Neuro Questions

Question 1

The two parts of the nervous system are the:
a.
Motor and sensory.
b.
Central and peripheral.
c.
Peripheral and autonomic.
d.
Hypothalamus and cerebral.

Answer 1

B

Question 2

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 very easily and becomes angry. The nurse recalls that the cerebral lobe responsible for these behaviors is the __________ lobe.
a.
Frontal
b.
Parietal
c.
Occipital
d.
Temporal

Answer 2

A

Question 3

Which statement concerning the areas of the brain is true?
a.
The cerebellum is the center for speech and emotions.
b.
The hypothalamus controls body temperature and regulates sleep.
c.
The basal ganglia are responsible for controlling voluntary movements.
d.
Motor pathways of the spinal cord and brainstem synapse in the thalamus

Answer 3

B

Question 4

The area of the nervous system that is responsible for mediating reflexes is the:
a.
Medulla.
b.
Cerebellum.
c.
Spinal cord.
d.
Cerebral cortex

Answer 4

C

Question 5

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?
a.
Corticospinal tract, medulla, and basal ganglia
b.
Pyramidal tract, hypothalamus, and sensory cortex
c.
Lateral spinothalamic tract, thalamus, and sensory cortex
d.
Anterior spinothalamic tract, basal ganglia, and sensory cortex

Answer 5

C

Question 6

A patient with a lack of oxygen to his heart will have pain in his chest and possibly in the shoulder, arms, or jaw. The nurse knows that the best explanation why this occurs is which one of these statements?
a.
A problem exists with the sensory cortex and its ability to discriminate the location.
b.
The lack of oxygen in his heart has resulted in decreased amount of oxygen to the areas experiencing the pain.
c.
The sensory cortex does not have the ability to localize pain in the heart; consequently, the pain is felt elsewhere.
d.
A lesion has developed in the dorsal root, which is preventing the sensation from being transmitted normally

Answer 6

C

Question 7

The ability that humans have to perform very skilled movements such as writing is controlled by the:
a.
Basal ganglia.
b.
Corticospinal tract.
c.
Spinothalamic tract.
d.
Extrapyramidal tract

Answer 7

B

Question 8

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 that is related to these findings would concern the nurse?
a.
Thalamus
b.
Brainstem
c.
Cerebellum
d.
Extrapyramidal tract

Answer 8

C

Question 9

Which of these statements about the peripheral nervous system is correct?
a.
The CNs enter the brain through the spinal cord.
b.
Efferent fibers carry sensory input to the central nervous system through the spinal cord.
c.
The peripheral nerves are inside the central nervous system and carry impulses through their motor fibers.
d.
The peripheral nerves carry input to the central nervous system by afferent fibers and away from the central nervous system by efferent fibers.

Answer 9

D

Question 10

A patient has a severed spinal nerve as a result of trauma. Which statement is true in this situation?
a.
Because there are 31 pairs of spinal nerves, no effect results if only one nerve is severed.
b.
The dermatome served by this nerve will no longer experience any sensation.
c.
The adjacent spinal nerves will continue to carry sensations for the dermatome served by the severed nerve.
d.
A severed spinal nerve will only affect motor function of the patient because spinal nerves have no sensory component.

Answer 10

C

Question 11

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?
a.
Reflexes will be normal.
b.
Reflexes cannot be elicited.
c.
All reflexes will be diminished but present.
d.
Some reflexes will be present, depending on the area of injury

Answer 11

A

Question 12

During an assessment of an 80-year-old patient, the nurse notices the following: an inability to identify vibrations at her ankle and to identify the position of her big toe, a slower and more deliberate gait, and a slightly impaired tactile sensation. All other neurologic findings are normal. The nurse should interpret that these findings indicate:
a.
CN dysfunction.
b.
Lesion in the cerebral cortex.
c.
Normal changes attributable to aging.
d.
Demyelination of nerves attributable to a lesion

Answer 12

C

Question 13

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:
a.
“Have you been extremely tired lately?”
b.
“You probably just need to drink more liquids.”
c.
“I’ll refer you for a complete neurologic examination.”
d.
“You need to get up slowly when you’ve been lying down or sitting.”

Answer 13

D

Question 14

During the taking of the health history, a patient tells the nurse that “it feels like the room is spinning around me.” The nurse would document this finding as:
a.
Vertigo.
b.
Syncope.
c.
Dizziness.
d.
Seizure activity

Answer 14

A

Question 15

When taking the health 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?
a.
“Does your muscle tone seem tense or limp?”
b.
“After the seizure, do you spend a lot of time sleeping?”
c.
“Do you have any warning sign before your seizure starts?”
d.
“Do you experience any color change or incontinence during the seizure?”

Answer 15

C

Question 16

In obtaining a health 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 response should the nurse make?
a.
“Does your family know you are drinking every day?”
b.
“Does the tremor change when you drink alcohol?”
c.
“We’ll do some tests to see what is causing the tremor.”
d.
“You really shouldn’t drink so much alcohol; it may be causing your tremor.”

Answer 16

B

Question 17

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?
a.
Glasgow Coma Scale
b.
Neurologic recheck examination
c.
Screening neurologic examination
d.
Complete neurologic examination

Answer 17

D

Question 18

During an assessment of the CNs, the nurse finds the following: asymmetry when the patient smiles or frowns, uneven lifting of the 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 CNs?
a.
Motor component of CN IV
b.
Motor component of CN VII
c.
Motor and sensory components of CN XI
d.
Motor component of CN X and sensory component of CN VII

Answer 18

B

Question 19

The nurse is testing the function of CN XI. Which statement best describes the response the nurse should expect if this nerve is intact? The patient:
a.
Demonstrates the ability to hear normal conversation.
b.
Sticks out the tongue midline without tremors or deviation.
c.
Follows an object with his or her eyes without nystagmus or strabismus.
d.
Moves the head and shoulders against resistance with equal strength

Answer 19

D

Question 20

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 these results would the nurse expect to find?
a.
Firm, rigid resistance to movement
b.
Mild, even resistance to movement
c.
Hypotonic muscles as a result of total relaxation
d.
Slight pain with some directions of movement

Answer 20

B

Question 21

When the nurse asks a 68-year-old patient to stand with his feet together and arms at his side with his eyes closed, he starts to sway and moves his feet farther apart. The nurse would document this finding as:
a.
Ataxia.
b.
Lack of coordination.
c.
Negative Homans sign.
d.
Positive Romberg sign

Answer 21

D

Question 22

The nurse is performing 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 of her knees. Her response is extremely slow and she frequently misses. What should the nurse suspect?
a.
Vestibular disease
b.
Lesion of CN IX
c.
Dysfunction of the cerebellum
d.
Inability to understand directions

Answer 22

C

Question 23

During the taking of the health history of a 78-year-old man, his wife states that he occasionally has problems with short-term memory loss and confusion: “He can’t even remember how to button his shirt.” When assessing his sensory system, which action by the nurse is most appropriate?
a.
The nurse would not test the sensory system as part of the examination because the results would not be valid.
b.
The nurse would perform the tests, knowing that mental status does not affect sensory ability.
c.
The nurse would proceed with an explanation of each test, making certain that the wife understands.
d.
Before testing, the nurse would assess the patient’s mental status and ability to follow directions

Answer 23

D

Question 24

The assessment of a 60-year-old patient has taken longer than anticipated. In testing his pain perception, the nurse decides to complete the test as quickly as possible. When the nurse applies the sharp point of the pin on his arm several times, he is only able to identify these as one “very sharp prick.” What would be the most accurate explanation for this?
a.
The patient has hyperesthesia as a result of the aging process.
b.
This response is most likely the result of the summation effect.
c.
The nurse was probably not poking hard enough with the pin in the other areas.
d.
The patient most likely has analgesia in some areas of arm and hyperalgesia in others

Answer 24

B

Question 25

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 notices that the patient is unable to feel vibrations on the great toe or ankle bilaterally, but she is able to feel vibrations on both patellae. Given this information, what would the nurse suspect?
a.
Hyperalgesia
b.
Hyperesthesia
c.
Peripheral neuropathy
d.
Lesion of sensory cortex

Answer 25

C

Question 26

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?
a.
Extinction
b.
Astereognosis
c.
Graphesthesia
d.
Tactile discrimination

Answer 26

B

Question 27

The nurse is testing the deep tendon reflexes of a 30-year-old woman who is in the clinic for an annual physical examination. When striking the Achilles heel and quadriceps muscle, the nurse is unable to elicit a reflex. The nurse’s next response should be to:
a.
Ask the patient to lock her fingers and pull.
b.
Complete the examination, and then test these reflexes again.
c.
Refer the patient to a specialist for further testing.
d.
Document these reflexes as 0 on a scale of 0 to 4+

Answer 27

A

Question 28

In assessing a 70-year-old patient who has had a recent cerebrovascular accident, the nurse notices right-sided weakness. What might the nurse expect to find when testing his reflexes on the right side?
a.
Lack of reflexes
b.
Normal reflexes
c.
Diminished reflexes
d.
Hyperactive reflexes

Answer 28

D

Question 29

When the nurse is testing the triceps reflex, what is the expected response?
a.
Flexion of the hand
b.
Pronation of the hand
c.
Extension of the forearm
d.
Flexion of the forearm

Answer 29

C

Question 30

When the nurse is testing the triceps reflex, what is the expected response?
a.
Flexion of the hand
b.
Pronation of the hand
c.
Extension of the forearm
d.
Flexion of the forearm

Answer 30

C

Question 31

During the assessment of an 80-year-old patient, the nurse notices that his hands show tremors when he reaches for something and his head is always nodding. No associated rigidity is observed with movement. Which of these statements is most accurate?
a.
These findings are normal, resulting from aging.
b.
These findings could be related to hyperthyroidism.
c.
These findings are the result of Parkinson disease.
d.
This patient should be evaluated for a cerebellar lesion

Answer 31

A

Question 32

While the nurse is taking the history of a 68-year-old patient who sustained a head injury 3 days earlier, he tells the nurse that he is on a cruise ship and is 30 years old. The nurse knows that this finding is indicative of a(n):
a.
Great sense of humor.
b.
Uncooperative behavior.
c.
Inability to understand questions.
d.
Decreased level of consciousness.

Answer 32

D

Question 33

The nurse is caring for a patient who has just had neurosurgery. To assess for increased intracranial pressure, what would the nurse include in the assessment?
a.
CNs, motor function, and sensory function
b.
Deep tendon reflexes, vital signs, and coordinated movements
c.
Level of consciousness, motor function, pupillary response, and vital signs
d.
Mental status, deep tendon reflexes, sensory function, and pupillary response

Answer 33

C

Question 34

During an assessment of a 22-year-old woman who sustained a head injury from an automobile accident 4 hours earlier, the nurse notices the following changes: pupils were equal, but now the right pupil is fully dilated and nonreactive, and the left pupil is 4 mm and reacts to light. What do these findings suggest?
a.
Injury to the right eye
b.
Increased intracranial pressure
c.
Test inaccurately performed
d.
Normal response after a head injury

Answer 34

B

Question 35

A 32-year-old woman tells the nurse that she has noticed “very sudden, jerky movements” mainly in her hands and arms. She says, “They seem to come and go, primarily when I am trying to do something. I haven’t noticed them when I’m sleeping.” This description suggests:
a.
Tics.
b.
Athetosis.
c.
Myoclonus.
d.
Chorea.

Answer 35

D

Question 36

During an assessment of a 62-year-old man, the nurse notices the patient has a stooped posture, shuffling walk with short steps, flat facial expression, and pill-rolling finger movements. These findings would be consistent with:
a.
Parkinsonism.
b.
Cerebral palsy.
c.
Cerebellar ataxia.
d.
Muscular dystrophy

Answer 36

A

Question 37

During an assessment of a 32-year-old patient with a recent head injury, the nurse notices that the patient responds to pain by extending, adducting, and internally rotating his arms. His palms pronate, and his lower extremities extend with plantar flexion. Which statement concerning these findings is most accurate? This patient’s response:
a.
Indicates a lesion of the cerebral cortex.
b.
Indicates a completely nonfunctional brainstem.
c.
Is normal and will go away in 24 to 48 hours.
d.
Is a very ominous sign and may indicate brainstem injury

Answer 37

D

Question 38

A 78-year-old man has a history of a cerebrovascular accident. The nurse notes that when he walks, his left arm is immobile against the body with flexion of the shoulder, elbow, wrist, and fingers and adduction of the shoulder. His left leg is stiff and extended and circumducts with each step. What type of gait disturbance is this individual experiencing?
a.
Scissors gait
b.
Cerebellar ataxia
c.
Parkinsonian gait
d.
Spastic hemiparesis

Answer 38

D

Question 39

In a person with an upper motor neuron lesion such as a cerebrovascular accident, which of these physical assessment findings should the nurse expect?
a.
Hyperreflexia
b.
Fasciculations
c.
Loss of muscle tone and flaccidity
d.
Atrophy and wasting of the muscles

Answer 39

A

Question 40

A 59-year-old patient has a herniated intervertebral disk. Which of the following findings should the nurse expect to see on physical assessment of this individual?
a.
Hyporeflexia
b.
Increased muscle tone
c.
Positive Babinski sign
d.
Presence of pathologic reflexes

Answer 40

A

Question 41

A patient is unable to perform rapid alternating movements such as rapidly patting her knees. The nurse should document this inability as:
a.
Ataxia.
b.
Astereognosis.
c.
Presence of dysdiadochokinesia.
d.
Loss of kinesthesia

Answer 41

C

Question 42

The nurse knows that determining whether a person is oriented to his or her surroundings will test the functioning of which structure(s)?
a.
Cerebrum
b.
Cerebellum
c.
CNs
d.
Medulla oblongata

Answer 42

A

Question 43

During an examination, the nurse notices severe nystagmus in both eyes of a patient. Which conclusion by the nurse is correct? Severe nystagmus in both eyes:
a.
Is a normal occurrence.
b.
May indicate disease of the cerebellum or brainstem.
c.
Is a sign that the patient is nervous about the examination.
d.
Indicates a visual problem, and a referral to an ophthalmologist is indicated

Answer 43

B

Question 44

The nurse knows that testing kinesthesia is a test of a person’s:
a.
Fine touch.
b.
Position sense.
c.
Motor coordination.
d.
Perception of vibration

Answer 44

B

Question 45

The nurse is reviewing a patient’s medical record and notes that he is in a coma. Using the Glasgow Coma Scale, which number indicates that the patient is in a coma?
a.
6
b.
12
c.
15
d.
24

Answer 45

A

Question 46

A man who was found wandering in a park at 2 AM has been brought to the emergency department for an examination; he said he fell and hit his head. During the examination, the nurse asks him to use his index finger to touch the nurse’s finger, then his own nose, then the nurse’s finger again (which has been moved to a different location). The patient is clumsy, unable to follow the instructions, and overshoots the mark, missing the finger. The nurse should suspect which of the following?
a.
Cerebral injury
b.
Cerebrovascular accident
c.
Acute alcohol intoxication
d.
Peripheral neuropathy

Answer 46

C

Question 47

The nurse is assessing the neurologic status of a patient who has a late-stage brain tumor. With the reflex hammer, the nurse draws a light stroke up the lateral side of the sole of the foot and inward, across the ball of the foot. In response, the patient’s toes fan out, and the big toe shows dorsiflexion. The nurse interprets this result as:
a.
Negative Babinski sign, which is normal for adults.
b.
Positive Babinski sign, which is abnormal for adults.
c.
Clonus, which is a hyperactive response.
d.
Achilles reflex, which is an expected response

Answer 47

B