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The neurologist is testing the function of a patients cerebellum and basal ganglia. What action will most accurately test these structures?
- A. Have the patient identify the location of a cotton swab on his or her skin with the eyes closed.
- B. Elicit the patients response to a hypothetical problem.
- C. Ask the patient to close his or her eyes and discern between hot and cold stimuli.
- D. Guide the patient through the performance of rapid, alternating movements.
Correct Answer: D
Rationale: Rapid, alternating movements test cerebellar and basal ganglia coordination. Sensory tests assess peripheral nerves, and hypothetical problems evaluate cognition.
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The nurse is planning the care of a patient with Parkinsons disease. The nurse should be aware that treatment will focus on what pathophysiological phenomenon?
- A. Premature degradation of acetylcholine
- B. Decreased availability of dopamine
- C. Insufficient synthesis of epinephrine
- D. Delayed reuptake of serotonin
Correct Answer: B
Rationale: Parkinsons disease results from reduced dopamine availability in the basal ganglia, impacting movement. Other neurotransmitters listed are not primarily involved.
A nurse is assessing reflexes in a patient with hyperactive reflexes. When the patients foot is abruptly dorsiflexed, it continues to beat two to three times before settling into a resting position. How would the nurse document this finding?
- A. Rigidity
- B. Flaccidity
- C. Clonus
- D. Ataxia
Correct Answer: C
Rationale: Clonus is characterized by rhythmic muscle contractions, such as foot beating after dorsiflexion, indicating hyperactive reflexes. Rigidity is increased muscle tone, flaccidity is lack of tone, and ataxia is uncoordinated movement.
A patient exhibiting an uncoordinated gait has presented at the clinic. Which of the following is the most plausible cause of this patients health problem?
- A. Cerebellar dysfunction
- B. A lesion in the pons
- C. Dysfunction of the medulla
- D. A hemorrhage in the midbrain
Correct Answer: A
Rationale: The cerebellum coordinates movement and balance, so dysfunction causes uncoordinated gait. Pons, medulla, and midbrain lesions affect other functions like respiration or eye movement.
A trauma patient in the ICU has been declared brain dead. What diagnostic test is used in making the determination of brain death?
- A. Magnetic resonance imaging (MRI)
- B. Electroencephalography (EEG)
- C. Electromyelography (EMG)
- D. Computed tomography (CT)
Correct Answer: B
Rationale: EEG confirms brain death by showing no electrical activity. MRI, CT, and EMG are not standard for this determination.
The nurse caring for an 80 year-old patient knows that she has a pre-existing history of dulled tactile sensation. The nurse should first consider what possible cause for this patients diminished tactile sensation?
- A. Damage to cranial nerve VIII
- B. Adverse medication effects
- C. Age-related neurologic changes
- D. An undiagnosed cerebrovascular accident in early adulthood
Correct Answer: C
Rationale: Aging reduces sensory receptor density, dulling tactile sensation. Cranial nerve VIII affects hearing, medications may cause other effects, and an old CVA is less likely without evidence.