Week #9: Neuro Flashcards
A client’s patellar reflex is normal for the right side but diminished on the left. Using the scale for grading reflexes, how should the nurse document this finding?
a) Right knee +4; left knee +3
b) Right knee +1; left knee +3
c) Right knee +2; left knee +1
d) Right knee +3; left knee +2
c) Right knee +2; left knee +1
A nurse is preparing to assess the cranial nerves of a client. The nurse is about to test CN I. What would the nurse do?
a) Perform the Weber test
b) Use a Snellen chart to test visual acuity
c) Ask a client to identify scents
d) Test extraocular eye movements
c) Ask a client to identify scents
A client says that an object placed in the hand is a pair of scissors when the object is a paper clip. Which aspect of the client’s neurologic system should the nurse identify as being compromised?
a) Responsiveness
b) Sensory
c) Motor
d) Position sense
b) Sensory
When assessing cranial nerves IX and X, which of the following would the nurse consider as an abnormal finding?
a) Contraction of the pharyngeal muscle
b) Upward movement of the palate
c) Asymmetrical tongue movement
d) Impaired swallowing
d) Impaired swallowing
When evaluating a client’s risk for cerebrovascular accident, which client would the nurse identify as being at highest risk?
a) 68-year old African American male with hypertension
b) 35-year old African American who has sleep apnea
c) 55-year old Caucasian male who has 2 beers a week
d) 42-year old Caucasian woman who smokes
a) 68-year old African American male with hypertension
A nurse is preparing to assess a client’s cerebellar function. What aspect of neurological function should the nurse address?
a) Sensation
b) Remote memory
c) Mental status exam
d) Balance
d) Balance
As people age, several neurological changes occur. Neurons, brain size, and neurotransmitters decrease. What are some of the results of aging on the neurological system? Select all that apply.
a) Delayed reflexes
b) Reduced response to stimuli
c) Inability to process nutrients
d) More frequent seizures
e) Slower thought processing
a) Delayed reflexes
b) Reduced response to stimuli
e) Slower thought processing
Which of the following tests would be most appropriate for the nurse to use when assessing motor function of the trigeminal nerve?
a) Have the client smile, frown, and wrinkle the forehead
b) Ask the client to differentiate sharp and dull sensations on the face
c) Palpate the temporal and masseter muscles while the client clenches teeth
d) Assess dilation of pupils with direct light
c) Palpate the temporal and masseter muscles while the client clenches teeth
Lifestyle can play a big part in developing risk factors for stroke. Which of the following can greatly reduce a client’s risk for stroke? Select all that apply.
a) Quitting smoking
b) Regularly exercising
c) Following a sedentary lifestyle
d) Maintaining a healthy weight
e) Eating a high-sodium diet
a) Quitting smoking
b) Regularly exercising
d) Maintaining a health weight
The nurse enters a client’s room to administer a prescribed anticoagulant for atrial fibrillation. The client exhibits new onset facial drooping and slurred speech. What is the nurse’s priority action?
a) Assess the client’s bleeding time before medication administration
b) Administer the PO anticoagulant immediately
c) Assess the client’s vital signs and cranial nerves
d) Ask the client to raise both arms in front of the client’s body
d) Ask the client to raise both arms in front of the client’s body
Extraocular movements (EOMs) down & in
Cranial Nerve IV (Trochlear)
Provides most parasympathetic innervation to a large region; effects include digestion, defecation, slowed heart rate, and reduced contraction strength
Cranial Nerve X (Vagus)
Extraocular movements (EOMs) lateral
Cranial Nerve VI (Abducens)
Taste and sensation for the anterior 2/3 of the tongue and soft palate; serves as the primary motor nerve for facial expression
Cranial Nerve VII (Facial)
Pharyngeal muscle elevation for swallowing & speech; parotid gland secretion; general sensory (pain, touch, temperature) function
Cranial Nerve IX (Glossopharyngeal)
Tongue movement
Cranial Nerve XII (Hypoglossal)
Extraocular movements (EOMs) upward, medial, downward, up and in; eyelid raising and pupil constriction
Cranial Nerve III (Oculomotor)
Swallowing and speaking; innervates the muscles that turn the head and elevates the shoulders (shoulder shrug)
Cranial Nerve XI (Spinal Accessory)
Smell and smell interpretation, including peristalsis, salivation, and sexual stimulation
Cranial Nerve I (Olfactory)
Ophthalmic branch: sensation to the cornea, conjunctiva, nasal mucosa, forehead, and nose
Maxillary branch: sensation to the skin of the cheek and nose, lower eyelid, upper jaw, teeth, and oral mucosa
Mandibular branch: sensation to the lower jaw and motor function to muscles of mastication
Cranial Nerve V (Trigeminal)
Hearing & equilibrium
Cranial Nerve VIII (Acoustic)
Vision, including visual acuity and peripheral vision
Cranial Nerve II (Optic)
Fibers connect the CNS with organs (including the heart and kidneys), smooth muscle, and glands in the voluntary division of the nervous system.
a) True
b) False
a) True
Increases in CSF pressure can lead to herniation of the brain and compression of the brainstem; such compression may alter respiratory function and reduce consciousness.
a) True
b) False
a) True
