Chapter 15: Neurologic System
Wilson: Health Assessment for Nursing Practice, 6th Edition
MULTIPLE CHOICE
1. A nurse assesses a patient with a head injury who has slowing intellectual functioning,
personality changes, and emotional lability. The nurse correlates these findings with which
area of the brain?
a. Frontal lobe
b. Parietal lobe
c. Thalamus
d. Temporal lobe
ANS: A
The frontal lobe controls intellectual function, awareness of self, personality, and autonomic
responses related to emotion. The parietal lobe receives sensory input such as position sense,
touch, shape, and texture of objects. The thalamus is a relay and integration station from the
spinal cord to the cerebral cortex and other parts of the brain. The temporal lobe contains the
primary auditory cortex. It also interprets auditory, visual, and somatic sensory inputs that are
stored in thought and memory.
DIF: Cognitive Level: Understand REF: p. 308
TOP: Nursing Process: Assessment
MSC: NCLEX Patient Needs: Physiologic Integrity: Physiologic Adaptation: Alteration in Body
Systems
2. In assessing a patient with damage to the occipital lobe, the nurse correlates which clinical
manifestation to this injury?
a. Intentional tremors
b. Visual changes
c. Decreased hearing
d. Inability to formulate words
ANS: B
The occipital lobe contains the visual cortex. Intentional tremors are caused by cerebellar
problems. The temporal lobe contains the auditory cortex. The ability to formulate words
comes from the Broca area in the frontal lobe.
DIF: Cognitive Level: Understand REF: p. 308
TOP: Nursing Process: Assessment
MSC: NCLEX Patient Needs: Physiologic Integrity: Physiologic Adaptation: Alteration in Body
Systems
3. Which patient behavior indicates to the nurse that the patient’s facial cranial nerve (CN VII) is
intact?
a. The patient’s eyes move to the left, right, up, down, and obliquely.
b. The patient moistens the lips with the tongue.
c. The sides of the mouth are symmetric when the patient smiles.
d. The patient’s eyelids blink periodically.
ANS: C
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, Health Assessment for Nursing Practice 6th Edition Wilson Test Bank
The finding in option C represents facial symmetry, which is controlled by the facial cranial
nerve (CN VII). The finding in option A represents movement of the extraocular muscles,
which are controlled by the oculomotor, trochlear, and abducens cranial nerves (CN III, IV,
and VI, respectively). The finding in option B represents movement of the tongue, which is
controlled by the hypoglossal cranial nerve (CN XII). The finding in option D represents
function of the oculomotor cranial nerve (CN III).
DIF: Cognitive Level: Apply REF: p. 321
TOP: Nursing Process: Assessment
MSC: NCLEX Patient Needs: Physiologic Integrity: Reduction of Risk Potential: System Specific
Assessments
4.
a. The patient understands speech but is unable to translate ideas into meaningful
speech.
b. The patient is unable to comprehend speech and thus does not respond verbally.
c. The patient is able to understand speech but has difficulty forming words, creating
muffled speech.
d. The patient is unable to comprehend speech and responds inappropriately to
conversation.
ANS: A
The inability to translate ideas into meaningful speech or writing is termed expressive aphasia
or nonfluent aphasia and is associated with lesions in the Broca area in the frontal lobe. The
inability to comprehend the speech of others is called receptive aphasia or fluent aphasia and
is associated with lesions in the Wernicke area in the temporal lobe. Speech pattern A is more
consistent with patients who have involvement of muscles of speech rather than neurologic
deficits. Speech pattern D is not relevant to this patient.
DIF: Cognitive Level: Apply REF: p. 317
TOP: Nursing Process: Assessment
MSC: NCLEX Patient Needs: Physiologic Integrity: Physiologic Adaptation: Alteration in Body
Systems
5. The nurse hears in a report that a patient has receptive or fluent aphasia. What communication
abilities does the nurse anticipate from this patient?
a. The patient understands speech but is unable to translate ideas into meaningful
speech.
b. The patient is able to understand speech but has difficulty forming words creating
muffled speech.
c. The patient is unable to comprehend speech and thus does not respond verbally.
d. The patient is emotionally liable and cries easily, which interferes with the ability
to communicate.
ANS: C
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