PCHA CORE 2026 MAIN EXAMS QUESTIONS AND
ANSWERS SURE A+
✔✔The nurse has just stuck herself with a sharp needle. In order for the nurse to be
able to interpret this sensation, which of the following areas must be intact? - ✔✔lateral
spinothalamic tract, thalamus, and sensory cortex.
✔✔While taking a health history on the patient, the nurse notes a history of polio as a
child. During the physical exam, the nurse also notes flaccid paralysis of the patient's
left leg only with atrophy of the leg muscles. The patient's paralysis would be due to
damage of the: - ✔✔ventral horn cells
✔✔The patient has uncoordinated rapid alternating movements, an intentional tremor
when asked to perform finger-to-nose movements, and sways excessively with the eyes
open and closed. The nurse would suspect a lesion in the: - ✔✔cerebellum
✔✔The patient is admitted to the neurology unit following a motor vehicle accident with
severe head injuries. The patient opens the eyes to pain, but the patient's words are
incomprehensible. With painful stimuli, the patient has rigid flexion of the upper arms
which are held tightly to the chest, and the feet are plantar flexed and internally rotated.
The patient's Glasgow Come Scale score is 7. What information would the nurse give to
this patient's family when they ask about the patient's condition? - ✔✔"His condition is
very, very serious. The next 48 hours will be critical."
✔✔Which of the following must be functioning in order to correctly interpret numbers
written in the palm of the hand (graphesthesia)? - ✔✔contralateral parietal lobe
✔✔The Glasgow Coma scale involves assessment of: - ✔✔eye opening, verbal
response, and motor response
✔✔Which of the following is true regarding assessment of the neurologic system? -
✔✔Babinski reflex in a 2-month-old is considered normal.
✔✔The patient arrives to the Emergency Department following a motorcycle accident in
which the patient was thrown from a motorcycle. Initial tests show the patient has
completely severed the spinal cord only at the level of the third thoracic vertebrae. The
anterior horn cells are intact. What would be the most likely findings upon examination
of this client? - ✔✔Severe muscle weakness or paralysis (spinal shock) below the level
of the lesion initially (24-48 hours), followed by spastic paralysis within several days or
weeks.
✔✔While performing a neurologic exam on , the nurse notes rapid rhythmic contraction
of muscle groups while testing the ankle (Achilles) reflex. This finding is referred to as: -
✔✔clonus
, ✔✔The practitioner places a key in the hand of the patient; the patient identifies it as a
penny. What term would the nurse use to describe the result of this sensory exam? -
✔✔Astereognosis
✔✔The nurse is testing the deep tendon reflexes of a patient who is in the clinic for an
annual physical examination. When striking the Achilles tendon, the nurse is unable to
elicit a reflex. The nurse's next response should be to: - ✔✔assess for the reflex again
while asking the patient to lock her fingers and "pull".
✔✔One of the earliest and most sensitive signs of a change in the patient's condition is:
- ✔✔Change in level of consciousness.
✔✔Lower motor neurons differ from upper motor neurons primarily in that lesions of the
lower motor neurons - ✔✔cause hyporeflexia and flaccidity.
✔✔The nurse is testing the patient's deep tendon reflexes. The nurse holds the reflex
hammer with the dominant hand between the thumb and index finger. A striking motion
is generated with the wrist, and the tendon is tapped briskly with a smooth, direct arc.
The hammer is left in place over the tendon as the reflex occurs. Critique the nurse's
technique. - ✔✔The hammer should be removed after the tendon is tapped.
✔✔A painful stimuli may be performed to assess level of consciousness. - ✔✔true
✔✔The patient is brought into the Emergency Department after being involved in a
motor vehicle accident. Upon completion of the neurologic exam, the nurse records a
'zero' response for the patellar reflex. Based on this finding, the nurse suspects damage
at what segment of the spinal cord? - ✔✔L2, 3, 4
✔✔The patient is diagnosed with a lesion of the posterior (dorsal) column. What would
be the expected sensory findings of this individual? - ✔✔B & C
- inability to recognize objects when placed in the hand
- inability to recognize finger position
✔✔The nurse is assessing dermatome levels of the patient. The nurse notes the patient
has numbness in the area around the umbilicus. Which spinal nerve is associated with
this finding? - ✔✔T10
✔✔The patient reports an inability to firmly hold a pencil at times due to numbness and
tingling in the thumb. The patient also reports "neck pain." When performing the
neurologic assessment, the nurse notes decreased sensory response on both thumbs
bilaterally. Based on these findings, where would the nurse expect the lesion to be? -
✔✔sixth cervical nerve (C6)
ANSWERS SURE A+
✔✔The nurse has just stuck herself with a sharp needle. In order for the nurse to be
able to interpret this sensation, which of the following areas must be intact? - ✔✔lateral
spinothalamic tract, thalamus, and sensory cortex.
✔✔While taking a health history on the patient, the nurse notes a history of polio as a
child. During the physical exam, the nurse also notes flaccid paralysis of the patient's
left leg only with atrophy of the leg muscles. The patient's paralysis would be due to
damage of the: - ✔✔ventral horn cells
✔✔The patient has uncoordinated rapid alternating movements, an intentional tremor
when asked to perform finger-to-nose movements, and sways excessively with the eyes
open and closed. The nurse would suspect a lesion in the: - ✔✔cerebellum
✔✔The patient is admitted to the neurology unit following a motor vehicle accident with
severe head injuries. The patient opens the eyes to pain, but the patient's words are
incomprehensible. With painful stimuli, the patient has rigid flexion of the upper arms
which are held tightly to the chest, and the feet are plantar flexed and internally rotated.
The patient's Glasgow Come Scale score is 7. What information would the nurse give to
this patient's family when they ask about the patient's condition? - ✔✔"His condition is
very, very serious. The next 48 hours will be critical."
✔✔Which of the following must be functioning in order to correctly interpret numbers
written in the palm of the hand (graphesthesia)? - ✔✔contralateral parietal lobe
✔✔The Glasgow Coma scale involves assessment of: - ✔✔eye opening, verbal
response, and motor response
✔✔Which of the following is true regarding assessment of the neurologic system? -
✔✔Babinski reflex in a 2-month-old is considered normal.
✔✔The patient arrives to the Emergency Department following a motorcycle accident in
which the patient was thrown from a motorcycle. Initial tests show the patient has
completely severed the spinal cord only at the level of the third thoracic vertebrae. The
anterior horn cells are intact. What would be the most likely findings upon examination
of this client? - ✔✔Severe muscle weakness or paralysis (spinal shock) below the level
of the lesion initially (24-48 hours), followed by spastic paralysis within several days or
weeks.
✔✔While performing a neurologic exam on , the nurse notes rapid rhythmic contraction
of muscle groups while testing the ankle (Achilles) reflex. This finding is referred to as: -
✔✔clonus
, ✔✔The practitioner places a key in the hand of the patient; the patient identifies it as a
penny. What term would the nurse use to describe the result of this sensory exam? -
✔✔Astereognosis
✔✔The nurse is testing the deep tendon reflexes of a patient who is in the clinic for an
annual physical examination. When striking the Achilles tendon, the nurse is unable to
elicit a reflex. The nurse's next response should be to: - ✔✔assess for the reflex again
while asking the patient to lock her fingers and "pull".
✔✔One of the earliest and most sensitive signs of a change in the patient's condition is:
- ✔✔Change in level of consciousness.
✔✔Lower motor neurons differ from upper motor neurons primarily in that lesions of the
lower motor neurons - ✔✔cause hyporeflexia and flaccidity.
✔✔The nurse is testing the patient's deep tendon reflexes. The nurse holds the reflex
hammer with the dominant hand between the thumb and index finger. A striking motion
is generated with the wrist, and the tendon is tapped briskly with a smooth, direct arc.
The hammer is left in place over the tendon as the reflex occurs. Critique the nurse's
technique. - ✔✔The hammer should be removed after the tendon is tapped.
✔✔A painful stimuli may be performed to assess level of consciousness. - ✔✔true
✔✔The patient is brought into the Emergency Department after being involved in a
motor vehicle accident. Upon completion of the neurologic exam, the nurse records a
'zero' response for the patellar reflex. Based on this finding, the nurse suspects damage
at what segment of the spinal cord? - ✔✔L2, 3, 4
✔✔The patient is diagnosed with a lesion of the posterior (dorsal) column. What would
be the expected sensory findings of this individual? - ✔✔B & C
- inability to recognize objects when placed in the hand
- inability to recognize finger position
✔✔The nurse is assessing dermatome levels of the patient. The nurse notes the patient
has numbness in the area around the umbilicus. Which spinal nerve is associated with
this finding? - ✔✔T10
✔✔The patient reports an inability to firmly hold a pencil at times due to numbness and
tingling in the thumb. The patient also reports "neck pain." When performing the
neurologic assessment, the nurse notes decreased sensory response on both thumbs
bilaterally. Based on these findings, where would the nurse expect the lesion to be? -
✔✔sixth cervical nerve (C6)
