Question 1

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?

Accepted Answer

A reflex is a defense mechanism of the nervous system.It operates below the level of conscious control and permits a quick reaction to potentially painful or damaging situations.

Question 2

A patient has a severed spinal nerve as a result of trauma.Which of these statements is true in this situation?

Accepted Answer

A dermatome is a circumscribed skin area that is supplied mainly from one spinal cord segment through a particular spinal nerve.The dermatomes overlap,which is a form of biologic insurance.That is,if one nerve is severed,most of the sensations can be transmitted by the spinal nerve above and spinal nerve below.

Question 3

The two parts of the nervous system are the:

Accepted Answer

The nervous system can be divided into two parts-central and peripheral.The central nervous system includes the brain and spinal cord.The peripheral nervous system includes the 12 pairs of cranial nerves,the 31 pairs of spinal nerves,and all their branches.

Question 4

A 50-year-old woman is in the clinic for weakness in her left arm and leg that she has noticed for the past week.The nurse should perform which type of neurologic examination?

Accepted Answer

The nurse should perform a complete neurologic examination on persons who have neurologic concerns (e.g.,headache,weakness,loss of coordination)or who have shown signs of neurologic dysfunction.The Glasgow Coma scale is used to define a person's level of consciousness.The neurologic recheck examination is appropriate for persons with demonstrated neurologic deficits.The screening neurologic examination is performed on seemingly well persons who have no significant subjective findings from the history.

Question 5

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

Accepted Answer

A nerve is a bundle of fibers outside the central nervous system.The peripheral nerves carry input to the central nervous system by their sensory afferent fibers and deliver output from the central nervous system by the efferent fibers.

Question 6

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

Accepted Answer

Aging is accompanied by a progressive decrease in cerebral blood flow.In some people this causes dizziness and a loss of balance with position change.These people need to be taught to get up slowly.The other responses are incorrect.

Question 7

When taking the history on a patient with a seizure disorder,the nurse assesses whether the patient has an aura.Which of these would be the best question for obtaining this information?

Accepted Answer

Aura is a subjective sensation that precedes a seizure;it could be auditory,visual,or motor.The other questions are not correct regarding asking about an aura.

Question 8

The area of the nervous system that is responsible for mediating reflexes is the:

Accepted Answer

The spinal cord is the main highway for ascending and descending fiber tracts that connect the brain to the spinal nerves,and it mediates reflexes.

Question 9

A patient with lack of oxygen to his heart will have pain in his chest and possibly the shoulder,arms,or jaw.The nurse knows that the statement that best explains why this occurs is which of these?

Accepted Answer

The sensory cortex is arranged in a specific pattern,forming a corresponding "map" of the body.Pain in the right hand is perceived at a specific spot on the map.Some organs are absent from the brain map,such as the heart,liver,and spleen.Pain originating in these organs is referred because no felt image exists in which to have pain.Pain is felt "by proxy" by another body part that does have a felt image.The other responses are not correct explanations.

Question 10

Which of these statements concerning areas of the brain is true?

Accepted Answer

The hypothalamus is a vital area with many important functions: temperature controller,sleep center,anterior and posterior pituitary gland regulator,and coordinator of autonomic nervous system activity and emotional status.The cerebellum controls motor coordination,equilibrium,and balance.The basal ganglia control autonomic movements of the body.The motor pathways of the spinal cord synapse in various areas of the spinal cord,not the thalamus.

Question 11

During an assessment of an 80-year-old patient,the nurse notices the following: inability to identify vibrations at the ankle and to identify position of big toe,slower and more deliberate gait,and slightly impaired tactile sensation.All other neurologic findings are normal.The nurse should interpret that these findings indicate:

Accepted Answer

Some aging adults show a slower response to requests,especially for those calling for coordination of movements.The findings listed are normal in the absence of other significant abnormal findings.The other responses are incorrect.

Question 12

During an assessment of the cranial nerves,the nurse finds the following: asymmetry when the patient smiles or frowns,uneven lifting of eyebrows,sagging of the lower eyelids,and escape of air when the nurse presses against the right puffed cheek.This would indicate dysfunction of which of these cranial nerves?

Accepted Answer

The findings listed reflect a dysfunction of the motor component of cranial nerve VII,the facial nerve.

Question 13

While gathering equipment after an injection,a nurse accidentally received a prick from an improperly capped needle.To interpret this sensation,which of these areas must be intact?

Accepted Answer

The spinothalamic tract contains sensory fibers that transmit the sensations of pain,temperature,and crude or light touch.Fibers carrying pain and temperature sensations ascend the lateral spinothalamic tract,whereas those of crude touch form the anterior spinothalamic tract.At the thalamus,the fibers synapse with another sensory neuron,which carries the message to the sensory cortex for full interpretation.The other options are not correct.

Question 14

A mother of a 1-month-old infant asks the nurse why it takes so long for infants to learn to roll over.The nurse knows that the reason for this is that:

Accepted Answer

The infant's sensory and motor development proceeds along with the gradual acquisition of myelin because myelin is needed to conduct most impulses.Very little cortical control exists,and the neurons are not yet myelinated.The other responses are not correct.

Question 15

In obtaining a 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 should the nurse's response be?

Accepted Answer

Senile tremor is relieved by alcohol,although this is not a recommended treatment.The nurse should assess whether the person is abusing alcohol in an effort to relieve the tremor.

Question 16

While obtaining a history of a 3-month-old infant from the mother,the nurse asks about the infant's ability to suck and grasp the mother's finger.What is the nurse assessing?

Accepted Answer

Questions regarding reflexes include such questions as "What have you noticed about the infant's behavior," "Do the infant's sucking and swallowing seem coordinated," and "Does the infant grasp your finger?" The other responses are incorrect.

Question 17

The ability that humans have to perform very skilled movements such as writing is controlled by the:

Accepted Answer

Corticospinal fibers mediate voluntary movement,particularly very skilled,discrete,purposeful movements,such as writing.The corticospinal tract (also known as the pyramidal tract)is a newer,"higher" motor system that humans have that permits very skilled and purposeful movements.The other responses are not related to skilled movements.

Question 18

During the history,a patient tells the nurse that "it feels like the room is spinning around me." The nurse would document this as:

Accepted Answer

True vertigo is rotational spinning caused by neurologic dysfunction or a problem in the vestibular apparatus or the vestibular nuclei in the brainstem.Dizziness is a lightheaded,swimming sensation.Syncope is a sudden loss of strength or a temporary loss of consciousness.Seizure activity is characterized by altered or loss of consciousness,involuntary muscle movements,and sensory disturbances.

Question 19

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 and becomes angry very easily.The nurse recalls that the cerebral lobe responsible for these behaviors is the _____ lobe.

Accepted Answer

The frontal lobe has areas concerned with personality,behavior,emotions,and intellectual function.The parietal lobe has areas concerned with sensation;the occipital lobe is responsible for visual reception;and the temporal lobe is concerned with hearing,taste and smell.

Question 20

A 30-year-old woman tells the nurse that she has been very unsteady and has had difficulty in maintaining her balance.Which area of the brain would the nurse be concerned about with these findings?

Accepted Answer

The cerebellar system coordinates movement,maintains equilibrium,and helps maintain posture.The thalamus is the main relay station where sensory pathways of the spinal cord,cerebellum,and brainstem for synapses on their way to the cerebral cortex.The brainstem consists of the midbrain,pons,and medulla and has various functions,especially concerning autonomic centers.The extrapyramidal tract maintains muscle tone for gross automatic movements,such as walking.

Quiz 23: Neurologic System