Question 1

A trauma patient was admitted to the ICU with a brain injury. The patient had a change in level of consciousness, increased vital signs, and became diaphoretic and agitated. The nurse should recognize which of the following syndromes as the most plausible cause of these symptoms?

Accepted Answer

A)  Adrenal crisis 
B)  Hypothalamic collapse 
C)  Sympathetic storm 
D)  Cranial nerve deficit

Question 2

The nurse is performing a neurologic assessment of a patient whose injuries have rendered her unable to follow verbal commands. How should the nurse proceed with assessing the patients level of consciousness (LOC)?

Accepted Answer

A)  Assess the patients vital signs and correlate these with the patients baselines. 
B)  Assess the patients eye opening and response to stimuli. 
C)  Document that the patient currently lacks a level of consciousness. 
D)  Facilitate diagnostic testing in an effort to obtain objective data.

Question 3

A patient is scheduled for a myelogram and the nurse explains to the patient that this is an invasive procedure, which assesses for any lesions in the spinal cord. The nurse should explain that the preparation is similar to which of the following neurologic tests?

Accepted Answer

A)  Lumbar puncture 
B)  MRI 
C)  Cerebral angiography 
D)  EEG

Question 4

The nurse is conducting a focused neurologic assessment. When assessing the patients cranial nerve
Function, the nurse would include which of the following assessments?

Accepted Answer

A)  Assessment of hand grip 
B)  Assessment of orientation to person, time, and place 
C)  Assessment of arm drift 
D)  Assessment of gag reflex

Question 5

What term is used to describe the fibrous connective tissue that hugs the brain closely and extends into every fold of the brains surface?

Accepted Answer

A)  Dura mater 
B)  Arachnoid 
C)  Fascia 
D)  Pia mater

Question 6

A patient is being given a medication that stimulates her parasympathetic system. Following administration of this medication, the nurse should anticipate what effect?

Accepted Answer

A)  Constricted pupils 
B)  Dilated bronchioles 
C)  Decreased peristaltic movement 
D)  Relaxed muscular walls of the urinary bladder

Question 7

In the course of a focused neurologic assessment, the nurse is palpating the patients major muscle groups at rest and during passive movement. Data gleaned from this assessment will allow the nurse to describe which of the following aspects of neurologic function?

Accepted Answer

A)  Muscle dexterity 
B)  Muscle tone 
C)  Motor symmetry 
D)  Deep tendon reflexes

Question 8

The nurse has admitted a new patient to the unit. One of the patients admitting orders is for an adrenergic medication. The nurse knows that this medication will have what effect on the circulatory system?

Accepted Answer

A)  Thin, watery saliva 
B)  Increased heart rate 
C)  Decreased BP 
D)  Constricted bronchioles

Question 9

The nurse is admitting a patient to the unit who is diagnosed with a lower motor neuron lesion. What entry in the patients electronic record is most consistent with this diagnosis?

Accepted Answer

A)  Patient exhibits increased muscle tone. 
B)  Patient demonstrates normal muscle structure with no evidence of atrophy. 
C)  Patient demonstrates hyperactive deep tendon reflexes. 
D)  Patient demonstrates an absence of deep tendon reflexes.

Question 10

When caring for a patient with an altered level of consciousness, the nurse is preparing to test cranial nerve VII. What assessment technique would the nurse use to elicit a response from cranial nerve VII?

Accepted Answer

A)  Palpate trapezius muscle while patient shrugs should against resistance. 
B)  Administer the whisper or watch-tick test. 
C)  Observe for facial movement symmetry, such as a smile. 
D)  Note any hoarseness in the patients voice.

Question 11

A gerontologic nurse educator is providing practice guidelines to unlicensed care providers. Because reaction to painful stimuli is sometimes blunted in older adults, what must be used with caution?

Accepted Answer

A)  Hot or cold packs 
B)  Analgesics 
C)  Anti-inflammatory medications 
D)  Whirlpool baths

Question 12

An elderly patient is being discharged home. The patient lives alone and has atrophy of his olfactory organs. The nurse tells the patients family that it is essential that the patient have what installed in the home?

Accepted Answer

A)  Grab bars 
B)  Nonslip mats 
C)  Baseboard heaters 
D)  A smoke detector

Question 13

A patient is scheduled for CT scanning of the head because of a recent onset of neurologic deficits. What should the nurse tell the patient in preparation for this test?

Accepted Answer

A)  No metal objects can enter the procedure room. 
B)  You need to fast for 8 hours prior to the test. 
C)  You will need to lie still throughout the procedure. 
D)  There will be a lot of noise during the test.

Question 14

A nurse is caring for a patient diagnosed with Mnires disease. While completing a neurologic examination on the patient, the nurse assesses cranial nerve VIII. The nurse would be correct in identifying the function of this nerve as what?

Accepted Answer

A)  Movement of the tongue 
B)  Visual acuity 
C)  Sense of smell 
D)  Hearing and equilibrium

Question 15

A 72-year-old man has been brought to his primary care provider by his daughter, who claims that he has been experiencing uncharacteristic lapses in memory. What principle should underlie the nurses assessment and management of this patient?

Accepted Answer

A)  Loss of short-term memory is normal in older adults, but loss of long-term memory is pathologic. 
B)  Lapses in memory in older adults are considered benign unless they have negative consequences. 
C)  Gradual increases in confusion accompany the aging process. 
D)  Thorough assessment is necessary because changes in cognition are always considered to be pathologic.

Question 16

The nurse is planning the care of a patient with Parkinsons disease. The nurse should be aware that treatment will focus on what pathophysiological phenomenon?

Accepted Answer

A)  Premature degradation of acetylcholine 
B)  Decreased availability of dopamine 
C)  Insufficient synthesis of epinephrine 
D)  Delayed reuptake of serotonin

Question 17

The nurse is caring for a patient who exhibits abnormal results of the Weber test and Rinne test. The nurse should suspect dysfunction involving what cranial nerve?

Accepted Answer

A)  Trigeminal 
B)  Acoustic 
C)  Hypoglossal 
D)  Trochlear

Question 18

A nurse is assessing reflexes in a patient with hyperactive reflexes. When the patients foot is abruptly dorsiflexed, it continues to beat two to three times before settling into a resting position. How would the nurse document this finding?

Accepted Answer

A)  Rigidity 
B)  Flaccidity 
C)  Clonus 
D)  Ataxia

Question 19

A patient for whom the nurse is caring has positron emission tomography (PET) scheduled. In preparation, what should the nurse explain to the patient?

Accepted Answer

A)  The test will temporarily limit blood flow through the brain. 
B)  An allergy to iodine precludes getting the radio-opaque dye. 
C)  The patient will need to endure loud noises during the test. 
D)  The test may result in dizziness or lightheadedness.

Question 20

A patient exhibiting an uncoordinated gait has presented at the clinic. Which of the following is the most plausible cause of this patients health problem?

Accepted Answer

A)  Cerebellar dysfunction 
B)  A lesion in the pons 
C)  Dysfunction of the medulla 
D)  A hemorrhage in the midbrain

Exam 64: Assessment of Neurologic Function