Nca 623 Module 4 Questions And Answers
With Verified 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: -
ANSWER✔✔Ability to smile.
All of the following are symptoms of Guillian Barre' EXCEPT: -
ANSWER✔✔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: -
ANSWER✔✔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: - ANSWER✔✔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: - ANSWER✔✔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? - ANSWER✔✔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 _________ -
ANSWER✔✔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 - ANSWER✔✔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? - ANSWER✔✔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? -
ANSWER✔✔Complex partial seizures
All of the following are potential causes for seizures or increased seizure risk
potential from baseline EXCEPT: - ANSWER✔✔adherence with current epileptic
regimen
Abscence nonmotor seizures is a form of a generalized seizure and has no post-
ictal state: True or False - ANSWER✔✔true
With Verified 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: -
ANSWER✔✔Ability to smile.
All of the following are symptoms of Guillian Barre' EXCEPT: -
ANSWER✔✔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: -
ANSWER✔✔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: - ANSWER✔✔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: - ANSWER✔✔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? - ANSWER✔✔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 _________ -
ANSWER✔✔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 - ANSWER✔✔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? - ANSWER✔✔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? -
ANSWER✔✔Complex partial seizures
All of the following are potential causes for seizures or increased seizure risk
potential from baseline EXCEPT: - ANSWER✔✔adherence with current epileptic
regimen
Abscence nonmotor seizures is a form of a generalized seizure and has no post-
ictal state: True or False - ANSWER✔✔true
