MARYVILLE NURS 612 FINAL EXAM ACTUAL
QUESTIONS AND CORRECT ANSWERS
◉ The Examiner asks the patient to close her eyes and then place a
vibrating tuning fork on the patients ankle and asks her to indicate
what is felt. What is being assessed?.
Answer: Primary sensory function
◉ Multiple sclerosis.
Answer: Fatigue, bowel and bladder dysfunction, sexual dysfunction,
sensory changes, muscle weakness
◉ Myasthenia gravis.
Answer: An autoimmune disorder of neuromuscular junction
involved with muscle activation.
◉ Whisper Test.
Answer: CN V111 acoustic
◉ Patient sticks out tongue and moves it from side to side.
Answer: CN X11 Hypoglossal
,◉ Taste test with sugar, salt, and lemon.
Answer: CN V11 and CN 1X Facial and glossopharyngeal
◉ Patient puffs out cheeks and shows teeth.
Answer: CN V11 facial
◉ Patient shrugs shoulders against examiner's hands.
Answer: CN X1 Spinal accessary
◉ Smell test with coffee, orange and cloves.
Answer: CN 1 Olfactory
◉ Eyes constrict and dilate in response to light.
Answer: CN 111 oculomotor
◉ patient clinches teeth (temporal muscles contracted).
Answer: CN V Trigeminal
◉ positive Babinski sign be considered a normal finding in what
ages?.
Answer: 0-24 months
, ◉ The nurse observes the gait of a client as he enters the room. He
uses short steps, keeps his knees in contact, and walks with
considerable effort. What term is used to describe this gait?.
Answer: Scissors gait
◉ A nurse observes very fine, rapid, continuous twitching of a
patient's finger while at rest. How should the nurse document this
finding?.
Answer: Fasciculation
A fasciculation is a fine, rapid twitching that may occur with some
lower motor neuron disease. Paralysis is loss of motor function.
Spasticity is abnormally increased muscle tone. An intention tremor
is an involuntary contraction of a muscle group occurring with
voluntary movement
◉ Under what conditions should a patient be tested for clonus?.
Answer: When deep tendon reflexes are hyperactive
Clonus, repeated reflex muscle movement, is tested when a patient
has hyperactive reflexes. It is found with diseases of the upper motor
neuron. Nuchal rigidity, neck stiffness, is a sign of meningeal
irritation. Absent reflexes are associated with lower motor neuron
diseases. Decorticate positioning, a state of flexion with the arms
adducted, occurs with hemispheric lesion of the cerebral cortex.
QUESTIONS AND CORRECT ANSWERS
◉ The Examiner asks the patient to close her eyes and then place a
vibrating tuning fork on the patients ankle and asks her to indicate
what is felt. What is being assessed?.
Answer: Primary sensory function
◉ Multiple sclerosis.
Answer: Fatigue, bowel and bladder dysfunction, sexual dysfunction,
sensory changes, muscle weakness
◉ Myasthenia gravis.
Answer: An autoimmune disorder of neuromuscular junction
involved with muscle activation.
◉ Whisper Test.
Answer: CN V111 acoustic
◉ Patient sticks out tongue and moves it from side to side.
Answer: CN X11 Hypoglossal
,◉ Taste test with sugar, salt, and lemon.
Answer: CN V11 and CN 1X Facial and glossopharyngeal
◉ Patient puffs out cheeks and shows teeth.
Answer: CN V11 facial
◉ Patient shrugs shoulders against examiner's hands.
Answer: CN X1 Spinal accessary
◉ Smell test with coffee, orange and cloves.
Answer: CN 1 Olfactory
◉ Eyes constrict and dilate in response to light.
Answer: CN 111 oculomotor
◉ patient clinches teeth (temporal muscles contracted).
Answer: CN V Trigeminal
◉ positive Babinski sign be considered a normal finding in what
ages?.
Answer: 0-24 months
, ◉ The nurse observes the gait of a client as he enters the room. He
uses short steps, keeps his knees in contact, and walks with
considerable effort. What term is used to describe this gait?.
Answer: Scissors gait
◉ A nurse observes very fine, rapid, continuous twitching of a
patient's finger while at rest. How should the nurse document this
finding?.
Answer: Fasciculation
A fasciculation is a fine, rapid twitching that may occur with some
lower motor neuron disease. Paralysis is loss of motor function.
Spasticity is abnormally increased muscle tone. An intention tremor
is an involuntary contraction of a muscle group occurring with
voluntary movement
◉ Under what conditions should a patient be tested for clonus?.
Answer: When deep tendon reflexes are hyperactive
Clonus, repeated reflex muscle movement, is tested when a patient
has hyperactive reflexes. It is found with diseases of the upper motor
neuron. Nuchal rigidity, neck stiffness, is a sign of meningeal
irritation. Absent reflexes are associated with lower motor neuron
diseases. Decorticate positioning, a state of flexion with the arms
adducted, occurs with hemispheric lesion of the cerebral cortex.
