Neurological Review of Systems Questions

Neurological Review of Systems Questions Related

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A nurse assesses a patient diagnosed with functional neurological (conversion) disorder. Which comment is most likely from this patient?

  • A. Since my father died, I've been short of breath and had sharp pains that go down my left arm, but I think it's just indigestion.
  • B. I have daily problems with nausea, vomiting, and diarrhea. My skin is very dry and I think I'm getting seriously dehydrated.
  • C. Sexual intercourse is painful. I pretend as if I'm asleep so I can avoid it. I think it's starting to cause problems with my marriage.
  • D. I get choked very easily and have trouble swallowing when I eat. I think I might have cancer of the esophagus.
Correct Answer: A

Rationale: Step-by-step rationale:
1. The correct answer is A because the patient's symptoms (shortness of breath and left arm pains) do not have a clear medical explanation, indicating a functional neurological disorder.
2. The patient attributing symptoms to indigestion suggests a psychological rather than physical origin.
3. Choices B, C, and D describe physical symptoms with potential organic causes, not typically associated with conversion disorder.
4. B is more indicative of gastrointestinal issues, C of sexual dysfunction, and D of possible esophageal pathology, making them less likely in a conversion disorder context.

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What is the most important method of diagnosing functional headaches?

  • A. CT scan
  • B. Electromyography (EMG)
  • C. Cerebral blood flow studies
  • D. Thorough history of the headache
Correct Answer: D

Rationale: A thorough history is critical for diagnosing functional headaches

The foremost observation to make when providing care to a patient in status epilepticus is

  • A. hydration
  • B. patency of airway
  • C. temperature elevation
  • D. response to environmental stimuli
Correct Answer: B

Rationale: Maintaining airway patency is critical in status epilepticus to ensure adequate oxygenation.

The presence of ataxia suggests damage to any of the following EXCEPT:

  • A. cerebellar
  • B. thalamus
  • C. vestibular nucleus
  • D. vagal nerve
Correct Answer: D

Rationale: Vagal nerve is the correct answer because ataxia, which is a lack of coordination, is typically associated with damage to the cerebellum, thalamus, or vestibular system. The vagal nerve, however, is primarily involved in autonomic functions and does not play a direct role in motor coordination.

During the rehabilitative phase following his cerebrovascular accident Mr. K. is taught measures to relieve or prevent constipation. Which of these statements indicates that Mr. K. needs further health teaching?

  • A. I eat whole-wheat bread with my meals.
  • B. I eat fruit three times a day.
  • C. I don't drink fluids after 4 P.M.
  • D. I don't like to take enemas.
Correct Answer: C

Rationale: Restricted fluid intake contributes to constipation.

Which of the following is not a side effect of dopamine agonists?

  • A. Drowsiness
  • B. Nausea
  • C. Impulse control disorder
  • D. Livedo reticularis
Correct Answer: D

Rationale: Livedo reticularis is not a side effect of dopamine agonists. Common side effects include drowsiness, nausea, and impulse control disorders.

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