Grand Canyon University - ANP 650 Quiz 1 |
100% Correct Verified Q&A | Adult-
Gerontology Acute Care Mastery | Pass
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Section 1: Cognitive and Neurological Assessment
Q1: What is an early sign of Alzheimer's disease that the nurse
practitioner should notice on a patient's physical assessment?
A. Positive Romberg sign
B. Cranial nerve I impairment
C. Bone conduction is greater than air conduction
D. Mini Mental State Exam (MMSE) score of 13
Correct Answer: B
Rationale: Cranial nerve I (olfactory) impairment is an early sign of
Alzheimer's disease and other neurodegenerative conditions. A positive
Romberg sign indicates proprioceptive dysfunction. Bone conduction greater
than air conduction suggests conductive hearing loss. An MMSE score of 13
indicates moderate to severe cognitive impairment, which is not an early
finding.
VERIFIED ✓ ANP 650 Quiz 1
Q2: A 65-year-old male patient with well-controlled class I myasthenia
gravis presents to the ER with double vision. What is the next step?
A. Intubation to provide rest to the patient's respiratory muscles
B. Corticosteroids
C. Thymectomy
D. Intravenous immunoglobulin infusion
Correct Answer: D
Rationale: IV immunoglobulin (IVIG) is indicated for myasthenia gravis
,exacerbations to rapidly reduce circulating antibodies. Intubation is not
indicated unless respiratory failure develops. Corticosteroids are used for
chronic management but take weeks to show effect. Thymectomy is a surgical
option for thymoma-associated myasthenia but is not an emergency
intervention.
VERIFIED ✓ ANP 650 Quiz 1
Q3: What component is NOT a part of the Mini Mental Status Exam
(MMSE)?
A. Hygiene
B. Recall
C. Writing
D. Attention
Correct Answer: A
Rationale: The MMSE assesses orientation, registration,
attention/calculation, recall, and language (including writing). Hygiene is not
a component of the MMSE; it is assessed in the general physical examination
or mental status examination. Recall, writing, and attention are all tested in
the MMSE.
VERIFIED ✓ ANP 650 Quiz 1
Q4: What condition or disease can cause diplopia?
A. Weakness of CN III
B. Weakness of CN IV
C. An irregularity in the cornea or lens
D. All of the above
Correct Answer: D
Rationale: Diplopia (double vision) can result from CN III or CN IV weakness
causing ocular misalignment, or from corneal or lens irregularities causing
refractive errors. Hypertension alone does not cause diplopia unless it leads to
a neurological event affecting cranial nerves.
,VERIFIED ✓ ANP 650 Quiz 1
Q5: A 72-year-old patient presents with progressive memory loss,
difficulty finding words, and impaired judgment. The NP notes the
patient has difficulty with executive function tasks. What is the most
likely diagnosis?
A. Alzheimer's disease
B. Frontotemporal dementia
C. Vascular dementia
D. Lewy body dementia
Correct Answer: A
Rationale: Alzheimer's disease typically presents with progressive memory
loss, word-finding difficulty, and impaired executive function. Frontotemporal
dementia presents with personality and behavioral changes early. Vascular
dementia has a stepwise decline. Lewy body dementia presents with visual
hallucinations and Parkinsonian features.
VERIFIED ✓ ANP 650 Quiz 1
Q6: Which cranial nerve is assessed by asking the patient to shrug their
shoulders against resistance?
A. CN IX (Glossopharyngeal)
B. CN X (Vagus)
C. CN XI (Spinal Accessory)
D. CN XII (Hypoglossal)
Correct Answer: C
Rationale: CN XI (spinal accessory nerve) innervates the sternocleidomastoid
and trapezius muscles. Shoulder shrug against resistance tests the trapezius,
and head turning against resistance tests the sternocleidomastoid. CN IX and X
are assessed with gag reflex and voice. CN XII is assessed by tongue
protrusion.
VERIFIED ✓ ANP 650 Quiz 1
, Q7: A patient presents with acute onset of severe headache,
photophobia, and nuchal rigidity. What diagnostic test should the NP
prioritize?
A. CT scan of the head without contrast
B. MRI of the brain
C. Lumbar puncture
D. EEG
Correct Answer: A
Rationale: A non-contrast CT scan of the head should be performed first to
rule out intracranial hemorrhage or mass effect before performing a lumbar
puncture. If CT is negative, a lumbar puncture can be performed to evaluate
for meningitis or subarachnoid hemorrhage. MRI and EEG are not initial tests
for this presentation.
VERIFIED ✓ ANP 650 Quiz 1
Q8: The Mini Mental Status Exam (MMSE) score ranges from:
A. 0 to 20
B. 0 to 30
C. 0 to 50
D. 0 to 100
Correct Answer: B
Rationale: The MMSE has a maximum score of 30 points. Scores of 24-30
indicate no cognitive impairment, 18-23 indicate mild cognitive impairment,
and 0-17 indicate severe cognitive impairment. The Montreal Cognitive
Assessment (MoCA) has a maximum score of 30 as well.
VERIFIED ✓ ANP 650 Quiz 1
Q9: Which of the following is a characteristic finding in Parkinson's
disease?
100% Correct Verified Q&A | Adult-
Gerontology Acute Care Mastery | Pass
Guaranteed - A+ Graded
Section 1: Cognitive and Neurological Assessment
Q1: What is an early sign of Alzheimer's disease that the nurse
practitioner should notice on a patient's physical assessment?
A. Positive Romberg sign
B. Cranial nerve I impairment
C. Bone conduction is greater than air conduction
D. Mini Mental State Exam (MMSE) score of 13
Correct Answer: B
Rationale: Cranial nerve I (olfactory) impairment is an early sign of
Alzheimer's disease and other neurodegenerative conditions. A positive
Romberg sign indicates proprioceptive dysfunction. Bone conduction greater
than air conduction suggests conductive hearing loss. An MMSE score of 13
indicates moderate to severe cognitive impairment, which is not an early
finding.
VERIFIED ✓ ANP 650 Quiz 1
Q2: A 65-year-old male patient with well-controlled class I myasthenia
gravis presents to the ER with double vision. What is the next step?
A. Intubation to provide rest to the patient's respiratory muscles
B. Corticosteroids
C. Thymectomy
D. Intravenous immunoglobulin infusion
Correct Answer: D
Rationale: IV immunoglobulin (IVIG) is indicated for myasthenia gravis
,exacerbations to rapidly reduce circulating antibodies. Intubation is not
indicated unless respiratory failure develops. Corticosteroids are used for
chronic management but take weeks to show effect. Thymectomy is a surgical
option for thymoma-associated myasthenia but is not an emergency
intervention.
VERIFIED ✓ ANP 650 Quiz 1
Q3: What component is NOT a part of the Mini Mental Status Exam
(MMSE)?
A. Hygiene
B. Recall
C. Writing
D. Attention
Correct Answer: A
Rationale: The MMSE assesses orientation, registration,
attention/calculation, recall, and language (including writing). Hygiene is not
a component of the MMSE; it is assessed in the general physical examination
or mental status examination. Recall, writing, and attention are all tested in
the MMSE.
VERIFIED ✓ ANP 650 Quiz 1
Q4: What condition or disease can cause diplopia?
A. Weakness of CN III
B. Weakness of CN IV
C. An irregularity in the cornea or lens
D. All of the above
Correct Answer: D
Rationale: Diplopia (double vision) can result from CN III or CN IV weakness
causing ocular misalignment, or from corneal or lens irregularities causing
refractive errors. Hypertension alone does not cause diplopia unless it leads to
a neurological event affecting cranial nerves.
,VERIFIED ✓ ANP 650 Quiz 1
Q5: A 72-year-old patient presents with progressive memory loss,
difficulty finding words, and impaired judgment. The NP notes the
patient has difficulty with executive function tasks. What is the most
likely diagnosis?
A. Alzheimer's disease
B. Frontotemporal dementia
C. Vascular dementia
D. Lewy body dementia
Correct Answer: A
Rationale: Alzheimer's disease typically presents with progressive memory
loss, word-finding difficulty, and impaired executive function. Frontotemporal
dementia presents with personality and behavioral changes early. Vascular
dementia has a stepwise decline. Lewy body dementia presents with visual
hallucinations and Parkinsonian features.
VERIFIED ✓ ANP 650 Quiz 1
Q6: Which cranial nerve is assessed by asking the patient to shrug their
shoulders against resistance?
A. CN IX (Glossopharyngeal)
B. CN X (Vagus)
C. CN XI (Spinal Accessory)
D. CN XII (Hypoglossal)
Correct Answer: C
Rationale: CN XI (spinal accessory nerve) innervates the sternocleidomastoid
and trapezius muscles. Shoulder shrug against resistance tests the trapezius,
and head turning against resistance tests the sternocleidomastoid. CN IX and X
are assessed with gag reflex and voice. CN XII is assessed by tongue
protrusion.
VERIFIED ✓ ANP 650 Quiz 1
, Q7: A patient presents with acute onset of severe headache,
photophobia, and nuchal rigidity. What diagnostic test should the NP
prioritize?
A. CT scan of the head without contrast
B. MRI of the brain
C. Lumbar puncture
D. EEG
Correct Answer: A
Rationale: A non-contrast CT scan of the head should be performed first to
rule out intracranial hemorrhage or mass effect before performing a lumbar
puncture. If CT is negative, a lumbar puncture can be performed to evaluate
for meningitis or subarachnoid hemorrhage. MRI and EEG are not initial tests
for this presentation.
VERIFIED ✓ ANP 650 Quiz 1
Q8: The Mini Mental Status Exam (MMSE) score ranges from:
A. 0 to 20
B. 0 to 30
C. 0 to 50
D. 0 to 100
Correct Answer: B
Rationale: The MMSE has a maximum score of 30 points. Scores of 24-30
indicate no cognitive impairment, 18-23 indicate mild cognitive impairment,
and 0-17 indicate severe cognitive impairment. The Montreal Cognitive
Assessment (MoCA) has a maximum score of 30 as well.
VERIFIED ✓ ANP 650 Quiz 1
Q9: Which of the following is a characteristic finding in Parkinson's
disease?
