NCA 623 Module 4 QUESTIONS | WITH
COMPLETE SOLUTIONS `100% CORRECT.
A 50 year old women presents to the ED with complaints of acute left sided facial pain,
inability to close her left eye and left ear pain that developed over the last 12 hours.
Typical exam finding for Bell's Palsy may include all EXCEPT: - Ability to smile.
All of the following are symptoms of Guillian Barre' EXCEPT: - Increased deep tendon
reflexes.
A 52 year old male presents with a rapidly progressive weakness in his legs that is
moving up the trunk. He also has absent reflexes and no sensory change. You learn
that this patient had been diagnosed with flu a month ago but has fully recovered from
the virus. Based on what you know about complications from the flu, the top of your list
for differential diagnosis for this patient's condition is: - Guillain Barre syndrome.
A 44-year-old woman with advanced HIV disease is evaluated in the ER. She complains
of a 1-week history of headache, fever, and malaise without nuchal rigidity. A head CT
shows mild atrophy, but no mass lesions. A lumbar puncture is performed and analysis
of the cerebrospinal fluid shows a WBC count of 30 cells/mm3 predominantly
lymphocytes, protein of 100 mg/dL, glucose 38 mg/dL, and negative Gram's stain. The
cerebrospinal opening pressure was measured as 32 cm H2O. The Nurse Practitioner
is concerned that: - this patient most likely has an opportunistic fungal infection such as
Cryptococcus neoformans or Listeria monocytogenes; the most common causes of
meningitis in HIV infected patients.
A 32-year-old male with a recent skateboard fall and subsequent diagnosis of a basal
skull fracture is admitted to the trauma floor. Over the past 24 hours he begins to have
signs and symptoms of fever, nuchal rigidity, and changes in mental status. The trauma
NP performs a lumbar puncture and decides to start the patient on empiric antibiotic
therapy for bacterial meningitis, pending CSF results. All of the antibiotic combinations
below are acceptable initial treatment regimens EXCEPT: - piperacillin-tazobactam +
vancomycin.
A 25 year old woman is diagnosed with bacterial meningitis. She has a positive Kernig's
sign. What is a positive Kernig's sign? - Flexion of the thigh to 90 degrees, which
produces pain with leg extension
, A 42 year old woman presents to the Emergency Department (ED) with complaints of
weakness, dizziness, lack of coordination, and difficulty with gait. She underwent
magnetic resonance imaging (MRI) which indicated spinal lesions and examination of
the cerebral spinal fluid (CSF) indicated oligoclonal bands and elevated immunoglobulin
G (IgG). The most likely diagnosis is _________ - Multiple sclerosis
A 40-year-old woman is suspected of having Myasthenia Gravis. You order a Tensilon
test. If the patient does in fact have Myasthenia Gravis, the Tensilon test will reveal -
increased muscle strength
A 23 year old female with a history of epilepsy has been taking valproate sodium for the
past 5 years. She presents to neurology clinic and states she wants to start a family.
She has not had any seizures for the past 3 years. What is the most appropriate step in
this patient's care? - Obtain repeat EEG and MRI to help guide decisions on continued
use of valproate sodium prior to pregnancy.
A 29 year old male presents to the neurology clinic for follow-up evaluation of epilepsy
that started 9 years ago. Currently he average 3-4 seizures per month. His seizures are
preceded by a warning of deja vu and a rising abdominal sensation, followed by lip
smacking and speech arrest for 1-2 minutes then postictal disorientation and amnesia.
What is the patient's most likely diagnosis? - Complex partial seizures
All of the following are potential causes for seizures or increased seizure risk potential
from baseline EXCEPT: - adherence with current epileptic regimen
Abscence nonmotor seizures is a form of a generalized seizure and has no post-ictal
state: True or False - true
A 20 year old male presents for an epilepsy follow-up after being diagnosed about 10
years ago. He averages about 3 seizurs per month. His seizures are preceded by a
warning of deja-vu and queasiness of the abdomen, followed by lip smacking and
speech arrest for 1-2 minitures, then postictal disorientation and amnesia occur. As an
advanced provider you understand that his most likey diagnosis is: - complex-partial
seizures
True or False: Tonic-Clonic seizures are a generalized onset motor seizure with NO
loss of consciousness and NO pos-ictal state. - false
Petit-Mal abscence seizures have a sudden arrest of motor activity with a blank starte
and is someitmes assiciated with other types of sieures. - true
True or False: Tonic Clonic Grand-Mal seizures is a form of generalized seizures with
tonic contractions then clonic contractions with development of rigid muscles, a loss of
conciousness, and post-ictal state that may be preceded by an aura prior to the seizure.
- true
COMPLETE SOLUTIONS `100% CORRECT.
A 50 year old women presents to the ED with complaints of acute left sided facial pain,
inability to close her left eye and left ear pain that developed over the last 12 hours.
Typical exam finding for Bell's Palsy may include all EXCEPT: - Ability to smile.
All of the following are symptoms of Guillian Barre' EXCEPT: - Increased deep tendon
reflexes.
A 52 year old male presents with a rapidly progressive weakness in his legs that is
moving up the trunk. He also has absent reflexes and no sensory change. You learn
that this patient had been diagnosed with flu a month ago but has fully recovered from
the virus. Based on what you know about complications from the flu, the top of your list
for differential diagnosis for this patient's condition is: - Guillain Barre syndrome.
A 44-year-old woman with advanced HIV disease is evaluated in the ER. She complains
of a 1-week history of headache, fever, and malaise without nuchal rigidity. A head CT
shows mild atrophy, but no mass lesions. A lumbar puncture is performed and analysis
of the cerebrospinal fluid shows a WBC count of 30 cells/mm3 predominantly
lymphocytes, protein of 100 mg/dL, glucose 38 mg/dL, and negative Gram's stain. The
cerebrospinal opening pressure was measured as 32 cm H2O. The Nurse Practitioner
is concerned that: - this patient most likely has an opportunistic fungal infection such as
Cryptococcus neoformans or Listeria monocytogenes; the most common causes of
meningitis in HIV infected patients.
A 32-year-old male with a recent skateboard fall and subsequent diagnosis of a basal
skull fracture is admitted to the trauma floor. Over the past 24 hours he begins to have
signs and symptoms of fever, nuchal rigidity, and changes in mental status. The trauma
NP performs a lumbar puncture and decides to start the patient on empiric antibiotic
therapy for bacterial meningitis, pending CSF results. All of the antibiotic combinations
below are acceptable initial treatment regimens EXCEPT: - piperacillin-tazobactam +
vancomycin.
A 25 year old woman is diagnosed with bacterial meningitis. She has a positive Kernig's
sign. What is a positive Kernig's sign? - Flexion of the thigh to 90 degrees, which
produces pain with leg extension
, A 42 year old woman presents to the Emergency Department (ED) with complaints of
weakness, dizziness, lack of coordination, and difficulty with gait. She underwent
magnetic resonance imaging (MRI) which indicated spinal lesions and examination of
the cerebral spinal fluid (CSF) indicated oligoclonal bands and elevated immunoglobulin
G (IgG). The most likely diagnosis is _________ - Multiple sclerosis
A 40-year-old woman is suspected of having Myasthenia Gravis. You order a Tensilon
test. If the patient does in fact have Myasthenia Gravis, the Tensilon test will reveal -
increased muscle strength
A 23 year old female with a history of epilepsy has been taking valproate sodium for the
past 5 years. She presents to neurology clinic and states she wants to start a family.
She has not had any seizures for the past 3 years. What is the most appropriate step in
this patient's care? - Obtain repeat EEG and MRI to help guide decisions on continued
use of valproate sodium prior to pregnancy.
A 29 year old male presents to the neurology clinic for follow-up evaluation of epilepsy
that started 9 years ago. Currently he average 3-4 seizures per month. His seizures are
preceded by a warning of deja vu and a rising abdominal sensation, followed by lip
smacking and speech arrest for 1-2 minutes then postictal disorientation and amnesia.
What is the patient's most likely diagnosis? - Complex partial seizures
All of the following are potential causes for seizures or increased seizure risk potential
from baseline EXCEPT: - adherence with current epileptic regimen
Abscence nonmotor seizures is a form of a generalized seizure and has no post-ictal
state: True or False - true
A 20 year old male presents for an epilepsy follow-up after being diagnosed about 10
years ago. He averages about 3 seizurs per month. His seizures are preceded by a
warning of deja-vu and queasiness of the abdomen, followed by lip smacking and
speech arrest for 1-2 minitures, then postictal disorientation and amnesia occur. As an
advanced provider you understand that his most likey diagnosis is: - complex-partial
seizures
True or False: Tonic-Clonic seizures are a generalized onset motor seizure with NO
loss of consciousness and NO pos-ictal state. - false
Petit-Mal abscence seizures have a sudden arrest of motor activity with a blank starte
and is someitmes assiciated with other types of sieures. - true
True or False: Tonic Clonic Grand-Mal seizures is a form of generalized seizures with
tonic contractions then clonic contractions with development of rigid muscles, a loss of
conciousness, and post-ictal state that may be preceded by an aura prior to the seizure.
- true
