Week 3 Neurology Across the Lifespan Flashcards
You are watching a nurse practitioner examine a pediatric patient. You would expect the NP to assess the neurological system in which order?
Cerebral function, cranial nerves, motor function, sensory function, coordination, reflexes The neurologic examination moves from the highest level of functioning to the lowest. Cerebral function is tested first; then cranial nerves (CNs), motor function, sensory function, coordination; and finally reflexes.
You are collecting a history from a 4-year-old pediatric patient who presented with a neurological complaint. Which history would be considered to be the most accurate based on the developmental age of the child?
Since the child is 4, you collect a history from both the child and at least one family member. Historical information from children older than 3 years and from one or more family members provides the most accurate picture.
How do you assess the oculomotor, trochlear, and abducens?
pupillary response to light, EOM, ptosis
how would you asses the Glossopharyngeal, vagus
symmetrical risk fo soft palate, gag reflex
how would you assess spinal accessory nerve
turns head against resistance, shoulder shrug
How would you test the trigeminal nerve?
Sensation to light facial touch, temporalis, and masseter strength
how would you test vestibulocochlear nerve?
Weber & Rinne; whisper test
how would you test facial nerve?
symmetry of smile and rise of eyebrows, orbicularis oculi strength, strength with cheeks puffed out
how would you test hypoglossal nerve?
tongue protrudes midline
how would you test optic nerve?
visual acuity, visual fields, fundoscopic exam
What HA is often unilateral, and associated w/ nausea, photophobia or visual changes?
Migraine
What HA has pain behind the browbone and/or cheekbones?
Sinus
What HA has pain in and around done eye and occurs in bouts
cluster
what headache is like a band squeezing the head?
TTH
A patient reports two episodes of visual disturbances and eye pain that lasted 1–2 days each, about 2 months apart. Which diagnostic testing will the provider order initially?
MRI
A patient who sustained a head injury has a Glasgow Coma score (GCS) of 14. The patient’s spouse reported that the patient lost consciousness for approximately 7 minutes after falling down the stairs. A head computed tomography (CT) scan does not reveal brain lesions. Which treatment is indicated?
Admission to the hospital with a neurosurgical evaluation This patient had loss of consciousness longer than 5 minutes and has a GCS of 14; both are indications for admission to the hospital with a neurosurgery consult, even though the CT is currently normal.
The parents of a 4-year-old child bring the child to the clinic after observing a brief seizure of less than 2 minutes in their child. In the clinic, the child has a temperature of 103.1 °F, and the primary care pediatric nurse practitioner notes posterior pharyngitis and tonsilitis. A rapid strep swab is positive. The child is alert and responding normally. What will the nurse practitioner do?
Prescribe an antibiotic for the tonsilitis and reassure the parents
A child who has had a single, nonfebrile seizure has a normal neurologic exam. Which diagnostic test is indicated?
EEG
A child who has sustained a head injury after falling on the playground is brought to the clinic. The parents report that the child cried immediately and was able to walk around after falling. The primary care pediatric nurse practitioner notes slight slurring of the child’s speech and the child has vomited twice in the exam room. Which course of action is warranted?
Admit the child to the hospital for a neurology consult
A 35-year-old patient reports suddenly experiencing an asymmetric smile along with drooping and tearing in one eye. The patient has a history of a recent viral illness but is otherwise healthy. During the exam, the provider notes that there is unilateral full-face paralysis on the right side. What is the initial intervention for this patient?
Prescribe oral corticosteroids
What cranial nerve is responsible for tongue movement? CN VIII CN IX & CN X CN XI CN XII
CN XII
A possible complication of Bell’s palsy is: (pick one) Corneal ulceration Acute glaucoma Inability to swallow Loss of sensation on affected side
corneal ulceration
During a sports examination, a 16 year old patient is noted to have a few beats of horizontal nystagmus on extreme lateral gaze that disappear when the eyes move back towards midline. Which statement best describes this clinical finding? It is caused by occult bleeding of the retinal artery This is a normal finding It is a sign of possible brain mass This is a borderline result and requires further evaluation
This is a normal finding
Which of the following viral infections is associated with the occasional abnormal forms of lymphocytes during an acute infection? CMV EBV HPV Coxackievirus
EBV like in mono
