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NUR 631 Exam 3-neuro, musculoskeletal-mental health
QUESTIONS AND CORRECT ANSWERS LATEST UPDATE
JUST RELEASED THIS YEAR
A 60-year-old retired seamstress comes to your office, complaining of decreased sensation in
her hands and feet. She states that she began to have the problems in her feet a year ago but
now it has started in her hands also. She also complains of some weakness in her grip. She
has had no recent illnesses or injuries. Her past medical history consists of having type 2
diabetes for 20 years. She now takes insulin and oral medications for her diabetes. She has
been married for 40 years. She has two healthy children. Her mother has Alzheimer's disease
and coronary artery disease. Her father died of a stroke and also had diabetes. She denies any
tobacco, alcohol, or drug use. On examination she has decreased deep tendon reflexes in the
patellar and Achilles tendons. She has decreased sensation of fine touch, pressure, and
vibration on both feet. She has decreased two-point discrimination on her hands. Her grip
strength is
C) Peripheral polyneuropathy
A 21-year-old engineering student comes to your office, complaining of leg and back pain and
of tripping when he walks. He states this started 3 months ago with back and buttock pain but
has since progressed to feeling weak in his left leg. He denies any bowel or bladder
symptoms. He can think of no specific traumatic incidences but he was a defensive lineman in
high school and junior college. His past medical history is unremarkable. He denies tobacco
use or alcohol or drug abuse. His parents are both healthy. On examination he is tender over
the lumbar spine and he has a positive straight-leg raise on the left. His Achilles tendon deep
reflex is decreased on the left. While watching his gait you notice he has to pick his left foot
up high in order not to trip.
What abnormality of gait does he most likely have?
A) Sensory ataxia
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B) Parkinsonian gait
C) Steppage gait
D) Spastic hemiparesis
C) Steppage gait
A 17-year-old high school student is brought in to your emergency room in a comatose state.
His friends have accompanied him and tell you that they have been shooting up heroin
tonight and they think their friend may have had too much. The patient is unconscious and
cannot protect his airway, so he is intubated. His heart rate is 60 and he is breathing through
the ventilator. He is not posturing and he does not respond to a sternal rub. Preparing to
finish the neurologic examination, you get a penlight.
What size pupils do you expect to see in this comatose patient?
A) Pinpoint pupils
B) Large pupils
C) Asymmetric pupils
D) Irregularly shaped pupils
A) Pinpoint pupils
A 37-year-old woman is brought into your emergency room comatose. The paramedics say
her husband found her unconscious in her home. Her past medical history consists of type 1
diabetes and she is on insulin. In the ambulance the paramedics obtained a glucose check and
her sugar was 15 (normal is 70 to 105). They began a dextrose saline infusion and intubated
her to protect her airway. Despite their efforts, she is posturing in the emergency room with
her arms straight at her side and her jaw clenched. Her legs are also straight and her feet are
plantar flexed.
What type of posturing is she showing?
A) Decorticate rigidity
B) Decerebrate rigidity
C) Hemiplegia
D) Chorea
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B) Decerebrate rigidity
A 19-year-old college student, Todd, is brought to your clinic by his mother. She is concerned
that there is something seriously wrong with him. She states for the past 6 months his
behavior has become peculiar and he has flunked out of college. Todd denies any recent
illness or injuries. His past medical history is remarkable only for a broken foot. His parents
are both healthy. He has a paternal uncle who had similar symptoms in college. The patient
admits to smoking cigarettes and drinking alcohol. He also admits to marijuana use but none
in the last week. He denies using any other substances. He denies any feelings of depression
or anxiety. While speaking with Todd and his mother you do a complete physical examination,
which is essentially normal. When you question him on how he is feeling, he says that he is
very worried that Microsoft has stolen his software for creating a better browser. He tells you
he has se
D) Schizophrenia
A 24-year-old secretary comes to your clinic, complaining of difficulty sleeping, severe
nightmares, and irritability. She states it all began 6 months ago when she went to a fast food
restaurant at midnight. While she was waiting in her car a man entered through the
passenger door and put a gun to her head. He had her drive to a remote area, where he took
her money and threatened to kill her. When the gun jammed he panicked and ran off. Ever
since this occurred the patient has been having these symptoms. She states she jumps at
every noise and refuses to drive at night. She states her anxiety has had such a marked
influence on her job performance she is afraid she will be fired. She denies any recent
illnesses or injuries. Her past medical history is unremarkable. On examination you find a
nervous woman appearing her stated age. Her physical examination is unremarkable. You
recommend medication and counseling.
What
C) Post-traumatic stress disorder
NUR 631 Exam 3-neuro, musculoskeletal-mental health
QUESTIONS AND CORRECT ANSWERS LATEST UPDATE
JUST RELEASED THIS YEAR
A 60-year-old retired seamstress comes to your office, complaining of decreased sensation in
her hands and feet. She states that she began to have the problems in her feet a year ago but
now it has started in her hands also. She also complains of some weakness in her grip. She
has had no recent illnesses or injuries. Her past medical history consists of having type 2
diabetes for 20 years. She now takes insulin and oral medications for her diabetes. She has
been married for 40 years. She has two healthy children. Her mother has Alzheimer's disease
and coronary artery disease. Her father died of a stroke and also had diabetes. She denies any
tobacco, alcohol, or drug use. On examination she has decreased deep tendon reflexes in the
patellar and Achilles tendons. She has decreased sensation of fine touch, pressure, and
vibration on both feet. She has decreased two-point discrimination on her hands. Her grip
strength is
C) Peripheral polyneuropathy
A 21-year-old engineering student comes to your office, complaining of leg and back pain and
of tripping when he walks. He states this started 3 months ago with back and buttock pain but
has since progressed to feeling weak in his left leg. He denies any bowel or bladder
symptoms. He can think of no specific traumatic incidences but he was a defensive lineman in
high school and junior college. His past medical history is unremarkable. He denies tobacco
use or alcohol or drug abuse. His parents are both healthy. On examination he is tender over
the lumbar spine and he has a positive straight-leg raise on the left. His Achilles tendon deep
reflex is decreased on the left. While watching his gait you notice he has to pick his left foot
up high in order not to trip.
What abnormality of gait does he most likely have?
A) Sensory ataxia
, Page 2 of 26
B) Parkinsonian gait
C) Steppage gait
D) Spastic hemiparesis
C) Steppage gait
A 17-year-old high school student is brought in to your emergency room in a comatose state.
His friends have accompanied him and tell you that they have been shooting up heroin
tonight and they think their friend may have had too much. The patient is unconscious and
cannot protect his airway, so he is intubated. His heart rate is 60 and he is breathing through
the ventilator. He is not posturing and he does not respond to a sternal rub. Preparing to
finish the neurologic examination, you get a penlight.
What size pupils do you expect to see in this comatose patient?
A) Pinpoint pupils
B) Large pupils
C) Asymmetric pupils
D) Irregularly shaped pupils
A) Pinpoint pupils
A 37-year-old woman is brought into your emergency room comatose. The paramedics say
her husband found her unconscious in her home. Her past medical history consists of type 1
diabetes and she is on insulin. In the ambulance the paramedics obtained a glucose check and
her sugar was 15 (normal is 70 to 105). They began a dextrose saline infusion and intubated
her to protect her airway. Despite their efforts, she is posturing in the emergency room with
her arms straight at her side and her jaw clenched. Her legs are also straight and her feet are
plantar flexed.
What type of posturing is she showing?
A) Decorticate rigidity
B) Decerebrate rigidity
C) Hemiplegia
D) Chorea
, Page 3 of 26
B) Decerebrate rigidity
A 19-year-old college student, Todd, is brought to your clinic by his mother. She is concerned
that there is something seriously wrong with him. She states for the past 6 months his
behavior has become peculiar and he has flunked out of college. Todd denies any recent
illness or injuries. His past medical history is remarkable only for a broken foot. His parents
are both healthy. He has a paternal uncle who had similar symptoms in college. The patient
admits to smoking cigarettes and drinking alcohol. He also admits to marijuana use but none
in the last week. He denies using any other substances. He denies any feelings of depression
or anxiety. While speaking with Todd and his mother you do a complete physical examination,
which is essentially normal. When you question him on how he is feeling, he says that he is
very worried that Microsoft has stolen his software for creating a better browser. He tells you
he has se
D) Schizophrenia
A 24-year-old secretary comes to your clinic, complaining of difficulty sleeping, severe
nightmares, and irritability. She states it all began 6 months ago when she went to a fast food
restaurant at midnight. While she was waiting in her car a man entered through the
passenger door and put a gun to her head. He had her drive to a remote area, where he took
her money and threatened to kill her. When the gun jammed he panicked and ran off. Ever
since this occurred the patient has been having these symptoms. She states she jumps at
every noise and refuses to drive at night. She states her anxiety has had such a marked
influence on her job performance she is afraid she will be fired. She denies any recent
illnesses or injuries. Her past medical history is unremarkable. On examination you find a
nervous woman appearing her stated age. Her physical examination is unremarkable. You
recommend medication and counseling.
What
C) Post-traumatic stress disorder
