NR 509 APEA NEUROLOGY EXAM WITH
SATISFIED QUESTIONS AND ANSWERS
Question:
Whenconducting aneurologic exam, which oneof thefollowing assessments
... [Show More] isnot
consideredpartofthe mental status assessment?
LevelofalertnessCranial NerveII (CNII) CorrectAppropriatenessof responsesOrientation to
time
Explanation:
Whenconductinganeurologic exam, mental statusassessment shouldincludeevaluationof
thelevelofalertness, appropriateness of responses, and orientation to person, place, and
time. Assessing cranial nerve II would be part of the cranial nerve assessment.
Question:
A mother reports tothenursepractitioner thather teenager mightbetakingdrugsbecause
earlier todaythe teenager had a mild seizure and now has an unstable gait and is beginning
to complain of shortness ofbreath. These symptoms might be consistent with a possible
overdose of:
barbiturates.amphetamines. Correctmarijuana.opioids.
Explanation:
Amphetamines arecentral nervoussystem (CNS)stimulants. Theteenagercouldexhibitsigns
ofataxia,respiratorydistress,seizures,coma, myocardial infarction,deathifhe/she
consumedthissubstance.
Impaired memory, judgment,andattention,slurredspeech,drowsiness,andirritabilityare
suggestiveofcentralnervous system depressants (CNS). Barbiturates,alcoholand
benzodiazepines fall inthis class.
Opioids may cause euphoria, drowsiness, constricted pupils and some of the same symptoms
as CNS depressants. Marijuanaintoxication wouldpresent withrelaxation,euphoria,
detachment, talkativeness,slowed perception of time, and possible anxiety or paranoia.
Question:
Sudden,brief, rapidjerks, involvingthetrunkor limbs maybe
consistent with:a myoclonic seizure. Correct
anabsent seizure.
a myoclonicatonicseizure.
afocalseizure withimpairmentofconsciousness.
Explanation:
A patient experiencing a myoclonic seizure manifests sudden, brief, rapid jerks, involving the
trunk or limbs. A suddenbrief lapseofconsciousness with momentaryblinking, staring,or
movementsof thelipsand hands but no falling is consistent with an absent seizure. During a
myoclonic atonic seizure, the patientexperiences asuddenlossofconsciousness withfalling
butno movements. Injury mayoccur.
Focal seizures with impairment of consciousness the person appears confused. Automatisms
include automatic motorbehaviors suchaschewing,smackingthelips, walkingabout,and
unbuttoningclothes.
Question:
Which of the following neurological assessment findings indicate the need for further
evaluation? Liftingonefootand thentheother when theinfant isheldupright withthefeet
touchingasolidsurfaceFanning and hyperextension of the toes when thesole is stroked
upward from theheel
Grasping a finger placed in the neonate's
palm Weakandineffectivesucking
movements CorrectExplanation:
Weakandineffectivesucking movements wouldindicatetheneedfor furtherevaluationsince
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:
Anexampleofproximal
weaknessis:theright shoulder.
Correct
theright hand.
botharms. Incorrect
ontheright sideof the
face.Explanation:
There are 4 different patterns of weakness: Proximal, distal, symmetric, and asymmetric. An
example ofproximal weakness is weakness intheshoulderorhipgirdle. Distal weakness
occursinthehandsor 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 femalepatient complainsof weakness inherhand whenopeningajar. This findingcouldbe
suggestiveof which type of weakness pattern?
ProximalDistal CorrectSymmetricAsymmetric
Explanation:
Toidentifydistal weakness,askabouthand movements whenopeningajar,canorusing
scissors orascrewdriver. Another example is a problems like tripping when walking.
Question:
A patientpresents withanalteredlevelofconsciousness. He/sheisconsideredinastuporous
stateifhe/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 responsetoinner needorexternalstimuli.opens theeyesand
looksat theexaminer,but respondsslowlyandis somewhat confused.
Explanation:
A stuporouspatientarousesfrom sleepafterexposuretopainfulstimuli,verbal responses
areslow,andlapses into an unresponsive state. A lethargic patient appears drowsy but
opens the eyes, looks at the examiners,answers thequestions,and thenfallsasleep. An
obtundedpatientopenstheeyesand looks at the examiner, but responds slowly and is
somewhat confused. A comatose patient remains unarousable with eyes closed. There is no
evident response toinner need or external stimuli.
Question:
One way toassess cerebellar function wouldbetohave thepatient:
hop on one foot. Correctread out loud. Incorrectshrug the shoulders.discriminate between
light andsharp 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, walkingheel-to-toe, and touchingtheexaminer's fingerand
theexaminees'nose. Readingout loudtestsvisual acuity; shrugging shoulders assesses the
spinal accessory nerve and discriminating pain between light and sharp assesses the
sensory system [Show Less]