N112 Midterm questions Flashcards

1
Q
The extrapyramidal system is located in the:
A.	hypothalamus.
B.	cerebellum.
C.	basal ganglia.
D.	medulla.
A

C. basal ganglia.

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2
Q

Testing the deep tendon reflexes gives the examiner information regarding the intactness of the:
A. corticospinal tract.
B. medulla.
C. reflex arc at specific levels in the spinal cord.
D. upper motor and lower motor neuron synaptic junction.

A

C. reflex arc at specific levels in the spinal cord.

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3
Q
An abnormal sensation of burning or tingling is best described as:
A.	paralysis.
B.	paresis.
C.	paresthesia.
D.	paraphasia.
A

C. paresthesia.

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4
Q
Automatic associated movements of the body are under the control and regulation of:
A.	the basal ganglia.
B.	the thalamus.
C.	the hypothalamus.
D.	Wernicke's area.
A

A. the basal ganglia.

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5
Q
What term is used to describe involuntary muscle movements?
A.	Ataxia
B.	Flaccidity
C.	Athetosis
D.	Vestibular function
A

C. Athetosis

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6
Q

Clonus that may be seen when testing deep tendon reflexes is characterized by a(n):
A. additional contraction of the muscle that is of greater intensity than the first.
B. set of rapid, rhythmic contractions of the same muscle.
C. parallel response in the opposite extremity.
D. contraction of the muscle that appears after the tendon is hit the second time.

A

B. set of rapid, rhythmic contractions of the same muscle.

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7
Q
The presence of primitive reflexes in a newborn infant is indicative of:
A.	immaturity of the nervous system.
B.	prematurity of the infant.
C.	mental retardation.
D.	spinal cord alterations.
A

A. immaturity of the nervous system.

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8
Q

Cerebellar function is tested by:
A. muscle strength assessment.
B. performance of rapid alternating movements.
C. the Phalen maneuver.
D. superficial pain and touch assessment.

A

B. performance of rapid alternating movements.

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9
Q
The \_\_\_\_\_\_\_\_\_\_\_\_\_ coordinates movement, maintains equilibrium, and helps maintain posture.
A.	extrapyramidal system
B.	cerebellum
C.	upper and lower motor neurons
D.	basal ganglia
A

B. cerebellum

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10
Q

During the assessment of extraocular movements, two back-and-forth oscillations of the eyes in the extreme lateral gaze occurs. This response indicates:
A. that the individual needs to be referred for a more complete eye examination.
B. a disease of the vestibular system and that should be evaluated.
C. an expected movement of the eyes during this procedure.
D. this assessment should be repeated in 15 minutes to allow the eyes to rest.

C. Nystagmus is a back-and-forth normally.

A

C. an expected movement of the eyes during this procedure.

Nystagmus is a back-and-forth oscillation of the eyes. End-point nystagmus, a few beats of horizontal nystagmus at extreme lateral gaze, occurs normally.

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11
Q
The \_\_\_\_\_\_ reflex is an example of a \_\_\_\_\_\_\_\_\_ reflex.
A.	plantar; deep tendon
B.	abdominal; superficial
C.	quadriceps; pathologic
D.	corneal light; visceral
A

B. abdominal; superficial
Rationale
A. Deep tendon reflexes test the reflex arc at the spinal level and include the biceps, triceps, brachioradialis, quadriceps, and Achille (NOT plantar)

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12
Q
An area of the body that is supplied mainly from one spinal segment through a particular spinal nerve is identified as a:
A.	dermatome.
B.	dermal segmentation.
C.	hemisphere.
D.	crossed representation.
A

A. dermatome.

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13
Q
Increased tactile fremitus would be evident in an individual who has which of the following conditions?
A.	Emphysema
B.	Pneumonia
C.	Crepitus
D.	Pneumothorax
A

B. Pneumonia

Decreased fremitus occurs when anything obstructs transmission of vibrations (e.g., obstructed bronchus, pleural effusion or thickening, pneumothorax, or emphysema).

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14
Q
A clinical manifestation common in an individual with chronic obstructive pulmonary disease (COPD) is:
A.	periodic breathing patterns.
B.	pursed-lip breathing.
C.	unequal chest expansion.
D.	hyperventilation.
A

B. pursed-lip breathing.
B. An individual with COPD may purse the lips in a whistling position. By exhaling slowly and against a narrow opening, the pressure in the bronchial tree remains positive, and fewer airways collapse.

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15
Q
The thoracic cage is defined by all of the following except the:
A.	sternum.
B.	ribs.
C.	costochondral junction.
D.	diaphragm.
A

C. costochondral junction.

Rationale
The thoracic cage is defined by the sternum, ribs, vertebrae, and diaphragm.

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16
Q
Inspiration is primarily facilitated by which of the following muscles?
A.	Diaphragm and abdominus rectus
B.	Trapezia and sternomastoids
C.	Internal intercostals and abdominal
D.	Diaphragm and intercostals
A

D. Diaphragm and intercostals

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17
Q

Which of the following voice sounds would be a normal finding?
A. The voice transmission is distinct and sounds close to the ear.
B. The “eeeee” sound is clear and sounds like “eeeee”.
C. The whispered sound is transmitted clearly.
D. Whispered “1-2-3” is audible and distinct.

A

B. The “eeeee” sound is clear and sounds like “eeeee”.

A normal finding from voice sounds is egophony; “eeeee” heard through the stethoscope clearly.

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18
Q

The gradual loss of intraalveolar septa and a decreased number of alveoli in the lungs of the elderly cause:
A. hyperventilation.
B. spontaneous atelectasis.
C. decreased surface area for gas exchange.
D. decreased dead space.

A

C. decreased surface area for gas exchange.

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19
Q

The function of the trachea and bronchi is to:
A. transport gases between the environment and the lung parenchyma.
B. condense inspired air for better gas exchange.
C. moisturize air for optimum respiration.
D. increase air turbulence and velocity for maximum gas transport.

A

A. transport gases between the environment and the lung parenchyma.

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20
Q
Stridor is a high-pitched, inspiratory crowing sound commonly associated with:
A.	upper airway obstruction.
B.	atelectasis.
C.	congestive heart failure.
D.	pneumothorax.
A

A. upper airway obstruction.

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21
Q

Percussion of the chest is:
A. a useful technique for identifying small lesions in lung tissue.
B. helpful only in identifying surface alterations of lung tissue.
C. is not influenced by the overlying chest muscle and fat tissue.
D. normal if a dull note is elicited.

A

B. helpful only in identifying surface alterations of lung tissue.

Resonance is a low-pitched, clear, hollow sound that predominates with percussion of healthy lung tissue.

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22
Q
Which of the following correctly expresses the relationship to the lobes of the lungs and their anatomic position?
A.	Upper lobes—lateral chest
B.	Upper lobes—posterior chest
C.	Lower lobes—posterior chest
D.	Lower lobes—anterior chest
A

C. Lower lobes—posterior chest

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23
Q

An increase in the transverse diameter of the chest cage in a pregnant female is due to a(n):
A. compensatory increase in respiratory parenchyma.
B. increase in estrogen.
C. increase in surfactant.
D. increase in tidal volume.

A

B. increase in estrogen.

The increase in estrogen level during pregnancy relaxes the chest cage ligaments. This allows an increase in the transverse diameter of the chest cage by 2 cm, and the costal angle widens.

24
Q

Binaural interaction at the level of the brain stem permits:
A. interpretation of sound.
B. identification and location of the direction of the sound.
C. amplification of sound.
D. direction of sound toward the appropriate conduction pathway.

A

B. identification and location of the direction of the sound.

25
Q

Which of the following behaviors demonstrated by an individual may be indicative of hearing loss?
A. Not looking at the examiner when being questioned
B. Frequently asking for the question to be repeated
C. Talking in a high-pitched voice
D. Speaking slowly with well-articulated consonants

A

B. Frequently asking for the question to be repeated

26
Q

Which of the following children is at risk of recurrent otitis media?
A. An 18-month-old infant who lives with a smoker.
B. A 2-year-old child who has had two ear infections in the past 6 months.
C. A 6-month-old infant who has a sibling who had tubes inserted at 3 years of age.
D. An 18-month-old infant who has had three episodes of ear infections in a 5-month period.

A

D. An 18-month-old infant who has had three episodes of ear infections in a 5-month period.

A first episode of otitis media (OM) that occurs within 3 months of life increases risk of recurrent OM. Recurrent OM is 3 episodes in past 3 months or 4 episodes within the past year.

27
Q
The labyrinth of the inner ear is responsible for maintaining the body's:
A.	binaural interaction.
B.	air conduction.
C.	equilibrium.
D.	pressure equalization.
A

C. equilibrium.

28
Q

When an otoscope examination is performed on an older adult client, the tympanic membrane may be:
A. pinker than that of a younger adult.
B. thinner than that of a younger adult.
C. whiter than that of a younger adult.
D. more mobile than that of a younger adult.

A

C. whiter than that of a younger adult.

29
Q
The position of the tympanic membrane in the neonate is more \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_, making it more difficult to visualize with the otoscope.
A.	horizontal
B.	vertical
C.	perpendicular
D.	oblique
A

A. horizontal

30
Q

The tympanic membrane of a child with acute otitis media would be:
A. flat and slightly pulled in at the center.
B. mobile and would flutter with the Valsalva maneuver.
C. bulging with a distinct red color.
D. shiny and translucent, with a pearly gray color.

A

C. bulging with a distinct red color.

31
Q

If the tympanic membrane has white dense areas, the examiner suspects:
A. perforation from a ruptured membrane.
B. scarring from recurrent ear infections.
C. serous fluid from serous otitis media.
D. a fungal infection.

A

B. scarring from recurrent ear infections.

32
Q
The extraocular muscles consist of four straight or \_\_\_\_\_\_\_\_ muscles and two slanting or \_\_\_\_\_\_ muscles.
A.	palpebral; conjugate
B.	superior; inferior
C.	rectus; oblique
D.	rectilinear; diagonal
A

C. rectus; oblique

33
Q
A slight protrusion of the eyeballs may be noticed when examining individuals who come from which ethnic/cultural group?
A.	Asian
B.	African American
C.	Hispanic
D.	American Indian
A

B. African American

34
Q
The location in the brain where optic nerve fibers from the temporal fields of vision cross over is identified as the:
A.	optic chiasm.
B.	fovea centralis.
C.	optic disc.
D.	choroid.
A

A. optic chiasm.

35
Q

Which of the following groups of individuals need to be tested for the presence of color blindness (deficiency)?
A. Black males between the ages of 10 and 15 years
B. White males between the ages of 4 and 8 years
C. Asian females between the ages of 3 and 6 years
D. White females between the ages of 4 and 8 years

A

B. White males between the ages of 4 and 8 years

Color blindness is an inherited recessive X-linked trait affecting about 8% of white males and 4% of black males. Test only boys for color vision, once between the ages of 4 and 8 years.

36
Q

Which of the following statements is true in regard to the results obtained from use of the Snellen chart?
A. The smaller the denominator, the poorer the vision.
B. The larger the denominator, the poorer the vision.
C. The larger the numerator, the better the vision.
D. The smaller the numerator, the poorer the vision.

A

B. The larger the denominator, the poorer the vision.

37
Q
The lens of the eye functions as a:
A.	refracting medium.
B.	mediator of light.
C.	sensory facilitator.
D.	controller of intraocular pressure.
A

A. refracting medium.

38
Q

When inspecting the eyeballs of an African American individual, which of the following might the examiner expect to observe?
A. A slight misalignment of the eyeballs
B. A slight yellow discoloration of the sclera
C. Small brown macules on the sclera
D. A slight amount of drainage around the lacrimal apparatus

A

C. Small brown macules on the sclera

39
Q
The normal color of the optic disc is:
A.	red.
B.	creamy pink.
C.	creamy yellow-orange to pink.
D.	creamy red to yellow-orange.
A

C. creamy yellow-orange to pink.

40
Q

Which of the following is an expected response on the cover test?
A. The covered eye moves into a relaxed position.
B. The covered eye maintains its position when uncovered.
C. The uncovered eye is unable to maintain its gaze on a fixed object.
D. The covered eye jumps to reestablish fixation when it is uncovered.

A

B. The covered eye maintains its position when uncovered.

41
Q

Which of the following findings is associated with Horner syndrome?
A. Bilateral miosis
B. Bilateral mydriasis
C. A unilateral small regular pupil that reacts to light and accommodation
D. A unilateral dilated pupil with no reaction to light or accommodation

A

C. A unilateral small regular pupil that reacts to light and accommodation
Horner syndrome is caused by a lesion of the sympathetic nerve. An individual with Horner syndrome will have a unilateral, small, regular pupil that does react to light and accommodation. There will be unilateral ptosis and absence of sweat on the same side.

42
Q
Decreased vision in the elderly may be due to which of the following conditions?
A.	Macular degeneration
B.	Retinoblastoma
C.	Fixation
D.	Presbyopia
A

A. Macular degeneration

43
Q

What tests do you perform to test cerebellar fxn?

A
Balance (Gait, tandem walking)
Romberg
RAM
Coordination &skilled movements
Reflexes
44
Q
Cranial nerves:
Oh
Once
One
Takes
The
Airplane
Flight
A
Great
Vacation
Seems
Heavenly
A
I. Olfactory
II. Optic
III. Oculomotor
IV. Trochlear
V. Trigeminal
VI. Abducens
VII.Facial
VIII. Acoustic
IX. Glossopharyngeal
X. Vagus
XI. Spinal Accesory
XII. Hypoglossal
45
Q

I. Olfactory: Sensory or Motor and function

A

Sensory: Smell

46
Q

II. Optic: S or M and fxn?

A

Sensory: Vision

47
Q

III. Oculomotor: S or M and fxn?

A

EOM, opening of eyes, pupil constriction and lens shape; Mixed

48
Q

IV. Trochlear: S or M and fxn?

A

down, inward movement of eye; Motor

49
Q

V. Trigeminal S or M and fxn?

A

Mastication; Mixed

50
Q

VI. Abducens S or M and fxn?

A

lateral eye movement Motor

51
Q

VII. Facial S or M and fxn?

A

motor to facial muscles and sensory to taste

52
Q

VIII. Acoustic S or M and fxn?

A

hearing and equilibrium; Sensory

53
Q

IX. Glossopharyngal S or M and fxn?

A

Pharynx, swallowing (Motor). taste back of tongue (sensory)

54
Q

X. Vagus S or M and fxn?

A

taste and sensation of the pharnyx. Controls swallowing, gag, and salivating. Talking and swallowing. Mixed

55
Q

XI. Spinal Accessory S or M and fxn?

A

movement of Sternomastoid and trapezius. Motor

56
Q

XII. Hypoglossal

A

tongue movement. Motor