Deck 17: Alterations in Cognitive Systems,Cerebral Hemodynamics,and Motor Function

Question 1

What stimulus causes posthyperventilation apnea (PHVA)?

A) Changes in PCO2 levels
B) Changes in PaCO2 levels
C) Damage to the forebrain
D) Any arrhythmic breathing pattern

Answer 1

Changes in PaCO2 levels

Question 2

What term describes the loss of the comprehension or production of language?

A) Agnosia
B) Aphasia
C) Akinesia
D) Dysphasia

Answer 2

Aphasia

Question 3

Status epilepticus is considered a medical emergency because of the:

A) Loss of consciousness
B) Development of cerebral hypoxia
C) Possibility of a head injury during seizures
D) Decrease in brain metabolism

Answer 3

Development of cerebral hypoxia

Question 4

The most critical aspect in correctly diagnosing a seizure disorder and establishing its cause is:

A) Computed tomographic (CT) scan
B) Cerebrospinal fluid analysis
C) Skull x-ray studies
D) Health history

Question 5

Cognitive operations cannot occur without the effective functioning of the brain's:

A) Pons
B) Medulla oblongata
C) Reticular activating system
D) Cingulate gyrus

Question 6

Which intracerebral disease process is capable of producing diffuse dysfunction?

A) Closed head trauma with bleeding
B) Subdural pus collections
C) Neoplasm
D) Infarct emboli

Question 7

What type of seizure starts in the fingers and progressively spreads up the arm and extends to the leg?

A) Complex-psychomotor seizure
B) Focal (partial) Jacksonian seizure
C) Generalized seizures
D) Atonic-drop seizure

Question 8

A clinical manifestation caused by damage to the lower pons includes an abnormal:

A) Flexion with or without extensor response of the lower extremities
B) Extension response of the upper and lower extremities
C) Extension response of the upper extremities and flexion response of the lower extremities
D) Flaccid response in the upper and lower extremities

Question 9

A sudden,explosive,disorderly discharge of cerebral neurons is termed:

A) Reflex
B) Seizure
C) Epilepsy
D) Convulsion

Question 10

Which person is at the greatest risk for developing delirium?

A) An individual with diabetes celebrating a 70th birthday
B) A depressed Hispanic woman
C) An individual on the second day after hip replacement
D) A man diagnosed with schizophrenia

Question 11

What area of the brain mediates the executive attention functions?

A) Limbic
B) Prefrontal
C) Parietal
D) Occipital

Question 12

Which midbrain dysfunction causes pupils to be pinpoint size and fixed in position?

A) Diencephalon dysfunction
B) Oculomotor cranial nerve dysfunction
C) Dysfunction of the tectum
D) Pontine dysfunction

Question 13

Posthyperventilation apnea (PHVA)ceases and rhythmic breathing is resumed when levels of arterial:

A) Carbon dioxide increase
B) Carbon dioxide become normal
C) Oxygen increase
D) Oxygen decrease

Question 14

What characteristic is a medical criterion of brain death?

A) Akinetic mutism
B) Coma
C) Apnea
D) Locked-in syndrome

Question 15

Cheyne-Stokes respirations are described as a:

A) Sustained deep rapid but regular pattern of breathing
B) Crescendo-decrescendo pattern of breathing, followed by a period of apnea
C) Prolonged inspiratory period, gradually followed by a short expiratory period
D) Completely irregular breathing pattern with random shallow, deep breaths and irregular pauses

Question 16

With receptive dysphasia (fluent),the individual is able to:

A) Respond in writing, but not in speech.
B) Produce verbal speech, but not comprehend language.
C) Comprehend speech, but not verbally respond.
D) Neither respond verbally nor comprehend speech.

Question 17

What is the normal intracranial pressure (in mm Hg)?

A) 5 to 15
B) 7 to 20
C) 12 to 14
D) 80 to 120

Question 18

What is the most common infratentorial brain disease process that results in the direct destruction of the reticulating activation system (RAS)?

A) Cerebrovascular disease
B) Demyelinating disease
C) Neoplasms
D) Abscesses

Question 19

Vomiting is associated with central nervous system (CNS)injuries that compress which of the brain's anatomic locations?

A) Vestibular nuclei in the lower brainstem
B) Floor of the third ventricle
C) Any area in the midbrain
D) Diencephalon

Question 20

A complex partial seizure is described as:

A) Alternating of tonic and clonic movements
B) Impairment of both consciousness and the ability to react to exogenous stimuli
C) Focal motor movement without loss of consciousness
D) One seizure followed by another in less than 1 minute

Question 21

What type of posturing exists when a person with a severe closed head injury has all four extremities in rigid extension with the forearms in hyperpronation and the legs in plantar extension?

A) Decorticate
B) Decerebrate
C) Spastic
D) Cerebellar

Question 22

What type of cerebral edema occurs when permeability of the capillary endothelium increases after injury to the vascular structure?

A) Cytotoxic
B) Interstitial
C) Vasogenic
D) Ischemic

Question 23

Antipsychotic drugs cause tardive dyskinesia by mimicking the effects of increased:

A) Dopamine
B) Gamma-aminobutyric acid
C) Norepinephrine
D) Acetylcholine

Question 24

Which characteristic is the most critical index of nervous system dysfunction?

A) Size and reactivity of pupils
B) Pattern of breathing
C) Motor response
D) Level of consciousness

Question 25

The existence of regular,deep,and rapid respirations after a severe closed head injury is indicative of neurologic injury to the:

A) Lower midbrain
B) Pontine area
C) Supratentorial
D) Cerebral area

Question 26

The body compensates for a rise in intracranial pressure by first displacing the:

A) Cerebrospinal fluid
B) Arterial blood
C) Venous blood
D) Cerebral cells

Question 27

Tactile agnosia is related to injury of which area of the brain?

A) Frontotemporal
B) Parietal
C) Temporal
D) Broca area

Question 28

Cerebral edema is an increase in the fluid content of the brain's:

A) Ventricles
B) Tissue
C) Neurons
D) Meninges

Question 29

Neurofibrillary tangles characterize which neurologic disorder?

A) Dementia syndrome
B) Delirium
C) Alzheimer disease
D) Parkinson disease

Question 30

Uncal herniation occurs when:

A) The hippocampal gyrus shifts from the middle fossa through the tentorial notch into the posterior fossa.
B) The diencephalon shifts from the middle fossa straight downward through the tentorial notch into the posterior fossa.
C) The cingulate gyrus shifts under the falx cerebri.
D) A cerebellar tonsil shifts through the foramen magnum.

Question 31

Since his cerebrovascular accident,a man has been denying his left hemiplegia.What term is used to describe this finding?

A) Visual agnosia
B) Anosognosia
C) Amusia agnosia
D) Agraphia agnosia

Question 32

A communicating hydrocephalus is caused by an impairment of the:

A) Cerebrospinal fluid flow between the ventricles
B) Cerebrospinal fluid flow into the subarachnoid space
C) Blood flow to the arachnoid villi
D) Absorption of cerebrospinal fluid

Question 33

After a cerebrovascular accident,a man is unable to either feel or identify a comb with his eyes closed.This is an example of:

A) Agraphia
B) Tactile agnosia
C) Anosognosia
D) Prosopagnosia

Question 34

Which dyskinesia involves involuntary movements of the face,trunk,and extremities?

A) Paroxysmal
B) Tardive
C) Hyperkinesia
D) Cardive

Question 35

Dilated and sluggish pupils,widening pulse pressure,and bradycardia are clinical findings evident of which stage of intracranial hypertension?

A) 1
B) 2
C) 3
D) 4

Question 36

Dilation of the ipsilateral pupil,following uncal herniation,is the result of pressure on which cranial nerve (CN)?

A) Optic (CN I)
B) Abducens (CN VI)
C) Oculomotor (CN III)
D) Trochlear (CN IV)

Question 37

Which edema is most often observed with noncommunicating hydrocephalus?

A) Metabolic
B) Interstitial
C) Vasogenic
D) Ischemic

Question 38

Diagnostic criteria for a persistent vegetative state include:

A) Absence of eye opening
B) Lack of subcortical responses to pain stimuli
C) Roving eye movements with visual tracking
D) Return of autonomic functions such as gastrointestinal function

Question 39

Stage 1 intracranial hypertension is caused by the:

A) Loss of autoregulation that normally maintains constant blood flow during changes in cerebral perfusion pressure
B) Displacement of cerebrospinal fluid, followed by compression of the cerebral venous system
C) Vasoconstriction of the cerebral arterial system with reciprocal increase in systemic blood pressure
D) Compression of the medulla oblongata in the brainstem by herniation of the cerebral cortex

Question 40

Most dysphasias are associated with cerebrovascular accidents involving which artery?

A) Anterior communicating
B) Posterior communicating
C) Circle of Willis
D) Middle cerebral

Question 41

Parkinson disease is a degenerative disorder of the brain's:

A) Hypothalamus
B) Anterior pituitary
C) Frontal lobe
D) Basal ganglia

Question 42

Which assessment finding marks the end of spinal shock?

A) Return of blood pressure and heart rate to normal
B) Gradual return of spinal reflexes
C) Return of bowel and bladder function
D) Evidence of diminished deep tendon reflexes and flaccid paralysis

Question 43

Clinical manifestations of Parkinson disease are caused by a deficit in which of the brain's neurotransmitters?

A) Gamma-aminobutyric acid
B) Dopamine
C) Norepinephrine
D) Acetylcholine

Question 44

The clinical manifestations of Parkinson disease include: (Select all that apply.)

A) Fragmented sleep
B) Drooping eyelids
C) Depression
D) Muscle stiffness
E) Bradykinesia

Question 45

Tremors at rest,rigidity,akinesia,and postural abnormalities are a result of the atrophy of neurons in the brain's:

A) Caudate that produces serotonin
B) Putamen that produces gamma-aminobutyric acid
C) Substantia nigra that produces dopamine
D) Hypothalamus that produces acetylcholine

Question 46

In Parkinson disease the basal ganglia influence the hypothalamic function to produce which clinical manifestations? (Select all that apply.)

A) Inappropriate diaphoresis
B) Gastric retention
C) Vomiting
D) Diarrhea
E) Urinary retention

Question 47

Dementia is commonly characterized by the deterioration in which abilities? (Select all that apply.)

A) Sociability
B) Balance
C) Memory
D) Speech
E) Decision making

Question 48

Characteristics of primary motor neuron atrophy include:

A) Loss of sensation in distal, proximal, or midline muscles
B) Fasciculations and muscle cramps
C) Flaccid paralysis with paresthesia
D) Spastic paralysis with increased deep tendon reflexes

Question 49

The weakness resulting from the segmental paresis and paralysis characteristic of anterior horn cell injury is difficult to recognize because:

A) Upper motor neurons are involved.
B) The injury is microscopic.
C) Two or more nerve roots supply each muscle.
D) The person is unable to feel the involved muscles.