Med Surg Ch 35 Assessment of Neurological
Function Test Questions Fully Solved
Mr. Smith presents with complaints of severe headaches for several weeks. The nurse recognizes which
parameter as an important component of the neurological examination for this patient?
A. Cranial nerve assessment
B. Glasgow Coma Scale assessment
C. Assessing the Babinski's reflex
D. Assessing cerebral perfusion pressure - Answer Answer: A
Rationale: Cranial nerve assessment is an important component of a comprehensive neurological assess-
ment. The Glasgow Coma Scale is used to assess wakefulness and arousal state. Mr. Smith is awake and
has been working and participating in life activ- ities. A Babinski reflex would be assessed if an upper
motor neuron lesion, multiple sclerosis, or drug and alcohol problems were suspected, not for someone
presenting with a headache. Cerebral perfusion pressure requires a ICP monitoring, not indicated in a
patient complaining of headache.
The nurse anticipates which as the next step in the assessment process after the neurological
examination?
A. An MRI
B. Evoked potentials
C. Lumbar puncture
D. A CT scan - Answer Answer: D
Rationale: A lumbar puncture is an invasive proce- dure and is not part of an initial diagnostic work-up
for headache. Evoked potentials are nerve conduc- tive studies, not appropriate for this patient. A CT
scan is an inexpensive and quick diagnostic tool and is usually the first screening procedure ordered.
MRIs are expensive and take a much longer time to process. If the CT reveals problems, an MRI may be
done to gather more information.
What information from Mr. Smith's history may make him ineligible for magnetic resonance imaging
(MRI)?
A. History of cerebrovascular accident with residual hemiplegia
B. History of cardiac dysrhythmias requiring pacemaker
C. History of seizure disorders controlled by antiepileptic drugs
, D. History of deep vein thrombosis requiring anticoagulant therapy - Answer Answer: B
Rationale: If the patient has a permanent cardiac pacemaker, this would be a contraindication for an
MRI. This diagnostic study uses magnetic fields to obtain images. Metal may interfere with the magnetic
field and may also be a safety hazard. An implanted device that contains metal such as
a pacemaker may make the MRI contraindicated because the magnetic field may disable the device.
Due to Mr. Smith's complaints of persistent headaches, the nurse assesses for other signs of increased
intracranial pressure. Which finding may also be associated with increased intracranial pressure?
A. Change in level of consciousness
B. Tachycardia
C. Diaphoresis
D. Hypotension - Answer Answer: A
Rationale: Patients with increased ICP demonstrate symptoms of changes in level of consciousness,
vomiting, headaches, and seizures. Late symptoms are alterations in vital signs. The classic signs of
increased ICP include elevated blood pressure
with a widening pulse pressure, bradycardia, and irregular respirations.
The nurse's role in the overall patient assessment process includes which of the following actions?
(Select all that apply.)
A. Patient education about the process
B. Assessing for allergies to seafood
C. Explaining CT scan test results
D. Providing reassurance that all will be okay
E. Checking renal function laboratory values - Answer Answer: A, B, and E
Rationale: The physician would explain the results. Reassurance that all will be okay may be unrealistic.
The nurse recognizes that patients with major changes in personality most likely have damage in which
lobe of the brain?
A. Frontal B. Occipital
C. Parietal D. Temporal - Answer Answer: A
Rationale: The frontal lobe is responsible for voluntary motor movement, Broca's speech, personality,
and behavior. The occipital lobe is primarily responsible for vision. The parietal lobe is responsible for
Function Test Questions Fully Solved
Mr. Smith presents with complaints of severe headaches for several weeks. The nurse recognizes which
parameter as an important component of the neurological examination for this patient?
A. Cranial nerve assessment
B. Glasgow Coma Scale assessment
C. Assessing the Babinski's reflex
D. Assessing cerebral perfusion pressure - Answer Answer: A
Rationale: Cranial nerve assessment is an important component of a comprehensive neurological assess-
ment. The Glasgow Coma Scale is used to assess wakefulness and arousal state. Mr. Smith is awake and
has been working and participating in life activ- ities. A Babinski reflex would be assessed if an upper
motor neuron lesion, multiple sclerosis, or drug and alcohol problems were suspected, not for someone
presenting with a headache. Cerebral perfusion pressure requires a ICP monitoring, not indicated in a
patient complaining of headache.
The nurse anticipates which as the next step in the assessment process after the neurological
examination?
A. An MRI
B. Evoked potentials
C. Lumbar puncture
D. A CT scan - Answer Answer: D
Rationale: A lumbar puncture is an invasive proce- dure and is not part of an initial diagnostic work-up
for headache. Evoked potentials are nerve conduc- tive studies, not appropriate for this patient. A CT
scan is an inexpensive and quick diagnostic tool and is usually the first screening procedure ordered.
MRIs are expensive and take a much longer time to process. If the CT reveals problems, an MRI may be
done to gather more information.
What information from Mr. Smith's history may make him ineligible for magnetic resonance imaging
(MRI)?
A. History of cerebrovascular accident with residual hemiplegia
B. History of cardiac dysrhythmias requiring pacemaker
C. History of seizure disorders controlled by antiepileptic drugs
, D. History of deep vein thrombosis requiring anticoagulant therapy - Answer Answer: B
Rationale: If the patient has a permanent cardiac pacemaker, this would be a contraindication for an
MRI. This diagnostic study uses magnetic fields to obtain images. Metal may interfere with the magnetic
field and may also be a safety hazard. An implanted device that contains metal such as
a pacemaker may make the MRI contraindicated because the magnetic field may disable the device.
Due to Mr. Smith's complaints of persistent headaches, the nurse assesses for other signs of increased
intracranial pressure. Which finding may also be associated with increased intracranial pressure?
A. Change in level of consciousness
B. Tachycardia
C. Diaphoresis
D. Hypotension - Answer Answer: A
Rationale: Patients with increased ICP demonstrate symptoms of changes in level of consciousness,
vomiting, headaches, and seizures. Late symptoms are alterations in vital signs. The classic signs of
increased ICP include elevated blood pressure
with a widening pulse pressure, bradycardia, and irregular respirations.
The nurse's role in the overall patient assessment process includes which of the following actions?
(Select all that apply.)
A. Patient education about the process
B. Assessing for allergies to seafood
C. Explaining CT scan test results
D. Providing reassurance that all will be okay
E. Checking renal function laboratory values - Answer Answer: A, B, and E
Rationale: The physician would explain the results. Reassurance that all will be okay may be unrealistic.
The nurse recognizes that patients with major changes in personality most likely have damage in which
lobe of the brain?
A. Frontal B. Occipital
C. Parietal D. Temporal - Answer Answer: A
Rationale: The frontal lobe is responsible for voluntary motor movement, Broca's speech, personality,
and behavior. The occipital lobe is primarily responsible for vision. The parietal lobe is responsible for
