Deck 22: Neurologic System

Question 1

The major function of the sympathetic nervous system is to

A)orchestrate the stress response.
B)coordinate fine motor movement.
C)determine proprioception.
D)contribute input from visual, labyrinthine, and proprioceptive sources.
E)perceive stereognosis.

Answer 1

orchestrate the stress response.

Question 2

The thalamus is the major integration center for perception of

A)speech.
B)olfaction.
C)pain.
D)thoughts.
E)visceral responses to emotions.

Answer 2

pain.

Question 3

The motor cortex of the brain is in the

A)corpus callosum.
B)frontal lobe.
C)limbic system.
D)occipital lobe.
E)parietal lobe.

Answer 3

frontal lobe.

Question 4

Environmental hazards and cognitive function are data needed for the personal and social history section of a neurologic assessment for

A)adolescents.
B)every patient.
C)persons with seizures.
D)pregnant women.
E)infants.

Question 5

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.
E)Murphy sign.

Question 6

Which area of the brain is responsible for perceiving sounds and for determining their source?

A)Frontal lobe
B)Occipital lobe
C)Parietal lobe
D)Temporal lobe
E)Brainstem

Question 7

The finger-to-nose test allows assessment of

A)coordination and fine motor function.
B)point location.
C)sensory function.
D)two-point discrimination.
E)stereognosis.

Question 8

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.
E)coordinating fine motor movements.

Question 9

The awareness of body position is known as

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

Question 10

Motor maturation proceeds in an orderly progression from

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

Question 11

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
E)Emotions and behavior

Question 12

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.
E)spinal tract.

Question 13

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

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

Question 14

You are examining a patient in the emergency department who has recently sustained head trauma. To initially assess this patient's neurologic status, you would

A)ask him to discriminate between the smell of orange and peppermint.
B)test the six cardinal points of gaze.
C)palpate the jaw muscles as the patient clenches teeth.
D)observe for swallowing and test the gag reflex.
E)test the patient's tongue movements.

Question 15

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)decreased dermatomes.
E)diminished intelligence quotient.

Question 16

If a patient cannot shrug the 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
E)CN XII, hypoglossal

Question 17

The major portion of brain growth and myelinization occurs between ____ year(s) of age.

A)birth and 1
B)2 and 3
C)4 and 7
D)11 and 14
E)16 and 21

Question 18

A neurologic past medical history should include data about

A)family patterns of dexterity and dominance.
B)circulatory problems.
C)educational level.
D)immunizations.
E)allergies.

Question 19

Cerebrospinal fluid serves as a

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

Question 20

Nerves that arise from the brain rather than the spinal cord are called

A)sympathetic.
B)parasympathetic.
C)cranial.
D)autonomic.
E)lower motor neurons.

Question 21

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.
E)chest.

Question 22

Which of the following 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)Diminished senses of smell and taste
E)Reduced gag reflex

Question 23

Which one of the following conditions is consistent with Brown-Séquard syndrome?

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

Question 24

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

A)Serratus anterior
B)Biceps
C)Pectoralis major
D)Triceps
E)Deltoid

Question 25

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
E)Moro reflex

Question 26

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.
E)myasthenia gravis.

Question 27

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)brisk reflexes.
E)tonic neck or torso spasms.

Question 28

When using a monofilament to assess sensory function, the examiner

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.
E)assesses only the dorsal surface of the foot with the patient's eyes open.

Question 29

On a scale of 0 to 4+, which deep tendon reflex score is appropriate for a finding of clonus in a patient?

A)0
B)1+
C)2+
D)3+
E)4+

Question 30

A positive Babinski sign is normal until what age?

A)3 to 6 months
B)9 to 15 months
C)16 to 24 months
D)3 years
E)5 years

Question 31

You have asked a patient to close his eyes and identify an object placed in his hand. You are evaluating

A)stereognosis.
B)graphesthesia.
C)vibratory sense.
D)two-point discrimination.
E)extinction phenomenon.

Question 32

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.
E)checking the infant's gag reflex.

Question 33

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.
E)Parkinsonian gait.

Question 34

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

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

Question 35

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

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

Question 36

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

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

Question 37

To assess a cremasteric reflex, the examiner strokes the

A)skin around the anus and observes for the anal wink.
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.
E)sole of the foot and observes whether the toes fan down and out.

Question 38

It is especially important to test for ankle clonus if

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

Question 39

When assessing a 17-year-old patient for nuchal rigidity, you gently raise his head off the examination table. He involuntarily flexes his hips and knees. To confirm your suspicions associated with this positive test result, you would also perform a test for the _____ sign.

A)Kernig
B)Babinski
C)obturator
D)Brudzinski
E)Murphy

Question 40

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

A)2 months
B)4 months
C)7 months
D)10 months
E)12 months

Question 41

A clinical syndrome of intracranial hypertension that mimics brain tumors is

A)meningitis.
B)myasthenia gravis.
C)Guillain-Barré syndrome.
D)pseudotumor cerebri.
E)Bell palsy.

Question 42

Diabetic peripheral neuropathy will likely produce

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

Question 43

Persons with Parkinson disease have an altered gait that is 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-step fashion.
E)wide-based, staggering, and lurching steps.

Question 44

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.
E)trigeminal neuralgia.