NR 509 WEEK 6 QUIZ QUESTIONS & ANSWERS &
EXPLANATION |BEST GRADES REAL EXAM
1.A patient with alcoholism is brought in with confusion. You ask him to “stop traffic” with his palms and notice
that every few seconds his palms suddenly move toward the floor. What does this indicate?
A) Stroke
B) Metabolic problems
C) Carpal tunnel syndrome
D) Severe fatigue and weakness
Ans:
Feedback: This is asterixis and represents the inability to maintain a sustained contraction of the muscles. It is
usually due to various metabolic diseases. A variant of this is called “milkmaid's grip” in which the patient is
asked to grasp two fingers. A positive occurs if the patient is unable to sustain the grip and it feels as if the
patient is trying to milk a cow. Most would consider checking an ammonia level in this patient. A stroke is less
likely to produce bilateral symptom
2.Which of the following is a “red flag” regarding patients presenting with headache?
A) Unilateral headache
B) Pain over the sinuses
C) Age over 50
D) Phonophobia and photophobia Ans:
Explanation: A
unilateral headache is often seen with migraines and may commonly be accompanied by
phonophobia and photophobia. Pain over the sinuses from sinus congestion may also be unilateral
and produce pain. Migraine and sinus headaches are common and generally benign. A new severe
headache in someone over 50 can be associated with more serious etiologies for headache. Other
red flags include: acute onset, “the worst headache of my life”; very high blood pressure; rash or
signs of infection; known presence of cancer, HIV, or pregnancy; vomiting; recent head trauma; and
persistent neurologic problems.
3.A patient with alcoholism is brought in with confusion. You ask him to “stop traffic” with his palms and notice
that every few seconds his palms suddenly move toward the floor. What does this indicate?
A) Stroke
B) Metabolic problems
C) Carpal tunnel syndrome
Feedback: This is asterixis and represents the inability to maintain a sustained contraction of the muscles. It is
usually due to various metabolic diseases. A variant of this is called “milkmaid's grip” in which the patient is
asked to grasp two fingers. A positive occurs if the patient is unable to sustain the grip and it feels as if the
patient is trying to milk a cow. would consider checking an ammonia level in this patient. A stroke is less likely
to produce bilateral symptoms. Carpal tunnel represents a sensory loss in the median nerve distribution.
EXPLANATION |BEST GRADES REAL EXAM
1.A patient with alcoholism is brought in with confusion. You ask him to “stop traffic” with his palms and notice
that every few seconds his palms suddenly move toward the floor. What does this indicate?
A) Stroke
B) Metabolic problems
C) Carpal tunnel syndrome
D) Severe fatigue and weakness
Ans:
Feedback: This is asterixis and represents the inability to maintain a sustained contraction of the muscles. It is
usually due to various metabolic diseases. A variant of this is called “milkmaid's grip” in which the patient is
asked to grasp two fingers. A positive occurs if the patient is unable to sustain the grip and it feels as if the
patient is trying to milk a cow. Most would consider checking an ammonia level in this patient. A stroke is less
likely to produce bilateral symptom
2.Which of the following is a “red flag” regarding patients presenting with headache?
A) Unilateral headache
B) Pain over the sinuses
C) Age over 50
D) Phonophobia and photophobia Ans:
Explanation: A
unilateral headache is often seen with migraines and may commonly be accompanied by
phonophobia and photophobia. Pain over the sinuses from sinus congestion may also be unilateral
and produce pain. Migraine and sinus headaches are common and generally benign. A new severe
headache in someone over 50 can be associated with more serious etiologies for headache. Other
red flags include: acute onset, “the worst headache of my life”; very high blood pressure; rash or
signs of infection; known presence of cancer, HIV, or pregnancy; vomiting; recent head trauma; and
persistent neurologic problems.
3.A patient with alcoholism is brought in with confusion. You ask him to “stop traffic” with his palms and notice
that every few seconds his palms suddenly move toward the floor. What does this indicate?
A) Stroke
B) Metabolic problems
C) Carpal tunnel syndrome
Feedback: This is asterixis and represents the inability to maintain a sustained contraction of the muscles. It is
usually due to various metabolic diseases. A variant of this is called “milkmaid's grip” in which the patient is
asked to grasp two fingers. A positive occurs if the patient is unable to sustain the grip and it feels as if the
patient is trying to milk a cow. would consider checking an ammonia level in this patient. A stroke is less likely
to produce bilateral symptoms. Carpal tunnel represents a sensory loss in the median nerve distribution.
