anal reflexes, the nurse practitioner strokes the four quadrants of the anus with a cotton swab. A loss of anal reflex is noted. This finding could be suggestive of a pathologic lesion in which segmented level of the spine? Sacral 2, 3, and 4 The part of the brain that maintains homeostasis is the: hypothalamus Symptoms indicative of Shaken Baby Syndrome are related to: uncontrollable cerebral edema and hypoxia On examination of the adult patient, symptoms of flexed posture, tremor, rigidity, and shuffling gait are observed. These findings are consistent with: Parkinson’s disease The level of consciousness that refers to the patient that arouses from sleep only after painful stimuli is known as: stupor When upper motor neuron systems are damaged below the crossover of its tracts in the medulla, motor impairment develops on the same side. This term is: ipsilateral A form of aphasia where articulation is good, but sentences lack meaning is referred to as: Wernicke’s aphasia When upper motor neuron systems are damaged above the crossover tracts in the medulla, motor impairment develops on the opposite side. This term is: contralateral A sudden brief lapse on consciousness with momentary blinking, staring, or movements of the lips and hands but no falling is consistent with: an absent seizure A patient is asked to visually follow a finger through the cardinal fields of gaze. Which cranial nerves are being assessed? III, IV, VI When a patient complains of severe headache that have worsened over the last few weeks, but she has no other symptoms, a most likely diagnosis would be: a tumor A form of aphasia in which the person has word-finding difficulties for speaking and writing is known as: anomic aphasia A neurologic assessment to evaluate neurologic input to the cerebellum is: Romberg test Symmetric weakness of the distal muscles of the legs suggests a: polyneuropathy A patient presents with a history of a temperature of 102F, headache, and pink papules on the upper chest several hours ago. Petechiae and ecchymosis are noted on the trunk. These skin lesions may be indicative of: meningococcemia When assessing the cranial nerves, the nurse practitioner observes that the soft palate does not rise when the patient is instructed to say “ah”. This finding couldbe suggestive of a bilateral lesion in which cranial nerve? Cranial nerve X (CN X) A progressive disorder of the nervous system that affects movement is known as: Parkinson’s disease A rhythmic oscillatory movement of a body part resulting from the contraction of opposing muscle groups is: a tremor On examination of an eighteen-year-old which one of the following neurological signs would be helpful if meningitis is suspected? Loss of the anal reflex Bilateral weakness in the cranial nerve V (CN V) would be suggestive of a: bilateral hemispheric disease A form of aphasia in which the person has difficulty speaking and understanding words and is unable to read or write them is termed: global aphasia The term used to describe the impaired ability to adjust one’s body position is: bradykinesia When assessing coordination of muscles movement, four areas of the nervous system function in a integrate way. These areas include the motor, cerebellar, the vestibular, and the sensory systems. Which system coordinates position sense? Sensory system Involuntary movements of the body that are slower and more twist and writhing than choreiform movements, and have a larger amplitude are suggestive of: athetoid movements The part of the brain that coordinates all movement and helps maintain the body upright in space is the: cerebellum To evaluate a patient’s response to temperature sensation, the nurse practitioner would ask the patient to identify: an object as being hot or cold Ataxia, diplopia, and dysarthria can be symptoms associated with all of the following conditions except: polyneuropathy During this type of seizure activity, the patient experiences partial seizures that resemble tonic-clonic seizures. The patient may recall the aura and a unilateral neurological deficit is present during the postictal period. This type of seizure activity is referred to as a: focal seizure that becomes generalized A teenager is being assessed for possible acute marijuana usage and appears intoxicated. Findings consistent with marijuana intoxication could include: euphoria, talkativeness, and paranoia The term used to describe a lack of strength (or firmness) is: weakness The term used to describe low back pain with nerve pain that radiates down the leg is: sciatica When testing for corneal reflex, an absent blink reflex is noted. This finding may be suggestive of a lesion in which cranial nerve? Cranial nerve VII (CN VII) Symptoms of a migraine headache can include throbbing, nausea or vomiting, duration of one day, and be unilateral and/or disabling. How many of these symptoms should be present to classify the headache as a migraine? Three of the five Uncontrolled electrical activity in the brain, which may produce minor physical signs, thought disturbances, or disturbed motor activity is: seizure When evaluative the sensory system, testing the spinothalamic tracts would include assessing sensations of: pain and temperature An ischemic stroke: an infarction of the central nervous system tissue that may be silent or symptomatic On physical exam, the soft palate does not rise, there is an absent gag reflex, and the patient complains of taste abnormalities. This requires further evaluation of the: glossopharyngeal nerve (IX) Involuntary rhythmic, repetitive, bizarre movements that chiefly involve the face, mouth, jaw, and tongue are known as: oral-facial dyskinesias The central nervous system extends from the medulla into the: spinal cord Anesthesia refers to: absence of touch sensation When eliciting deep tendon reflexes in the ankle, the nurse practitioner notes an abnormal reflex in the right ankle. This abnormality is probably consistent with a pathological lesion in which segmented level of the spine? Sacral 1 When assessing the cranial nerves, the nurse practitioner uses the tongue blade to gently stimulate the back of the throat on each side. A unilateral absence of the gag reflex is noted. This finding could be suggestive of a unilateral lesion in which cranial nerve? Cranial nerve IX (CN IX) A patient is unable to identify the smell of an orange. The inability could reflex an abnormality in cranial nerves: I Dysphonia refers to: an impairment in volume of the voice Hyperesthesia refers to: increased sensitivity to touch An ambulatory child with spastic cerebral palsy needs a diet: high in calories Physical exam of a well two-week-old infant revels a little dimple with a small amount of hair just about the sacral area. This could be: spina bifida occulta The level of consciousness that refers to the patient who opens his eyes, looks at the person speaking to him but responds slowly and appears confused is known as: obtundation Discriminative sensations include all of the following except: deep tendon reflexes The most widely used tool available to assess for dementia in elderly patients is the: Mini Mental State Examination (MMSE) When trying to determine the level of consciousness in a patient whose level of consciousness if altered, a lethargic patient: appears drowsy but opens the eyes, looks at the examiners, answers the questions, and then falls asleep An example of distal weakness is: the right hand The term used to describe the absence or loss of control of voluntary muscle movements is: akinesia While assessing the trigeminal nerve V (CN V) for sensory function, the patient repots a pain sensation on the right check. This finding could be consistent with a: cranial nerve disorder An infant with fetal alcohol syndrome would: be irritable, hyperactive and exhibit a high-pitched cry A female patient complains of weakness in her hand when opening a jar. This finding could be suggestive of which type of weakness pattern? Distal Which choice is least likely to be an example of asymmetric weakness? Both arms When assessing the cranial nerves, the nurse practitioner instructs the patient to raise both eyebrows, frown and smile. These maneuvers would be assessing which cranial nerve? Cranial nerve VII (CN VII) A patient experiences difficulty rising from a sitting position without arm support. This would be suggestive of: proximal muscle weakness of the pelvic girdle and legs The thalamus and the basal ganglion are located in the: gray matter One maneuver used to assess coordination is to observe the patient: walking heel-to-toe in a straight line A term used to describe muscle wasting or loss of muscle bulk is: muscle atrophy The level of consciousness that refers to the patient that appears drowsy but can open his eyes, respond to questions, then fall back to sleep is known as: lethargy Brief, repetitive, stereotyped, coordinated movements occurring at irregular intervals are consistent with: facial tics A type of seizure activity that includes tonic and the clonic movements and usually starts in the hand, foot or face then spreads to other parts of the body is known as a: Jacksonian seizure. The cranial sutures are closes on the head of a 9-month-old infant. This indicates: craniosynostosis Walking on the toes and heels may reveal: distal muscle weakness in the legs Aphonia refers to: the loss of voice Which one of the following senses is most often affected in patients on long-term antibiotic therapy? Hearing The term used to describe involuntary muscle spasms and twisting of the limbs is: dystonia Intention tremors appear with movement and: worsen as the target gets closer A teenager presents with signs of being gleeful, somewhat drowsy, and unable to focus. On examination, B/P 90/65, pupils constricted, and speech slurred. These symptoms are consisted with: opioid intoxication An abnormal or unpleasant sense of touch is termed: dysesthesia While palpating the temporal and masseter muscles, the patient is asked to clench his teeth and move his jaw from side to side. This maneuver would be assessing which cranial nerve? Cranial nerve V (CN V) Involuntary movements of the body that involve larger portions of the body, including the trunk resulting in grotesque, twisting postures are suggestive of: dystonic movements The part of the brain tissue that consists of neuronal axons that are coated with myelin is the: white matter When assessing an elderly patient for delirium, the recommended instrument with the best supportive data is the: Confusion Assessment Method (CAM) To identify sensory deficits comparing symmetric areas, the nurse practitioner would compare the sensation: in both arms [Show Less]
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Chamberlain College of Nursing NR 509 APEA Neurology 2021/22
Question 1: Sudden, brief, rapid jerks, involving the trunk or limbs may be consistent with: a myoclonic seizure. Correct an absent seizure. a myocloni... [Show More] c atonic seizure. a focal seizure with impairment of consciousness. Explanation: A patient experiencing a myoclonic seizure manifests sudden, brief, rapid jerks, involving the trunk or limbs. A sudden brief lapse of consciousness with momentary blinking, staring, or movements of the lips and hands but no falling is consistent with an absent seizure. During a myoclonic atonic seizure, the patient experiences a sudden loss of consciousness with falling but no movements. Injury may occur. Focal seizures with impairment of consciousness the person appears confused. Automatisms include automatic motor behaviors such as chewing, smacking the lips, walking about, and unbuttoning clothes. Question 2: Which of the following neurological assessment findings indicate the need for further evaluation? Lifting one foot and then the other when the infant is held upright with the feet touching a solid surface Fanning and hyperextension of the toes when the sole is stroked upward from the heel Grasping a finger placed in the neonate's palm Weak and ineffective sucking movements Correct Explanation: Weak and ineffective sucking movements would indicate the need for further evaluation since any weak, absent, asymmetrical or fine jumping movements would suggest neurological system disorders. The other choices represent common reflexes found in the normal newborn: Babinski, grasping, and stepping. Question 3: An example of proximal weakness is: the right shoulder. Correct the right hand. both arms. Incorrecton the right side of the face. Explanation: There are 4 different patterns of weakness: Proximal, distal, symmetric, and asymmetric. An example of proximal weakness is weakness in the shoulder or hip girdle. Distal weakness occurs in the hands or feet. Symmetric weakness occurs in the same areas on both sides of the body. An asymmetric weakness occurs in a portion of the face or extremity - a form of focal weakness. Question: A female patient complains of weakness in her hand when opening a jar. This finding could be suggestive of which type of weakness pattern? ProximalDistal CorrectSymmetricAsymmetric Explanation: To identify distal weakness, ask about hand movements when opening a jar, can or using scissors or a screwdriver. Another example is a problems like tripping when walking. Question: A patient presents with an altered level of consciousness. He/she is considered in a stuporous state if he/she: appears drowsy but opens the eyes, looks at the examiners, answers the questions, and then falls asleep.arouses from sleep after exposure to painful stimuli, exhibits slow verbal responses, and easily lapses into an unresponsive state. Correctremains unarousable with eyes closed. There is no evident response to inner need or external stimuli.opens the eyes and looks at the examiner, but responds slowly and is somewhat confused. Explanation: A stuporous patient arouses from sleep after exposure to painful stimuli, verbal responses are slow, and lapses into an unresponsive state. A lethargic patient appears drowsy but opens the eyes, looks at the examiners, answers the questions, and then falls asleep. An obtunded patient opens the eyes and looks at the examiner, but responds slowly and is somewhat confused. A comatose patient remains unarousable with eyes closed. There is no evident response to inner need or external stimuli.Question: One way to assess cerebellar function would be to have the patient: hop on one foot. Correctread out loud. Incorrectshrug the shoulders.discriminate between light and sharp pain. Explanation: The cerebellar function tests are used to monitor the patient's sense of equilibrium, which includes the patient's gait (walk), ability to stand upright with eyes closed (Romberg test), touch finger to nose, and move the heel to opposite knee while lying down. Other examples also include: hopping on one foot, walking heel-to-toe, and touching the examiner's finger and the examinees' nose. Reading out loud tests visual acuity; shrugging shoulders assesses the spinal accessory nerve and discriminating pain between light and sharp assesses the sensory system. Question: Hypesthesia refers to: absence of touch sensation.decreased sensitivity to touch. Correctincreased sensitivity to touch. Incorrectabsence of pain sensation. Explanation: Anesthesia is absence of touch sensation; hypesthesia is decreased sensitivity to touch; hyperesthesia is increased sensitivity to touch; and analgesia refers to absence of pain sensation. Question: When conducting a neurologic exam, which one of the following assessments is not considered part of the mental status assessment? [Show Less]
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Chamberlain College of Nursing NR 509 APEA QUESTIONS AND EXPLANATIONS 2021/22
Question: A transient ischemic attack is: a transient episode of neurologic dysfunction by focal brain, spinal cord, or retinal ischemia, without acute ... [Show More] infarction. Correctan infarction of the central nervous system tissue that may be silent or symptomatic.the abrupt onset of motor or sensory deficits. Incorrectfocal or asymmetric weaknesses caused by central and peripheral nerve damage. Explanation: TIA is now defined as “a transient episode of neurological dysfunction caused by focal brain, spinal cord, or retinal ischemia, without acute infarction.” Ischemic stroke is “an infarction of central nervous system tissue” that may be symptomatic or silent. The other terms are not related to the new definitions. Question: A patient is asked to visually follow a finger through the cardinal fields of gaze. Which cranial nerves are being assessed? III, IVIII, IV, VI CorrectV, VI, VII Explanation: Visually following a finger through the cardinal fields of gaze is one way to assess the oculomotor (CN III), trochlear (CN IV) and abducens (CN VI) nerves. CN I is the olfactory nerve and assesses smell. CN II is the optic nerve and assesses visual acuity. CN V is the trigeminal nerve and assesses both sensory and motor functions. Question: Uncontrolled electrical activity in the brain, which may produce minor physical signs, thought disturbances, or disturbed motor activity is: dystonia.bradykinesia.tremor.seizure. CorrectExplanation: A seizure is an uncontrolled electrical activity in the brain which may produce minor physical signs, thought disturbances, or disturbed motor activity, or a combination of symptoms. Dystonia is a neurological disorder that causes involuntary muscle spasms and twisting of the limbs. Bradykinesia is the term used to describe the impaired ability to adjust to one's body position. This symptom is noted in patients who have Parkinson's disease. A rhythmic oscillatory movement of a body part resulting from the contraction of opposing muscle groups is a tremor. Question: When evaluating the sensory system, testing the posterior columns tract would include assessing sensations of: position and vibration. Correctpain and temperature.deep touch. Incorrectdiscriminative sensations. Explanation: When evaluating the sensory system, testing the spinothalamic tracts would include assessing sensations of pain and temperature. Assessing position and vibration evaluate the posterior columns. Light touch assesses both the spinothalamic and posterior column tracts. To assess discriminative sensation, both the spinothalamic and posterior columns tracts as well as the cortex would be assessed. Question: Physical exam of a well two-week-old infant reveals a little dimple with a small amount of hair just above the sacral area. This could be: an unusual finding but within normal limits. Incorrecthirsutism.Arnold -Chiari malformation. spina bifida occulta. Correct Explanation: There are four types of spina bifida: occulta, closed neural tube defects, meningocele, and myelomeningocele. Occulta is the mildest and most common form in which one or more vertebrae are malformed. The name “occulta,” which means “hidden,” indicates that a layer of skin covers the malformation, or opening in the vertebrae. This form of spina bifida, present in 10-20 percent of the general population, rarely causes disability or symptoms. Closed neural tube defects are often recognized early in life due to an abnormal tuft or clump of hair or a small dimple or birthmark on theskin at the site of the spinal malformation. Meningocele and myelomeningocele generally involve a fluidfilled sac—visible on the back—protruding from the spinal canal. In meningocele, the sac may be covered by a thin layer of skin. In most cases of myelomeningocele, there is no layer of skin covering the sac and an area of abnormally developed spinal cord tissue is usually exposed. Hirsutism is an excessive amount of hair on the body usually caused by a hormonal imbalance. An Arnold-Chiari malformation is a cyst-like formation in the fourth ventricle, cerebellum or brainstem. Question: A female patient complains of weakness in her arm when combing her hair. This finding could be suggestive of which type of weakness pattern? Proximal CorrectDistal IncorrectSymmetricAsymmetric Explanation: To identify proximal weakness, ask about difficulty with movements such as combing hair, reaching up to a shelf, getting up out of a chair, or climbing a high step. Question: What geriatric condition is characterized by normal alertness but progressive global deterioration of cognition in multiple domains? [Show Less]
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Chamberlain College of Nursing NR 509 APEA Womens health 2021/22
Question: When palpating the cervix during the bimanual exam, cervical motion tenderness (chandelier sign) is noted. This tenderness could be suggestive ... [Show More] of: retroversion of the uterus.pelvic inflammatory disease. Correctvulvar lesions. IncorrectBartholin gland infection. Explanation: Cervical motion tenderness, also known as Chandelier's sign, and/or adnexal tenderness, suggest pelvic inflammatory disease, ectopic pregnancy, or appendicitis. Question: In a female diagnosed with a first-degree uterine prolapse, the cervix: is located in its normal position. has slipped but is well within the vagina. Correctis located in the introitus.and vagina are outside the introitus. Explanation: Uterine prolapse occurs in progressive stages. The uterus becomes retroverted and descends down the vaginal canal to the exterior. In first-degree prolapse, the cervix is still well within the vagina. In seconddegree prolapse, it is at the introitus. In third-degree prolapse (procidentia), the cervix and vagina are outside the introitus. Question: Daughters of women who took Diethylstilbestrol (DES) during pregnancy are at a high risk for developing all of the following abnormalities except: columnar epithelium covering most or all of the cervix.a slit- like cervical os. Correctvaginal adenosis.a circular collar or ridge of tissue between the cervix and the vagina. Explanation:Daughters of women who took Diethylstilbestrol (DES) during pregnancy are at greatly increased risk for several abnormalities: columnar epithelium that covers most or all of the cervix vaginal adenosis, and a circular collar or ridge of tissue, of varying shapes, between the cervix and vagina. The slit-like cervical os is a normal variation. Question: A female patient presents with a profuse, yellowish, green vaginal discharge that is malodorous. This vaginal discharge is most consistent with: candidal vaginitis.bacterial vaginosis.Trichomonal vaginitis. Correctgonorrhea. Explanation: Trichomonas vaginalis causes trichomonal vaginitis. Presenting symptoms include a profuse, yellowish, green vaginal discharge that is malodorous. Candidal vaginitis produces a white and curd-like thin discharge that is rarely malodorous. With bacterial vaginosis, the discharge can be gray or white, thin, malodorous (fishy), and not usually profuse. The discharge associated with gonorrhea is usually thick and bloody. Question: The most common causes of sexual problems in females are related to: lack of sexual desire.inadequate vaginal lubrication. Incorrectpsychosocial factors. Correctpelvic disorders. [Show Less]
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APEA Neurology Review Questions
Question Text Correct Answer Your Answer Result An 8-month-old with a significant head lag would suggest the need for: a neurological evaluation. ... [Show More] exercises that strengthen the neck muscles. Incorrect One maneuver used to assess coordination is to observe the patient: walking heel-to-toe in a straight line. squeezing the examiner's fingers. Incorrect During this type of seizure activity, the patient loses consciousness suddenly, sometimes with a cry, and the body stiffens into tonic extensor rigidity. Breathing stops, and the person becomes cyanotic. A clonic phase of rhythmic muscular contraction follows. This type of seizure activity is referred to as a: grand mal seizure. Jacksonian seizure. Incorrect [Show Less]
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Chamberlain College of Nursing NR 509 APEA Orthopedics 2021/22
Question: A tool for assessing risk factors for osteoporotic fractures is the: DEXA.FRAX. CorrectBRCA1.HAARM. Incorrect Explanation: The FRAX calculato... [Show More] r generates fracture risk based on age, body mass index, parental fracture history, use of glucocorticoids, presence of rheumatoid arthritis or secondary osteoporosis, and tobacco and alcohol use. It has been validated for black, Hispanic, and Asian women in the USA and has calculators that are country and continent specific. Duel energy x-ray absorptiometry, DEXA, is the optimal standard for measuring bone density. BRAC1 is a gene that can mutate and increase the risk of breast cancer. HAARM is the melanoma risk model. Question: Anserine bursitis arises from: excessive running. Correctexcessive kneeling. Incorrectarthritis.trauma Explanation: Anserine bursitis arises from excessive running, valgus knee deformity, fibromyalgias, and osteoarthritis. Prepatellar bursitis (“housemaid’s knee”) arises from excessive kneeling. A popliteal or “baker’s” cyst arises from distention of the gastrocnemius semimembranous bursa from underlying arthritis or trauma. Question: When examining the knee, which of the following symptoms could be indicative of a positive Adduction (Varus) Stress Test? Pain in the lateral joint line CorrectPain in the medial joint line IncorrectPain in the anterior joint lineA click along the medial joint line. Explanation:The Adduction (or Varus) Stress Test is a maneuver that evaluates the function of the lateral collateral ligament. To perform this test, the knee is held in 30 degrees of flexion. With one hand on the medial side of the knee and one hand on the ankle, an adduction force is gently applied. If pain is noted in the lateral joint line, this could be indicative of a lateral collateral ligament tear. When tenderness extends more to the proximal or distal joint line, the collateral ligament may be the cause of pain instead of the meniscus. Question: When assessing the knee, the examiner instructs the patient to straighten his knee. This motion would assess knee: flexion.extension. Correctinternal rotation.external rotation. Explanation: Having the patient straighten his leg assesses extension of the knee. The examiner instructs the patient to bend his knee. This maneuver assesses knee flexion. Internal rotation of the knee could be elicited by having the patient swing his lower leg toward the midline while sitting. Instructing the patient to swing his leg away from his midline while sitting assesses external rotation of the knee. Question: When performing an examination of a tender left finger on an adult, the surrounding tissue reveals warmth, edema, and redness. This finding could be suggestive of: carcinoma.muscular atrophy. synovitis. Incorrectgouty arthritis. Correct Explanation: Redness, warmth, and edema over a tender joint suggest septic or gouty arthritis infection, or possibly rheumatoid arthritis. Question: An example of a fibrous joint would be the: vertebral bodies of the spine.skull. Correctshoulder. Incorrectpubic symphysis of the pelvis.Explanation: The skull is an example of the fibrous joint. Examples of synovial joints include the shoulder, knee, hip, wrist, distal radioulnar, elbow, and carpals. Vertebral bodies of the spine and the pubic symphysis of the pelvis are examples of cartilaginous joints. Question: To palpate the medial meniscus, slightly internally rotate the tibia and palpate the medial soft tissue along the: lateral joint line of the knee.on either side of the patella.upper edge of the tibial plateau. Correcttop of the patella. Explanation: To palpate the medial meniscus, slightly internally rotate the tibia and palpate the medial soft tissue along the upper edge of the tibial plateau. The lateral meniscus is palpated on the lateral joint line by placing the patient's knee in slight flexion. To palpate the tibiofemoral joint, face the patient's knee and place the thumbs in the soft-tissue depressions on either side of the patellar tendon. Question: A patient complains of a sharp burning pain in the neck and right arm with associated paresthesias and weakness. These symptoms may be associated with: mechanical neck pain.mechanical neck pain with whiplash.cervical radiculopathy. Correctcervical myelopathy [Show Less]
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APEA QUESTION Bank Orthopedics (317 QUESTIONS WITH 100% CORRECT EXPLANATIONS)
Question: A tool for assessing risk factors for osteoporotic fractures is the: FRAX Explanation: The FRAX calculator generates fracture risk based on a... [Show More] ge, body mass index, parental fracture history, use of glucocorticoids, presence of rheumatoid arthritis or secondary osteoporosis, and tobacco and alcohol use. It has been validated for black, Hispanic, and Asian women in the USA and has calculators that are country and continent specific. Duel energy x-ray absorptiometry, DEXA, is the optimal standard for measuring bone density. BRAC1 is a gene that can mutate and increase the risk of breast cancer. HAARM is the melanoma risk model. Question: Anserine bursitis arises from: excessive running. Correctexcessive kneeling. Incorrectarthritis.trauma Explanation: Anserine bursitis arises from excessive running, valgus knee deformity, fibromyalgias, and osteoarthritis. Prepatellar bursitis (“housemaid’s knee”) arises from excessive kneeling. A popliteal or “baker’s” cyst arises from distention of the gastrocnemius semimembranous bursa from underlying arthritis or trauma. Question: When examining the knee, which of the following symptoms could be indicative of a positive Adduction (Varus) Stress Test? Pain in the lateral joint Explanation: The Adduction (or Varus) Stress Test is a maneuver that evaluates the function of the lateral collateral ligament. To perform this test, the knee is held in 30 degrees of flexion. With one hand on the medial side of the knee and one hand on the ankle, an adduction force is gently applied. If pain is noted in the lateral joint line, this could be indicative of a lateral collateral ligament tear. When tenderness extends more to the proximal or distal joint line, the collateral ligament may be the cause of pain instead of the meniscus. Question:When assessing the knee, the examiner instructs the patient to straighten his knee. This motion would assess knee: Extension Explanation: Having the patient straighten his leg assesses extension of the knee. The examiner instructs the patient to bend his knee. This maneuver assesses knee flexion. Internal rotation of the knee could be elicited by having the patient swing his lower leg toward the midline while sitting. Instructing the patient to swing his leg away from his midline while sitting assesses external rotation of the knee. Question: When performing an examination of a tender left finger on an adult, the surrounding tissue reveals warmth, edema, and redness. This finding could be suggestive of: gouty arthritis Explanation: Redness, warmth, and edema over a tender joint suggest septic or gouty arthritis infection, or possibly rheumatoid arthritis. Question: An example of a fibrous joint would be the: Skull Explanation: The skull is an example of the fibrous joint. Examples of synovial joints include the shoulder, knee, hip, wrist, distal radioulnar, elbow, and carpals. Vertebral bodies of the spine and the pubic symphysis of the pelvis are examples of cartilaginous joints. Question: To palpate the medial meniscus, slightly internally rotate the tibia and palpate the medial soft tissue along the: upper edge of the tibial plateau Explanation:To palpate the medial meniscus, slightly internally rotate the tibia and palpate the medial soft tissue along the upper edge of the tibial plateau. The lateral meniscus is palpated on the lateral joint line by placing the patient's knee in slight flexion. To palpate the tibiofemoral joint, face the patient's knee and place the thumbs in the soft-tissue depressions on either side of the patellar tendon. Question: A patient complains of a sharp burning pain in the neck and right arm with associated paresthesias and weakness. These symptoms may be associated with: Cervical radiculopathy [Show Less]
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Chamberlain College of Nursing NR 509 Cardio APEA 2021/22
Question 1: The lymphatic ducts drain into the: arterial system. venous system. Correct arteriovenous system. capillary bed. Incorrect Explanation: ... [Show More] The lymphatic ducts drain into the venous system. Question 2: While auscultating the patient's heart, a medium, soft murmur is audible. It is pansystolic and heard loudest at the apex with radiation to the left axilla. These findings are consistent with: tricuspid regurgitation.mitral regurgitation. Correcta ventricular septal defect.an innocent murmur. Incorrect Explanation: Mitral regurgitation produces a pansystolic, harsh murmur heard loudest at the apex with radiation toward the left axilla. The intensity of the murmur can be soft or if there is an atrial thrill, it can be loud. With tricuspid regurgitation, the murmur is audible loudest at the left sternal border with radiation to the right sternal border, xiphoid area, or to the left midclavicular line. It produces a blowing sound and is pansystolic. The murmur of an uncomplicated ventricular septal defect has a high pitch and is usually heard throughout systole. An innocent murmur is heard loudest at mid systole near the second to fourth intercostal spaces between the left sternal border and the apex. It usually decreases or disappears when sitting. Question 3: Which of the following group of symptoms would be suggestive of an infant experiencing a congenital heart defect associated with a decreased pulmonary blood flow pattern? Tissue perfusion greater than 3 seconds, bluish colored skin, and poor feeding Correct Abnormal heart sounds, capillary refill less than 2 seconds, and oxygen saturation less than 95% Capillary refill less than 2 seconds, tissue perfusion less than 3 seconds, and oxygen saturation greater than 95% Poor feeding, audible heart murmur, and oxygen saturation greater than 95%Explanation: Infants with defects resulting from decreased pulmonary blood flow have cyanosis because of desaturated blood entering systemic circulation and/or because of the inability to get blood to the lungs. Tetralogy of Fallot (TOF), pulmonary atresia and tricuspid atresia all fall in this category and are considered cyanotic defects. Due to the ventricular septal defect in TOF, the absence of the tricuspid valve or pulmonary valve in tricuspid and pulmonary atresia, one should hear abnormal heart sounds either due to the murmur in TOF or single heart sounds of S1 or S2 in pulmonary atresia or tricuspid atresia. Usually these infants have activity intolerance and therefore, experience failure to thrive because of their inability to consume enough formula to gain weight appropriately. Capillary refill is usually prolonged due to poor oxygenation and poor perfusion secondary to the defect as well as the O2 sats being lower than normal, sometimes even in the 80% range. Question 4: Right atrial pressure can be determined by: palpating the carotid pulse. Incorrect identifying the pulsations of the right jugular vein. Correct analyzing the arterial blood gases. assessing for dependent edema. Explanation: Jugular venous pressure reflects pressure in the right atrium and is best assessed from pulsations in the right internal jugular vein. This is an indicator of cardiac function and right heart hemodynamics. Palpating the carotid artery denotes arterial pressure; analyzing blood gases reflects the status of the arterial blood. Assessing for dependent edema is a reflection of heart failure and poor venous return and not atrial pressure. Question 5: When assessing the heart rate of a healthy 13-month-old child, which one of the following sites is the most appropriate for this child? [Show Less]
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Chamberlain College of Nursing NR 509 APEA HEENT 2021/22
Question: The function of the auditory ossicles is to: transmit the light reflex to the light cone.transform sound vibrations into mechanical waves for t... [Show More] he inner ear. Correctto capture sound waves from the external ear for transmission into the middle ear.to separate the inner ear from the middle ear. Explanation: The function of the auditory ossicles is to transform sound vibrations into mechanical waves for the inner ear Question: A 35-year-old patient complains of vertigo accompanied by nausea and vomiting. Examination reveals bilateral diplopia and an unsteady gait. These symptoms could be suggestive of: an arrhythmia.a neurological condition. Correctan inner ear infection. Incorrectorthostatic hypotension. Explanation: Vertigo symptoms associated with neurologic conditions include: ataxia, diplopia, and dysarthria. Symptoms associated with cardiovascular conditions and vertigo include arrhythmias, orthostatic hypotension, vasovagal stimulation, lightheadedness, weakness, or presyncope. Question: A 60-year-old was concerned about a yellowish colored lesion above her right eyelid. Findings revealed a slightly raised yellowish, well circumscribed plaque along the nasal area of her right eyelid. This finding is most consistent with: a pinguecula.a chalazion.episcleritis.xanthelasma. Correct Explanation:Slightly raised, yellowish, well-circumscribed plaques appearing along the nasal area of one or both eyelids are consistent with lipid disorders and called xanthelasma. Pinguecula refer to harmless, yellowish, triangular nodules in the bulbar conjunctiva on either side of the iris. A chalazion is a nontender nodule usually on the underside of the eyelid. Episcleritis is an ocular inflammation of the episcleral vessels. Question: Assessment of a patient's visual acuity resulted in 20/200 using the Snellen eye chart. This means that: at 200 feet the patient can read printed information that a person with normal vision could read at 20 feet.at 20 feet the patient can read printed information that a person with normal vision could read at 200 feet. Correctthe patient has normal visual acuity.the patient may not be able to read so he should be tested with the picture or "E" eye charts. Explanation: Visual acuity that is corrected to 20/200 constitutes legal blindness. The larger the number under 20, the worse the visual acuity. If this is a new finding, the patient needs ophthalmologic evaluation. Question: Findings following assessment of a person's left eye gaze include impaired movements when attempting to look upward, downward, or inward. This condition is most consistent with: a conjugate gaze.left cranial nerve III (oculomotor) paralysis Correctcranial nerve IV (trochlear) paralysis.cranial nerve VI (abducens) paralysis [Show Less]
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