APEA 6440 /Psych Neuro 6020/APEA Neuro | MusculoSkeletal | APEA Psych 2020 - €17,80   In winkelwagen

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APEA 6440 /Psych Neuro 6020/APEA Neuro | MusculoSkeletal | APEA Psych 2020

APEA Neuro | MusculoSkeletal | APEA Psych Question: Sudden, brief, rapid jerks, involving the trunk or limbs may be consistent with: a myoclonic seizure. Correct Question: 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: Jacksonian Seizure (tonic & clonic movements that start unilaterally & spread to other parts of the body). Question: An infant presents with an inappropriately increasing head circumference hydrocephalus confirmed by CT Scan. In addition to these findings, which one of the following would also be consistent with hydrocephalus? ?Tense bulging fontanel? Question: The classic signs of a basilar skull fracture include hemotympanum and: CSF leak from nose and ears Question: The cranial sutures are closed on the head of a 9 month old infant. This indicates: Craniosynostosis Question: A patient presents with history of temperature 102 F, HA, and pink papules on the upper chest, etc.. Known about The clinical presentation of meningococcemia may include any of the following: • A nonspecific prodrome of cough, headache, and sore throat • The above followed by a few days of upper respiratory symptoms, increasing temperature, & chills • Subsequent malaise, weakness, myalgias, headache, nausea, vomiting, & arthralgias • The characteristic petechial skin rash is usually located on the trunk & legs & may rapidly evolve into purpura Question: The part of the peripheral nervous system that controls involuntary actions is known as the: autonomic nervous system Explanation: The PNS can be broken down into two systems: the autonomic nervous system, which regulates involuntary actions such as breathing and digestion, and the somatic nervous system, which governs voluntary action and body reflexes. Question: A teenager is being assessed for possible acute marijuana usage and appears intoxicated. Findings consistent with marijuana intoxication could include: Euphoria, talkativeness, and paranoia. Explanation: Marijuana intoxication would present with relaxation, euphoria, detachment, talkativeness, slowed perception of time, & possible anxiety or paranoia. Question: Most peripheral nerves contain afferent and efferent fibers. The term afferent refers to: Sensory nerve fibers. Explanation: Sensory neurons (afferent) – connected to receptors; transmit information to the CNS Question: Which of the following neurological assessment findings indicate the need for further evaluation? Weak & ineffective sucking movements Correct Explanation: Weak & ineffective sucking movements would indicate the need for further evaluation since any weak, absent, asymmetrical or fine jumping movements would suggest neurological system disorders. The other choices represent common reflexes found in the normal newborn: Babinski, grasping, & stepping. Question: An example of proximal weakness is: the right shoulder. Correct Explanation: There are 4 different patterns of weakness: Proximal, distal, symmetric, & 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: A female patient complains of weakness in her hand when opening a jar. This finding could be suggestive of which type of weakness pattern? Distal Correct 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: A patient presents with an altered level of consciousness. He/she is considered in a stuporous state if he/she: Arouses from sleep after exposure to painful stimuli, exhibits slow verbal responses, & easily lapses into an unresponsive state. Correct Explanation: A stuporous patient arouses from sleep after exposure to painful stimuli, verbal responses are slow, & lapses into an unresponsive state. A lethargic patient appears drowsy but opens the eyes, looks at the examiners, answers the questions, & then falls asleep. An obtunded patient opens the eyes & looks at the examiner, but responds slowly & is somewhat confused. A comatose patient remains unarousable with eyes closed. There is no evident response to inner need or external stimuli. Question: One way to assess cerebellar function would be to have the patient: hop on one foot. Correct 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, & move the heel to opposite knee while lying down. Other examples also include: hopping on one foot, walking heel-to-toe, & touching the examiner's finger & the examinees' nose. Reading out loud tests visual acuity; shrugging shoulders assesses the spinal accessory nerve (CN XI) & discriminating pain between light & sharp assesses the sensory system. Question: Hypesthesia refers to: decreased sensitivity to touch. Correct Explanation: Anesthesia is absence of touch sensation; hypesthesia is decreased sensitivity to touch; hyperesthesia is increased sensitivity to touch; & analgesia refers to absence of pain sensation. Question: When conducting a neurologic exam, which one of the following assessments is not considered part of the mental status assessment? Cranial Nerve II (CNII) Correct Explanation: When conducting a neurologic exam, mental status assessment should include evaluation of the level of alertness, appropriateness of responses, & orientation to person, place, & time. Assessing cranial nerve II would be part of the cranial nerve assessment. Question: A mother reports to the nurse practitioner that her teenager might be taking drugs because earlier today the teenager had a mild seizure & now has an unstable gait & is beginning to complain of shortness of breath. These symptoms might be consistent with a possible overdose of: Amphetamines. Correct Explanation: Amphetamines are central nervous system (CNS) stimulants. The teenager could exhibit signs of ataxia, respiratory distress, seizures, coma, myocardial infarction, death if he/she consumed this substance. Impaired memory, judgment, & attention, slurred speech, drowsiness, & irritability are suggestive of central nervous system depressants (CNS). Barbiturates, alcohol & benzodiazepines fall in this class. Opioids may cause euphoria, drowsiness, constricted pupils & some of the same symptoms as CNS depressants. Marijuana intoxication would present with relaxation, euphoria, detachment, talkativeness, slowed perception of time, & possible anxiety or paranoia. Question: An ischemic stroke is: an infarction of the central nervous system tissue that may be silent or symptomatic. Correct Explanation: Ischemic stroke is “an infarction of central nervous system tissue” that may be symptomatic or silent. TIA is now defined as “a transient episode of neurological dysfunction caused by focal brain, spinal cord, or retinal ischemia, without acute infarction.” The other terms are not related to the new definitions. Question: By placing the patient in the supine position, the nurse practitioner raises the patient's relaxed & straightened leg while flexing the leg at the hip, then dorsiflexes the foot. This maneuver is known as: the straight-leg raise. Correct Explanation: By placing the patient in the supine position, the nurse practitioner raises the patient's relaxed & straightened leg while flexing the leg at the hip, then dorsiflexes the foot. This maneuver is known as the straight leg raise & is used to evaluate sciatica. It is positive if there is pain down the back of the leg below the knee. Ipsilateral calf wasting & weak ankle dorsiflexion may be present. Question: 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: Lethargy. Correct Explanation: Lethargy refers to the patient that appears drowsy but can open his eyes, respond to questions, then fall back to sleep. An obtunded patient opens his eyes, looks at the person speaking to him but responds slowly & appears confused. The level of consciousness that refers to the ability of the patient to respond fully & appropriately to stimuli is known as alertness. A stuporous patient arouses from sleep only after painful stimuli. Question: 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, & the sensory systems. Which system coordinates a steady posture? Cerebellar system Correct Explanation: Coordination of muscle movement requires that four areas of the nervous system function in an integrated way: motor system for muscle strength, cerebellar system for rhythmic movements & steady posture, vestibular system for balance & coordinating eye, head, & body movements, & sensory system for position sense. Question: An older adult presenting with signs of undernourishment, slowed motor performance, & loss of muscle mass or weakness suggests: Frailty. Correct Explanation: Undernutrition, slowed motor performance, loss of muscle mass, or weakness suggests frailty. Question: Postural tremors appear when the affected part is: is actively maintaining a posture. Correct Explanation: Tremors are rhythmic oscillatory movements. Postural tremors appear when the affected part is actively maintaining a posture. Examples include the fine rapid tremor of hyperthyroidism, the tremors of anxiety & fatigue, & benign essential tremor. The other choices are not consistent with postural tremors. Question: A discriminative sensation that describes the ability to identify an object by feeling it is: stereognosis. Correct Explanation: A discriminative sensation that describes the ability to identify an object by feeling it is stereognosis. The patients eyes must be closed. Graphesthesia, or number identification, is the ability to identify a number when drawn in the hand of a patient whose eyes are closed. The ability to identify an object touching 2 areas simultaneously is termed two-point discrimination. Astereognosis is a term used to describe the inability to recognize objects placed in the hand. Question: When evaluating a patient for weakness of the upper extremities, bilateral distal weakness is noted. This finding could be suggestive of: polyneuropathy. Correct Explanation: Bilateral predominantly distal weakness suggests a polyneuropathy, as in diabetes. Proximal limb weakness, usually symmetric & without sensory loss, occurs in myopathies from alcohol, glucocorticoids, & inflammatory muscle disorders like myositis & dermatomyositis. In the neuromuscular junction disorder myasthenia gravis, there is proximal, typically asymmetric weakness that gets worse with effort. Question: When observing for thenar atrophy of the hands, a typical observation is: furrowing in the spaces between the metacarpals. Correct Explanation: Flattening of the thenar & hypothenar eminences & furrowing between the metacarpals suggests atrophy. Localized atrophy of the thenar & hypothenar eminences suggests damage to the median & ulnar nerves. Normally, the metacarpal spaces are full & slightly depressed & the thenar & hypothenar appear full & convex. Motor neuron disease, rheumatoid arthritis, & protein-calorie malnutrition can cause atrophy in the hand. Question: Fasciculations in atrophic muscles suggest: a lower motor neuron disease. Correct Explanation: Fasciculations are small muscle twitches & can be found in any muscle of the body. Fasciculations are not usually serious but can be annoying. If they occur in atrophic muscles, this may suggest a lower motor neuron disease. They are not seen in central or peripheral nervous system disease or rheumatoid arthritis. Question: The part of the brain that controls most functions in the body & is responsible for breathing, heart rate, & articulate speech is the: Brainstem. Correct Explanation: The nerve connections of the motor & sensory systems from the main part of the brain to the rest of the body pass through the brainstem. The brainstem controls most functions in the body but mostly responsible for breathing, heart rate, & articulate speech. The cerebrum controls all voluntary actions of the body with the aid of the cerebellum. The diencephalon relays sensory information between brain regions & controls many autonomic functions of the peripheral nervous system. It also connects structures of the endocrine system with the nervous system & works in conjunction with limbic system structures to generate & manage emotions & memories. The cerebellum, which lies at the base of the brain, coordinates all movement & helps maintain the body upright in space. Question: Assessing the neurological status of a child with a ventriculoperitoneal shunt should include: Use of the Glasgow coma scale. Correct Explanation: The Glasgow coma scale addresses eye, verbal, & motor responses to determine a neurological assessment score & is the first sign of improvement or deterioration in neurological status. Also, signs of increased intracranial pressure should be assessed. Kernig's sign is any resistance or pain when the child is supine & the leg is extended & knee bent. A positive sign is more consistent with meningitis. Brudzinski's sign is an involuntary flexion of the knee or hip when the child is in the supine position & the neck is flexed & is also consistent with meningitis. The Monroe-Kellie Doctrine states that the sum of brain, CSF, & blood within the cranial vault is constant. So an increase or decrease in one causes a compensatory increase or decrease in one or both of the others. It is an hypothesis & not an assessment. Question: What geriatric condition is characterized by normal alertness but progressive global deterioration of cognition in multiple domains? Alzheimer's disease Correct Explanation: Alzheimer's disease is a geriatric condition in which normal alertness is present but progressive global deterioration of cognition occurs in multiple domains, including short-term memory, but with sparing of memory for remote events, subtle language errors, visuospatial perceptual difficulties, & changes in executive function, or the ability to perform sequential tasks such as instrumental activities of daily living (IADLs). Delirium is a serious disturbance in a person's mental abilities that results in a decreased awareness of one's environment & confused thinking. Cognitive impairment is an intermediate stage between the expected cognitive decline of normal aging & the more serious decline of dementia. Parkinson's disease is a progressive disorder of the nervous system that affects movement. Question: An abnormal or unpleasant sense of touch is termed: dysesthesia. Correct Explanation: An abnormal or unpleasant sense of touch is termed dysesthesia. Dysarthria is the term used to describe difficulty forming words. Paresthesia is a sensation of tingling, tickling, prickling, pricking, or burning of a person's skin. Metatarsalgia is a term used to describe pain & tenderness in the metatarsals. Question: 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? Lumbar 2, 3, & 4 Correct Explanation: The segmented levels of the deep tendon reflexes are: Ankle: sacral 1; knee: lumbar 2,3, & 4; Supinator & biceps: cervical 5 & 6; & triceps: cervical 6 & 7. Question: 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: alcohol myopathy. Correct Explanation: Proximal limb weakness, usually symmetric & without sensory loss, occurs in myopathies from alcohol, glucocorticoids, & inflammatory muscle disorders like myositis & dermatomyositis. Bilateral predominantly distal weakness suggests a polyneuropathy, as in diabetes. In the neuromuscular junction disorder myasthenia gravis, there is proximal, typically asymmetric weakness that gets worse with effort. Question: The term used to describe involuntary muscle spasms & twisting of the limbs is: dystonia. Correct Explanation: Dystonia is a neurological disorder that causes involuntary muscle spasms & twisting of the limbs. Bradykinesia is the term used to describe the impaired ability to adjust to one's body position. This symptom is noted in patients who have Parkinson's disease. The absence or loss of control of voluntary muscle movements is akinesia. Dyskinesia is defined as the presence of involuntary muscle movements such as tics or chorea. These movements can be seen in children who have rheumatic fever. Question: 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: cluster headaches. Correct Explanation: Headaches that are episodic with several each day for 4-6 weeks with an extended period of relief for 6-12 months are most likely cluster headaches. Cluster headaches are more common in men than women. CRITERIA FOR COMMON HEADACHE SYNDROMES Question: Which of the following symptoms may be associated with a tumor of the eighth cranial nerve? Dizziness Correct Explanation: The eighth cranial nerve (CN) is the vestibulocochlear nerve & it is responsible for hearing & balance. The main symptoms of an acoustic neuroma are hearing loss & tinnitus. They are caused by a tumor affecting the auditory nerve. Inability to close the eye would reflect an abnormality of CN VII, the facial nerve. CN I, the olfactory nerve, is responsible for the sense of smell. Two cranial nerves are responsible for the taste, CN VII & X. Question: When trying to determine the level of consciousness in a patient whose level of consciousness is altered, a comatose patient: remains unarousable with eyes closed. Correct Explanation: A comatose patient remains unarousable with eyes closed. There is no evident response to inner need or external stimuli. A lethargic patient appears drowsy but opens the eyes, looks at the examiners, answers the questions, & then falls asleep. An obtunded patient opens the eyes & looks at the examiner, but responds slowly & is somewhat confused. A stuporous patient arouses from sleep after exposure to painful stimuli, verbal responses are slow, & lapses into an unresponsive state. Question: A female patient complaints of weakness in both arms when transferring the wet clothes from the washer & placing them in the dryer. This finding could be suggestive of which type of weakness pattern? Symmetric Correct Explanation: To identify symmetric weakness, ask about experiencing weakness in the same area on both sides of the body. Question: Which developmental area is predominantly affected by lead poisoning? Cognition Correct Explanation: Lead is a naturally-occurring element that can be harmful to humans when ingested or inhaled, particularly to children under the age of 6 years. Lead poisoning can cause a number of adverse human health effects, but is particularly detrimental to the neurological development of children. Question: A form of aphasia in which the person has word-finding difficulties for speaking & writing is known as: Anomic aphasia. Correct Explanation: With anomic aphasia, the person has word-finding difficulties & because of the difficulties, the person struggles to find the right words for speaking & writing. In Broca's aphasia, speech is confluent, slow, with few words & laborious effort. Inflection & articulation are impaired but words are meaningful, with nouns, transitive verbs, & important adjectives. Small grammatical words are often dropped. With Wernicke's aphasia, speech is fluent, often rapid, voluble, & effortless. Inflection & articulation are good, but sentence

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