[Ex4] - C14 - AP

Question 1

14-1. When a patient asks what the somatic nervous system controls, how should the nurse respond?
It controls:

a. the heart.
b. the spinal cord.
c. skeletal muscle.
d. smooth muscle organs.

Answer 1

ANS: C

The somatic nervous system consists of pathways that regulate voluntary motor control, the
skeletal muscle system. The somatic nervous system does not control the heart; the autonomic
nervous system controls the heart, the spinal cord, and the smooth muscle organs.

Question 2

14-2. A nurse is preparing to teach about nerves. Which information should the nurse include? The
axon leaves the cell body at the:

a. axon hillock.
b. Nissl body.
c. node of Ranvier.
d. myelin sheath.

Answer 2

ANS: A

The axon hillock is the cone-shaped process where the axon leaves the cell body. The Nissl
body is involved in protein synthesis. Axons branch at the node of Ranvier. The myelin sheath
covers the entire membrane.

Question 3

14-3. When a student asks in which region of the neuron do nerve impulses travel the fastest, how
should the nurse respond? The:

a. large axon.
b. axon hillock.
c. cell body.
d. dendrites.

Answer 3

ANS: A

Large axons transmit impulses at a faster rate than cell bodies. The axon hillock has a low
threshold level. The dendrites carry impulses toward the cell body but not as quickly as large
axons.

Question 4

14-4. A neurologist is teaching the staff about motor neurons. Which structural classification
identifies motor neurons?

a. Unipolar
b. Pseudounipolar
c. Bipolar
d. Multipolar

Answer 4

ANS: D

A motor neuron is typically multipolar. Unipolar neurons are found in the retina.
Pseudounipolar neurons have one process; the dendritic portion of each of these neurons
extends away from the CNS, and the axon portion projects into the CNS. Bipolar neurons are
found in the eye.

Question 5

14-5. An experiment looking at an isolated neuron revealed a sensory nerve with one process
containing a dendritic portion extending away from the CNS and an axon extending toward
the CNS. Which of the following classifications would this neuron fall into?

a. Bipolar
b. Multipolar
c. Pseudounipolar
d. Interpolar

Answer 5

ANS: C

Pseudounipolar neurons have one process; the dendritic portion of each of these neurons
extends away from the CNS, and the axon portion projects into the CNS. Bipolar neurons
have two distinct processes arising from the cell body. Multipolar neurons are the most
common and have multiple processes capable of extensive branching. A motor neuron is
typically multipolar. Interpolar is not a type of neuron.

Question 6

14-6. A cell was isolated from the CNS. A researcher revealed that its main function was to clear
cellular debris. What type of cell is the researcher studying?

a. Astrocyte
b. Ependymal cell
c. Microglia
d. Schwann cell

Answer 6

ANS: C

Microglia remove debris (phagocytosis) in the CNS. Astrocytes and ependymal cells are
neuroglial cells and do not have phagocytic properties. Schwann cells help form the myelin
sheath in the peripheral nervous system (PNS).

Question 7

14-7. Which neurons have the capacity for regeneration?

a. Unmyelinated neurons in the brain
b. Myelinated neurons in the spinal cord
c. Myelinated peripheral neurons
d. Postganglionic motor neurons

Answer 7

ANS: C

Regeneration is limited to myelinated fibers and generally occurs only in the PNS.
Regeneration does not occur in unmyelinated neurons, myelinated neurons in the spinal cord,
or postganglionic motor neurons.

Question 8

14-8. When a presynaptic neuron is stimulated in a patient’s body by an electrical current,
neurotransmitters are released from the:

a. synapse.
b. synaptic bouton.
c. synaptic cleft.
d. receptor.

Answer 8

ANS: B

When an impulse originates in a presynaptic neuron, the impulse reaches the vesicles, where
chemicals (neurotransmitters) are stored in the synaptic bouton. Neurons are not physically
continuous with one another. The region between adjacent neurons is called a synapse. The
synaptic cleft is the space between the neurons. Neurotransmitters attach to the receptor.

Question 9

14-9. Neurotransmitters interact with the postsynaptic membrane by binding to which structure?

a. Receptor
b. Nissl body
c. Glial cell
d. Neurofibril

Answer 9

ANS: A

Neurotransmitters bind to a receptor. The Nissl body is involved in protein synthesis.
Neurotransmitters do not bind to glial cells. Neurofibrils provide support for the neuron.

Question 10

14-10. If a neuron’s membrane potential is held close to the threshold potential by excitatory
postsynaptic potentials (EPSPs), the neuron is said to be:

a. hyperpolarized.
b. facilitated.
c. integrated.
d. inhibited.

Answer 10

ANS: B

Facilitation refers to the effect of EPSP on the plasma membrane potential. The postsynaptic
neuron’s plasma membrane may be inhibited, which is called hyperpolarized. When the
neuron’s membrane potential is held close to the threshold potential, the neuron is facilitated,
not integrated or inhibited.

Question 11

14-11. A patient brought to the emergency room (ER) with severe burns is requesting something for
the excruciating pain and is medicated with morphine, which blocks which of the following
neurotransmitters, thus reducing the pain?

a. Enkephalin
b. Dopamine
c. Acetylcholine
d. Substance P

Answer 11

ANS: D

Substance P is a neurotransmitter in pain transmission pathways. Blocking the release of
substance P by morphine reduces pain. The opiates morphine and heroin bind to endorphin
and enkephalin receptors on presynaptic neurons. Dopamine is a neurotransmitter involved in
activity. Acetylcholine plays a role in nerve conduction presynaptically.

Question 12

14-12. A 19-year-old college student reports to his primary care provider that he cannot stay awake
in class regardless of how much sleep he gets. Under-stimulation of which area of the brain is
likely the site of the problem?

a. Corpora quadrigemina
b. Reticular activating system
c. Cerebellum
d. Hypothalamus

Answer 12

ANS: B

The reticular activating system is responsible for wakefulness, not the corpora quadrigemina,
the cerebellum, or the hypothalamus.

Question 13

14-13. After rehabilitation for severe brain damage following a motor vehicle accident, a patient
reports that her thought processes and ability to concentrate are impaired. Which area does the
nurse suspect is damaged?

a. Thalamus
b. Limbic
c. Prefrontal
d. Occipital

Answer 13

ANS: C

The prefrontal area is responsible for goal-oriented behavior (e.g., ability to concentrate),
short-term or recall memory, the elaboration of thought, and inhibition of the limbic areas of
the CNS. Goal-oriented behavior is not the function of the thalamus, limbic system, or
occipital area.

Question 14

14-14. A neurologist is teaching about the region responsible for motor aspects of speech. Which
area is the neurologist discussing?

a. Wernicke area
b. Broca area
c. Brodmann area 4
d. Brodmann area 6

Answer 14

ANS: B

The Broca area is responsible for the motor aspects of speech. Motor aspects of speech are not
the function of the Wernicke area or Brodmann areas 4 and 6.

Question 15

14-15. A patient is looking at a picture of the brain and points to the convolutions on the surface of
the cerebrum. The nurse should tell the patient these are called:

a. sulci.
b. fissures.
c. reticular formations.
d. gyri.

Answer 15

ANS: D

The surface of the cerebrum (cerebral cortex) is covered with convolutions called gyri, which
greatly increase the cortical surface area and the number of neurons. Neither sulci, fissures,
nor reticular formations cover the cerebrum in a fashion that increases its surface.

Question 16

14-16. Where is the primary visual cortex of the brain located?

a. Frontal lobe
b. Temporal lobe
c. Occipital lobe
d. Parietal lobe

Answer 16

ANS: C

The visual cortex is located in the occipital lobe.

Question 17

14-17. A nurse is preparing to teach about functions to maintain homeostasis and instinctive
behavioral patterns. Which area of the brain is the nurse discussing?

a. Thalamus
b. Medulla
c. Cerebellum
d. Hypothalamus

Answer 17

ANS: D

The hypothalamus functions to maintain a constant internal environment and instinctive
behavioral patterns. The thalamus serves as a relay center for information from the basal
ganglia and cerebellum to the appropriate motor area. The medulla controls reflex activities,
such as heart rate, respiration, blood pressure, coughing, sneezing, swallowing, and vomiting.
The cerebellum is responsible for reflexive, involuntary fine-tuning of motor control, for
maintaining balance and posture through extensive neural connections.

Question 18

14-18. When a nurse is teaching about the transverse fiber tract that connects the two cerebral
hemispheres, what term should the nurse use?

a. Peduncle
b. Corpus callosum
c. Basal ganglia
d. Pons

Answer 18

ANS: B

The corpus callosum connects the two cerebral hemispheres and is essential in coordinating
activities between hemispheres. The peduncle is made up of efferent fibers of the
corticospinal, corticobulbar, and corticopontocerebellar tracts. The basal ganglia is a portion
of the pyramidal system. The pons (bridge) is easily recognized by its bulging appearance
below the midbrain and above the medulla.

Question 19

14-19. A student nurse asks the nurse what controls reflex activities concerned with heart rate and
blood pressure. What is the nurse’s best response? These reflex activities are controlled by
the:

a. medulla oblongata.
b. pons.
c. midbrain.
d. cerebrum.

Answer 19

ANS: A

The medulla oblongata, not the pons, controls reflex activities, such as heart rate, respiration,
blood pressure, coughing, sneezing, swallowing, and vomiting. The midbrain is primarily a
relay center for motor and sensory tracts, as well as a center for auditory and visual reflexes.
The cerebrum plays a role in the transfer of information.

Question 20

14-20. Blockage of which of the following would cause hydrocephalus?

a. Cerebral aqueduct
b. Inferior colliculi
c. Red nucleus
d. Tegmentum

Answer 20

ANS: A

Blockage of the cerebral aqueduct leads to hydrocephalus. Hydrocephalus is not a result of
dysfunction of the inferior colliculi, red nucleus, or tegmentum.

Question 21

14-21. A patient presents with altered respiratory patterns following head trauma. Based on the
symptoms, which of the following areas does the nurse suspect is injured?

a. Cerebrum
b. Cerebellum
c. Midbrain
d. Reticular formation

Answer 21

ANS: D

The reticular formation is a large network of diffuse nuclei that control vital reflexes, such as
those controlling cardiovascular function and respiration. Respiratory function is not
controlled by the cerebrum, cerebellum, or midbrain.

Question 22

14-22. A nurse recalls that characteristics of upper motor neurons include:

a. directly innervating muscles.
b. influencing and modifying spinal reflex arcs.
c. cell bodies located in the gray matter of the spinal cord.
d. dendritic processes extending out of the CNS.

Answer 22

ANS: B

Upper motor neurons are completely contained within the CNS. Their primary roles are
controlling fine motor movement and influencing/modifying spinal reflex arcs and circuits.
They do not innervate muscles. Lower motor neurons interact with gray matter. Dendrites are
part of neurons.

Question 23

14-23. A nurse is teaching about the area of the spinal cord that contains cell bodies involved in the
autonomic nervous system. Which of the following areas is the nurse discussing?

a. Anterior horn
b. Ventral horn
c. Lateral horn
d. Dorsal horn

Answer 23

ANS: C

The lateral horn contains cell bodies within the autonomic nervous system. Both the anterior
and ventral horns contain the nerve cell bodies for efferent pathways that leave the spinal cord
by way of spinal nerves. The dorsal horn contains sensory neurons.

Question 24

14-24. A neurologist is teaching about sensory pathways. Which information should the neurologist
include? Sensory pathways in the spinal cord to the thalamus are included in the:

a. corticospinal tract.
b. pyramids.
c. spinothalamic tract.
d. anterior column.

Answer 24

ANS: C

The spinothalamic tract carries nerve impulses from the spinal cord to the thalamus in the
diencephalon; the corticospinal tract carries motor impulses. The pyramids assist with motor
movements. The anterior column carries nerve impulses.

Question 25

14-25. A nurse is discussing the membrane that separates the cerebellum from the cerebrum. What
term should the nurse use to describe this membrane?

a. Tentorium cerebelli
b. Falx cerebri
c. Arachnoid membrane
d. Temporal lobe

Answer 25

ANS: A

The tentorium cerebelli, a common landmark, is a membrane that separates the cerebellum
below from the cerebral structures above. The cerebellum is not separated by the falx cerebri,
the arachnoid membrane, or the temporal lobe.

Question 26

14-26. What term should the nurse use when talking about the outermost membrane surrounding the
brain?

a. Dura mater
b. Arachnoid mater
c. Pia mater
d. Falx cerebri

Answer 26

ANS: A

The dura mater is the outer layer of the brain. The arachnoid is a spongy, web-like structure
that loosely follows the contours of the cerebral structures. The pia mater adheres to the
contours of the brain. The falx cerebri dips between the two cerebral hemispheres along the
longitudinal fissure.

Question 27

14-27. Cerebrospinal fluid (CSF) can accumulate around the brain when there is injury to the sites of
CSF reabsorption, which are called the:

a. arachnoid villi.
b. epidural foramina.
c. lateral apertures.
d. choroid plexuses.

Answer 27

ANS: A

CSF is reabsorbed through a pressure gradient between the arachnoid villi and the cerebral
venous sinuses. CSF absorption does not occur in the epidural foramina, the lateral apertures,
or the choroid plexuses.

Question 28

14-28. Which structure ensures collateral blood flow from blood vessels supplying the brain?

a. Carotid arteries
b. Basal artery
c. Circle of Willis
d. Vertebral arteries

Answer 28

ANS: C

The circle of Willis ensures collateral blood circulation. Collateral circulation is not associated
with the basal artery or the vertebral arteries. The carotid arteries supply the brain.

Question 29

14-29. What type of cell supports the forming of the blood–brain barrier (BBB)?

a. Endothelial
b. Schwann
c. Oligodendrocyte
d. Astrocyte

Answer 29

ANS: D

Endothelial cells in brain capillaries, with their intracellular tight junctions, are the sites of the
BBB. Supporting cells include astrocytes, pericytes, and microglia. Schwann cells provide
structural support and nutrition for the neurons. Oligodendrocytes form the myelin sheaths.

Question 30

14-30. When a patient’s vagus nerve is stimulated, what does the nurse expect to observe?

a. Increased gastrointestinal activity
b. Increased heart rate
c. Pupil constriction
d. Vasoconstriction

Answer 30

ANS: A

Stimulation of the vagus nerve increases gastrointestinal activity. Stimulation of the vagus
decreases heart rate, causes pupil dilation, and leads to vasodilation.

Question 31

14-31. A patient suffers from head trauma that affects cranial nerve I. Which of the following
symptoms would the nurse expect?

a. Visual disturbances
b. Loss of sense of smell
c. Loss of ability to taste
d. Hearing disturbances

Answer 31

ANS: B

Cranial nerve I controls the sense of smell. Visual disturbances are associated with cranial
nerve II. Cranial nerve VII is related to tasting. Cranial nerve VIII is related to hearing.

Question 32

14-32. Which neurotransmitter is released when a patient’s parasympathetic motor neurons are
stimulated?

a. Epinephrine
b. Serotonin
c. Acetylcholine
d. Substance P

Answer 32

ANS: C

Parasympathetic motor neurons release acetylcholine. Adrenergic motor neurons release
epinephrine. Serotonin is associated with the brain. Substance P is a neurotransmitter in pain
transmission pathways. Blocking the release of substance P by morphine reduces pain.

Question 33

14-33. Which action will occur when a patient’s 1-receptors are stimulated?

a. Dilation of the coronary arteries
b. Vasoconstriction of arteries
c. Increase in the strength of myocardial contraction
d. Decrease in the rate of myocardial contraction

Answer 33

ANS: C

Stimulation of 1-receptors results in increased strength and rate of myocardial contraction.
1-receptor stimulation does not affect the coronary arteries. á1-receptor simulation leads to
dilation.

Question 34

14-34. A patient begins taking a new drug that causes pupil dilation, vasoconstriction, decreased
gastrointestinal motility, and goose bumps. Which of the following receptors are activated?

a. alpha-1
b. Á2
c. beta-1
d. B2

Answer 34

ANS: A

Alpha-1 stimulation leads to pupil dilation. á2 stimulation leads to inhibition of intestinal secretions.
Beta-1 stimulation leads to miosis or pupillary constriction. â2 stimulation leads to pupillary
constriction.

Question 35

14-35. The nurse is assessing the patient with a pen light. The integrity of which cranial nerve is
being evaluated?

a. Olfactory
b. Vagus
c. Oculomotor
d. Trigeminal

Answer 35

ANS: C

In evaluating the oculomotor nerve, the pupils are examined for size, shape, and equality;
pupillary reflex tested with a pen light (pupils should constrict when illuminated); and ability
to follow moving objects. The olfactory nerve is assessed using smells. The vagus nerve is
assessed using the ophthalmoscope. The trigeminal nerve is assessed with a safety pin and hot
and cold objects for sensations of pain, touch, and temperature.

Question 36

14-36. A nurse remembers the brain receives approximately ____% of the cardiac output.

a. 80
b. 40
c. 20
d. 10

Answer 36

ANS: C

The brain receives approximately 20% of the cardiac output.