NURS 550 FINAL EXAM Latest Update
Comprehensive Questions with Correct
Answers Graded Perfect Score A+
3 important questions when examining the nervous system of a patient - Answer -- Is the mental
status intact?
- Are R and L sided findings the same or symmetric?
- If findings are assymmetric or otherwise abnormal, do the causative lesions lie in the central nervous
system or the peripheral nervous system?
3 ways to assess attention - Answer -Digital span: give the patient a string of numbers to recite
back to you
Serial 7s: ask the patient to subtract serial 7s from 100
Spelling backward: ask the patient to spell W-O-R-L-D backwards
A 29 year old woman's comes to your office. As you take the history you notice that she is speaking very
quickly, and jumping from topic to topic so rapidly that you have trouble following her. You are able to
find some connections b/w ideas, but it is difficult. Which word describes this thought process?
A. Derailment
B. Flight of ideas
C. Circumstantiality
D. Incoherence - Answer -B. Flight of ideas
A 33 year old construction worker comes for evaluation and tax of acute onset of low back pain. He
notes that the pain is an aching located in the lumbosacral area. It has been present intermittently for
several years; there is no known trauma or injury. He points to the left lower back. The pain does not
radiate and there is no numbness or tingling in the legs or incontinence. He was moving furniture over
the weekend. On exam you note muscle spasm, w/normal deep tendon reflexes and muscle strength.
What is the most likely cause of the back pain?
A. Herniated disc
B. Compression fx
C. Mechanical low back pain
D. Ankylosing spondylitis - Answer -C. Mechanical low back pain
,A patient present w/a left sided facial droop. On further testing, you note that he is unable to wrinkle his
forehead on the left and has decreased taste. Which of the following is true?
A. This represents a central lesion
B. This represents a CN IV lesion
C. This represents a paralysis of CN VII
D. This most likely represents a stroke - Answer -C. This represents a paralysis of CN VII
A patient who presents to the clinic complaining of hand pain says she was told by a friend that it is most
likely carpal tunnel syndrome. Upon assessing the patient, which would be suggestive of carpal tunnel
syndrome?
A. Hand pain when holding both hands in acute extension
B Numbness and tingling when tapping over the course of the radial nerve
C Symptoms related to compression are evident in all of the fingers
D None of the above - Answer -D None of the above
The symptoms of carpal tunnel syndrome are: numbness and tingling with pressing backs of hands
together in acute flexion for 60 seconds, tingling with tapping over the median nerve as it enters the
carpal tunnel, pain or numbness of the first three fingers of the hand but not in the palm
Abnormal Thought content
Compulsions
Obsessions
Phobias
Anxiety - Answer -Compulsions - repetitive behaviors that a person feels driven to perform to
prevent or produce some future state of affairs
Obsessions - recurrent, uncontrollable thoughts, images, or impulses that a patient considers
unacceptable
Phobias - persistent fear of a stimuli the patient feels is irrational
Anxiety - apprehension or fear that may be focused (phobia) or free floating (general sense of dread)
Abnormal Thought Content: delusions - Answer -False, fixed beliefs that are not shared by other
members of the person's culture
Somatic delusions: believing that one has a disease or defect that he does not
Systematized delusion: a single delusion with many elaborations around a single theme all systematized
into a complex network
Delusions of persecution, grandeur, jealousy, controlled by outside forces
, Delusion of reference: a person believes. An outside event or object has an unusual personal reference
to them; i.e. a comment passing earth means the patient should buy a car
Abnormal thought processes:
Circumstantiality
Derailment
Flight of Ideas
Neologisms
Incoherence
Blocking
Confabulation
Perseveration
Echolalia
Clanging - Answer -Circumstantiality - speech characterized by indirection and delay due to the
patients excessive use of details that have no connection to the point
Derailment - speech in which a person shifts topics with no apparent relations between the tropics
Flight of ideas - accelerated change of topics in a very fast but generally coherent manner
Neologisms - invented or distorted words
Incoherence - speech that is incomprehensible because it is illogical
Blocking - Sudden interruption of speech, before the completion of an idea, occurs in normal ppl
Confabulation - fabrication of facts to hide memory impairment
Perseveration - persistent repetition of words or ideas
Echolalia - repetition of the words or phrases of others
Clanging - choosing a word on the basis of sound rather than meaning
abnormalities of perception:
Illusions
Hallucinations - Answer -Illusions - internal stimuli, misinterpretations of real stimuli; e.g., the
postman leaves mail, therefore there is a plot to poison the patient
Hallucinations - a subjective external stimuli the patient hears or sees that others do not hear or see and
that the patient may not recognize as false; these can be auditory, visual, olfactory, gustatory, or tactile
Abscess - Answer -large pus filled >.5-1 cm from fluctuant-furuncle
Comprehensive Questions with Correct
Answers Graded Perfect Score A+
3 important questions when examining the nervous system of a patient - Answer -- Is the mental
status intact?
- Are R and L sided findings the same or symmetric?
- If findings are assymmetric or otherwise abnormal, do the causative lesions lie in the central nervous
system or the peripheral nervous system?
3 ways to assess attention - Answer -Digital span: give the patient a string of numbers to recite
back to you
Serial 7s: ask the patient to subtract serial 7s from 100
Spelling backward: ask the patient to spell W-O-R-L-D backwards
A 29 year old woman's comes to your office. As you take the history you notice that she is speaking very
quickly, and jumping from topic to topic so rapidly that you have trouble following her. You are able to
find some connections b/w ideas, but it is difficult. Which word describes this thought process?
A. Derailment
B. Flight of ideas
C. Circumstantiality
D. Incoherence - Answer -B. Flight of ideas
A 33 year old construction worker comes for evaluation and tax of acute onset of low back pain. He
notes that the pain is an aching located in the lumbosacral area. It has been present intermittently for
several years; there is no known trauma or injury. He points to the left lower back. The pain does not
radiate and there is no numbness or tingling in the legs or incontinence. He was moving furniture over
the weekend. On exam you note muscle spasm, w/normal deep tendon reflexes and muscle strength.
What is the most likely cause of the back pain?
A. Herniated disc
B. Compression fx
C. Mechanical low back pain
D. Ankylosing spondylitis - Answer -C. Mechanical low back pain
,A patient present w/a left sided facial droop. On further testing, you note that he is unable to wrinkle his
forehead on the left and has decreased taste. Which of the following is true?
A. This represents a central lesion
B. This represents a CN IV lesion
C. This represents a paralysis of CN VII
D. This most likely represents a stroke - Answer -C. This represents a paralysis of CN VII
A patient who presents to the clinic complaining of hand pain says she was told by a friend that it is most
likely carpal tunnel syndrome. Upon assessing the patient, which would be suggestive of carpal tunnel
syndrome?
A. Hand pain when holding both hands in acute extension
B Numbness and tingling when tapping over the course of the radial nerve
C Symptoms related to compression are evident in all of the fingers
D None of the above - Answer -D None of the above
The symptoms of carpal tunnel syndrome are: numbness and tingling with pressing backs of hands
together in acute flexion for 60 seconds, tingling with tapping over the median nerve as it enters the
carpal tunnel, pain or numbness of the first three fingers of the hand but not in the palm
Abnormal Thought content
Compulsions
Obsessions
Phobias
Anxiety - Answer -Compulsions - repetitive behaviors that a person feels driven to perform to
prevent or produce some future state of affairs
Obsessions - recurrent, uncontrollable thoughts, images, or impulses that a patient considers
unacceptable
Phobias - persistent fear of a stimuli the patient feels is irrational
Anxiety - apprehension or fear that may be focused (phobia) or free floating (general sense of dread)
Abnormal Thought Content: delusions - Answer -False, fixed beliefs that are not shared by other
members of the person's culture
Somatic delusions: believing that one has a disease or defect that he does not
Systematized delusion: a single delusion with many elaborations around a single theme all systematized
into a complex network
Delusions of persecution, grandeur, jealousy, controlled by outside forces
, Delusion of reference: a person believes. An outside event or object has an unusual personal reference
to them; i.e. a comment passing earth means the patient should buy a car
Abnormal thought processes:
Circumstantiality
Derailment
Flight of Ideas
Neologisms
Incoherence
Blocking
Confabulation
Perseveration
Echolalia
Clanging - Answer -Circumstantiality - speech characterized by indirection and delay due to the
patients excessive use of details that have no connection to the point
Derailment - speech in which a person shifts topics with no apparent relations between the tropics
Flight of ideas - accelerated change of topics in a very fast but generally coherent manner
Neologisms - invented or distorted words
Incoherence - speech that is incomprehensible because it is illogical
Blocking - Sudden interruption of speech, before the completion of an idea, occurs in normal ppl
Confabulation - fabrication of facts to hide memory impairment
Perseveration - persistent repetition of words or ideas
Echolalia - repetition of the words or phrases of others
Clanging - choosing a word on the basis of sound rather than meaning
abnormalities of perception:
Illusions
Hallucinations - Answer -Illusions - internal stimuli, misinterpretations of real stimuli; e.g., the
postman leaves mail, therefore there is a plot to poison the patient
Hallucinations - a subjective external stimuli the patient hears or sees that others do not hear or see and
that the patient may not recognize as false; these can be auditory, visual, olfactory, gustatory, or tactile
Abscess - Answer -large pus filled >.5-1 cm from fluctuant-furuncle
