Question 1

A patient with a lack of oxygen to his heart will have pain in his chest and possibly in the shoulder,arms,or jaw.The nurse knows that the best explanation why this occurs is which one of these statements?

Accepted Answer

A) A problem exists with the sensory cortex and its ability to discriminate the location. 
B) The lack of oxygen in his heart has resulted in decreased amount of oxygen to the areas experiencing the pain. 
C) The sensory cortex does not have the ability to localize pain in the heart; consequently, the pain is felt elsewhere. 
D) A lesion has developed in the dorsal root, which is preventing the sensation from being transmitted normally.

Question 2

A 32-year-old woman tells the nurse that she has noticed "very sudden,jerky movements" mainly in her hands and arms.She says,"They seem to come and go,primarily when I am trying to do something.I haven't noticed them when I'm sleeping." This description suggests:

Accepted Answer

A) Tics. 
B) Athetosis. 
C) Myoclonus. 
D) Chorea.

Question 3

During the assessment of an 80-year-old patient,the nurse notices that his hands show tremors when he reaches for something and his head is always nodding.No associated rigidity is observed with movement.Which of these statements is most accurate?

Accepted Answer

A) These findings are normal, resulting from aging. 
B) These findings could be related to hyperthyroidism. 
C) These findings are the result of Parkinson disease. 
D) This patient should be evaluated for a cerebellar lesion.

Question 4

A 21-year-old patient has a head injury resulting from trauma and is unconscious.There are no other injuries.During the assessment what would the nurse expect to find when testing the patient's deep tendon reflexes?

Accepted Answer

A) Reflexes will be normal. 
B) Reflexes cannot be elicited. 
C) All reflexes will be diminished but present. 
D) Some reflexes will be present, depending on the area of injury.

Question 5

During an assessment of the CNs,the nurse finds the following: asymmetry when the patient smiles or frowns,uneven lifting of the eyebrows,sagging of the lower eyelids,and escape of air when the nurse presses against the right puffed cheek.This would indicate dysfunction of which of these CNs?

Accepted Answer

A) Motor component of CN IV 
B) Motor component of CN VII 
C) Motor and sensory components of CN XI 
D) Motor component of CN X and sensory component of CN VII

Question 6

Which of these tests would the nurse use to check the motor coordination of an 11-month-old infant?

Accepted Answer

A) Denver II 
B) Stereognosis 
C) Deep tendon reflexes 
D) Rapid alternating movements

Question 7

The nurse is testing the function of CN XI.Which statement best describes the response the nurse should expect if this nerve is intact? The patient:

Accepted Answer

A) Demonstrates the ability to hear normal conversation. 
B) Sticks out the tongue midline without tremors or deviation. 
C) Follows an object with his or her eyes without nystagmus or strabismus. 
D) Moves the head and shoulders against resistance with equal strength.

Question 8

When the nurse is testing the triceps reflex,what is the expected response?

Accepted Answer

A) Flexion of the hand 
B) Pronation of the hand 
C) Extension of the forearm 
D) Flexion of the forearm

Question 9

The nurse is performing an assessment on a 29-year-old woman who visits the clinic complaining of "always dropping things and falling down." While testing rapid alternating movements,the nurse notices that the woman is unable to pat both of her knees.Her response is extremely slow and she frequently misses.What should the nurse suspect?

Accepted Answer

A) Vestibular disease 
B) Lesion of CN IX 
C) Dysfunction of the cerebellum 
D) Inability to understand directions

Question 10

The nurse is assessing the neurologic status of a patient who has a late-stage brain tumor.With the reflex hammer,the nurse draws a light stroke up the lateral side of the sole of the foot and inward,across the ball of the foot.In response,the patient's toes fan out,and the big toe shows dorsiflexion.The nurse interprets this result as:

Accepted Answer

A) Negative Babinski sign, which is normal for adults. 
B) Positive Babinski sign, which is abnormal for adults. 
C) Clonus, which is a hyperactive response. 
D) Achilles reflex, which is an expected response.

Question 11

The area of the nervous system that is responsible for mediating reflexes is the:

Accepted Answer

A) Medulla. 
B) Cerebellum. 
C) Spinal cord. 
D) Cerebral cortex.

Question 12

During an assessment of an 80-year-old patient,the nurse notices the following: an inability to identify vibrations at her ankle and to identify the position of her big toe,a slower and more deliberate gait,and a slightly impaired tactile sensation.All other neurologic findings are normal.The nurse should interpret that these findings indicate:

Accepted Answer

A) CN dysfunction. 
B) Lesion in the cerebral cortex. 
C) Normal changes attributable to aging. 
D) Demyelination of nerves attributable to a lesion.

Question 13

The nurse is performing a neurologic assessment on a 41-year-old woman with a history of diabetes.When testing her ability to feel the vibrations of a tuning fork,the nurse notices that the patient is unable to feel vibrations on the great toe or ankle bilaterally,but she is able to feel vibrations on both patellae.Given this information,what would the nurse suspect?

Accepted Answer

A) Hyperalgesia 
B) Hyperesthesia 
C) Peripheral neuropathy 
D) Lesion of sensory cortex

Question 14

A 78-year-old man has a history of a cerebrovascular accident.The nurse notes that when he walks,his left arm is immobile against the body with flexion of the shoulder,elbow,wrist,and fingers and adduction of the shoulder.His left leg is stiff and extended and circumducts with each step.What type of gait disturbance is this individual experiencing?

Accepted Answer

A) Scissors gait 
B) Cerebellar ataxia 
C) Parkinsonian gait 
D) Spastic hemiparesis

Question 15

A 30-year-old woman tells the nurse that she has been very unsteady and has had difficulty in maintaining her balance.Which area of the brain that is related to these findings would concern the nurse?

Accepted Answer

A) Thalamus 
B) Brainstem 
C) Cerebellum 
D) Extrapyramidal tract

Question 16

During the taking of the health history of a 78-year-old man,his wife states that he occasionally has problems with short-term memory loss and confusion: "He can't even remember how to button his shirt." When assessing his sensory system,which action by the nurse is most appropriate?

Accepted Answer

A) The nurse would not test the sensory system as part of the examination because the results would not be valid. 
B) The nurse would perform the tests, knowing that mental status does not affect sensory ability. 
C) The nurse would proceed with an explanation of each test, making certain that the wife understands. 
D) Before testing, the nurse would assess the patient's mental status and ability to follow directions.

Question 17

During the neurologic assessment of a "healthy" 35-year-old patient,the nurse asks him to relax his muscles completely.The nurse then moves each extremity through full range of motion.Which of these results would the nurse expect to find?

Accepted Answer

A) Firm, rigid resistance to movement 
B) Mild, even resistance to movement 
C) Hypotonic muscles as a result of total relaxation 
D) Slight pain with some directions of movement

Question 18

When the nurse asks a 68-year-old patient to stand with his feet together and arms at his side with his eyes closed,he starts to sway and moves his feet farther apart.The nurse would document this finding as:

Accepted Answer

A) Ataxia. 
B) Lack of coordination. 
C) Negative Homans sign. 
D) Positive Romberg sign.

Question 19

Which of these statements about the peripheral nervous system is correct?

Accepted Answer

A) The CNs enter the brain through the spinal cord. 
B) Efferent fibers carry sensory input to the central nervous system through the spinal cord. 
C) The peripheral nerves are inside the central nervous system and carry impulses through their motor fibers. 
D) The peripheral nerves carry input to the central nervous system by afferent fibers and away from the central nervous system by efferent fibers.

Question 20

The wife of a 65-year-old man tells the nurse that she is concerned because she has noticed a change in her husband's personality and ability to understand.He also cries very easily and becomes angry.The nurse recalls that the cerebral lobe responsible for these behaviors is the __________ lobe.

Accepted Answer

A) Frontal 
B) Parietal 
C) Occipital 
D) Temporal

Exam 23: Neurologic System