Question 1

A trauma patient in the ICU has been declared brain dead. What diagnostic test is used in making the determination of brain death?

Accepted Answer

A)   Magnetic resonance imaging (MRI) 
B)   Electroencephalography (EEG) 
C)   Electromyelography (EMG) 
D)   Computed tomography (CT)  B

Question 2

A patient is admitted to the medical unit with an exacerbation of multiple sclerosis. When assessing this patient, the nurse has the patient stick out her tongue and move it back and forth. What is the nurse assessing?

Accepted Answer

A)   Function of the hypoglossal nerve
B)   Function of the vagus nerve
C)   Function of the spinal nerve
D)   Function of the trochlear nerve A

Question 3

The nurse is caring for a patient with an upper motor neuron lesion. What clinical manifestations should the nurse anticipate when planning the patients neurologic assessment?

Accepted Answer

A)   Decreased muscle tone
B)   Flaccid paralysis
C)   Loss of voluntary control of movement
D)   Slow reflexes C

Question 4

The neurologic nurse is testing the function of a patients cerebellum and basal ganglia. What action will most accurately test these structures?

Accepted Answer

A)   Have the patient identify the location of a cotton swab on his or her skin with the eyes closed.
B)   Elicit the patients response to a hypothetical problem.
C)   Ask the patient to close his or her eyes and discern between hot and cold stimuli.
D)   Guide the patient through the performance of rapid, alternating movements.

Question 5

The physician has ordered a somatosensory evoked responses (SERs) test for a patient for whom the nurse is caring. The nurse is justified in suspecting that this patient may have a history of what type of neurologic disorder?

Accepted Answer

A)   Hypothalamic disorder
B)   Demyelinating disease
C)   Brainstem deficit
D)   Diabetic neuropathy

Question 6

Assessment is crucial to the care of patients with neurologic dysfunction. What does accurate and appropriate assessment require? Select all that apply.

Accepted Answer

A)   The ability to select mediations for the neurologic dysfunction
B)   Understanding of the tests used to diagnose neurologic disorders
C)   Knowledge of nursing interventions related to assessment and diagnostic testing
D)   Knowledge of the anatomy of the nervous system
E)   The ability to interpret the results of diagnostic tests

Question 7

During the performance of the Romberg test, the nurse observes that the patient sways slightly. What is the nurses most appropriate action?

Accepted Answer

A)   Facilitate a referral to a neurologist.
B)   Reposition the patient supine to ensure safety.
C)   Document successful completion of the assessment.
D)   Follow up by having the patient perform the Rinne test.

Question 8

A gerontologic nurse planning the neurologic assessment of an older adult is considering normal, agerelated changes. Of what phenomenon should the nurse be aware?

Accepted Answer

A)   Hyperactive deep tendon reflexes
B)   Reduction in cerebral blood flow
C)   Increased cerebral metabolism
D)   Hypersensitivity to painful stimuli

Question 9

A patient with lower back pain is scheduled for myelography using metrizamide (a water-soluble contrast dye). After the test, the nurse should prioritize what action?

Accepted Answer

A)   Positioning the patient with the head of the bed elevated 45 degrees
B)   Administering IV morphine sulfate to prevent headache
C)   Limiting fluids for the next 12 hours
D)   Helping the patient perform deep breathing and coughing exercises

Question 10

The nurse caring for an 80 year-old patient knows that she has a pre-existing history of dulled tactile sensation. The nurse should first consider what possible cause for this patients diminished tactile sensation?

Accepted Answer

A)   Damage to cranial nerve VIII
B)   Adverse medication effects
C)   Age-related neurologic changes
D)   An undiagnosed cerebrovascular accident in early adulthood

Question 11

The nurse educator is reviewing the assessment of cranial nerves. What should the educator identify as the specific instances when cranial nerves should be assessed? Select all that apply.

Accepted Answer

A)   When a neurogenic bladder develops
B)   When level of consciousness is decreased
C)   With brain stem pathology
D)   In the presence of peripheral nervous system disease
E)   When a spinal reflex is interrupted

Question 12

The nursing students are learning how to assess function of cranial nerve VIII. To assess the function of cranial nerve VIII the students would be correct in completing which of the following assessment techniques?

Accepted Answer

A)   Have the patient identify familiar odors with the eyes closed.
B)   Assess papillary reflex.
C)   Utilize the Snellen chart.
D)   Test for air and bone conduction (Rinne test) .

Question 13

A patient is brought to the ER following a motor vehicle accident in which he sustained head trauma. Preliminary assessment reveals a vision deficit in the patients left eye. The nurse should associate this abnormal finding with trauma to which of the following cerebral lobes?

Accepted Answer

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

Question 14

The patient in the ED has just had a diagnostic lumbar puncture. To reduce the incidence of a postlumbar puncture headache, what is the nurses most appropriate action?

Accepted Answer

A)   Position the patient prone.
B)   Position the patient supine with the head of bed flat.
C)   Position the patient left side-lying.
D)   Administer acetaminophen as ordered.

Question 15

A patient scheduled for magnetic resonance imaging (MRI) has arrived at the radiology department. The nurse who prepares the patient for the MRI should prioritize which of the following actions?

Accepted Answer

A)   Withholding stimulants 24 to 48 hours prior to exam
B)   Removing all metal-containing objects
C)   Instructing the patient to void prior to the MRI
D)   Initiating an IV line for administration of contrast

Question 16

The nurse is doing an initial assessment on a patient newly admitted to the unit with a diagnosis of cerebrovascular accident (CVA). The patient has difficulty copying a figure that the nurse has drawn and is diagnosed with visual-receptive aphasia. What brain region is primarily involved in this deficit?

Accepted Answer

A)   Temporal lobe
B)   Parietal-occipital area
C)   Inferior posterior frontal areas
D)   Posterior frontal area

Question 17

A patient had a lumbar puncture performed at the outpatient clinic and the nurse has phoned the patient and family that evening. What does this phone call enable the nurse to determine?

Accepted Answer

A)   What are the patients and familys expectations of the test
B)   Whether the patients family had any questions about why the test was necessary
C)   Whether the patient has had any complications of the test
D)   Whether the patient understood accurately why the test was done

Question 18

A patient in the OR goes into malignant hyperthermia due to an abnormal reaction to the anesthetic. The nurse knows that the area of the brain that regulates body temperature is which of the following?

Accepted Answer

A)   Cerebellum
B)   Thalamus
C)   Hypothalamus
D)   Midbrain

Question 19

A patient is having a fight or flight response after receiving bad news about his prognosis. What affect will this have on the patients sympathetic nervous system?

Accepted Answer

A)   Constriction of blood vessels in the heart muscle
B)   Constriction of bronchioles
C)   Increase in the secretion of sweat
D)   Constriction of pupils

Question 20

A patient is currently being stimulated by the parasympathetic nervous system. What effect will this nervous stimulation have on the patients bladder?

Accepted Answer

A)   The parasympathetic nervous system causes urinary retention.
B)   The parasympathetic nervous system causes bladder spasms.
C)   The parasympathetic nervous system causes urge incontinence.
D)   The parasympathetic nervous system makes the bladder contract.

Exam 64: Assessment of Neurologic Function