NR 509 APEA NEUROLOGY EXAM WITH SATISFIED QUESTIONS AND ANSWERS

NR 509 APEA NEUROLOGY EXAM WITH SATISFIED QUESTIONS AND ANSWERS Question: When conducting a neurologic exam, which one of the following assessments is not consideredpartofthe mental status assessment? LevelofalertnessCranial NerveII (CNII) CorrectAppropriatenessof responsesOrientation to time Explanation: Whenconductinganeurologic exam, mental statusassessment shouldincludeevaluationof thelevelofalertness, appropriateness of responses, and orientation to person, place, and time. Assessing cranial nerve II would be part of the cranial nerve assessment. Question: A mother reports tothenursepractitioner thather teenager mightbetakingdrugsbecause earlier todaythe teenager had a mild seizure and now has an unstable gait and is beginning to complain of shortness ofbreath. These symptoms might be consistent with a possible overdose of: tamines. Cds. Explanation: Amphetamines arecentral nervoussystem (CNS)stimulants. Theteenagercouldexhibitsigns ofataxia,respiratorydistress,seizures,coma, myocardial infarction,deathifhe/she consumedthissubstance. Impaired memory, judgment,andattention,slurredspeech,drowsiness,andirritabilityare suggestiveofcentralnervous system depressants (CNS). Barbiturates,alcoholand benzodiazepines fall inthis class. Opioids may cause euphoria, drowsiness, constricted pupils and some of the same symptoms as CNS depressants. Marijuanaintoxication wouldpresent withrelaxation,euphoria, detachment, talkativeness,slowed perception of time, and possible anxiety or paranoia. Question: Sudden,brief, rapidjerks, involvingthetrunkor limbs maybe consistent with:a myoclonic seizure. Correct anabsent seizure. a myoclonicatonicseizure. afocalseizure withimpairmentofconsciousness. Explanation: A patient experiencing a myoclonic seizure manifests sudden, brief, rapid jerks, involving the trunk or limbs. A suddenbrief lapseofconsciousness with momentaryblinking, staring,or movementsof thelipsand hands but no falling is consistent with an absent seizure. During a myoclonic atonic seizure, the patientexperiences asuddenlossofconsciousness withfalling butno movements. Injury mayoccur. Focal seizures with impairment of consciousness the person appears confused. Automatisms include automatic motorbehaviors suchaschewing,smackingthelips, walkingabout,and unbuttoningclothes. Question: Which of the following neurological assessment findings indicate the need for further evaluation? Liftingonefootand thentheother when theinfant isheldupright withthefeet touchingasolidsurfaceFanning and hyperextension of the toes when thesole is stroked upward from theheel Grasping a finger placed in the neonate's palm Weakandineffectivesucking movements CorrectExplanation: Weakandineffectivesucking movements wouldindicatetheneedfor furtherevaluationsince any weak,absent, asymmetrical or fine jumping movements would suggest neurological system disorders. The other choices represent common reflexes found in the normal newborn: Babinski, grasping, and stepping. Question: Anexampleofproximal weaknessis:theright shoulder. Correct theright hand. botharms. Incorrect ontheright sideof the face.Explanation: There are 4 different patterns of weakness: Proximal, distal, symmetric, and asymmetric. An example ofproximal weakness is weakness intheshoulderorhipgirdle. Distal weakness occursinthehandsor feet.Symmetric weakness occurs in the same areas on both sides of the body. An asymmetric weakness occurs in a portion of the face or extremity -a form of focal weakness. Question: A femalepatient complainsof weakness inherhand whenopeningajar. This findingcouldbe suggestiveof which type of weakness pattern? ProximalDistal CorrectSymmetricAsymmetric Explanation: Toidentifydistal weakness,askabouthand movements whenopeningajar,canorusing scissors orascrewdriver. Another example is a problems like tripping when walking. Question: A patientpresents withanalteredlevelofconsciousness. He/sheisconsideredinastuporous stateifhe/she: appears drowsy but opens the eyes, looks at the examiners, answers the questions, and then falls es from sleep after exposure to painful stimuli, exhibits slow verbal responses, and easily lapses into an unresponsive state. Correctremains unarousable with eyes closed. There is no evident responsetoinner theeyesand looksat theexaminer,but respondsslowlyandis somewhat confused. Explanation: A stuporouspatientarousesfrom sleepafterexposuretopainfulstimuli,verbal responses areslow,andlapses into an unresponsive state. A lethargic patient appears drowsy but opens the eyes, looks at the examiners,answers thequestions,and thenfallsasleep. An obtundedpatientopenstheeyesand looks at the examiner, but responds slowly and is somewhat confused. A comatose patient remains unarousable with eyes closed. There is no evident response toinner need or external stimuli. Question: One way toassess cerebellar function wouldbetohave thepatient: hop on one foot. Correctread out loud. Incorrectshrug the iminate between light andsharp pain. Explanation: The cerebellar function tests are used to monitor the patient's sense of equilibrium, which includes the patient's gait (walk), ability to stand upright with eyes closed (Romberg test), touch finger to nose, and move the heel to opposite knee while lying down. Other examples also include: hopping on one foot, walkingheel-to-toe, and touchingtheexaminer's fingerand theexaminees'nose. Readingout loudtestsvisual acuity; shrugging shoulders assesses the spinal accessory nerve and discriminating pain between light and sharp assesses the sensory system