©Jason McConnel 2025 ALL RIGHTS RESERVED.
Drexel nurs550 FINAL Exam Study Guide.
Alert - Answer✔patient awake and aware
level of consciousness - Answer✔how aware the person is of their environment
lethargic - Answer✔you must speak to the patient in a loud forceful manner to get a response
obtunded - Answer✔you must shake a patient to get a response
stuporous - Answer✔the patient is unarousable except by painful stimuli (sternal rub)
coma - Answer✔patient completely unarousable
short term memory - Answer✔covers events or memories that occurred minutes to days before
long-term memory - Answer✔covers events or memories that occurred months to years before
orientation - Answer✔aware of person (who they are), place (where they are), and time (when is
it)
perceptions - Answer✔awareness of the objects in the environment to the five senses and their
interrelationships
thought processes - Answer✔the logic, coherence, and relevance of a patient's thoughts as they
lead to thoughts and goals - HOW people think
insight - Answer✔awareness that thought, symptoms, or behaviors are normal or abnormal
ex: distinguishing that a daydream or hallucination is not real
judgement - Answer✔process of comparing and evaluating different possible courses of action
affect - Answer✔observable mood of a person expressed through facial expression, body
movements, voice
mood - Answer✔sustained emotion of the paint
- euthymic (tranquil, normal), dysthmic (chronic form of depression, low mood), manic (extreme
elevation and high energy)
language - Answer✔complex symbolic system for expressing hand written and verbal thoughts,
emotion, attention, and memory
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, ©Jason McConnel 2025 ALL RIGHTS RESERVED.
higher cognitive functions - Answer✔level of intelligence, assessed by vocabulary, knowledge
base, calculations, and abstract thinking
fluency - Answer✔involves the rate, flow, and melody of speech
hesitancies in speech - Answer✔seen in patients with aphasia from strokes
monotone inflections - Answer✔schizophrenia or severe depression
circumlocutions - Answer✔words or phrases are substituted for the word a person cannot
remember
paraphasias - Answer✔words are malformed, wrong, or invented
circumstanttiality - Answer✔speech characterized by indirection and delay due to the patients
excessive use of details that have no connection to the point
derailment - Answer✔speech in which a person shifts topics with no apparent relation between
the topics, no flow
flight of ideas - Answer✔accelerated change of topics in a very fast but generally coherent
manner
neologisms - Answer✔invented or distorted words
incoherence - Answer✔speech that is incomprehensible because it's illogical
blocking - Answer✔sudden interruption of speech, before the completion of an idea, occurs in
normal people
confabulation - Answer✔fabrication of facts to hide memory impairment
preservation - Answer✔persistant repetition of words or ideas
echolalia - Answer✔repetition of the words or phrases of others
clanging - Answer✔choosing a word on the basis of sound rather than meaning
compulsions - Answer✔repetitive behaviors that a person feels driven to perform to prevent or
produce some future state of affairs
obsessions - Answer✔recurrent, uncontrollable thoughts, images, or impulses that a patient
considered unacceptable
phobias - Answer✔persistent fear of a stimuli the patient feels is irrational (spiders, snakes, the
dark)
anxiety - Answer✔apprehension or fear that may be focused (phobia) or free floating (general
sense of dread)
delusions - Answer✔false, fixed beliefs that are not shared by other members of the person's
culture
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, ©Jason McConnel 2025 ALL RIGHTS RESERVED.
illusions - Answer✔misinterpretations of real stimuli
hallucinations - Answer✔subjective external stimuli the patient hears or sees that others do not
hear or see that the patient may not recognize as false; tense can be auditory, visual, olfactory,
gustatory, or tactile
calculating ability - Answer✔ask the patient to perform more difficult calculations such as
making change
major depressive disorder objective findings - Answer✔alteration in mood, thought, content, and
possibly speech
rule out other causes: metabolic abnormalities, drug use, intoxication, infection, thyroid disorders
MDD subjective findings - Answer✔historical risk factors that may mimic MDD
- other medical diagnoses
- medication/drugs
- acute illness and metabolic abnormalities
CN I - Answer✔olfactory; occlude each nostril and test different smells
CN II - Answer✔optic; test visual acuity with Snellen eye chart or hand-held card; inspect fundi;
screen visual fields by confrontation
CN II-III - Answer✔optic, oculomotor- inspect size and shape of pupils; test reactions to light
and near response
convergence test - Answer✔measures distance from your eyes to where both eyes can focus
without double vision
normal is 6-10 cm
CRP until 15 cm (convergence recovery point)
CN III, IV, VI - Answer✔oculomotor, trochlear, abducens- test extraocular movements in 6
cardinal directions of gaze; lid elevation; check convergence
CN V - Answer✔trigeminal- palpate temporal and masseter muscles while patient clenches
teeth; test forehead, each cheek, and jaw on each side for sharp or dull sensation; test corneal
reflex
CN VII - Answer✔facial- assess face for asymmetry, tics, abnormal movements
ask patient to raise eyebrows, frown, close eyes tightly, show teeth (grimace), smile, puff both
cheeks
CN VIII - Answer✔acoustic - test hearing, lateralization, and air and bone conduction
CN IX and X - Answer✔glossopharyngeal, vagus- assess if voice is hoarse; assess swallowing.
inspect movement of palate as the patient says "ah". test gag reflex, warning patient first
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Drexel nurs550 FINAL Exam Study Guide.
Alert - Answer✔patient awake and aware
level of consciousness - Answer✔how aware the person is of their environment
lethargic - Answer✔you must speak to the patient in a loud forceful manner to get a response
obtunded - Answer✔you must shake a patient to get a response
stuporous - Answer✔the patient is unarousable except by painful stimuli (sternal rub)
coma - Answer✔patient completely unarousable
short term memory - Answer✔covers events or memories that occurred minutes to days before
long-term memory - Answer✔covers events or memories that occurred months to years before
orientation - Answer✔aware of person (who they are), place (where they are), and time (when is
it)
perceptions - Answer✔awareness of the objects in the environment to the five senses and their
interrelationships
thought processes - Answer✔the logic, coherence, and relevance of a patient's thoughts as they
lead to thoughts and goals - HOW people think
insight - Answer✔awareness that thought, symptoms, or behaviors are normal or abnormal
ex: distinguishing that a daydream or hallucination is not real
judgement - Answer✔process of comparing and evaluating different possible courses of action
affect - Answer✔observable mood of a person expressed through facial expression, body
movements, voice
mood - Answer✔sustained emotion of the paint
- euthymic (tranquil, normal), dysthmic (chronic form of depression, low mood), manic (extreme
elevation and high energy)
language - Answer✔complex symbolic system for expressing hand written and verbal thoughts,
emotion, attention, and memory
1|Page
, ©Jason McConnel 2025 ALL RIGHTS RESERVED.
higher cognitive functions - Answer✔level of intelligence, assessed by vocabulary, knowledge
base, calculations, and abstract thinking
fluency - Answer✔involves the rate, flow, and melody of speech
hesitancies in speech - Answer✔seen in patients with aphasia from strokes
monotone inflections - Answer✔schizophrenia or severe depression
circumlocutions - Answer✔words or phrases are substituted for the word a person cannot
remember
paraphasias - Answer✔words are malformed, wrong, or invented
circumstanttiality - Answer✔speech characterized by indirection and delay due to the patients
excessive use of details that have no connection to the point
derailment - Answer✔speech in which a person shifts topics with no apparent relation between
the topics, no flow
flight of ideas - Answer✔accelerated change of topics in a very fast but generally coherent
manner
neologisms - Answer✔invented or distorted words
incoherence - Answer✔speech that is incomprehensible because it's illogical
blocking - Answer✔sudden interruption of speech, before the completion of an idea, occurs in
normal people
confabulation - Answer✔fabrication of facts to hide memory impairment
preservation - Answer✔persistant repetition of words or ideas
echolalia - Answer✔repetition of the words or phrases of others
clanging - Answer✔choosing a word on the basis of sound rather than meaning
compulsions - Answer✔repetitive behaviors that a person feels driven to perform to prevent or
produce some future state of affairs
obsessions - Answer✔recurrent, uncontrollable thoughts, images, or impulses that a patient
considered unacceptable
phobias - Answer✔persistent fear of a stimuli the patient feels is irrational (spiders, snakes, the
dark)
anxiety - Answer✔apprehension or fear that may be focused (phobia) or free floating (general
sense of dread)
delusions - Answer✔false, fixed beliefs that are not shared by other members of the person's
culture
2|Page
, ©Jason McConnel 2025 ALL RIGHTS RESERVED.
illusions - Answer✔misinterpretations of real stimuli
hallucinations - Answer✔subjective external stimuli the patient hears or sees that others do not
hear or see that the patient may not recognize as false; tense can be auditory, visual, olfactory,
gustatory, or tactile
calculating ability - Answer✔ask the patient to perform more difficult calculations such as
making change
major depressive disorder objective findings - Answer✔alteration in mood, thought, content, and
possibly speech
rule out other causes: metabolic abnormalities, drug use, intoxication, infection, thyroid disorders
MDD subjective findings - Answer✔historical risk factors that may mimic MDD
- other medical diagnoses
- medication/drugs
- acute illness and metabolic abnormalities
CN I - Answer✔olfactory; occlude each nostril and test different smells
CN II - Answer✔optic; test visual acuity with Snellen eye chart or hand-held card; inspect fundi;
screen visual fields by confrontation
CN II-III - Answer✔optic, oculomotor- inspect size and shape of pupils; test reactions to light
and near response
convergence test - Answer✔measures distance from your eyes to where both eyes can focus
without double vision
normal is 6-10 cm
CRP until 15 cm (convergence recovery point)
CN III, IV, VI - Answer✔oculomotor, trochlear, abducens- test extraocular movements in 6
cardinal directions of gaze; lid elevation; check convergence
CN V - Answer✔trigeminal- palpate temporal and masseter muscles while patient clenches
teeth; test forehead, each cheek, and jaw on each side for sharp or dull sensation; test corneal
reflex
CN VII - Answer✔facial- assess face for asymmetry, tics, abnormal movements
ask patient to raise eyebrows, frown, close eyes tightly, show teeth (grimace), smile, puff both
cheeks
CN VIII - Answer✔acoustic - test hearing, lateralization, and air and bone conduction
CN IX and X - Answer✔glossopharyngeal, vagus- assess if voice is hoarse; assess swallowing.
inspect movement of palate as the patient says "ah". test gag reflex, warning patient first
3|Page
