Deck 23: Neurologic System

Question 1

The finger to nose test allows assessment of:

A) coordination and fine motor function.
B) point location.
C) sensory function.
D) stereognosis.

Answer 1

coordination and fine motor function.

Question 2

Diabetic peripheral neuropathy will likely produce:

A) hyperactive ankle reflexes.
B) diminished pain sensation.
C) exaggerated vibratory sense.
D) hypersensitive temperature perception.

Answer 2

diminished pain sensation.

Question 3

The thalamus is the major integration center for the perception of:

A) speech.
B) olfaction.
C) pain.
D) thoughts.

Answer 3

pain.

Question 4

You are initially evaluating the equilibrium of Ms. Q. You ask her to stand, with her feet together and arms at her sides. She loses her balance. Ms. Q has a positive:

A) Kernig sign.
B) Homan sign.
C) McMurray test.
D) Romberg sign.

Question 5

The parasympathetic nervous system maintains the day-to-day function of:

A) digestion.
B) response to stress.
C) lymphatic supply to the brain.
D) lymphatic drainage of the brain.

Question 6

A neurologic past medical history should include data about:

A) allergies.
B) circulatory problems.
C) educational level.
D) immunizations.

Question 7

When assessing superficial pain, touch, vibration, and position perceptions, you are testing:

A) cerebellar function.
B) emotional status.
C) sensory function.
D) tendon reflexes.

Question 8

Which area of the brain maintains temperature control?

A) Epithalamus
B) Thalamus
C) Abducens
D) Hypothalamus

Question 9

The awareness of body position is known as:

A) proprioception.
B) graphesthesia.
C) stereognosis.
D) two-point discrimination.

Question 10

Cerebrospinal fluid serves as a:

A) nerve impulse transmitter.
B) red blood cell conveyer.
C) shock absorber.
D) mediator of voluntary skeletal movement.

Question 11

Motor maturation proceeds in an orderly progression from:

A) peripheral to central.
B) head to toe.
C) lateral to medial.
D) pedal to cephalic.

Question 12

The major function of the sympathetic nervous system is to:

A) orchestrate the stress response.
B) coordinate fine motor movement.
C) determine proprioception.
D) perceive stereognosis.

Question 13

Normal changes of the aging brain include:

A) increased velocity of nerve conduction.
B) diminished perception of touch.
C) increased total number of neurons.
D) diminished intelligence quotient.

Question 14

Deep pressure tests are used mostly for patients who are experiencing:

A) absent superficial pain sensation.
B) gait and stepping disturbances.
C) lordosis, osteoporosis, or arthritis.
D) tonic neck or torso spasms.

Question 15

As Mr. B enters the room, you observe that his gait is wide-based and he staggers from side to side while swaying his trunk. You would document Mr. B's pattern as:

A) dystonic ataxia.
B) cerebellar ataxia.
C) steppage gait.
D) tabetic stamping.

Question 16

The autonomic nervous system coordinates which of the following?

A) High-level cognitive function
B) Balance and affect
C) Internal organs of the body
D) Balance and equilibrium

Question 17

You are performing a two-point discrimination test as part of a well physical examination. The area with the ability to discern two points in the shortest distance is the:

A) back.
B) palms.
C) fingertips.
D) upper arms.

Question 18

The area of body surface innervated by a particular spinal nerve is called a:

A) dermatome.
B) nerve pathway.
C) spinal accessory area.
D) cutaneous zone.

Question 19

If a patient cannot shrug his or her shoulders against resistance, which cranial nerve (CN) requires further evaluation?

A) CN I, olfactory
B) CN V, trigeminal
C) CN IX, glossopharyngeal
D) CN XI, spinal accessory

Question 20

Which is the technique most often used for evaluating the neurologic system?

A) Auscultation
B) Inspection
C) Palpation
D) Percussion

Question 21

Vibratory sensory testing should be routinely done for the patient with:

A) Parkinson disease.
B) diabetes.
C) cerebral palsy.
D) Guillain-Barré syndrome.

Question 22

When you ask a patient to close his or her eyes and identify an object placed in the hand, you are evaluating:

A) stereognosis.
B) graphesthesia.
C) vibratory sensation.
D) extinction phenomenon.

Question 23

You are most concerned for the infant who has a:

A) weak palmar grasp at 3 months.
B) strong stepping reflex at 2 months.
C) weak plantar reflex at 9 months.
D) strong tonic neck at 6 months.

Question 24

Which condition is consistent with Brown-Séquard syndrome?

A) Central sensory loss that is generalized
B) Motor paralysis on the lesion side of the body
C) Multiple peripheral neuropathy of the joints
D) Spinal root paralysis below the umbilicus

Question 25

To assess a cremasteric reflex, the nurse strokes the:

A) sole of the foot and observes whether the toes fan down and out.
B) abdomen and observes whether the umbilicus moves away from the stimulus.
C) inner thigh and observes whether the testicle and scrotum rise on the stroked side.
D) palm and observes whether the fingers attempt to grasp.

Question 26

The immune system attacks the synaptic junction between the nerve and muscle fibers, blocking acetylcholine receptor sites in:

A) myasthenia gravis.
B) encephalitis.
C) multiple sclerosis.
D) cerebral palsy.

Question 27

Persons with Parkinson disease have an altered gait characterized by:

A) short shuffling steps.
B) the trunk in a backward position.
C) exaggerated swinging of the arms.
D) lifting the legs in a high-stepping fashion.

Question 28

Which condition is potentially life-threatening if not treated expeditiously with antibiotics?

A) HIV encephalopathy
B) Dementia
C) Parkinson disease
D) Bacterial meningitis

Question 29

Ipsilateral Horner syndrome indicates a cerebrovascular accident (CVA) occurring in the:

A) anterior portion of the pons.
B) internal or middle cerebral artery.
C) posterior inferior cerebellar artery.
D) vertebral or basilar arteries.

Question 30

To assess spinal levels L2, L3, and L4, which deep tendon reflex should be tested?

A) Triceps
B) Patellar
C) Biceps
D) Achilles

Question 31

Visible or palpable extension of the elbow is caused by reflex contraction of which muscle?

A) Achilles
B) Biceps
C) Patellar
D) Triceps

Question 32

Which is a concern, rather than an expected finding, in older adults?

A) Reduced ability to differentiate colors
B) Bilateral pillrolling of the fingers
C) Absent plantar reflex
D) Reduction in upward gaze

Question 33

On a scale of 1+ to 4+, which deep tendon reflex score is appropriate for a finding of clonus in a patient?

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

Question 34

An acute polyneuropathy that commonly follows a nonspecific infection occurring 10 to 14 days earlier and that primarily affects the motor and autonomic peripheral nerves in an ascending pattern is:

A) cerebral palsy.
B) HIV encephalopathy.
C) Guillain-Barré syndrome.
D) Rett syndrome.

Question 35

The ability to recognize a number traced on the skin is called:

A) stereognosis.
B) graphesthesia.
C) an extinction phenomenon.
D) two-point discrimination.

Question 36

It is especially important to test for ankle clonus if:

A) deep tendon reflexes are hyperactive.
B) deep tendon reflexes are hypoactive.
C) the Romberg sign is positive.
D) the patient has peripheral neuropathy.

Question 37

When using a monofilament to assess sensory function, the nurse:

A) uses two simultaneous monofilaments on similar bilateral points and then compares results.
B) applies both a monofilament and a pin on similar bilateral points and then compares results.
C) applies pressure to the monofilament until the filament bends.
D) strokes the monofilament along the skin from proximal to distal areas.

Question 38

At what age should the infant begin to transfer objects from hand to hand?

A) 2 months
B) 4 months
C) 7 months
D) 10 months

Question 39

Which sign is associated with meningitis and intracranial hemorrhage?

A) Babinski sign
B) Asymmetric tonic neck reflex
C) Doll's eye movement
D) Nuchal rigidity

Question 40

Cranial nerve XII may be assessed in an infant by:

A) watching the infant's facial expressions when crying.
B) observing the infant suck and swallow.
C) clapping hands and watching the infant blink.
D) observing the infant's rooting reflex.

Question 41

The tests for cortical sensory function include which of the following? (Select all that apply.)

A) Two-point discrimination
B) Extinction phenomenon
C) Superficial pain
D) Stereognosis
E) Touch