NUR 505 Module 8: Neurological,
Respiratory, Cardiovascular, Endocrine, &
Complex Pathophysiology
Neurological & Cranial Nerves (Questions 1–15)
1. A 65-year-old female reports difficulty navigating steps and stepping off curbs.
Which part of the nervous system is most likely affected?
• A) Frontal lobe
• B) Cerebellum
• C) Occipital lobe
• D) Brainstem
Answer: B) Cerebellum
Rationale: The cerebellum coordinates voluntary movement, equilibrium, and muscle
tone. Difficulty with steps suggests cerebellar dysfunction.
2. Which test is most appropriate to assess Cranial Nerve VIII (Acoustic)?
• A) Heel-to-shin test
• B) Snellen chart
• C) Whisper test and Rinne/Weber
• D) Cotton ball to cornea
,Answer: C) Whisper test and Rinne/Weber
Rationale: CN VIII (vestibulocochlear) is assessed with hearing tests. Whisper test
screens; Rinne/Weber differentiate conductive vs. sensorineural loss.
3. A patient cannot smoothly run each heel down the opposite shin. What domain
is impaired?
• A) Motor strength
• B) Cerebellar coordination
• C) Sensory discrimination
• D) Cranial nerve function
Answer: B) Cerebellar coordination
Rationale: Heel-to-shin test checks smooth, coordinated movement. Deviation suggests
cerebellar disease.
4. A patient has a Glasgow Coma Scale score of 3. How should the nurse assess for
pain?
• A) Ask the patient to rate pain 0–10
• B) Observe facial expression and body movement
• C) Use only family report
• D) Pain cannot be assessed
Answer: B) Observe facial expression and body movement
Rationale: GCS 3 indicates deep coma, but nonverbal signs (grimacing, withdrawal) can
indicate pain.
5. After a frontal lobe contusion from an MVA, which deficit is most likely?
• A) Blindness
• B) Difficulty speaking (expressive aphasia)
• C) Ataxia
• D) Hearing loss
Answer: B) Difficulty speaking (expressive aphasia)
Rationale: Broca’s area (frontal lobe) controls speech production. Injury here causes
expressive aphasia.
6. A nurse tests for Kernig’s sign. Which finding suggests meningeal irritation?
, • A) Pain when extending the knee with hip flexed
• B) Inability to touch chin to chest
• C) Pupil dilation
• D) Bilateral Babinski
Answer: A) Pain when extending the knee with hip flexed
Rationale: Kernig’s sign = resistance/pain with knee extension after hip flexion;
indicates meningeal inflammation.
7. To assess Cranial Nerve I (Olfactory), the nurse should ask the patient to:
• A) Stick out the tongue and move it side to side
• B) Follow a finger with eyes
• C) Occlude one nostril and identify a scent (e.g., coffee)
• D) Smile and raise eyebrows
Answer: C) Occlude one nostril and identify a scent (e.g., coffee)
Rationale: CN I is sensory for smell. Test each nostril separately with non-irritating
odors.
8. A patient cannot raise the soft palate or say “ah” symmetrically. Which cranial
nerves are likely affected?
• A) CN III and VI
• B) CN IX and X
• C) CN V and VII
• D) CN XI and XII
Answer: B) CN IX and X
Rationale: Glossopharyngeal (IX) and Vagus (X) control palate elevation and pharyngeal
movement.
9. A patient with a CVA cannot speak clearly. Which area is likely injured?
• A) Wernicke’s area
• B) Broca’s area
• C) Occipital lobe
• D) Cerebellum
Respiratory, Cardiovascular, Endocrine, &
Complex Pathophysiology
Neurological & Cranial Nerves (Questions 1–15)
1. A 65-year-old female reports difficulty navigating steps and stepping off curbs.
Which part of the nervous system is most likely affected?
• A) Frontal lobe
• B) Cerebellum
• C) Occipital lobe
• D) Brainstem
Answer: B) Cerebellum
Rationale: The cerebellum coordinates voluntary movement, equilibrium, and muscle
tone. Difficulty with steps suggests cerebellar dysfunction.
2. Which test is most appropriate to assess Cranial Nerve VIII (Acoustic)?
• A) Heel-to-shin test
• B) Snellen chart
• C) Whisper test and Rinne/Weber
• D) Cotton ball to cornea
,Answer: C) Whisper test and Rinne/Weber
Rationale: CN VIII (vestibulocochlear) is assessed with hearing tests. Whisper test
screens; Rinne/Weber differentiate conductive vs. sensorineural loss.
3. A patient cannot smoothly run each heel down the opposite shin. What domain
is impaired?
• A) Motor strength
• B) Cerebellar coordination
• C) Sensory discrimination
• D) Cranial nerve function
Answer: B) Cerebellar coordination
Rationale: Heel-to-shin test checks smooth, coordinated movement. Deviation suggests
cerebellar disease.
4. A patient has a Glasgow Coma Scale score of 3. How should the nurse assess for
pain?
• A) Ask the patient to rate pain 0–10
• B) Observe facial expression and body movement
• C) Use only family report
• D) Pain cannot be assessed
Answer: B) Observe facial expression and body movement
Rationale: GCS 3 indicates deep coma, but nonverbal signs (grimacing, withdrawal) can
indicate pain.
5. After a frontal lobe contusion from an MVA, which deficit is most likely?
• A) Blindness
• B) Difficulty speaking (expressive aphasia)
• C) Ataxia
• D) Hearing loss
Answer: B) Difficulty speaking (expressive aphasia)
Rationale: Broca’s area (frontal lobe) controls speech production. Injury here causes
expressive aphasia.
6. A nurse tests for Kernig’s sign. Which finding suggests meningeal irritation?
, • A) Pain when extending the knee with hip flexed
• B) Inability to touch chin to chest
• C) Pupil dilation
• D) Bilateral Babinski
Answer: A) Pain when extending the knee with hip flexed
Rationale: Kernig’s sign = resistance/pain with knee extension after hip flexion;
indicates meningeal inflammation.
7. To assess Cranial Nerve I (Olfactory), the nurse should ask the patient to:
• A) Stick out the tongue and move it side to side
• B) Follow a finger with eyes
• C) Occlude one nostril and identify a scent (e.g., coffee)
• D) Smile and raise eyebrows
Answer: C) Occlude one nostril and identify a scent (e.g., coffee)
Rationale: CN I is sensory for smell. Test each nostril separately with non-irritating
odors.
8. A patient cannot raise the soft palate or say “ah” symmetrically. Which cranial
nerves are likely affected?
• A) CN III and VI
• B) CN IX and X
• C) CN V and VII
• D) CN XI and XII
Answer: B) CN IX and X
Rationale: Glossopharyngeal (IX) and Vagus (X) control palate elevation and pharyngeal
movement.
9. A patient with a CVA cannot speak clearly. Which area is likely injured?
• A) Wernicke’s area
• B) Broca’s area
• C) Occipital lobe
• D) Cerebellum
