Question 1

To test for gross motor skill and coordination of a 6-year-old child, which of these techniques would be appropriate? Ask the child to:

Accepted Answer

A)  Hop on one foot
B)  Stand on his head
C)  Touch his finger to his nose
D)  Make "funny" faces at the nurse A

Question 2

The nurse is testing the function of cranial nerve 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 D

Question 3

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

Accepted Answer

A)  The cranial nerves enter the brain through the spinal cord.
B)  Efferent fibres 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 fibres.
D)  The peripheral nerves carry input to the central nervous system by afferent fibres and away from the central nervous system by efferent fibres. D

Question 4

In obtaining a health history on a 74-year-old patient, the nurse notes that he drinks alcohol daily and that he has noticed a tremor in his hands that affects his ability to hold things.With this information, what response should the nurse make?

Accepted Answer

A)  "Does your family know you are drinking every day?"
B)  "Does the tremor change when you drink alcohol?"
C)  "We'll do some tests to see what is causing the tremor."
D)  "You really shouldn't drink so much alcohol; it may be causing your tremor."

Question 5

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 he drags the toe in a semicircle 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 6

A multiple sclerosis patient is unable to perform rapid alternating movements, such as rapid patting of her knees.The nurse should document this inability as:

Accepted Answer

A)  Ataxia
B)  Astereognosis
C)  Dysdiadochokinesia
D)  Loss of kinesthesia

Question 7

After a spinal cord injury in a 40-year-old patient, the nurse is testing the intactness of the patient's reflex arcs.The nurse tests the triceps reflex to elicit what response for which spinal level?

Accepted Answer

A)  Flexion of the hand for C5 to C6
B)  Pronation of the hand for C5 to C6
C)  Extension of the forearm for C7 to C8
D)  Flexion of the forearm for C7 to C8

Question 8

During examination, the nurse notices severe back and forth oscillations in both eyes of the patient.Which conclusion by the nurse is correct regarding the findings? This:

Accepted Answer

A)  Is a normal occurrence
B)  May indicate disease of the cerebellum or brainstem
C)  Is a sign that the patient is nervous about the examination
D)  Indicates a visual problem, and a referral to an ophthalmologist is indicated

Question 9

To encourage quick response when observing someone experiencing symptoms of a stroke, the nurse uses the mnemonic:

Accepted Answer

A)  BUBBLE
B)  FAST
C)  PERRLA
D)  PQRST

Question 10

When the nurse asks a 68-year-old patient to stand with his feet together, arms at his side, and 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 11

During an assessment of a 62-year-old man, the nurse notices that the patient has a stooped posture, shuffling walk with short steps, flat facial expression, and pill-rolling finger movements.These findings would be consistent with:

Accepted Answer

A)  Parkinsonism
B)  Cerebral palsy
C)  Cerebellar ataxia
D)  Muscular dystrophy

Question 12

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 behaviours is the __________ lobe.

Accepted Answer

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

Question 13

In a person with an upper motor neuron lesion after a cerebrovascular accident, which of these physical assessment findings should the nurse expect?

Accepted Answer

A)  Hyper-reflexia
B)  Fasciculations
C)  Loss of muscle tone and flaccidity
D)  Atrophy and wasting of the muscles

Question 14

The nurse is providing an informational session on stroke at a community health centre and includes the following risk factors that should be modified to decrease risk for stroke: (Select all that apply.)

Accepted Answer

A)  Obesity
B)  Sedentary lifestyle
C)  Cigarette smoking
D)  Hypoglycemia
E)  High levels of low-density lipoprotein (LDL)  cholesterolF) Normotensive

Question 15

A 70-year-old woman tells the nurse that every time she gets up in the morning or after she has been sitting, she gets "really dizzy" and feels like she is going to fall over.The nurse's best response would be:

Accepted Answer

A)  "Have you been extremely tired lately?"
B)  "You probably just need to drink more liquids."
C)  "I'll refer you for a complete neurological examination."
D)  "You need to get up slowly when you've been lying down or sitting."

Question 16

The nurse is performing a neurological 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 17

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 (DTRs)?

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 18

To assess the head control of a 4-month-old infant, the nurse lifts up the infant in a prone position while supporting his chest.The nurse looks for what normal response? The infant:

Accepted Answer

A)  Raises the head and arches the back
B)  Extends the arms and drops down the head
C)  Flexes the knees and elbows with the back straight
D)  Holds the head at 45 degrees and keeps the back straight

Question 19

The nurse knows that determining whether a person is oriented to his or her surroundings will test the functioning of which structure(s)?

Accepted Answer

A)  Cerebrum
B)  Cerebellum
C)  Cranial nerves
D)  Medulla oblongata

Question 20

A 30-year-old woman tells the nurse that she has been very unsteady and has had difficulty 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

Exam 25: Neurological System