MASTERY: Complete Review, Study Guide & Test
Bank | 500+ Questions with Verified Answers |
2026/2027 Edition
Academic Year: 2026/2027 | Chamberlain University
Instructions: This exam consists of 50 multiple-choice questions. Select the single best
answer for each. Time Allowed: 120 minutes.
1. A 68-year-old patient with a left-hemisphere ischemic stroke presents with fluent
but nonsensical speech and impaired comprehension. Which cortical region is
most likely affected?
A. Brodmann area 4
*B. Wernicke area
C. Angular gyrus
D. Primary visual cortex
Rationale: Wernicke area (posterior superior temporal gyrus) governs language
comprehension; damage yields fluent aphasia with poor understanding. Broca
area (area 4) would produce non-fluent aphasia, angular gyrus lesions cause
alexia/agraphia, and primary visual cortex damage produces visual deficits, not
language.
2. A nursing student is asked why the right hand produces faster fine-movement
corrections than the left in a right-handed person. The best explanation involves
greater:
A. left anterior cerebral artery perfusion
B. right cerebellar hemisphere output
*C. left corticospinal tract myelination
D. right parasympathetic tone
Rationale: The left corticospinal tract (85 % crossed) innervates the right hand;
lifelong preferential use increases myelination and conduction velocity. The
cerebellum ipsilateral to the moving limb refines movement but does not explain
speed asymmetry.
, 3. A 19-year-old with a medulla oblongata demyelinating lesion develops
orthostatic hypotension. Which tract is most likely disrupted?
A. Spinothalamic
B. Lateral corticospinal
*C. Rostral ventrolateral medulla (RVLM) sympathetic pathway
D. Fasciculus gracilis
Rationale: RVLM premotor sympathetic neurons descend to spinal cord
intermediolateral cell column; interruption abolishes baroreflex-mediated
vasoconstriction on standing. Dorsal column (fasciculus gracilis) carries
proprioception, spinothalamic conveys pain/temperature, and corticospinal
tracts control voluntary movement.
4. A patient given IV fentanyl develops pinpoint pupils. Which midbrain structure
mediates this effect?
A. Superior colliculus
B. Red nucleus
*C. Edinger-Westphal nucleus
D. Substantia nigra pars reticulata
Rationale: μ-opioid receptor activation hyperpolarizes Edinger-Westphal
preganglionic parasympathetic neurons, increasing sphincter pupillae tone.
Superior colliculus orients gaze, red nucleus coordinates flexor tone, and
substantia nigra modulates basal ganglia output.
5. A 72-year-old with Alzheimer disease shows loss of cholinergic neurons. Which
basal forebrain nucleus is primarily involved?
*A. Nucleus basalis of Meynert
B. Locus coeruleus
C. Raphe nuclei
D. Pedunculopontine nucleus
Rationale: Nucleus basalis provides the cortical cholinergic input essential for
arousal and memory; its degeneration correlates with cognitive decline. Locus
coeruleus (norepinephrine) and raphe (serotonin) modulate mood/arousal, while
pedunculopontine influences locomotion.
6. During a grand-mal seizure, which ionic change first triggers the massive cortical
depolarization?
A. K+ efflux
*B. Rapid Ca2+-mediated glutamate release
C. Cl− influx
D. Na+ pump activation
Rationale: Voltage-gated Ca2+ influx into presynaptic terminals releases
glutamate that activates NMDA/AMPA receptors, initiating the paroxysmal