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Sitting relaxed and facing you, have your patient perform the following sequence of activities: With arms outstretched, alternately bring in each hand and touch the tip of each index finger to his nose. Next, have the patient rapidly alternate patting his knees with the palmer , then the dorsal aspects of his hands. Finally, have the patient rapidly extend and tap his foot against your hand. Which component of the neurological exam are you assessing?
- A. Sensory function
- B. Cerebellar function
- C. Cranial nerves
- D. Mental status
Correct Answer: B
Rationale: These activities assess cerebellar function, which includes coordination, balance, and fine motor skills. Sensory function, cranial nerves, and mental status are evaluated through different tests, such as pinprick sensation, cranial nerve examination, and cognitive assessments.
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A nurse assessing a patient diagnosed with a somatic system disorder is most likely to note that the patient:
- A. readily sees a relationship between symptoms and interpersonal conflicts.
- B. rarely derives personal benefit from the symptoms.
- C. has little difficulty communicating emotional needs.
- D. has unmet needs related to comfort and activity.
Correct Answer: D
Rationale: The correct answer is D because patients with somatic system disorders often have unmet needs related to comfort and activity. These patients may focus on physical symptoms to express underlying emotional distress or seek attention. Choice A is incorrect because patients with somatic disorders often struggle to see a relationship between symptoms and psychological conflicts. Choice B is incorrect because patients with somatic disorders may derive secondary gain from their symptoms. Choice C is incorrect because patients with somatic disorders often have difficulty expressing emotional needs.
The nurse practitioner conducting a neurological assessment on a patient uses a sterile cotton wisp to lightly touch the patient’s forehead, cheek, and chin. The nurse practitioner is testing the:
- A. Cranial nerve V (trigeminal)
- B. Cranial nerve VII (facial)
- C. Cranial nerve XII (hypoglossal)
- D. Cranial nerve II (optic)
Correct Answer: A
Rationale: The correct answer is A: Cranial nerve V (trigeminal). The nurse practitioner is testing the trigeminal nerve's sensory function by using a sterile cotton wisp to assess light touch sensation in the patient's forehead, cheek, and chin. The trigeminal nerve has three branches - ophthalmic, maxillary, and mandibular - which innervate these areas respectively. By assessing the patient's response to the light touch in these specific areas, the nurse practitioner can determine if the sensory function of the trigeminal nerve is intact.
Summary:
B: Cranial nerve VII (facial) controls facial expression, not sensation.
C: Cranial nerve XII (hypoglossal) controls tongue movement, not facial sensation.
D: Cranial nerve II (optic) is responsible for vision, not facial sensation.
A patient arrives in the ER with blurred and double vision, muscle weakness, and intolerance of temperature changes. The physician suspects multiple sclerosis. What test would you expect the physician to do in order to confirm his or her suspicions?
- A. CBC with a very low WBC count.
- B. MRI with gadolinium showing demyelination of nerve fibers.
- C. Endocrine function study with a low growth hormone and high T3 and T4.
- D. Fasting glucose test with a result over 300 mg/dL.
Correct Answer: B
Rationale: MRI with gadolinium is used to identify demyelination, which is characteristic of multiple sclerosis.
The affection of cerebellar may produce any of the following EXCEPT:
- A. nystagmus
- B. ataxia
- C. dysmetria
- D. dyspraxia
Correct Answer: D
Rationale: Dyspraxia is the correct answer because it is a disorder of motor planning and execution, typically associated with damage to the frontal or parietal lobes, rather than the cerebellum. The cerebellum is responsible for coordination, balance, and fine motor control, so its dysfunction results in ataxia, dysmetria, and nystagmus.
In the United States of America one most common neuropsychological tests used is known as:
- A. Honda-Reichstaadt Neuropsychological Test Battery.
- B. Halstead-Reitan Neuropsychological Test Battery.
- C. Haeffner-Risch Neuropsychological Test Battery.
- D. Hochman-Roider Neuropsychological Test Battery.
Correct Answer: B
Rationale: The Halstead-Reitan Neuropsychological Test Battery is one of the most commonly used neuropsychological assessments in the United States. It consists of a series of tests designed to evaluate brain and nervous system functioning, including measures of cognitive, motor, and sensory abilities. This battery is particularly useful for diagnosing brain damage, assessing the severity of neurological disorders, and planning rehabilitation strategies.