NSG 6440 APEA QUESTIONS NEUROLOGY
APEA QUESTIONS NEUROLOGY
The level of consciousness that refers to the ability of the patient to respond fully and
... [Show More] appropriately to stimuli is known as: alertness
When assessing the patient’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 3060 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 A patient is noted as lying supine in an abnormal posture with the upper arms
flexed tight to the sides with elbows, wrists, and fingers flexed. His legs are
extended and internally rotated and his feet and plantar flexed. This position is
consistent with: decorticate rigidity
Which one of the following symptoms is not associated with bulbar symptoms?
Dysesthesias
To evaluate a patient’s response to pain sensation, the nurse practitioner would
ask the patient to identify: pain as sharp or dull when the thumb is touched
using the sharp end of a safety pin
When assessing plantar reflexes, the nurse practitioner strokes the lateral aspect
of the sole from the heel to the ball of the right foot. Absence of movement of the
big toe is noted. This finding could be suggestive of a pathologic lesion in which
segmented level of the spine? Lumbar 5 and sacral 1
The principal muscles involved when closing the mouth are innervated by which
cranial nerve? Cranial nerve V (CN V)
When evaluating the sensory system, testing the posterior columns tract would
include assessing sensations of: position and vibration
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 V (CN V)
The inability to hop in place on each foot, could be suggestive of a: cerebellar
dysfunction
A transient ischemic attack is: a transient episode of neurologic dysfunction
by focal brain, spinal cord, or retinal ischemia, without acute infarction
Hyperalgesia refers to: increased sensitivity to pain
Sudden, brief, rapid jerks, involving the trunk or limbs may be consistent with: a
myoclonic seizure
Assessment of a 70-year-old’s ability to maintain personal safety would be most
adversely affected by declining function in the: sensory perception system
A patient presents with sweating, tremors, palpitations, hunger, and confusion.
This patient is most likely experiencing: hypoglycemia
Hypalgesia refers to: decreased sensitivity to pain
A patient comes into the clinic with an ataxic gait, complaints of a new-onset
headache and slurred speech that began about 2 hours ago. What is the likely
etiology of this event? Stroke or TIA
Mini mental status exam helps to identify patients who have symptoms of:
cognitive impairment
A 70-year-old exhibits a unilateral resting tremor. This likely indicates:
Parkinson’s disease
Which of the following below does NOT contribute to the risk of falls in older
adults? Decreased hearing
What produces demyelination of the nerve cells in the brain and spinal cord is:
multiple sclerosis
What medications is NOT used for migraine prophylaxis? Triptans
A 50-year-old patient reports acute pain in his lower back that started 2 weeks
ago after working in his yard. The pain radiates into his right leg intermittently. Hehas been managing his pain with ibuprofen. There are no red flags in his history
or on exam. When should consideration be given to imaging studies? At 4
weeks
A 14-year-old male client reports dull anterior knee pain, exacerbated by
kneeling. What is the likely etiology? Osgood-Schlatter disease
A 65-year-old male is diagnosed with an initial episode of gout. It is likely that he:
will have severe inflammation in a single joint
Which patient below should be screened for osteoporosis? 60-year-old male
with rheumatoid arthritis
Which statement below is true regarding NSAIDs for low back pain? They are
associated with more side effects than acetaminophen
An 8-year-old has a painful limp. He reports his knee hurts medially. On exam he
has pain with internal rotation of the hip. How should the NP manage this
situation? the NP should order a hip x-ray, CBC and ESR
A patient is at increased risk of osteopenia if she uses which form of birth
control? Injectable progestin
An adolescent athlete has sprained his ankle. What instruction should be given to
him regarding activity? He should be able to walk pain-free be he start to run
The drop arm test is used to assess patients with suspected: rotator cuff injury
A 79-year old frail adult reports that she had a fall last week. She had no broken
bone but is very core. In evaluating this adult, what question is most important to
ask? Have you had other falls this year?
Which criterion below is a criterion for Alzheimer’s disease? Impairment of
function
Which finding in a patient with migraine headache symptoms would compel the
examiner to order an imagining study? Rapidly increasing intensity of
headache
Which finding below is typical in a patient who has Bell’s palsy? Unilateral
numbness of the cheek
All of the following characteristics may be found in an older adult with dementia.
Which one is common in a patient with Alzheimer’s disease, but uncommon in a
patient with another type of dementia? Indifference
A 70-year-old patient has intermittent back pain secondary to a bulging disc for
more than 3 years. In the last year, it is constant (pain scale 2-3/10) and at times
is sharp. She is not a surgical candidate. What class of medication would be a
good choice for improvement of chronic pain in this patient? Gabapentin
A patient diagnosed with cluster headaches: should eliminate triggers like
nicotine and alcohol
Mr. Williams has moderate cognitive deficits attributed to Alzheimer’s disease
and has been started on a cholinesterase inhibitor. The purpose of this drug is to:
slow progression of his cognitive deficits
Which headache listed below is more likely to be triggered by food? migraine
A patient cannot stick his tongue out of his mouth and move it from side to side.
What cranial nerve is responsible for movement of the tongue? Cranial nerve XIICARDIAC
A heart rate of 100 – 180 beats per minute in an adult is considered: sinus
tachycardia
The external iliac lymph nodes drain lymphatic fluid from the following areas
except the: gluteal region
To assess aortic pulsations in patients with carotid obstruction, assess the pulse
using the: brachial region
The sacral lymph nodes receive lymphatic fluid from all the following except the:
gluteal region
The patient has had an internal pacemaker in place for five years. Pacemaker
failure is being considered because over the past few days, the patient has been
experiencing episodes of: hiccoughs
In older adults, the presence of heart sounds S3 suggests: heart failure
A patient described chest pain as persistent, sharp, and knife-like. These
symptoms are more characteristic of: pericarditis
In older adults, the presence of heart sound S4 suggests: hypertension
A disparity between the brachial and femoral pulses in a 4-month-old could
indicate: coarctation of the aorta
The axillary lymph nodes drain lymphatic fluid from all of the following areas
except the: anterior chest wall
Tissue ischemia is usually observed when assessing a patient with peripheral
artery disease (PAD). What other symptom could be assessed? Intermittent
claudication
Causes of orthostatic hypotension in older adults may include all of the following
except: impaired visual acuity
A finding suggestive of an inflamed lymph node would be one that is: tender and
moveable
On assessment, which one of the following symptoms would be noted as a
compensatory response to chronic hypoxia? Hematocrit (HCT) of 55%
The great saphenous vein enters the deep venous system by way of the:
femoral vein
A pediatric patient presents with erythema marginatum, chorea, and a heart
murmur. These symptoms are consistent with: rheumatic heart disease
Enlargement of which lymph nodes would be suggestive of metastasis from a
thoracic or abdominal malignancy? Supraclavicular
Presence of a heart murmur in a child would be considered organic if the child:
was a 2-year-old with a congenital heart defect
Heart sounds produced by a turbulence due to a temporary increase in blood
flow in predisposing conditions, such as hyperthyroidism, is considered: a
physiologic murmur
A patient complains of increased pain in the calf muscle and buttocks especially
after walking or riding his bicycle. He states that the pain stops after he sits still
for about 2-3 minutes. This condition may be associated with: intermittent
claudication Widened pulse pressure (PP) is defined as systolic blood pressure (SBP): minus diastolic blood pressure
When auscultating the apex of the heart in an 8-year-old, the bell of the stethoscope should be place at the: fifth intercostal space to the left of the midclavicular line
The posterior auricular lymph node is located: superficial to the mastoid process
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: mitral regurgitation
Characteristic symptoms of chronic arterial insufficiency may include which of the following? Feet appear pale on elevation and red on dependency
Warning signs of peripheral artery disease [Show Less]