Assessment of Neurologic Function Flashcards
A patient arrives to have an MRI done in the outpatient department.
Which information provided by the patient warrants further assessment
to prevent complications related to the MRI?
a. “I am trying to quit smoking and have a patch on.”
b. “I have been trying to get an appointment for so long.”
c. “I have not had anything to eat or drink for 3 hours.”
d. “My legs go numb sometimes when I sit too long.”
a. “I am trying to quit smoking and have a patch on.”
A patient is scheduled for an electroencephalogram (EEG) in the
morning. Which food on the patient’s tray should the nurse remove prior
to the test?
a. Orange juice
b. Toast
c. Coffee
d. Eggs
c. Coffee
The nurse is assisting with a lumbar puncture and observes that when the
health care provider obtains cerebrospinal fluid (CSF), it is clear and
colorless. What is the significance of this finding?
a. A subarachnoid hemorrhage
b. Severe sepsis
c. A normal finding; the fluid will be sent for testing to determine other
factors
d. Local trauma from the insertion of the needle
c. A normal finding; the fluid will be sent for testing to determine other
factors
A patient had a lumbar puncture 3 days ago in the outpatient clinic and
calls the nurse reporting a throbbing headache. Which education will the
nurse provide to the patient regarding relief of the discomfort? (Select all
that apply.)
a. Limit the amount of fluid to decrease cerebral edema.
b. Force fluids (unless contraindicated).
c. Get plenty of bed rest.
d. Take some over-the-counter analgesics.
e. Walk around.
b. Force fluids (unless contraindicated).
c. Get plenty of bed rest.
d. Take some over-the-counter analgesics.
A patient is having a lumbar puncture and the health care provider has
removed 20 mL of cerebrospinal fluid (CSF). Which nursing action is a
priority after the procedure?
a. Encourage the patient to ambulate immediately.
b. Have the patient lie flat for 6 hours.
c. Have the patient lie flat for 1 hour and then sit for 1 hour before
ambulating.
d. Have the patient lie in a semi-Fowler position with the head of the
bed at 30 degrees.
b. Have the patient lie flat for 6 hours.
The nurse is performing an assessment of cranial nerve function and asks
the patient to cover one nostril at a time to see if the patient can smell
coffee, alcohol, and mint. The patient is unable to smell any of the odors.
Which cranial nerve does the nurse identify is not functioning as it
should?
a. CN I
b. CN II
c. CN III
d. CN IV
a. CN I
The nurse obtains a Snellen eye chart when assessing cranial nerve
function. Which cranial nerve is the nurse testing when using the chart?
a. CN I
b. CN II
c. CN III
d. CN IV
b. CN II
A patient is being tested for a gag reflex. When the nurse places the
tongue blade to the back of the throat, there is no response elicited.
Which dysfunction does the nurse identify the patient is experiencing?
a. Dysfunction of the spinal accessory nerve
b. Dysfunction of the acoustic nerve
c. Dysfunction of the facial nerve
d. Dysfunction of the vagus nerve
d. Dysfunction of the vagus nerve
A patient sustained a head injury during a fall and has changes in
personality and affect. Which part of the brain does the nurse identify
has been affected in this injury?
a. Frontal lobe
b. Parietal lobe
c. Occipital lobe
d. Temporal lobe
a. Frontal lobe
A patient who has suffered a stroke is unable to maintain respiration and
is intubated and placed on mechanical ventilator support. Which portion
of the brain is most likely responsible for the inability to breathe?
a. Frontal lobe
b. Occipital lobe
c. Parietal lobe
d. Brain stem
d. Brain stem
A patient has expressive speaking aphasia after having a stroke. Which
portion of the brain does the nurse identify has been affected?
a. Temporal lobe
b. Inferior posterior frontal areas
c. Posterior frontal area
d. Parietal–occipital area
b. Inferior posterior frontal areas
The nurse is assessing the pupils of a patient who has had a head injury.
Which parasympathetic effect does the nurse identify the patient is
experiencing?
a. Dilated pupils
b. Constricted pupils
c. One pupil is dilated and the opposite pupil is normal
d. Roth spots
b. Constricted pupils
The nurse is caring for a patient who was involved in a motor vehicle
injury and sustained a head injury. When assessing deep tendon reflexes
(DTR), the nurse observes diminished or hypoactive reflexes. How will
the nurse document this finding?
a. 0
b. 1+
c. 2+
d. 3+
b. 1+
The nurse is performing a neurologic assessment and requests that the
patient stand with eyes open and then closed for 20 seconds to assess
balance. Which type of test is the nurse performing?
a. Weber test
b. Rinne test
c. Romberg test
d. Watch-tick test
c. Romberg test
A patient comes to the emergency department with severe pain in the
face that was stimulated by brushing the teeth. The nurse identifies
which cranial nerve dysfunction is causing this pain?
a. III
b. IV
c. V
d. VI
c. V
