Question 1

The nurse is performing a neurologic 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 notes the following: unable to feel vibrations on the great toe or ankle bilaterally;is able to feel vibrations on both patellae.Given this information,what would the nurse suspect?

Accepted Answer

Loss of vibration sense occurs with peripheral neuropathy (e.g. ,diabetes and alcoholism).Peripheral neuropathy is worse at the feet and gradually improves as you move up leg,as opposed to a specific nerve lesion,which has a clear zone of deficit for its dermatome.

Question 2

During the neurologic assessment of a "healthy" 35-year-old patient the nurse asks him to relax his muscles completely.The nurse then moves each extremity through full range of motion.Which of the following would the nurse expect to find?

Accepted Answer

Tone is the normal degree of tension (contraction)in voluntarily relaxed muscles.It shows a mild resistance to passive stretch.Normally,you will note a mild,even resistance to movement.

Question 3

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

Question 4

A 50-year-old woman is in the clinic for "weakness in my left arm and leg for the past week." The nurse will perform which type of neurologic examination?

Accepted Answer

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.

Question 5

When the nurse asks a 68-year-old patient to stand with feet together and arms at his side with his eyes closed,he starts to sway and moves his feet further apart.The nurse would document this finding as a(n):

Accepted Answer

Abnormal findings for Romberg's test: patient sways;falls;widens base of feet to avoid falling.Positive Romberg's sign is loss of balance that is increased by closing of the eyes.

Question 6

The nurse is doing an assessment on a 29-year-old woman who visits the clinic complaining of "always dropping things and falling down." While testing rapid alternating movements,the nurse notices that the woman is unable to pat both her knees.Her response is very slow and she misses frequently.What might the nurse suspect?

Accepted Answer

In rapid,alternating movements,slow,clumsy,and sloppy response occurs with cerebellar disease.

Question 7

Which of the following statements is accurate concerning areas of the brain?

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.

Question 8

The nurse places a key in the hand of a patient and he identifies it as a penny.What term would the nurse use to describe this finding?

Accepted Answer

Stereognosis: Test the person's ability to recognize objects by feeling their forms,sizes,and weights.Astereognosis: inability to identify objects correctly.Occurs in sensory cortex lesions.

Question 9

A patient with lack of oxygen to his heart will have pain in his chest and also possibly the shoulder,arms,or jaw.Which of the following best explains why this occurs?

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.

Question 10

While gathering equipment for an intravenous injection,a nurse accidentally received a prick from an improperly capped needle.To interpret this sensation,which of the following 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.

Question 11

In obtaining a history on a 74-year-old patient the nurse notes the following: he drinks alcohol daily;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.Assess whether the person is abusing alcohol in an effort to relieve tremor.

Question 12

During an assessment of the cranial nerves,the nurse finds the following: lack of blink in right eye with corneal reflex;intact ability to sense light touch on face;loss of movement with facial features on right side.This would indicate dysfunction of which of the following cranial nerves?

Accepted Answer

The findings listed reflect a dysfunction of the motor component of cranial nerve VII as well as the sensory afferent in cranial nerve V.

Question 13

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

Accepted Answer

Reflexes-What have you noticed about the baby's behavior? Do the baby's sucking and swallowing seem coordinated? Does the baby grasp your finger?

Question 14

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 15

The nurse is testing the function of cranial nerve XI.Which of the following best describes the response the nurse would expect if the nerve is intact?

Accepted Answer

Examine the sternomastoid and trapezius muscles for equal size.Check equal strength by asking the person to rotate the head forcibly against resistance applied to the side of the chin.Then ask the person to shrug the shoulders against resistance.These movements should feel equally strong on both sides.

Question 16

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

This motor system coordinates movement,maintains equilibrium,and helps maintain posture.

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 is a newer,"higher" motor system that humans have that permits very skilled and purposeful movements.

Question 18

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.

Question 19

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.

Question 20

When doing the history on a patient with a seizure disorder,the nurse assesses whether the patient has an aura.Which of the following 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.

Quiz 23: Neurologic System