AGNP Board Exam Question and Answers - Neurology Assessment_Complete Solution Rated A.

AGNP BOARD EXAM QUESTIONS Neurology Assessment (Questions 194) 1. When eliciting deep tendon reflexes in the knee, the nurse practitioner notes an abnormal reflex in the right knee. This abnormality is probably consis ...

AGNP BOARD EXAM QUESTIONS Neurology Assessment (Questions 194) 1. When eliciting deep tendon reflexes in the knee, the nurse practitioner notes an abnormal reflex in the right knee. This abnormality is probably consistent with a pathological lesion in which segmented level of the spine? 2. A 80 year old male visits the nurse practitioner for an annual well exam. History reveals two falls in the prior 12 months and difficulty with balance. The next step the nurse practitioner should take is: 3. When evaluating the sensory system, testing the spinothalamic tracts would include assessing sensations of: 4. When testing for corneal reflex, an absent blink reflex is noted. This finding may be suggestive of a lesion in which cranial nerve? 5. An example of symmetric weakness is: 6. One maneuver used to assess coordination is to observe the patient: 7. Assessment of a 70-year-old's ability to maintain personal safety would be most adversely affected by declining function in the: 8. A patient complains of experiencing symptoms of nausea, diaphoresis, and pallor triggered by a fearful or unpleasant event. These symptoms are most likely associated with: 9. An infant presents with an inappropriately increasing head circumference and hydrocephalus confirmed by CT scan. In addition to these findings, which one of the following would also be consistent with hydrocephalus? 10. Postural tremors appear when the affected part is: 11. Dysphonia refers to: 12. Symptoms of a migraine headache can include throbbing, nausea or vomiting, duration of one day, and be unilateral and/or disabling. How many of these symptoms should be present to classify the headache as a migraine? 13. The cranial sutures are closed on the head of a 9 month old infant. This indicates: 14. When upper motor neuron systems are damaged above the crossover of its tracts in the medulla, motor impairment develops on the opposite side. This term is: 15. The best method of detecting cognitive impairment or intellectual disability at an early age is by: 16. A term used to describe an increase in muscular bulk with diminished strength is: 17. A 40-year-old male presents with complaints of headaches. History reveals headaches that occurred daily for about 4-6 weeks. He had relief for 6 months but now they are recurring. These are most likely: 18. It is imperative to assess for suicidality and bipolar disorder in patients suspected of experiencing: 19. The level of consciousness that refers to the patient that remains unarousable with eyes closed without evidence of response to inner need or external stimuli is said to be in: 20. Brief, repetitive, stereotyped, coordinated movements occurring at irregular intervals are consistent with: 21. On examination of the adult patient, symptoms of flexed posture, tremor, rigidity, and shuffling gait are observed. These findings are consistent with: 22. When a patient complains of severe headaches that have worsened over the last few weeks but she has no other symptoms, a most likely diagnosis would be: 23. The term used to describe involuntary muscle movements, such as chorea, is: 24. While assessing the trigeminal nerve V (CN V) for sensory function, the patient reports a pain sensation on the right cheek. This finding could be consistent with a: 25. A progressive disorder of the nervous system that affects movement is known as: 26. Physical exam of a well two-week-old infant reveals a little dimple with a small amount of hair just above the sacral area. This could be: 27. The patient experiences a sudden loss of consciousness with falling without movements and injury may occur. This type of a seizure is consistent with: 28. A patient is instructed to stand, close both eyes, and extend both arms forward with the palms facing upward for 20-30 seconds. If the forearm drifts downward, this would indicate: 29. To identify sensory deficits comparing symmetric areas, the nurse practitioner would compare the sensation: 30. The three important questions that govern the neurological examination include: Is the mental status intact?, Are right-sided and left-sided findings symmetric?, and: 31. The level of consciousness that refers to the ability of the patient to respond fully and appropriately to stimuli is known as: 32. A transient ischemic attack is: 33. A patient is noted as lying supine with the jaws clenched and the neck extended with the arms adducted and stiffly extended at the elbows. His forearms are pronated, wrists and fingers flexed. The legs are extended at the knees and the feet are plantar flexed. This position is consistent with: 34. A mother reports to the nurse practitioner that her teenager might be taking drugs because earlier today the teenager had a mild seizure and now has an unstable gait and is beginning to complain of shortness of breath. These symptoms might be consistent with a possible overdose of: 35. Hypesthesia refers to: 36. With the adult patient lying supine, the nurse practitioner flexes the patient's leg at both the hip and the knee and then straightens the knee. Pain and increased resistance to extending the knee is noted. This is a positive: 37. When evaluating a patient for weakness of the upper extremities, bilateral proximal limb weakness without sensory loss is noted. This finding could be suggestive of: 38. Which one of the following assesses pain, temperature, and sensation using the distal and proximal areas testing pattern? 39. When trying to determine the level of consciousness in a patient whose level of consciousness is altered, a lethargic patient: 40. With the adult patient lying supine, the nurse practitioner flexes the patient's neck while observing the hips and knees. Flexion of both hips and knees was noted. This is a positive: 41. The part of the brain tissue that consists of neuronal axons that are coated with myelin is the: 42. The inability to hop in place on each foot, could be suggestive of a: 43. The term used to describe an abnormal tremor consisting of involuntary jerking movements, especially in the hands is: 44. When assessing an elderly patient for delirium, the recommended instrument with the best supportive data is the: 45. Walking on the toes and heels may reveal: 46. Involuntary rhythmic, repetitive, bizarre movements that chiefly involve the face, mouth, jaw, and tongue are known as: 47. Persistent blinking after glabellar tap and difficulty walking heel-to- toe are common in: 48. To evaluate a patient's response to light touch sensation, the nurse practitioner would ask the patient to identify: 49. A form of aphasia where articulation is good but sentences lack meaning is referred to as: 50. While assessing the cranial nerves, the nurse practitioner touches the cornea lightly with a wisp of cotton. This maneuver assesses which cranial nerve? 51. By placing the patient in the supine position, the nurse practitioner raises the patient's relaxed and straightened leg while flexing the leg at the hip, then dorsiflexes the foot. This maneuver is known as: 52. Hyperesthesia refers to: 53. A female patient complains of weakness in her hand when opening a jar. This finding could be suggestive of which type of weakness pattern? 54. When trying to determine the level of consciousness in a patient whose level of consciousness is altered, a comatose patient: 55. What geriatric condition is characterized by normal alertness but progressive global deterioration of cognition in multiple domains? 56. Having the patient shrug his shoulders and elicit neck movements would be testing Cranial Nerve: 57. To evaluate a patient's response to temperature sensation, the nurse practitioner would ask the patient to identify: 58. During this type of seizure activity, the patient experiences partial seizures that resemble tonic-clonic seizures. The patient may recall the aura and a unilateral neurologic deficit is present during the postictal period. This type of seizure activity is referred to as a: 59. The principal muscles involved when closing the mouth are innervated by which Cranial nerve? 60. A patient presents with history of temperature of 102°F, headache, and pink papules on the upper chest several hours ago. Petechiae and ecchymosis are noted on the trunk. These skin lesions may be indicative of: 61. Aphasia refers to: 62. The part of the brain that maintains homeostasis is the: 63. Sudden, brief, rapid jerks, involving the trunk or limbs may be consistent with: 64. Involuntary movements of the body that involve larger portions of the body, including the trunk resulting in grotesque, twisted postures are suggestive of: 65. On examination of an eighteen-year-old which one of the following neurological signs would not be helpful if meningitis is suspected? 66. The term used to describe the impaired ability to adjust to one's body position is: 67. With the adult patient lying supine, the nurse practitioner strokes the lateral aspect of the sole from the heel to the ball of the foot with the end of an applicator stick. Dorsiflexion of the big toe was noted. This is a positive: 68. When assessing the cranial nerves, the nurse practitioner instructs the patient to stick out his tongue and move it from side to side. This maneuver would be used to assess which cranial nerve? 69. Which of the following neurological assessment findings indicate the need for further evaluation? 70. Which of the following symptoms may be associated with a tumor of the eighth cranial nerve? 71. When assessing the cranial nerves, the nurse practitioner uses the tongue blade to gently stimulate the back of the throat on each side. A unilateral absence of the gag reflex is noted. This finding could be suggestive of a unilateral lesion in which cranial nerve? 72. When assessing abdominal cutaneous reflexes, the nurse practitioner strokes the lower abdomen, the localized twitch is absent. This finding could be suggestive of a pathologic lesion in which segmented level of the spine? 73. One way to assess cerebellar function would be to have the patient: 74. The term used to describe the absence or loss of control of voluntary muscle movements is: 75. A type of seizure activity that includes tonic and then clonic movements and usually starts in the hand, foot or face then spreads to other parts of the body is known as a: 76. When assessing coordination of muscle movement, four areas of the nervous system function in an integrated way. These areas include the motor, cerebellar, the vestibular, and the sensory systems. Which system coordinates muscle strength? 77. When a two-week-old infant presents with irritability, poor appetite, and rapid head growth with distended scalp veins, one should consider: 78. When evaluating the sensory system, testing the posterior columns tract would include assessing sensations of: 79. A patient experiences difficulty rising from a sitting position without arm support. This would be suggestive of: 80. An 8-month-old with a significant head lag would suggest the need for: 81. The most widely used tool available to assess for dementia in an elderly patient is the: 82. Uncontrolled electrical activity in the brain, which may produce minor physical signs, thought disturbances, or disturbed motor activity is: 83. A term used to describe an increase in muscular bulk with proportionate strength is: 84. The part of the brain that controls most functions in the body and is responsible for breathing, heart rate, and articulate speech is the: 85. Symptoms indicative of Shaken Baby Syndrome are related to: 86. Fasciculations in atrophic muscles suggest: 87. When assessing coordination of muscle movement, four areas of the nervous system function in an integrated way. These areas include the motor, cerebellar, the vestibular, and the sensory systems. Which system coordinates a steady posture? 88. Symmetric weakness of the distal muscles of the legs suggests a: 89. When upper motor neuron systems are damaged below the crossover of its tracts in the medulla, motor impairment develops on the same side. This term is: 90. The nurse practitioner instructs the patient to close his eyes and then grasps his big toe and moves the toe up or down asking the patient to correctly identify the direction of the movement. This is an example of identifying: 91. Which one of the following symptoms is not associated with bulbar symptoms? 92. Bilateral weakness in cranial nerve V (CN V) would be suggestive of a: 93. To evaluate a patient's response to a vibration sensation, the nurse practitioner would ask the patient to identify: 94. When assessing the patient's sense of position, instruct the patient to first stand with his feet together and eyes open, then instruct him to close both eyes for 30-60 seconds. If he loses his balance with his eyes closed, this is: 95. Intention tremors appear with movement and: 96. Intention tremors appear with movement and: 97. A form of aphasia in which the person has word-finding difficulties for speaking and writing is known as: 98. With Duchenne muscular dystrophy: 99. When eliciting deep tendon reflexes in the biceps, the nurse practitioner notes an abnormal reflex in the right biceps. This abnormality is probably consistent with a pathological lesion in which segmented level of the spine? 100. The part of the peripheral nervous system that regulates muscle movement and response to the sensations of pain and touch is the: 101. The term used to describe low back pain with nerve pain that radiates down the leg is: 102. An example of tandem walking is having the patient: 103. The level of consciousness that refers to the patient that appears drowsy but can open his eyes, respond to questions, then fall back to sleep is known as: 104. Most peripheral nerves contain afferent and efferent fibers. The term efferent refers to: 105. When eliciting deep tendon reflexes in the ankle, the nurse practitioner notes an abnormal reflex in the right ankle. This abnormality is probably consistent with a pathological lesion in which segmented level of the spine? 106. Ataxia, diplopia, and dysarthria can be symptoms associated with all of the following conditions except: 107. A discriminative sensation that describes the ability to identify an object by feeling it is: 108. A band of skin innervated by the sensory root of a single spinal nerve is termed a: 109. An example of distal weakness is: 110. To evaluate a patient's response to pain sensation, the nurse practitioner would ask the patient to identify: 111. Ptosis of the left eye would be suggestive of damage to which cranial nerve? 112. The most common cause of viral encephalitis in children is: 113. An older adult presenting with signs of undernourishment, slowed motor performance, and loss of muscle mass or weakness suggests: 114. The central nervous system extends from the medulla into the: 115. A patient is asked to visually follow a finger through the cardinal fields of gaze. Which cranial nerves are being assessed? 116. While palpating the temporal and masseter muscles, the patient is asked to clench his teeth and move his jaw from side to side. This maneuver would be assessing which cranial nerve? 117. When observing for thenar atrophy of the hands, a typical observation is: 118. A form of aphasia in which the person has difficulty speaking and understanding words and is unable to read or write is termed: 119. A rhythmic oscillatory movement of a body part resulting from the contraction of opposing muscle groups is: 120. The straight leg raise maneuver tests for: 121. Most peripheral nerves contain afferent and efferent fibers. The term afferent refers to: 122. Aphonia refers to: 123. The part of the brain tissue that rims the surfaces of the cerebral hemispheres, forming the cerebral cortex is known as the: 124. A sudden brief lapse of consciousness with momentary blinking, staring, or movements of the lips and hands but no falling is consistent with: 125. When assessing coordination of muscle movement, four areas of the nervous system function in an integrated way. These areas include the motor, cerebellar, the vestibular, and the sensory systems. Which system coordinates head movements? 126. What is an example of a disease or condition that appears in a dermatomal pattern? 127. The part of the brain that coordinates all movement and helps maintain the body upright in space is the: 128. A discriminative sensation that describes the ability to identify a number drawn in the hand when the patient's eyes are closed is: 129. Which one of the following senses is most often affected in patients on long-term antibiotic therapy? 130. The part of the peripheral nervous system that controls involuntary actions is known as the: 131. The classic signs of a basilar skull fracture include hemotympanum and: 132. When assessing plantar reflexes, the nurse practitioner strokes the lateral aspect of the sole from the heel to the ball of the right foot. Absence of movement of the big toe is noted. This finding could be suggestive of a pathologic lesion in which segmented level of the spine? 133. A female patient complaints of weakness in both arms when transferring the wet clothes from the washer and placing them in the dryer. This finding could be suggestive of which type of weakness pattern? 134. An indication that there is a malfunction of a ventriculoperitoneal (VP) shunt in an older child would be the presence of a: 135. When assessing coordination of muscle movement, four areas of the nervous system function in an integrated way. These areas include the motor, cerebellar, the vestibular, and the sensory systems. Which system coordinates position sense? 136. Involuntary movements of the body that are slower and more twisting and writhing than choreiform movements, and have a larger amplitude are suggestive of: 137. Symmetric weakness of the proximal muscles of the legs suggests a: 138. Winging of the scapula can be noted in patients with all of the following conditions except: 139. Symptoms of a subdural hematoma include: 140. The part of the brain that relays sensory information between brain regions and controls many autonomic functions of the peripheral nervous system is known as the: 141. An example of proximal weakness is: 142. Common physical findings in a young child with cerebral palsy include which one of the following? 143. Which of the following procedures should NOT be performed in a comatose patient? 144. A patient presents with an altered level of consciousness. He/she is considered in a stuporous state if he/she: 145. A female patient complains of weakness in her arm when combing her hair. This finding could be suggestive of which type of weakness pattern? 146. Assessing the neurological status of a child with a ventriculoperitoneal shunt should include: 147. The level of consciousness that refers to the patient who opens his eyes, looks at the person speaking to him but responds slowly and appears confused is known as: 148. On physical exam, the soft palate does not rise, there is an absent gag reflex, and the patient complains of taste abnormalities. This requires further evaluation of the: 149. An infant with fetal alcohol syndrome would: 150. The thalamus and the basal ganglion are located in the: 151. An ischemic stroke is: 152. Assessment findings in an infant with increased intracranial pressure would include: 153. A teenager is being assessed for possible acute marijuana usage and appears intoxicated. Findings consistent with marijuana intoxication could include: 154. The patient has his eyes closed and an area on his right leg is briefly touched by the nurse practitioner. The patient is instructed to open his eyes and point to the area that was touched. This is an example of the discriminative sensation known as: 155. The level of consciousness that refers to the patient that arouses from sleep only after painful stimuli is known as: 156. A teenager presents with signs of being gleeful, somewhat drowsy, and unable to focus. On examination , B/P 90/65, pupils constricted, and speech slurred. These symptoms are consistent with: 157. Analgesia refers to: 158. When conducting a neurologic exam, which one of the following assessments is not considered part of the mental status assessment? 159. The Glasgow coma scale assesses: 160. An ambulatory child with spastic cerebral palsy needs a diet: 161. Hyperalgesia refers to: 162. The term used to describe a distortion of any sense, especially that of touch, is: 163. With the patient lying supine, the nurse practitioner places her hands behind the patient's head while flexing his neck forward until his chin touches his chest. Neck stiffness with resistance to flexion is noted. This is a positive: 164. Resting tremors refer to those tremors that disappear: 165. The term used to describe a lack of strength (or firmness) is: 166. Disorders of speech fall into three groups that affect all of the following except the: 167. A patient is unable to identify the smell of an orange. This inability could reflect an abnormality in cranial nerves: 168. During this type of seizure activity, the patient appears confused. Automatisms include automatic motor behaviors such as chewing, smacking the lips, walking about, and unbuttoning clothes. This type of seizure activity is referred to as a: 169. A term used to describe muscle wasting or loss of muscle bulk is: 170. Anesthesia refers to: 171. During this type of seizure activity, the patient loses consciousness suddenly, sometimes with a cry, and the body stiffens into tonic extensor rigidity. Breathing stops, and the person becomes cyanotic. A clonic phase of rhythmic muscular contraction follows. This type of seizure activity is referred to as a: 172. A patient presents with sweating, tremors, palpitations, hunger, and confusion. This patient is most likely experiencing: 173. A patient presents with an altered level of consciousness. He/she is considered in an obtunded state if he/she: 174. The term used to describe involuntary muscle spasms and twisting of the limbs is: 175. A patient is noted as lying supine in an abnormal posture with the upper arms flexed tight to the sides with elbows, wrists, and fingers flexed. His legs are extended and internally rotated and his feet are plantar flexed. This position is consistent with: 176. Unilateral weakness in cranial nerve V (CN V) would be suggestive of a: 177. Which developmental area is predominantly affected by lead poisoning? 178. A patient who is being evaluated for frequent headaches, mentions that the headache worsens with coughing, sneezing, or when changing positions. Increasing pain with these maneuvers may be suggestive of: 179. A form of aphasia in which the speech is confluent, slow, with few words and laborious effort and inflection and articulation are impaired but words are meaningful, is termed: 180. A neurological assessment to evaluate neurologic input to the cerebellum is: 181. When assessing the cranial nerves, the nurse practitioner instructs the patient to raise both eyebrows, frown, and smile. These maneuvers would be assessing which cranial nerve? 182. A tension headache presents with pain in the: 189. Hypalgesia refers to: 190. An abnormal or unpleasant sense of touch is termed: 191. When a child presents with a history of a head injury sustained within the past four hours, a subdural hematoma should be expected because: 192. Dysarthria refers to: 193. Which of the following procedures should NOT be performed in a comatose patient? 194. When evaluating a patient for weakness of the upper extremities, bilateral distal weakness is noted. This finding could be suggestive of: 195. When assessing the cranial nerves, the nurse practitioner observes that the soft palate does not rise when the patient is instructed to say "ah". This finding could be suggestive of a bilateral lesion in which cranial nerve? 196. Discriminative sensations include all of the following except: 197. Which choice is least likely to be an example of asymmetric weakness? 198. When evaluating the six cardinal directions of gaze, a loss of conjugate movements is noted when the patient looks to his left. This finding could be consistent with damage to which cranial nerve? 199. When assessing anal reflexes, the nurse practitioner strokes the four quadrants of the anus with a cotton swab. A loss of anal reflex is noted. This finding could be suggestive of a pathologic lesion in which segmented level of the spine? 200. When eliciting deep tendon reflexes in the triceps, the nurse practitioner notes an abnormal reflex in the right triceps. This abnormality is probably consistent with a pathological lesion in which segmented level of the spine? 201. When comparing two sides of the body for symmetric sensation a symmetrical distal sensory loss would be suggestive of :