NR 509 APEA EXAM NEUROLOGY – QUESTION AND ANSWERS WITH EXPLANATIONS. CHAMBERLAIN COLLEGE OF NURSING

NR 509 APEA EXAM NEUROLOGY – QUESTION AND
ANSWERS WITH EXPLANATIONS. CHAMBERLAIN
COLLEGE OF NURSING


Question 1:

Sudden, brief, rapid jerks, involving the trunk or limbs may be consistent with:

a. a myoclonic seizure.
b. an absent seizure.
c. a myoclonic atonic seizure.
d. a focal seizure with impairment of

consciousness. Explanation:

A patient experiencing a myoclonic seizure manifests sudden, brief, rapid jerks, involving
the trunk or limbs. A sudden brief lapse of consciousness with momentary blinking,
staring, or movements of the lips and hands but no falling is consistent with an absent
seizure.
During a myoclonic atonic seizure, the patient experiences a sudden loss of consciousness
with falling but no movements. Injury may occur. Focal seizures with impairment of
consciousness the person appears confused. Automatisms include automatic motor
behaviors such as chewing, smacking the lips, walking about, and unbuttoning clothes.



Question 2:

Which of the following neurological assessment findings indicate the need for further
evaluation?

a. Lifting one foot and then the other when the infant is held upright with the
feet touching a solid surface
b. Fanning and hyperextension of the toes when the sole is stroked upward from
the heel
c. Grasping a finger placed in the neonate's
palm d. Weak and ineffective sucking movements


NR 509 APEA EXAM NEUROLOGY – QUESTION AND
ANSWERS WITH EXPLANATIONS. CHAMBERLAIN
COLLEGE OF NURSING

, NR 509 APEA EXAM NEUROLOGY – QUESTION AND
ANSWERS WITH EXPLANATIONS. CHAMBERLAIN
COLLEGE OF NURSING
Explanation:

Weak and ineffective sucking movements would indicate the need for further evaluation
since any weak, absent, asymmetrical or fine jumping movements would
suggestneurological system disorders. The other choices represent common reflexes found
in the normal newborn: Babinski, grasping, and stepping.

Question 3

An example of proximal weakness

is: a. the right shoulder.
b. the right hand.
c. both arms.
d. on the right side of the

face. Explanation:

There are 4 different patterns of weakness: Proximal, distal, symmetric, and asymmetric.
An example of proximal weakness is weakness in the shoulder or hip girdle. Distal
weakness occurs in the hands or feet. Symmetric weakness occurs in the same areas on
both sides of the body. An asymmetric weakness occurs in a portion of the face or
extremity
- a form of focal weakness.



Question 4

A female patient complains of weakness in her hand when opening a jar. This finding could
be suggestive of which type of weakness pattern?



a. Proximal
b. Distal
c. Symmetric


NR 509 APEA EXAM NEUROLOGY – QUESTION AND
ANSWERS WITH EXPLANATIONS. CHAMBERLAIN
COLLEGE OF NURSING

, NR 509 APEA EXAM NEUROLOGY – QUESTION AND
ANSWERS WITH EXPLANATIONS. CHAMBERLAIN
COLLEGE OF NURSING
d. Asymmetric



Explanation:

To identify distal weakness, ask about hand movements when opening a jar, can or using
scissors or a screwdriver. Another example is a problems like tripping when walking.
Question 5

A patient presents with an altered level of consciousness. He/she is considered in a
stuporous state if he/she:



a. appears drowsy but opens the eyes, looks at the examiners, answers the
questions, and then falls asleep.
b. arouses from sleep after exposure to painful stimuli, exhibits slow verbal
responses, and easily lapses into an unresponsive state.
c. remains unarousable with eyes closed. There is no evident response to inner need
or external stimuli.
d. opens the eyes and looks at the examiner, but responds slowly and is
somewhat confused.



Explanation:

A stuporous patient arouses from sleep after exposure to painful stimuli, verbal responses
are slow, and lapses into an unresponsive state. A lethargic patient appears drowsy but
opens the eyes, looks at the examiners, answers the questions, and then falls asleep. An
obtunded patient opens the eyes and looks at the examiner, but responds slowly and is
somewhat confused. A comatose patient remains unarousable with eyes closed. There is no
evident response to inner need or external stimuli.




NR 509 APEA EXAM NEUROLOGY – QUESTION AND
ANSWERS WITH EXPLANATIONS. CHAMBERLAIN
COLLEGE OF NURSING

, NR 509 APEA EXAM NEUROLOGY – QUESTION AND
ANSWERS WITH EXPLANATIONS. CHAMBERLAIN
COLLEGE OF NURSING
Question 6

One way to assess cerebellar function would be to have the patient:



a. hop on one foot.
b. read out loud.
c. shrug the shoulders.
d. discriminate between light and sharp pain.



Explanation:
The cerebellar function tests are used to monitor the patient's sense of equilibrium, which
includes the patient's gait (walk), ability to stand upright with eyes closed (Romberg test),
touch finger to nose, and move the heel to opposite knee while lying down. Other examples
also include: hopping on one foot, walking heel-to-toe, and touching the examiner's finger
and the examinees' nose. Reading out loud tests visual acuity; shrugging shoulders assesses
the spinal accessory nerve and discriminating pain between light and sharp assesses the
sensory system.



Question 7

Hypesthesia refers to:



a. absence of touch sensation.
b. decreased sensitivity to touch.
c. increased sensitivity to touch.
d. absence of pain sensation.



Explanation:

NR 509 APEA EXAM NEUROLOGY – QUESTION AND
ANSWERS WITH EXPLANATIONS. CHAMBERLAIN
COLLEGE OF NURSING