Chamberlain College of Nursing NR 509 APEA Exam NEUROLOGY – Question and Answers with Explanations
Question 1:
Sudden, brief, rapid jerks, involving
... [Show More] the trunk or limbs may be consistent with:
a. a myoclonic seizure.
b. an absent seizure.
c. a myoclonic atonic seizure.
d. 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?
a. Lifting one foot and then the other when the infant is held upright with the feet touching a solid surface
b. Fanning and hyperextension of the toes when the sole is stroked upward from the heel
c. Grasping a finger placed in the neonate's palm
d. Weak and ineffective sucking movements
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:
a. the right shoulder.
b. the right hand.
c. both arms.
d. on 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 4
A female patient complains of weakness in her hand when opening a jar. This finding could be suggestive of which type of weakness pattern?
a. Proximal
b. Distal
c. Symmetric
d. Asymmetric
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 5
A patient presents with an altered level of consciousness. He/she is considered in a stuporous state if he/she:
a. appears drowsy but opens the eyes, looks at the examiners, answers the questions, and then falls asleep.
b. arouses from sleep after exposure to painful stimuli, exhibits slow verbal responses, and easily lapses into an unresponsive state.
c. remains unarousable with eyes closed. There is no evident response to inner need or external stimuli.
d. 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 6
One way to assess cerebellar function would be to have the patient:
a. hop on one foot.
b. read out loud.
c. shrug the shoulders.
d. 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 7
Hypesthesia refers to:
a. absence of touch sensation.
b. decreased sensitivity to touch.
c. increased sensitivity to touch.
d. absence 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 8
When conducting a neurologic exam, which one of the following assessments is not considered part of the mental status assessment?
a. Level of alertness
b. Cranial Nerve II (CNII)
c. Appropriateness of responses
d. Orientation to time
Explanation:
When conducting a neurologic exam, mental status assessment should include [Show Less]