NP Neuro Assessment Review Questions and Answers 2026

NP Neuro Assessment Review Questions and Answers 2026 Mini-Mental State Examination (MMSE) Give you a quantifiable measure of cognitive functions of MSE - valid detector of organic disease - normal = 27 - 18-23 = mild cog dysfunction - 0-7 = severe cog dysfunction 1. orientation (name, place, time, profession) 2. registration - repeat back 3 words given to patient after 5 minutes 3. reading - please read this paper and do what it says 4. attention and calculation - spell this word backwards (use "world") 5. langauge - repeat the following sentence....assess for dysphagia Initial inspection considers these physicalities, behaviors with patient -appearance -facial expression -mood/affect -posture -LOC focused interview subjects to be included with geriatric assessment -syncope -seizures (spells, weakness, paralysis, tremors) -physiologic changes (hearing, sight) -new onset h/a -family history of neurological disorders -previous trauma/ environment exposure to chemicals -medication reconciliation -careful social history assessment 12 cranial nerves in order "Olympic Opium Occupies Troubled Triathletes After Finishing Vegas Gambling Still High" 1. Olfactory 2. Optic 3. Oculomotor 4. Trochlear 5. Trigeminal 6. Abducens 7. Facial 8. Vestibulocochlear 9. Glossopharyngeal 10. Vagus 11. Spinal Accessory 12. Hypoglossal Cranial Nerve Position Image and assessment note: CN 5 also includes sensory- dull and sharp, corneal reflex (cotton wisp) Cranial nerve function in order 1-12 mnemonic- sensory, motor or both "Some Say Marry Money, But My Brother Says Bad Business Marry Money" Cranial nerve function and assessment CN III, IV, VI: done together with extraocular movements and accommodation T/F? Altered smell sensation (CN1) is expected finding with older adults True Distortion of smell in both nostrils indicative of __________ one nostril indicative of _____________ both: early Alzheimer's onset one: frontal brain tumor CNII- The loss of accommodation, known as _____________, is normal age-related change. presbyopia CN III, IV, VI- check for ptosis (define) List differentials ptosis is upper lid drooping Differentials include: normal age-related change, MG, DM, CVA, Bell's Palsy, brain tumor senile mitosis Smaller pupils compared to adults (expected finding in older adults) age 70: 2.5; age 80: 2.0 T/F? vertical gaze and accommodation limitations are normal age-related changes. True. CN VII- Injuries, such as Bell's Palsy, will affect which part of the face? Central lesions will affect which part of the face? Bell's-both upper and lower face Central lesions- lower face only CN VIII- Weber test is used for _______________ Rhine test is used for _______________ Weber test-lateralization hearing loss (left vs. right) Rhine test- air vs. bone conduction hearing loss What is the most common cause of conduction hearing loss in older adults? cerumen (wax) impaction Presbycusis Hearing loss of higher tones (remember image: church picture with older adults listening to guitar playing) CN IX and X- Hoarseness in voice could indicate _______________ vocal cord paralysis **refer to ENT for evaluation, biopsy; especially with smoking history as could be cancerous lesion as well. CN XII- Tongue movement/ appearance differential if: 1. atrophy is present 2. tongue deviation to one side 1. atrophy: peripheral lesion 2. tongue deviation: unilateral lesion- tongue will deviate to affected side. Cerebellum function coordination of voluntary movements and balance Name ways to test cerebellar function Rhomberg test coordination tests Tandem walk- "Sobreity test" sensory testing graphesthesia stereognosis musculoskeltal testing deep tendon reflexes Rhomberg test assess balance and ataxia that initially postions the patient in unsupported standing, feet together, UE folded, looking at a fixed point straight ahead with eyes open. Follow with arms out, eyes closed. Normal = maintain each for 30 sec Perform this test with Rhomberg to assess for bilateral upper extremity muscle weakness Pronator drift test (hold both arms up, palms up- provider attempts to push down, should float back to normal position) - downward drift indicative of muscle weakness. Tandem Walking Test -Ask person to walk a straight line heel-to-toe tandem fashion -walk on toes, turn, walk on heels sensory testing procedures -sharp and dull (cotton wisp and end of broken cotton tip in various areas of body) -tuning fork (strike and place at distal phalange of each thumb) -temperature differentiation between hot and cold Coordination tests rapid alternating movements (supinate and pronate hands quickly of thighs- "slap the lap") heel-to-shin test (slide heel from ankle up shin on each leg)