Deck 67: Assessment of the Neurologic System

Question 1

Which confidence shared by a female client would alter the decision to use magnetic resonance imaging (MRI) as a diagnostic modality?

A) "I was too embarrassed to tell my doctor that I've had my breasts enlarged."
B) "I didn't tell my doctor that I've had my stomach stapled."
C) "My doctor would think I'm silly to have had a 'tummy tuck,' so I didn't tell him."
D) "No one knows I wear dentures, not even my husband. My doctor doesn't either."

Answer 1

"I didn't tell my doctor that I've had my stomach stapled."

Question 2

In assessing the cause of the decreased level of consciousness in a client in a coma, the diagnostic procedure that would provide the most accurate information is

A) computed tomography (CT) scan.
B) detailed history of the accident.
C) physical examination.
D) skull x-ray film.

Answer 2

computed tomography (CT) scan.

Question 3

When the nurse asks the client to raise the eyebrows and grimace or puff the cheeks, the nurse would be assessing the function of cranial nerve

A) VII.
B) VIII.
C) IX.
D) X.

Answer 3

VII.

Question 4

Neurologic examination reveals that a client has intact, functioning cranial nerves (CNs) III through XII. The nurse would conclude that the client has normal function of the

A) brain stem.
B) cerebellum.
C) cerebrum.
D) spinal cord.

Question 5

The nurse documents the client's gait as short, accelerating steps with the client shuffling in a forward-leaning posture and having difficulty starting and stopping. The nurse would identify this type of gait as

A) ataxic.
B) dystrophic.
C) festinating.
D) parkinsonian.

Question 6

During a lumbar puncture on a client in the lateral recumbent position, the physician remarks that the opening pressure is normal. The nurse would interpret this to mean that the pressure is

A) below 5 mm Hg.
B) between 6 and 13 mm Hg.
C) between 14 and 25 mm Hg.
D) above 25 mm Hg.

Question 7

If the client has adequate proprioception, the nurse would know that the client can

A) bend over at a 90-degree angle and return to ab upright position.
B) stand steady with feet together.
C) touch nose with eyes closed.
D) touch top lip with tip of tongue.

Question 8

In assessing a client for Babinski's reflex, the nurse would

A) press thumbs under the ball of the client's foot.
B) scrape the sole with a blunt object from heel toward great toe.
C) tap the sole with a percussion hammer at mid-arch.
D) tickle the sole of the client's foot with a fingernail.

Question 9

A client had a lumbar puncture and the report came back as follows: glucose 70 mg/dl, protein 32 mg/dl, opening pressure 230 mm H₂O, cells 100. The priority action by the nurse would be to

A) administer IV diuretics.
B) monitor the client's blood pressure every 15 minutes for an hour.
C) place the client in Trendelenburg position.
D) prepare to administer IV antibiotics.

Question 10

The nurse would point out to a client that the advantage of magnetic resonance spectroscopy (MRS) is that the procedure

A) assesses markers for neurodegenerative diseases.
B) can be used during pregnancy.
C) provides detailed images of bone tissue.
D) uses only small doses of radiation.

Question 11

In assessing function of cranial nerves (CN), the nurse offers a client toothpaste and the client can only identify it by smell. The nurse would record that

A) CN I is functional.
B) CN II is partially functional.
C) CN IV is non-functional.
D) CNs are unable to be assessed this way.

Question 12

The nurse is having a client sign the informed consent form before having an electromyography (EMG). What is the most appropriate response by the nurse when the client says "The doctor will use little needles to take samples to send to the lab."

A) Agree and have the client sign the form.
B) Ask if the client has any questions before signing.
C) Request the physician re-educate the client.
D) Tear up the consent form because now it is invalid.

Question 13

A nurse assessing a client's neurologic function. Which assessment is specifically added for the client who is suspected to have a spinal cord injury?

A) Bowel and bladder function
B) Cranial nerve function
C) Motor and sensory function
D) Pathologic reflexes

Question 14

The nurse asking a client questions that test orientation would include

A) "Can you count backward from 100 by 7s?"
B) "Do you have any brothers and sisters?"
C) "What would you do if you lost your house key?"
D) "What year is this?"

Question 15

A client with a head injury has had the caloric test performed using ice-cold water. When the water was injected into the auditory canal, the client's eyes moved slowly toward the irrigated side and then quickly returned to midline. The nurse would conclude after watching this reaction that the client

A) has an intact brain stem.
B) has brain death.
C) is likely to arouse within 24 hours.
D) will be permanently deaf.

Question 16

The nurse would explain to a client scheduled for an electroencephalogram (EEG) that an EEG

A) assesses for the presence of solid masses in the brain.
B) measures the adequacy of cerebral perfusion.
C) records cerebral blood flow patterns.
D) traces superficial electrical activity of the cerebral cortex.

Question 17

In assessing the function of CNs III, IV, and VI, the nurse would ask the client to

A) look straight ahead for examination with an ophthalmoscope.
B) move the eyes in six directions.
C) read a newspaper.
D) shut the eyes tightly.

Question 18

A client with a brain tumor is scheduled for a spiral CT scan. Which of these factors, if present in the client's history, would affect the nurse's preparation for the scan?

A) The client has periods of paresthesia in the hands.
B) The client is allergic to seafood and iodine.
C) The client is having trouble remembering recent events.
D) The client takes an anticonvulsant medication on a regular basis.

Question 19

When testing comprehension in a client who is expressively aphasic, the nurse lays out a pencil, a key, and a ball and then would

A) ask the client to pick up the ball.
B) hold up the key and ask, "What do you do with this?"
C) point to the pencil and ask, "What is this?"
D) point to the ball and ask "What can this be used for?"

Question 20

A nurse working on a rehabilitation unit is assessing a new admission, a client with a stable spinal cord injury. The nurse notes that the client is unable to shrug the shoulders. This finding indicates to the nurse that the level of spinal cord injury in the client is

A) C4-5.
B) C8-T1.
C) L1-3.
D) S1-2.