Health Assessment Mental/ Neuro (Ch. 5&22) Actual Exam Questions with Correct and Verified Answers

Health Assessment Mental/ Neuro (Ch. 5&22) Actual Exam Questions with Correct and Verified Answers The autonomic nervous system coordinates which of the following? a.High-level cognitive function b.Balance and affect c.Internal organs of the body d.Balance and equilibrium - Correct Answer C The autonomic nervous system coordinates the internal environment of the body by the sympathetic and parasympathetic nervous systems. The other options are associated with the cerebral cortex; its function consists of determining intelligence, personality, and motor function." "The major function of the sympathetic nervous system is to: strate the stress response. inate fine motor movement. mine proprioception. ive stereognosis. - Correct Answer A Stimulation of the sympathetic branch of the autonomic nervous system prepares the body for emergencies for fight or flight (stress response). The cerebellum plays a key role in the coordination of fine motor movements. Recognition of body parts and awareness of body position (proprioception) are dependent on the parietal lobe. Stereognosis is the ability to perceive the weight and form of solid objects by touch and is not under sympathetic control." "he parasympathetic nervous system maintains the day-to-day function of: tion. nse to stress. atic supply to the brain. atic drainage of the brain. - Correct Answer A The parasympathetic division functions in a complementary and counterbalancing manner to conserve body resources and maintain day to day body functions, such as digestion and elimination." "Cerebrospinal fluid serves as a: impulse transmitter. blood cell conveyer. absorber. tor of voluntary skeletal movement. - Correct Answer C Cerebrospinal fluid circulates between an interconnecting system of ventricles in the brain and around the brain and spinal cord, serving as a shock absorber." "Diabetic peripheral neuropathy will likely produce: active ankle reflexes. ished pain sensation. erated vibratory sense. sensitive temperature perception. - Correct Answer B Peripheral neuropathy is a disorder of the peripheral nervous system that results in motor and sensory loss in the distribution of one or more nerves, usually in the hands and feet. Patients may have sensations of numbness, tingling, burning, and cramping. In moderate to severe diabetic neuropathy, there is wasting of the foot muscles, absent ankle and knee reflexes, decreased or no vibratory sensation below the knees, and/or loss of pain or sharp touch sensation to the midcalf level." "The thalamus is the major integration center for the perception of: h. tion. . hts. - Correct Answer C The thalamus is the major integrating center for the perception of various sensations such as pain and temperature, serving as the relay center between the basal ganglia and cerebellum. The reception of speech and interpretation of speech are located in the Wernicke area. The olfactory sense is processed in the parietal lobe. The cerebrum holds memories, allows you to plan, and enables you to imagine and think." "The awareness of body position is known as: ioception. esthesia. ognosis. -point discrimination. - Correct Answer A Recognition of body parts and awareness of body position are known as proprioception. This is dependent on the parietal lobe. The other options are assessment techniques that test for sensory impairment." "Which area of the brain is responsible for perceiving sounds and determining their source? a.Frontal lobe b.Occipital lobe c.Parietal lobe d.Temporal lobe - Correct Answer D The temporal lobe is responsible for the perception and interpretation of sounds and determination of their source. The frontal lobe contains the motor cortex associated with voluntary skeletal movement. The occipital lobe contains the primary vision center. The parietal lobe is primarily responsible for processing received sensory data." "Peripheral nerves that arise from the brain rather than the spinal cord are called ___________ nerves. thetic ympathetic al omic - Correct Answer C Cranial nerves are peripheral nerves that arise from the brain rather than the spinal cord. The other choices refer to the autonomic nervous system." "Which area of the brain maintains temperature control? a.Epithalamus b.Thalamus c.Abducens d.Hypothalamus - Correct Answer D The hypothalamus is the major processing center of internal stimuli for the autonomic nervous system. It maintains temperature control, water metabolism, body fluid osmolarity, feeding behavior, and neuroendocrine activity. The epithalamus houses the pineal body and is responsible for sexual development and behavior. The thalamus conveys all sensory impulses, except olfaction, to and from the cerebrum before their distribution to appropriate associative sensory areas. The abducens is the sixth cranial nerve with motor function responsible for lateral eye movement." "If a patient cannot shrug his or her shoulders against resistance, which cranial nerve (CN) requires further evaluation? a.CN I, olfactory b.CN V, trigeminal c.CN IX, glossopharyngeal d.CN XI, spinal accessory - Correct Answer D CN XI is responsible for the motor ability to shrug the shoulders. CN I is associated with smell reception and interpretation. CN V is associated with opening of the jaw, chewing, and sensation of the cornea, iris, conjunctiva, eyelids, forehead, nose, teeth, tongue, ear, and facial skin. CN IX is associated with swallowing function, sensation of the nasopharynx, gag reflex, taste, secretion of salivary glands, carotid reflex, and swallowing." "Motor maturation proceeds in an orderly progression from: heral to central. to toe. al to medial. to cephalic. - Correct Answer B Motor maturation proceeds in a cephalocaudal direction. Motor control of the head and neck develops first, followed by the trunk and extremities. The other choices are incorrect because they relate the maturation sequence inappropriately, from outward to central." "Normal changes of the aging brain include: ased velocity of nerve conduction. ished perception of touch. ased total number of neurons. ished intelligence quotient. - Correct Answer B Sensory perceptions of touch and pain are diminished by aging. The velocity of nerve impulse conduction declines, so responses to stimuli take longer. The number of cerebral neurons is thought to decrease by 1% a year, beginning at 50 years of age; however, the vast number of reserve cells inhibits the appearance of clinical signs." "The area of body surface innervated by a particular spinal nerve is called a: tome. pathway. l accessory area. eous zone. - Correct Answer A The sensory and motor fibers of each spinal nerve supply and receive information to a segment of skin known as a dermatome. Nerve pathway and spinal accessory area refer to nerve routes. Cutaneous zone refers to a skin area that transmits fine mechanical information and normal exogenous thermal information at the same time." "A neurologic past medical history should include data about: gies. latory problems. tional level. izations. - Correct Answer B The neurologic past medical history should include data concerning neurovascular problems such as stroke, aneurysm, and brain surgery. The other answers are not pertinent medical information for the neurologic past medical history." "Which of the following is the technique most often used for evaluating the neurologic system? a.Auscultation b.Inspection c.Palpation d.Percussion - Correct Answer B The evaluation tool of inspection is used most often. Inspection of gait and response to questions can provide data concerning neurologic system function." "When assessing superficial pain, touch, vibration, and position perceptions, you are testing: ellar function. onal status. ry function. n reflexes. - Correct Answer C Superficial pain, touch, vibration, and position perceptions are sensory functions." "You are initially evaluating the equilibrium of Ms. Q. You ask her to stand, with her feet together and arms at her sides. She loses her balance. Ms. Q has a positive: a.Kernig sign. b.Homan sign. c.McMurray test. d.Romberg sign. - Correct Answer D The Romberg test has the patient stand with the eyes closed, feet together, and arms at the sides. A slight swaying movement of the body is expected, but not to the extent of falling. Loss of balance results in a positive Romberg test. The Kernig sign indicates meningeal irritation, the Homan sign indicates venous thrombosis, and the McMurray test is a rotation test for demonstrating a torn meniscus." "The finger to nose test allows assessment of: ination and fine motor function. location. ry function. ognosis. - Correct Answer A To perform the finger to nose test, the patient closes both eyes and touches his or her nose with the index finger, alternating hands while gradually increasing the speed. This tests coordination and fine motor skills. All the other choices test sensory function without motor function." "You are performing a two-point discrimination test as part of a well physical examination. The area with the ability to discern two points in the shortest distance is the: . . rtips. arms. - Correct Answer C The fingertips can discern two points with a minimal distance of 2 to 8 mm, the back, 40 to 70 mm, the palms, 8 to 12 mm, and the upper arms, 75 mm." "As Mr. B enters the room, you observe that his gait is wide-based and he staggers from side to side while swaying his trunk. You would document Mr. B's pattern as: nic ataxia. ellar ataxia. age gait. ic stamping. - Correct Answer B A cerebellar gait (cerebellar ataxia) occurs when the patient's feet are wide-based, with a staggering gait, lurching from side to side, often accompanied by swaying of the trunk. Dystonic ataxia is jerky dancing movements that appear nondirectional. Steppage gait is noted when the hip and knee are elevated excessively high to lift the plantar-flexed foot off the ground. The foot is brought down with a slap and the patient is unable to walk on the heels. Tabetic stamping occurs when the legs are positioned far apart, lifted high, and forcibly brought down with each step; in this case, the heel stamps on the ground." "Deep pressure tests are used mostly for patients who are experiencing: t superficial pain sensation. and stepping disturbances. sis, osteoporosis, or arthritis. neck or torso spasms. - Correct Answer A Deep pressure sensation is tested by squeezing the trapezius, calf, or biceps muscle, thus causing discomfort. When superficial pain sensation is not intact, further assessments of temperature and deep pressure sensation are performed." "Vibratory sensory testing should be routinely done for the patient with: a.Parkinson disease. tes. ral palsy. d.Guillain-Barré syndrome. - Correct Answer B Diabetic neuropathy must be routinely assessed in all diabetic patients. In moderate to severe cases, decreased or absent vibratory sensation occurs below the knees, which should be assessed with a tuning fork. The other choices do not result in sensation deficits." "To assess a cremasteric reflex, the nurse strokes the: of the foot and observes whether the toes fan down and out. en and observes whether the umbilicus moves away from the stimulus. thigh and observes whether the testicle and scrotum rise on the stroked side. and observes whether the fingers attempt to grasp. - Correct Answer C Stroking the inner thigh of a male patient (proximal to distal) will elicit the cremasteric reflex. The testicle and scrotum rise on the stroked side. Stroking the sole of the foot elicits a Babinski sign. Stroking the abdomen elicits an abdominal reflex. Stroking the palm elicits a palmar grasp." "When you ask a patient to close her or his eyes and identify an object placed in the hand, you are evaluating: ognosis. esthesia. tory sensation. ction phenomenon. - Correct Answer A Stereognosis is the ability to recognize an object through touch and manipulation. Tactile agnosia, an inability to recognize objects by touch, suggests a parietal lobe lesion. Graphesthesia tests the patient's ability to identify the figure being drawn on the palm. The vibratory sense uses a tuning fork placed on a bony prominence, and the extinction phenomenon tests sensation by simultaneously touching bilateral sides of the body with a sterile needle." "The ability to recognize a number traced on the skin is called: ognosis. esthesia. extinction phenomenon. -point discrimination. - Correct Answer B The ability to recognize a number traced on the skin is called graphesthesia. Stereognosis is the ability to recognize an object through touch and manipulation. The extinction phenomenon test and two-point discrimination assess a person's ability to discern the number of pinpoints and their location." "Which one of the following conditions is consistent with Brown-Séquard syndrome? a.Central sensory loss that is generalized b.Motor paralysis on the lesion side of the body c.Multiple peripheral neuropathy of the joints d.Spinal root paralysis below the umbilicus - Correct Answer B Parietal spinal sensory syndrome (Brown-Séquard syndrome) is noted when pain and temperature sensation occur one to two dermatomes below the lesion on the opposite side of the body from the lesion. Proprioceptive loss and motor paralysis occur on the lesion side of the body." "To assess spinal levels L2, L3, and L4, which deep tendon reflex should be tested? a.Triceps b.Patellar c.Biceps d.Achilles - Correct Answer B To assess spinal levels L2-L4, the patellar reflex should be tested. The patellar tendon is the only deep tendon that assesses the lumbar spinal level. The triceps and biceps tendon are tested to assess the cervical spine, whereas the Achilles tendon is tested to assess the sacral spine" "When using a monofilament to assess sensory function, the nurse: two simultaneous monofilaments on similar bilateral points and then compares results. es both a monofilament and a pin on similar bilateral points and then compares results. es pressure to the monofilament until the filament bends. es the monofilament along the skin from proximal to distal areas. - Correct Answer C The monofilament is placed on several smooth spots of the patient's plantar foot for seconds. Adequate pressure applied by the monofilament is measured by the bend of the monofilament." "Visible or palpable extension of the elbow is caused by reflex contraction of which muscle? a.Achilles b.Biceps c.Patellar d.Triceps - Correct Answer D The triceps tendon, when directly hit with the reflex hammer just above the elbow, will cause contraction of the triceps muscle and extension of the elbow." "It is especially important to test for ankle clonus if: tendon reflexes are hyperactive. tendon reflexes are hypoactive. Romberg sign is positive. patient has peripheral neuropathy. - Correct Answer A Test the ankle clonus when reflexes are hyperactive. Support the patient's knee in a flexed position and briskly dorsiflex the foot with your other hand. If clonus is present, there is recurrent ankle plantar flexion movement as long as the examiner retains the foot in dorsiflexion. Sustained clonus signifies the hypertonia of an upper motor neuron lesion." "Which sign is associated with meningitis and intracranial hemorrhage? a.Babinski sign b.Asymmetric tonic neck reflex c.Doll's eye movement d.Nuchal rigidity - Correct Answer D A stiff neck or nuchal rigidity is a sign associated with meningitis and intracranial hemorrhage. Test this by lifting the head of the patient to touch the chin while the patient lies in a supine position. Pain and resistance to neck motion are associated with nuchal rigidity." "When assessing a 17-year-old for nuchal rigidity, you gently raise his head off the examination table. He involuntarily flexes his hips and knees. To confirm your suspicions associated with this positive test, you would also perform a test for the __________ sign. a.Kernig b.Babinski ator d.Brudzinski - Correct Answer A The first action elicited the Brudzinski sign. This sign is an indicator of meningeal irritation. To confirm meningeal irritation, you would test for the Kerning sign, also a meningeal sign." "On a scale of 1+ to 4+, which deep tendon reflex score is appropriate for a finding of clonus in a patient? a.1+ b.2+ c.3+ d.4+ - Correct Answer D 1+ indicates a sluggish or diminished reflex. 2+ indicates an active or expected response. 3+ indicates more brisk than expected, slightly hyperactive. 4+ indicates brisk, hyperactive, with intermittent or transient clonus." "Cranial nerve XII may be assessed in an infant by: ing the infant's facial expressions when crying. ving the infant suck and swallow. ing hands and watching the infant blink. ving the infant's rooting reflex. - Correct Answer B Cranial nerve (CN) XII may be assessed in an infant by observing the infant suck and swallow, by pinching the nose, and then observing for the mouth to open and the tip of the tongue to rise in a midline position. Watching the infant's facial expressions when crying assesses CN VII. Clapping hands and watching the infant blink tests CN VIII. Observing the rooting reflex assesses CN V." "You are most concerned for the infant who has a: palmar grasp at 3 months. g stepping reflex at 2 months. plantar reflex at 9 months. g tonic neck at 6 months. - Correct Answer D The tonic neck reflex must disappear before the infant can roll over or bring his or her hands to their face; it should disappear by 6 months. The other choices are within expected ranges." "At what age should the infant begin to transfer objects from hand to hand? a.2 months b.4 months c.7 months d.10 months - Correct Answer C Transferring objects hand to hand begins at 7 months. Purposeful release of objects is noted as a normal finding by 10 months. Purposeful movements, such as reaching and grasping for objects, begin at about 2 months of age. The progress of taking objects with one hand begins at 6 months. There should be no tremors or constant overshooting of movements." "An acute polyneuropathy that commonly follows a nonspecific infection occurring 10 to 14 days earlier and that primarily affects the motor and autonomic peripheral nerves in an ascending pattern is: ral palsy. b.HIV encephalopathy. c.Guillain-Barré syndrome. d.Rett syndrome. - Correct Answer C Guillain-Barré syndrome—acute idiopathic polyneuritis—is an acute polyradiculoneuropathy that commonly follows a nonspecific infection that occurred 10 to 14 days earlier. It is characterized by ascending symmetric weakness with sensation preserved. An increase in severity occurs over days or weeks. A decrease in or absent strength and sensory loss may result, along with motor paralysis and respiratory muscle failure." "Which of the following is a concern, rather than an expected finding, in older adults? a.Reduced ability to differentiate colors b.Bilateral pill-rolling of the fingers c.Absent plantar reflex d.Reduction in upward gaze - Correct Answer B Bilateral pill-rolling is indicative of Parkinson disease; the other choices are expected findings with aging." "Which of the following conditions is potentially life-threatening if not treated expeditiously with antibiotics? a.HIV encephalopathy b.Dementia c.Parkinson disease d.Bacterial meningitis - Correct Answer D Meningitis is an inflammatory process in the meninges. Bacterial meningitis is a life-threatening illness if not rapidly treated with appropriate antibiotics. All the other diseases are neurologic disorders not treatable by antibiotics." "Ipsilateral Horner syndrome indicates a cerebrovascular accident (CVA) occurring in the: ior portion of the pons. nal or middle cerebral artery. rior inferior cerebellar artery. bral or basilar arteries. - Correct Answer C The posterior inferior cerebellar artery supplies the lateral and posterior portion of the medulla. A CVA involving this artery can produce a neurologic sign of ipsilateral Horner syndrome in the eye." "The immune system attacks the synaptic junction between the nerve and muscle fibers, blocking acetylcholine receptor sites in: henia gravis. halitis. ple sclerosis. ral palsy. - Correct Answer A Myasthenia gravis is a chronic autoimmune neuromuscular disease involving the lower motor neurons and muscle fibers. The immune system of infected individuals produces antibodies that destroy acetylcholine receptor sites at the neuromuscular junction. This blocks the nerve impulse from reaching the muscle and produces muscle fatigue. Encephalitis is acute inflammation of the brain and spinal cord involving the meninges. It is often caused by a virus, such as the herpes simplex virus. Multiple sclerosis is a progressive autoimmune disorder characterized by a combination of inflammation and degeneration of the myelin in the brain's white matter, leading to obstructed transmission of nerve impulses and decreased brain mass. Cerebral palsy is a permanent disorder of movement and posture development associated with nonprogressive (static) disturbances that occurred in the developing fetal or infant brain." "Persons with Parkinson disease have an altered gait characterized by: shuffling steps. trunk in a backward position. erated swinging of the arms. ng the legs in a high-stepping fashion. - Correct Answer A The altered gait of Parkinson disease has short shuffling steps, the posture is stooped forward, and the arms have limited swing." "You are assessing the deep tendon reflexes of a 28-year-old man. Your examination reveals that the patient's reflexes are normal. You would document this finding as _____. - Correct Answer 2+ Deep tendon reflexes are scored as follows: 0: No response 1+: Sluggish or diminished 2+: Active or expected response 3+: More brisk than expected, slightly hyperactive 4+: Brisk, hyperactive, with intermittent or transient clonus" "The motor cortex of the brain is in the _______________. - Correct Answer frontal lobe The frontal lobe contains the motor cortex associated with voluntary skeletal movement and fine repetitive motor movements, as well as the control of eye movements." "The major portion of brain growth and myelinization occurs between ____ and ____ year(s) old. - Correct Answer Birth & 1 The major portion of brain growth, along with myelinization of the brain and nervous system, occurs in the first year of life." "The tests for cortical sensory function include which of the following? (Select all that apply.) a.Two-point discrimination b.Extinction phenomenon c.Superficial pain d.Stereognosis e.Touch - Correct Answer A, B, D The following tests are tests for cortical sensory function—stereognosis, two-point discrimination, extinction phenomenon, graphesthesia, and point location." "When is the mental status portion of the neurologic system examination performed? a.During the history-taking process b.During assessment of cranial nerves and deep tendon reflexes c.During the time when questions related to memory are asked d.Continually, throughout the entire interaction with a patient - Correct Answer D A mental status evaluation should be continually performed throughout the patient encounter. Assessing and validating clues to determine the individual's ability to interact within the environment is a priority of the mental status evaluation." "A 69-year-old truck driver presents with a sudden loss of the ability to understand spoken language. This indicates a lesion in the: ral lobe. b.Broca area. al cortex. ellum. - Correct Answer A The temporal lobe, specifically in the Wernicke speech area, is responsible for the comprehension of spoken and written language." "Mr. DeLaurentis is a 58-year-old man who presents to your office with slumped posture and a lack of facial expression, which may indicate depression or: a.Parkinson disease. ty. of abstract reasoning. tion-deficit/hyperactivity disorder. - Correct Answer A A slumped posture and lack of facial expression may be clues to more than depression; they are also defining characteristics of Parkinson disease." "The ability for abstract thinking normally develops during: cy. childhood. scence. hood. - Correct Answer C Abstract thinking is an intellectual maturation that develops during adolescence." "The Mini-Mental State Examination (MMSE) may be used to: ate cognitive changes quantitatively. ate personality disorders qualitatively. ose neurologic disorders. mine the cause of memory loss. - Correct Answer A The MMSE is a standard tool that functions to estimate cognitive function quantitatively or to document cognitive changes serially." "Assessing orientation to person, place, and time helps determine: ty to understand analogies. act reasoning. tion span. of consciousness. - Correct Answer D Orientation to person, place, and time are measures of states of consciousness and awareness." "When you ask the patient to tell you the meaning of a proverb or metaphor, you are assessing which of the following? a.Level of consciousness b.Abstract reasoning c.Emotional stability d.Memory - Correct Answer B Asking the patient to tell you the meaning of a proverb, metaphor, or fable assesses the patient's ability to reason abstractly. Asking the patient to tell you the meaning of a proverb or metaphor does not assess level of consciousness, emotional stability, or memory. The Mini-Mental State Examination tests memory." "Impairment of arithmetic skills is often the result of: red execution of motor skills. red judgment. ptual distortions. ssion. - Correct Answer D The patient with depression can display difficulty with simple arithmetic calculations." "Peripheral neuropathy is most likely to be manifested by: red memory. red abstract reasoning. red writing ability. cinations. - Correct Answer C Uncoordinated writing or drawing may indicate peripheral neuropathy, dementia, parietal lobe damage, or a cerebellar lesion." "Recent memory may be tested by: g the patient to name the past four presidents. g the patient to listen to and repeat a series of numbers. ng the patient four items and asking him or her to list the items about 10 minutes later. g the patient about verifiable information, such as his or her mother's maiden name. - Correct Answer C Showing the patient four or five objects, saying you will ask about them in a few minutes, and then 10 minutes later asking the patient to list the objects is a technique to measure recent memory." "Loss of immediate and recent memory with retention of remote memory suggests: tion-deficit/hyperactivity disorder (ADHD). red judgment. r. tia. - Correct Answer D Dementia is the loss of both immediate and recent memory while retaining remote memories. ADHD is associated with recent and remote memory impairment. Impaired judgment is a thought process dysfunction. Stupor is impaired consciousness." "You ask the patient to follow a series of short commands to assess: ent. tion span. metic calculations. act reasoning. - Correct Answer B Asking the patient to follow a series of short commands will test attention span." "Which of these observations would be most significant when assessing the condition of a patient who has judgment impairment? a.Repeated failure to complete work obligations b.Forgetting family members' birth dates c.Going to church three times a week d.Planning for retirement in 20 years - Correct Answer A Inadequately dealing with business affairs indicates impaired judgment, whereas the other choices do not." "Appropriateness of logic, sequence, cohesion, and relevance to topics are markers for the assessment of: and feelings. tion span. ht process and content. act reasoning. - Correct Answer C Thought process and content are examined while observing the patient's patterns of thinking, especially appropriateness of sequence, logic, coherence, and relevance to the topics discussed." "Which type of hallucination is most commonly associated with alcohol withdrawal? a.Olfactory b.Visual c.Auditory d.Tactile - Correct Answer D Tactile hallucinations are most commonly associated with alcohol withdrawal." "Flight of ideas or loosening of associations is associated with: ia. onia. ple sclerosis. iatric disorders. - Correct Answer D Flight of ideas, loosening of associations, word salads, neologisms, clang associations, echolalia, and utterances of unusual sounds are all associated with psychiatric disorders." "Facial muscle or tongue weakness may result in: ia. red comprehension. gisms. alia. - Correct Answer A Aphasia can result from facial muscle or tongue weakness or from neurologic damage to the speech and language regions of the brain." "The Glasgow Coma Scale is used to: mine the cause of decreased consciousness. ose disorders that alter level of consciousness. ify consciousness. ct response to stimulant medications. - Correct Answer C The Glasgow Coma Scale is used when a patient has an altered level of consciousness and is used to quantify consciousness." "The Denver II is a tool used to determine: a.a child's IQ. b.a child's mood. er a child is educable. er a child is developing as expected. - Correct Answer D Denver II is a tool used to determine whether the child is developing fine and gross motor, language, personal, and social skills as expected according to the child's age." "When the Goodenough-Harris Drawing Test is administered to a child, the evaluator principally observes the: nce and form of body parts. r and race of the person drawn. ximate age and posture of the person drawn. h of time needed to draw a stick man. - Correct Answer A The presence and form of body parts provide a clue about the child's development when following the scoring criteria of the Goodenough-Harris Drawing Test." "An older adult is administered the Set Test and scores a 14. The nurse interprets this score as indicative of: ssion. tive impairment. ium. tia. - Correct Answer D Scores of less than 15 on this mental function test indicate dementia." "Which condition is considered progressive rather than reversible? a.Delirium b.Dementia c.Depression d.Anxiety - Correct Answer B Dementia is considered progressive and irreversible. Delirium has the potential for reversal. Depression and anxiety are reversible." "A clinical syndrome of failing memory and impairment of other intellectual functions, usually related to obvious structural diseases of the brain, describes: ium. tia. ssion. ty. - Correct Answer B Dementia results from a chronic progressive deterioration of the brain that results in failing memory and impairment of other intellectual functioning." "Mrs. Griffiths, a 28-year-old patient, presents to your office to discuss her attention-deficit/hyperactivity disorder (ADHD). Which statement is true in regard to ADHD? a.It occurs before 7 years of age. b.It is usually related to mental retardation. c.It is usually related to dementia. d.It is manifested by prolonged periods of catatonic behavior. - Correct Answer A ADHD occurs before 7 years of age. ADHD is not related to mental retardation, dementia, or prolonged periods of catatonic behavior." "An aversion to touch or being held, along with delayed or absent language development, is characteristic of: tion-deficit/hyperactivity disorder. m. tia. l retardation. - Correct Answer B Autistic disorder involves a combination of behavioral traits (lack of awareness of others, aversion to touch or being held, odd or repetitive behaviors, or preoccupation with parts of objects) and communication deficits (usually echolalia [parrot speech])." "You are interviewing a 20-year-old patient with a new-onset psychotic disorder. The patient is apathetic and has disturbed thoughts and language patterns. The nurse recognizes this behavior pattern as consistent with a diagnosis of: ssion. tic disorder. . ophrenia. - Correct Answer D Schizophrenia manifests as a psychotic disorder of early adult onset, with disturbances in language and speech, emotions and social withdrawal, and apathy. Depression and mania do not have the language or speech component. Autistic disorders are not psychotic disorders, and they usually begin before 3 years of age." "The patient who is delirious usually maintains orientation to: . . n. mstance. - Correct Answer C The person with delirium is unable to orient to time, place, or circumstance, but remains oriented to person." "While interviewing a patient, you ask him to explain the "Lion and the Mouse" to assess: ng comprehension. tion span. and feeling. ning skills. - Correct Answer D Having the patient explain fables or metaphors determines abstract reasoning skills." "The Mini-Mental State Examination (MMSE) should be administered for the patient who: lost in her neighborhood. s an excessive amount of time. repetitive ritualistic behaviors. illegal hallucinogenic drugs. - Correct Answer A The MMSE is a tool used to quantitatively estimate cognitive function or to serially document cognitive changes. Getting lost in a familiar territory is a sign of possible cognitive impairment." "Under most conditions, adult patients should be able to repeat a series of _____________ numbers. - Correct Answer five to eight Most adults should be able to immediately recall a series of five to eight numbers forward and a series of four to six numbers backward." "The examiner should be concerned about neurologic competence if a social smile cannot be elicited by the time a child is _________ old. - Correct Answer 3 months A social smile is expected in the 2- to 3-month-old infant. If it is difficult or impossible to elicit a social smile by 3 months, the infant may not be neurologically intact." "Which of the following clinical assessments will test attention span? a.Spell WORLD backward. b.Draw a clock. c.Say the days of the week. d.Do arithmetic calculations. e.Explain "a stitch in time saves nine." - Correct Answer A, C, D Clinical assessments to test attention span include spell WORLD backward, say the days of the week, and do arithmetic calculations. Drawing a clock tests writing ability, and explaining a "stitch in time saves nine" tests abstract reasoning." "Which of the following are signs and symptoms of dementia? a.Aphasia b.Apathy c.Odd behaviors d.Disintegration of personality e.Lack of awareness of others - Correct Answer A, B, D Aphasia, apathy, and disintegration of personality are all characteristics of dementia. Odd behaviors and lack of awareness of others are characteristics of autism." "