TestcBankc-cBrunnerc&cSuddarth'scTextbookcofcMedical-SurgicalcNursingc14ec(Hinklec2017) 1223
Chapter 65: Assessment of Neurologic Function
c c c c c
1. AcpatientciscbroughtctocthecERcfollowingcacmotorcvehiclecaccidentcincwhichchecsustainedcheadctrauma.cPrel
iminarycassessmentcrevealscacvisioncdeficitcincthecpatientscleftceye.cThecnursecshouldcassociatecthiscabnorm
alcfindingcwithctraumactocwhichcofcthecfollowingccerebralclobes?
A) Temporal
B) Occipital
C) Parietal
D) Frontal
Ans: B
Feedback:
Thecposteriorclobecofctheccerebralchemisphereciscresponsiblecforcvisualcinterpretation.cThectemporalclobecco
ntainscthecauditorycreceptivecareas.cThecparietalclobeccontainscthecprimarycsensoryccortex,candciscessentialcto
cancindividualscawarenesscofcthecbodycincspace,cascwellcascorientationcincspacecandcspatial
relations.c Thec frontalc lobec functionsc inc concentration,c abstractc thought,c informationc storagec orc memory,
andcmotorcfunction.
2. Acpatientcscheduledcforcmagneticcresonancecimagingc(MRI)chascarrivedcatcthecradiologycdepartment.cThecnur
secwhocpreparescthecpatientcforcthecMRIcshouldcprioritizecwhichcofcthecfollowingcactions?
A) Withholdingcstimulantsc24ctoc48chourscpriorc tocexam
B) Removingc allc metal-containingc objects
C) Instructingcthecpatientc toc voidcpriorctocthecMRI
D) InitiatingcancIVclinecforcadministrationcofccontrastc
Ans: B
Feedback:
Patientc preparationc forc anc MRIc consistsc ofc removingc allc metal-
containingc objectsc priorc toc thecexamination.cWithholdingcstimulantscwouldcnotcaffectcancMRI;cthiscrelatesc
tocancelectroencephalographyc(EEG).cInstructingcthecpatientctocvoidciscpatientcpreparationcforcaclumbarcpunc
ture.cInitiatingcancIVcline
forcadministrationcofccontrastcwouldcbecdonecifcthecpatientc waschavingcacCTcscancwithccontrast.
,TestcBankc-cBrunnerc&cSuddarth'scTextbookcofcMedical-SurgicalcNursingc14ec(Hinklec2017) 1224
3. Acgerontologiccnursecplanningcthecneurologiccassessmentcofcancoldercadultciscconsideringcnormal,cage-
crelatedcchanges.cOfcwhatcphenomenoncshouldcthecnursecbecaware?
A) Hyperactivec deepc tendonc reflexes
B) Reductionc inc cerebralc bloodcflow
C) Increasedc cerebralc metabolism
D) Hypersensitivityctocpainfulcstimulic
Ans: B
Feedback:
Reductionc inc cerebralc bloodc flowc (CBF)c isc ac changec thatc occursc inc thec normalc agingc process.c Deepctend
oncreflexesccancbecdecreasedcor,cincsomeccases,cabsent.cCerebralcmetabolismcdecreasescascthecpatientcadvanc
escincage.cReactionctocpainfulcstimulicmaycbecdecreasedcwithcage.cBecausecpainciscancimportantcwarningcsig
nal,ccautioncmustcbecusedcwhenchotcorccoldcpackscarecused.
4. Thecnursechascadmittedcacnewcpatientctocthecunit.cOnecofcthecpatientscadmittingcordersciscforcancadrenergic
cmedication.cThecnursecknowscthatcthiscmedicationcwillchavecwhatceffectconctheccirculatorycsystem?
A) Thin,cwateryc saliva
B) Increasedc heartc rate
C) Decreasedc BP
D) Constrictedc bronchioles
Ans: B
Feedback:
Thectermcadrenergiccrefersctocthecsympatheticcnervouscsystem.cSympatheticceffectscincludecancincreasedcrat
ecandcforcecofcthecheartbeat.cCholinergicceffects,cwhichccorrespondctocthecparasympatheticcdivisioncofctheca
utonomiccnervouscsystem,cincludecthin,cwaterycsaliva,cdecreasedcratecandcforcecofcheartbeat,candcdecreasedc
BP.
5. Acnurseciscassessingcreflexescincacpatientcwithchyperactivecreflexes.cWhencthecpatientscfootciscabruptlycdorsifl
exed,citccontinuesctocbeatctwoctocthreectimescbeforecsettlingcintocacrestingcposition.cHowcwouldcthecnursecdoc
umentcthiscfinding?
A) Rigidity
,TestcBankc-cBrunnerc&cSuddarth'scTextbookcofcMedical-SurgicalcNursingc14ec(Hinklec2017) 1225
B) Flaccidity
C) Clonus
D) Ataxia
Ans: C
Feedback:
Whencreflexescarecverychyperactive,cacphenomenonccalledcclonuscmaycbecelicited.cIfcthecfootciscabruptlycdor
siflexed,citcmayccontinuectocbeatctwoctocthreectimescbeforecitcsettlescintocacpositioncofcrest.cRigiditycisc ancinc
reasecincmusclectonecatcrestccharacterizedcbycincreasedcresistancectocpassivecstretch.cFlacciditycis
lackcofc musclectone.cAtaxiac iscthecinabilityctoccoordinatec musclec movements,cresultingcincdifficulty
walking,c talking,c andc performingc self-carec activities.
6. Thecnurseciscdoingcancinitialcassessmentconcacpatientcnewlycadmittedctocthecunitcwithcacdiagnosiscofccerebrova
scularc accidentc (CVA).c Thec patientc hasc difficultyc copyingc ac figurec thatc thec nursec hasc drawnc andciscdiagnose
dcwithcvisual-receptivecaphasia.cWhatcbraincregionciscprimarilycinvolvedcincthiscdeficit?
A) Temporalc lobe
B) Parietal-occipitalc area
C) Inferiorc posteriorc frontalc areas
D) Posteriorc frontalc area
Ans: B
Feedback:
Difficultyc copyingc ac figurec thatc thec nursec hasc drawnc wouldc bec consideredc visual-
receptivec aphasia,cwhichcinvolvescthecparietal-
occipitalcarea.cExpressivecaphasia,cthecinabilityctocexpressconeself,ciscoftencassociatedc withc damagec toc thec fr
ontalc area.c Receptivec aphasia,c thec inabilityc toc understandc whatc someone
elseciscsaying,ciscoftencassociatedcwithcdamagectocthectemporalclobecarea.
7. Whatctermciscusedctocdescribecthecfibrouscconnectivectissuecthatchugscthecbrainccloselycandcextendscintoceve
rycfoldcofcthecbrainscsurface?
A) Durac mater
B) Arachnoid
, TestcBankc-cBrunnerc&cSuddarth'scTextbookcofcMedical-SurgicalcNursingc14ec(Hinklec2017) 1226
C) Fascia
D) Piacmater
Ans: D
Feedback:
Thectermcmeningescdescribescthecfibrouscconnectivectissuecthatccoverscthecbraincandcspinalccord.cThecmenin
geschavecthreeclayers,cthecduracmater,carachnoid,candcpiacmater.cThecpiacmaterciscthecinnermostcmembranec t
hatc hugsc thec brainc closelyc andc extendsc intoc everyc foldc ofc thec brainsc surface.c Thec durac mater,
thecoutermostc layer,c coversc thec brainc andc spinalc cord.cThec arachnoid,c thec middlec membrane,c is
responsiblec forc thec productionc ofc cerebrospinalc fluid.
8. Thecnursecisccaringcforcacpatientcwithcancuppercmotorcneuronclesion.cWhatcclinicalcmanifestationscshouldcthec
nursecanticipatecwhencplanningcthecpatientscneurologiccassessment?
A) Decreasedc musclec tone
B) Flaccidcparalysis
C) Losscofc voluntaryc controlcofc movement
D) Slowcreflexes
Ans: C
Feedback:
Uppercmotorcneuronclesionscdocnotccausecmusclecatrophy,cflaccidcparalysis,corcslowcreflexes.cHowever,cupp
ercmotorcneuronclesionscnormallyccauseclosscofcvoluntaryccontrol.
9. Thecnurseciscadmittingcacpatientctocthecunitcwhociscdiagnosedcwithcaclowercmotorcneuronclesion.cWhatcentr
ycincthecpatientscelectroniccrecordciscmostcconsistentcwithcthiscdiagnosis?
A) Patientc exhibitsc increasedc musclec tone.
B) Patientc demonstratesc normalc musclec structurec withc noc evidencec ofc atrophy.
C) Patientc demonstratesc hyperactivec deepc tendonc reflexes.
D) Patientc demonstratescanc absencec ofc deepc tendonc reflexes.
Ans: D
Chapter 65: Assessment of Neurologic Function
c c c c c
1. AcpatientciscbroughtctocthecERcfollowingcacmotorcvehiclecaccidentcincwhichchecsustainedcheadctrauma.cPrel
iminarycassessmentcrevealscacvisioncdeficitcincthecpatientscleftceye.cThecnursecshouldcassociatecthiscabnorm
alcfindingcwithctraumactocwhichcofcthecfollowingccerebralclobes?
A) Temporal
B) Occipital
C) Parietal
D) Frontal
Ans: B
Feedback:
Thecposteriorclobecofctheccerebralchemisphereciscresponsiblecforcvisualcinterpretation.cThectemporalclobecco
ntainscthecauditorycreceptivecareas.cThecparietalclobeccontainscthecprimarycsensoryccortex,candciscessentialcto
cancindividualscawarenesscofcthecbodycincspace,cascwellcascorientationcincspacecandcspatial
relations.c Thec frontalc lobec functionsc inc concentration,c abstractc thought,c informationc storagec orc memory,
andcmotorcfunction.
2. Acpatientcscheduledcforcmagneticcresonancecimagingc(MRI)chascarrivedcatcthecradiologycdepartment.cThecnur
secwhocpreparescthecpatientcforcthecMRIcshouldcprioritizecwhichcofcthecfollowingcactions?
A) Withholdingcstimulantsc24ctoc48chourscpriorc tocexam
B) Removingc allc metal-containingc objects
C) Instructingcthecpatientc toc voidcpriorctocthecMRI
D) InitiatingcancIVclinecforcadministrationcofccontrastc
Ans: B
Feedback:
Patientc preparationc forc anc MRIc consistsc ofc removingc allc metal-
containingc objectsc priorc toc thecexamination.cWithholdingcstimulantscwouldcnotcaffectcancMRI;cthiscrelatesc
tocancelectroencephalographyc(EEG).cInstructingcthecpatientctocvoidciscpatientcpreparationcforcaclumbarcpunc
ture.cInitiatingcancIVcline
forcadministrationcofccontrastcwouldcbecdonecifcthecpatientc waschavingcacCTcscancwithccontrast.
,TestcBankc-cBrunnerc&cSuddarth'scTextbookcofcMedical-SurgicalcNursingc14ec(Hinklec2017) 1224
3. Acgerontologiccnursecplanningcthecneurologiccassessmentcofcancoldercadultciscconsideringcnormal,cage-
crelatedcchanges.cOfcwhatcphenomenoncshouldcthecnursecbecaware?
A) Hyperactivec deepc tendonc reflexes
B) Reductionc inc cerebralc bloodcflow
C) Increasedc cerebralc metabolism
D) Hypersensitivityctocpainfulcstimulic
Ans: B
Feedback:
Reductionc inc cerebralc bloodc flowc (CBF)c isc ac changec thatc occursc inc thec normalc agingc process.c Deepctend
oncreflexesccancbecdecreasedcor,cincsomeccases,cabsent.cCerebralcmetabolismcdecreasescascthecpatientcadvanc
escincage.cReactionctocpainfulcstimulicmaycbecdecreasedcwithcage.cBecausecpainciscancimportantcwarningcsig
nal,ccautioncmustcbecusedcwhenchotcorccoldcpackscarecused.
4. Thecnursechascadmittedcacnewcpatientctocthecunit.cOnecofcthecpatientscadmittingcordersciscforcancadrenergic
cmedication.cThecnursecknowscthatcthiscmedicationcwillchavecwhatceffectconctheccirculatorycsystem?
A) Thin,cwateryc saliva
B) Increasedc heartc rate
C) Decreasedc BP
D) Constrictedc bronchioles
Ans: B
Feedback:
Thectermcadrenergiccrefersctocthecsympatheticcnervouscsystem.cSympatheticceffectscincludecancincreasedcrat
ecandcforcecofcthecheartbeat.cCholinergicceffects,cwhichccorrespondctocthecparasympatheticcdivisioncofctheca
utonomiccnervouscsystem,cincludecthin,cwaterycsaliva,cdecreasedcratecandcforcecofcheartbeat,candcdecreasedc
BP.
5. Acnurseciscassessingcreflexescincacpatientcwithchyperactivecreflexes.cWhencthecpatientscfootciscabruptlycdorsifl
exed,citccontinuesctocbeatctwoctocthreectimescbeforecsettlingcintocacrestingcposition.cHowcwouldcthecnursecdoc
umentcthiscfinding?
A) Rigidity
,TestcBankc-cBrunnerc&cSuddarth'scTextbookcofcMedical-SurgicalcNursingc14ec(Hinklec2017) 1225
B) Flaccidity
C) Clonus
D) Ataxia
Ans: C
Feedback:
Whencreflexescarecverychyperactive,cacphenomenonccalledcclonuscmaycbecelicited.cIfcthecfootciscabruptlycdor
siflexed,citcmayccontinuectocbeatctwoctocthreectimescbeforecitcsettlescintocacpositioncofcrest.cRigiditycisc ancinc
reasecincmusclectonecatcrestccharacterizedcbycincreasedcresistancectocpassivecstretch.cFlacciditycis
lackcofc musclectone.cAtaxiac iscthecinabilityctoccoordinatec musclec movements,cresultingcincdifficulty
walking,c talking,c andc performingc self-carec activities.
6. Thecnurseciscdoingcancinitialcassessmentconcacpatientcnewlycadmittedctocthecunitcwithcacdiagnosiscofccerebrova
scularc accidentc (CVA).c Thec patientc hasc difficultyc copyingc ac figurec thatc thec nursec hasc drawnc andciscdiagnose
dcwithcvisual-receptivecaphasia.cWhatcbraincregionciscprimarilycinvolvedcincthiscdeficit?
A) Temporalc lobe
B) Parietal-occipitalc area
C) Inferiorc posteriorc frontalc areas
D) Posteriorc frontalc area
Ans: B
Feedback:
Difficultyc copyingc ac figurec thatc thec nursec hasc drawnc wouldc bec consideredc visual-
receptivec aphasia,cwhichcinvolvescthecparietal-
occipitalcarea.cExpressivecaphasia,cthecinabilityctocexpressconeself,ciscoftencassociatedc withc damagec toc thec fr
ontalc area.c Receptivec aphasia,c thec inabilityc toc understandc whatc someone
elseciscsaying,ciscoftencassociatedcwithcdamagectocthectemporalclobecarea.
7. Whatctermciscusedctocdescribecthecfibrouscconnectivectissuecthatchugscthecbrainccloselycandcextendscintoceve
rycfoldcofcthecbrainscsurface?
A) Durac mater
B) Arachnoid
, TestcBankc-cBrunnerc&cSuddarth'scTextbookcofcMedical-SurgicalcNursingc14ec(Hinklec2017) 1226
C) Fascia
D) Piacmater
Ans: D
Feedback:
Thectermcmeningescdescribescthecfibrouscconnectivectissuecthatccoverscthecbraincandcspinalccord.cThecmenin
geschavecthreeclayers,cthecduracmater,carachnoid,candcpiacmater.cThecpiacmaterciscthecinnermostcmembranec t
hatc hugsc thec brainc closelyc andc extendsc intoc everyc foldc ofc thec brainsc surface.c Thec durac mater,
thecoutermostc layer,c coversc thec brainc andc spinalc cord.cThec arachnoid,c thec middlec membrane,c is
responsiblec forc thec productionc ofc cerebrospinalc fluid.
8. Thecnursecisccaringcforcacpatientcwithcancuppercmotorcneuronclesion.cWhatcclinicalcmanifestationscshouldcthec
nursecanticipatecwhencplanningcthecpatientscneurologiccassessment?
A) Decreasedc musclec tone
B) Flaccidcparalysis
C) Losscofc voluntaryc controlcofc movement
D) Slowcreflexes
Ans: C
Feedback:
Uppercmotorcneuronclesionscdocnotccausecmusclecatrophy,cflaccidcparalysis,corcslowcreflexes.cHowever,cupp
ercmotorcneuronclesionscnormallyccauseclosscofcvoluntaryccontrol.
9. Thecnurseciscadmittingcacpatientctocthecunitcwhociscdiagnosedcwithcaclowercmotorcneuronclesion.cWhatcentr
ycincthecpatientscelectroniccrecordciscmostcconsistentcwithcthiscdiagnosis?
A) Patientc exhibitsc increasedc musclec tone.
B) Patientc demonstratesc normalc musclec structurec withc noc evidencec ofc atrophy.
C) Patientc demonstratesc hyperactivec deepc tendonc reflexes.
D) Patientc demonstratescanc absencec ofc deepc tendonc reflexes.
Ans: D
