NU 673 Exam 2 Actual Exam 2026/2027 – Complete Exam-
Style Questions with Detailed Rationales
Neurologic Assessment
1. A patient has weakness of the right arm and leg following a cerebral
infarction. Which finding most strongly suggests an upper motor
neuron lesion?
A. Flaccid paralysis
B. Decreased deep-tendon reflexes
C. Hyperreflexia
D. Muscle fasciculations
Answer: C
Rationale: Upper motor neuron lesions commonly produce spasticity,
hyperreflexia, and abnormal plantar responses. Flaccidity and
decreased reflexes are more characteristic of lower motor neuron
disease.
2. A patient suddenly develops a severe headache described as “the
worst headache of my life.” Which condition should the clinician
suspect first?
A. Migraine
B. Tension headache
C. Subarachnoid hemorrhage
D. Sinusitis
Answer: C
Rationale: A sudden, explosive “thunderclap” headache is classic for
subarachnoid hemorrhage and requires emergency evaluation.
,3. During assessment, a patient demonstrates a unilateral facial droop
involving the lower face but can wrinkle the forehead bilaterally. This
pattern most strongly suggests:
A. Peripheral CN VII palsy
B. Central facial weakness
C. Trigeminal neuropathy
D. Bell palsy
Answer: B
Rationale: A central lesion often spares forehead movement because
the upper facial muscles receive bilateral cortical innervation.
4. Which cranial nerve is primarily responsible for detecting smell?
A. CN I
B. CN II
C. CN V
D. CN VIII
Answer: A
Rationale: Cranial nerve I, the olfactory nerve, mediates the sense of
smell.
5. Which cranial nerve is assessed when visual acuity is tested?
A. CN II
B. CN III
C. CN IV
D. CN VI
Answer: A
Rationale: The optic nerve (CN II) carries visual information from the
retina to the brain.
6. A patient has difficulty maintaining balance when standing with the
feet together and eyes closed. This is a positive:
,A. Babinski test
B. Romberg test
C. Kernig test
D. Brudzinski test
Answer: B
Rationale: The Romberg test evaluates proprioception and vestibular
contributions to balance.
7. A positive Babinski response in an adult is characterized by:
A. Flexion of all toes
B. Downward movement of the great toe
C. Extension of the great toe with fanning of the other toes
D. Absent plantar response
Answer: C
Rationale: An extensor plantar response is abnormal in adults and may
indicate corticospinal tract dysfunction.
8. Which finding is most consistent with Parkinson disease?
A. Intention tremor
B. Bradykinesia
C. Hyperactive speech
D. Flaccid paralysis
Answer: B
Rationale: Bradykinesia, rigidity, resting tremor, and postural instability
are characteristic Parkinsonian findings.
9. A resting tremor associated with Parkinson disease typically:
A. Occurs only during purposeful movement
B. Improves with complete rest
C. Is most prominent at rest
D. Occurs exclusively during sleep
, Answer: C
Rationale: Parkinsonian tremor is classically a resting tremor and may
lessen with voluntary movement.
10. Which symptom is most characteristic of increased intracranial
pressure?
A. Persistent bradycardia without other findings
B. Morning headache associated with vomiting
C. Isolated ankle edema
D. Increased bowel sounds
Answer: B
Rationale: Headache, nausea/vomiting, altered mental status, and
visual changes may accompany increased intracranial pressure.
11. Which Glasgow Coma Scale component evaluates the patient's
ability to follow commands?
A. Eye opening
B. Verbal response
C. Motor response
D. Pupillary response
Answer: C
Rationale: The motor component assesses purposeful movement and
response to commands.
12. A patient is unable to identify an object placed in the hand despite
intact sensation. This deficit is called:
A. Aphasia
B. Agnosia
C. Ataxia
D. Apraxia
Style Questions with Detailed Rationales
Neurologic Assessment
1. A patient has weakness of the right arm and leg following a cerebral
infarction. Which finding most strongly suggests an upper motor
neuron lesion?
A. Flaccid paralysis
B. Decreased deep-tendon reflexes
C. Hyperreflexia
D. Muscle fasciculations
Answer: C
Rationale: Upper motor neuron lesions commonly produce spasticity,
hyperreflexia, and abnormal plantar responses. Flaccidity and
decreased reflexes are more characteristic of lower motor neuron
disease.
2. A patient suddenly develops a severe headache described as “the
worst headache of my life.” Which condition should the clinician
suspect first?
A. Migraine
B. Tension headache
C. Subarachnoid hemorrhage
D. Sinusitis
Answer: C
Rationale: A sudden, explosive “thunderclap” headache is classic for
subarachnoid hemorrhage and requires emergency evaluation.
,3. During assessment, a patient demonstrates a unilateral facial droop
involving the lower face but can wrinkle the forehead bilaterally. This
pattern most strongly suggests:
A. Peripheral CN VII palsy
B. Central facial weakness
C. Trigeminal neuropathy
D. Bell palsy
Answer: B
Rationale: A central lesion often spares forehead movement because
the upper facial muscles receive bilateral cortical innervation.
4. Which cranial nerve is primarily responsible for detecting smell?
A. CN I
B. CN II
C. CN V
D. CN VIII
Answer: A
Rationale: Cranial nerve I, the olfactory nerve, mediates the sense of
smell.
5. Which cranial nerve is assessed when visual acuity is tested?
A. CN II
B. CN III
C. CN IV
D. CN VI
Answer: A
Rationale: The optic nerve (CN II) carries visual information from the
retina to the brain.
6. A patient has difficulty maintaining balance when standing with the
feet together and eyes closed. This is a positive:
,A. Babinski test
B. Romberg test
C. Kernig test
D. Brudzinski test
Answer: B
Rationale: The Romberg test evaluates proprioception and vestibular
contributions to balance.
7. A positive Babinski response in an adult is characterized by:
A. Flexion of all toes
B. Downward movement of the great toe
C. Extension of the great toe with fanning of the other toes
D. Absent plantar response
Answer: C
Rationale: An extensor plantar response is abnormal in adults and may
indicate corticospinal tract dysfunction.
8. Which finding is most consistent with Parkinson disease?
A. Intention tremor
B. Bradykinesia
C. Hyperactive speech
D. Flaccid paralysis
Answer: B
Rationale: Bradykinesia, rigidity, resting tremor, and postural instability
are characteristic Parkinsonian findings.
9. A resting tremor associated with Parkinson disease typically:
A. Occurs only during purposeful movement
B. Improves with complete rest
C. Is most prominent at rest
D. Occurs exclusively during sleep
, Answer: C
Rationale: Parkinsonian tremor is classically a resting tremor and may
lessen with voluntary movement.
10. Which symptom is most characteristic of increased intracranial
pressure?
A. Persistent bradycardia without other findings
B. Morning headache associated with vomiting
C. Isolated ankle edema
D. Increased bowel sounds
Answer: B
Rationale: Headache, nausea/vomiting, altered mental status, and
visual changes may accompany increased intracranial pressure.
11. Which Glasgow Coma Scale component evaluates the patient's
ability to follow commands?
A. Eye opening
B. Verbal response
C. Motor response
D. Pupillary response
Answer: C
Rationale: The motor component assesses purposeful movement and
response to commands.
12. A patient is unable to identify an object placed in the hand despite
intact sensation. This deficit is called:
A. Aphasia
B. Agnosia
C. Ataxia
D. Apraxia
