NR509 APEA test week 6
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Question 1:
Sudden, brief, rapid jerks, involving the trunk or limbs may be consistent with:
a myoclonic seizure.
an absent seizure.
a myoclonic atonic seizure.
afocal seizure with impairment of consciousness.
Question 2:
Which of the following neurological assessment findings indicate the need for further evaluation?
Lifting one foot and then the other when the infant is held upright with the feet touching a solid surface
Fanning and hyperextension of the toes when the sole is stroked upward from the heel
Grasping a finger placed in the neonate's palm
Weak and ineffective sucking movements
Question 3:
An example of proximal weakness is:
the right shoulder.
the right hand.
both arms.
on the right side of the face.
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?
Proximal
Distal
Symmetric
Asymmetric
Question 5:
A patient presents with an altered level of consciousness. He/she is considered in a stuporous state if he/she:
appears drowsy but opens the eyes, looks at the examiners, answers the questions, and then falls asleep.
arouses from sleep after exposure to painful stimuli, exhibits slow verbal responses, and easily lapses into an unresponsive state.
remains unarousable with eyes closed.
There is no evident response to inner need or external stimuli.
opens the eyes and looks at the examiner, but responds slowly and is somewhat confused.
Question 6:
One way to assess cerebellar function would be to have the patient:
hop on one foot.
read out loud.
Inshrug the shoulders
discriminate between light and sharp pain.
Question 7:
Hypesthesia refers to:
absence of touch sensation.
decreased sensitivity to touch.
increased sensitivity to touch.
Inabsence of pain sensation.
Question 8:
When conducting a neurologic exam, which one of the following assessments is not considered part of the mental status assessment?
Level of alertness
Cranial Nerve II (CNII)
Appropriateness of responses
Orientation to time
Question 9:
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:
barbiturates.
amphetamines.
marijuana.
opioids.
Question 10:
An ischemic stroke is:
a transient episode of neurologic dysfunction by focal brain, spinal cord, or retinal ischemia, without acute infarction.
Inan infarction of the central nervous system tissue that may be silent or symptomatic.
the abrupt onset of motor or sensory deficits.
focal or asymmetric weaknesses caused by central and peripheral nerve damage.
Question 11:
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:
Kernig'ssign.
the straight-leg raise.
the plantar response.
the ankle reflex.
Question 12:
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:
obtundation.
alertness.
lethargy.
stupor.
Question 13:
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?
Motor system
Cerebellar system
Vestibular system
Sensory system
Question 14:
An older adult presenting with signs of undernourishment, slowed motor performance, and loss of muscle mass or weakness suggests:
depression.
frailty.
Parkinson'sdisease.
Alzheimer's disease.
Question 15:
Postural tremors appear when the affected part is:
atrest.
moving voluntarily.
Inis actively maintaining a posture.
getting closer to its target
Question 16:
A discriminative sensation that describes the ability to identify an object by feeling it is:
graphesthesia.
stereognosis.
two point discrimination.
astereognosis.
Question 17:
When evaluating a patient for weakness of the upper extremities, bilateral distal weakness is noted. This finding could be suggestive of:
alcoholmyopathy.
polyneuropathy.
myositis.
neuromuscular junction disorders.
Question 18:
When observing for thenar atrophy of the hands, a typical observation is:
furrowing in the spaces between the metacarpals.
thenar eminences appear full.
the hypothenar eminences would appear convex.
the spaces between the metacarpals would be slightly depressed.
Question 19:
Fasciculations in atrophic muscles suggest:
a lower motor neuron disease.
rheumatoid arthritis.
Inperipheral nervous system disease
a central nervous system disorder.
Question 20:
The part of the brain that controls most functions in the body and is responsible for breathing, heart rate, and articulate speech is the:
cerebrum.
brainstem.
cerebellum.
diencephalon.
Question 21:
Assessing the neurological status of a child with a ventriculoperitoneal shunt should include:
use of the Glasgow coma scale.
Kernig'ssign.
brudzinski'ssign.
Monroe-Kellie doctrine.
Question 22:
What geriatric condition is characterized by normal alertness but progressive global deterioration of cognition in multiple domains?
Delirium
Cognitiveimpairment
Parkinson'sdisease
Alzheimer's disease
Question 23:
An abnormal or unpleasant sense of touch is termed:
dysarthria.
dysesthesia.
metatarsalgia.
paresthesia.
Question 24:
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?
Cervical 5 and 6
Cervical 6 and 7
Lumbar 2, 3, and 4
Sacral 1
Question 25:
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.
polyneuropathy.
myositis.
neuromuscular junction disorders.
Question 26:
The term used to describe involuntary muscle spasms and twisting of the limbs is:
dystonia.
bradykinesia.
akinesia.
dyskinesia.
Question 27:
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:
tensionheadaches.
cluster headaches.
migraineheadaches.
sinus headaches.
Question 28:
Which of the following symptoms may be associated with a tumor of the eighth cranial nerve?
Dizziness
Inability to close the eyes
Loss of the sense of smellInability
to taste sour things
Question 29:
When trying to determine the level of consciousness in a patient whose level of consciousness is altered, a comatose patient:
opens the eyes and looks at the examiner, responds slowly, and is somewhat confused.
appears drowsy but opens the eyes, looks at the examiners, answers the questions, and then falls asleep.
arouses from sleep after exposure to painful stimuli, exhibits slow verbal response, and easily lapses into an unresponsive state.
remains unarousable with eyes closed.
Question 30:
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?
Proximal
Distal
Symmetric
Asymmetric
Question 31:
Which developmental area is predominantly affected by lead poisoning?
Nutrition
Communication
Cognition
Mobility
Question 32:
A form of aphasia in which the person has word-finding difficulties for speaking and writing is known as:
Broca'saphasia.
anomic aphasia.
Wernicke'saphasia.
global aphasia.
Question 33:
A patient presents with an altered level of consciousness. He/she is considered in an obtunded state if he/she:
arouses from sleep after exposure to painful stimuli, exhibits slow verbal responses, and easily lapses into an unresponsive state.
appears drowsy but opens eyes, looks at the examiners, answers the questions, and then falls asleep.
remains unarousable with eyes closed. There is no evident response to inner need or external stimuli.
opens the eyes and looks at the examiner, but responds slowly and is somewhat confused.
Question 34:
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:
Brudzinski's sign.
InKernig'ssign.
nuchal rigidity sign.
Babinski's sign.
Question 35:
Which of the following procedures should NOT be performed in a comatose patient?
Check corneal response
Check pupillary response
Dilate the pupils
Inspect the posterior pharynx
Question 36:
The term used to describe a distortion of any sense, especially that of touch, is:
absence of sensation.
weakness.
dysesthesia.
paresthesia.
Question 37:
Winging of the scapula can be noted in patients with all of the following conditions except:
liver disease.
injury to the long thoracic nerve.
musculardystrophy.
weakness of the serratus anterior muscle.
Question 38:
Resting tremors refer to those tremors that disappear:
atrest.
with voluntary movement.
when the affected part is actively maintaining a posture.
when the target gets closer.
Question 39:
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:
a normal finding.
lower motor neuron disease.
corticospinal tract lesion .
cerebellum lesion.
Question 40:
A progressive disorder of the nervous system that affects movement is known as:
delirium.
Functional impairment.
Parkinson's disease.
Alzheimer's disease.
Question 41:
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:
bilateral hemispheric disease.
central nervous system lesions.
cranial nerve disorder.
brainstem lesion.
Question 42:
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?
Cranial Nerve V (CN V)
Cranial Nerve VII (CN VII)
Cranial Nerve IX (CN IX)
Cranial Nerve XII (CN XII)
Question 43:
On examination of the adult patient, symptoms of flexed posture, tremor, rigidity, and shuffling gait are observed. These findings are consistent with:
drug induced reaction.
Functional impairment.
Parkinson's disease.
depression.
Question 44:
Brief, repetitive, stereotyped, coordinated movements occurring at irregular intervals are consistent with:
facial tics.
dystonicmovements
athetoidmovements.
oral-facial dyskinesias.
Question 45:
A sudden brief lapse of consciousness with momentary blinking, staring, or movements of the lips and hands but no falling is consistent with:
a myoclonic seizure.
an absent seizure.
a myoclonic atonic seizure
a focal seizure with impairment of consciousness.
Question 46:
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:
an unusual finding but within normal limits.
hirsutism.
Arnold -Chiari malformation.
spina bifida occulta.
Question 47:
Persistent blinking after glabellar tap and difficulty walking heel-to- toe are common in:
Alzheimer's disease.
MuscularDystrophy.
Parkinson’s disease.
Multiple Sclerosis.
Question 48:
An example of distal weakness is:
the right shoulder.
the right hand.
both arms
one the right side of the face.
Question 49:
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:
opioid intoxication.
an amphetamine overdose.
an overdose of benzodiazepines.
Inmarijuana usage.
Question 50:
An 8-month-old with a significant head lag would suggest the need for:
exercises that strengthen the neck muscles.
a follow-up visit in 2 months.
a neurological evaluation.
an orthopedic referral.
Question 51:
Symptoms of a subdural hematoma include:
noticeable bleeding between the dura and the skull on X-ray.
appropriate responses to questions.
noticeable bleeding between the dura and the cerebrum on X-ray.
absent retinal hemorrhages.
Question 52:
Assessment findings in an infant with increased intracranial pressure would include:
Increased hunger.
drowsiness.
papilledema.
blurred vision.
Question 53:
When evaluating the sensory system, testing the posterior columns tract would include assessing sensations of:
position and vibration.
pain and temperature.
deeptouch
discriminative sensations.
Question 54:
The term used to describe low back pain with nerve pain that radiates down the leg is:
asterixis.
sciatica.
dermatome.
stereognosis.
Question 55:
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:
Broca's aphasia.
anomicaphasia
Wernicke'saphasia.
global aphasia.
Question 56:
Symmetric weakness of the distal muscles of the legs suggests a:
polyneuropathy.
myopathy
sensoryneuropathy.
cerebellar disease.
Question 57:
Symmetric weakness of the proximal muscles of the legs suggests a:
polyneuropathy.
myopathy.
sensoryneuropathy.
cerebellar disease.
Question 58:
Dysarthria refers to:
the inability to produce or understand language.
the loss of voice.
an impairment in volume of the voice.
a defect in the muscular control of the speech apparatus.
Question 59:
Walking on the toes and heels may reveal:
distal muscular weakness in the legs.
ataxia.
a cerebellar dysfunction.
proximal weakness of the extensors of the hip.
Question 60:
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:
ipsilateral.
contralateral.
superficial.
intermediate.
Question 61:
An infant with fetal alcohol syndrome would:
appear calm, happy and cooing in the hospital crib.
be irritable, hyperactive and exhibit a high-pitched cry.
perspire, vomit and have diarrhea.
appear shaky, hypoactive, and in respiratory distress.
Question 62:
Involuntary movements of the body that are slower and more twisting and writhing than choreiform movements, and have a larger amplitude are suggestive of:
facialtics.
dystonicmovements.
athetoid movements.
oral-facial dyskinesias.
Question 63:
An example of symmetric weakness is:
the right shoulder.
the right hand
both arms.
one the right side of the face.
Question 64:
Anesthesia refers to:
decreased sensitivity to pain.
increased sensitivity to pain.
absence of pain sensation.
Inabsence of touch sensation.
Question 65:
When assessing an elderly patient for delirium, the recommended instrument with the best supportive data is the:
Delirium Rating Scale (DRS).
InConfusion Assessment Method (CAM).
Mini Mental State Examination (MMSE).
Delirium Superimposed on Dementia Algorithm (DSDA).
Question 66:
An indication that there is a malfunction of a ventriculoperitoneal (VP) shunt in an older child would be the presence of a:
headache upon awakening.
temperature greater than 100.8 degrees Fahrenheit
noticeable increase in activity.
bulging fontanels.
Question 67:
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?
Thoracic 8, 9, and 10
Thoracic 10, 11, and 12
Lumbar 5 and Sacral 1
Sacral 2, 3, and 4
Question 68:
While assessing the cranial nerves, the nurse practitioner touches the cornea lightly with a wisp of cotton. This maneuver assesses which cranial nerve?
Cranial Nerve II (CN II)
Cranial Nerve IV (CN IV)
Cranial Nerve V (CN V)
Cranial Nerve X (CN X)
Question 69:
The level of consciousness that refers to the patient that arouses from sleep only after painful stimuli is known as:
obtundation.
alertness.
lethargy.
stupor.
Question 70:
When evaluating the sensory system, testing the spinothalamic tracts would include assessing sensations of:
position and vibration.
pain and temperature.
deeptouch.
discriminative sensations.
Question 71:
Hypalgesia refers to:
decreased sensitivity to pain.
increased sensitivity to pain.
absence of pain sensation.
absence of touch sensation.
Explanation:
Analgesia refers to absence of pain sensation; hypalgesia to decreased sensitivity to pain; hyperalgesia to increased sensitivity; and anesthesia to absence of touch sensation.
Question 72:
Which choice is least likely to be an example of asymmetric weakness?
The right shoulder
The right hand
Both arms
One the right side of the face
Question 73:
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?
Motor system
Cerebellarsystem
Vestibular system
Sensory system
Question 74:
When comparing two sides of the body for symmetric sensation a symmetrical distal sensory loss would be suggestive of :
a lesion in the opposite cerebral hemisphere.
polyneuropathy.
a spinal cord lesion.
a peripheral lesion.
Question 75:
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:
reassess the patient in 6 months.
obtain cognitive and functional assessment.
assess respiratory assessment.
assess cardiac function.
Question 76:
The principal muscles involved when closing the mouth are innervated by which Cranial nerve?
Cranial nerve III (CN III)
Cranial nerve V (CN V)
Cranial nerve VII (CN VII)
InCranial nerve XII (CN XII)
Question 77:
The best method of detecting cognitive impairment or mental retardation at an early age is by:
performing neuropsychological testing of intelligence.
administration of an IQ test of cognitive abilities.
radiographic evaluation of the brain and brainstem.
assessment of the achievement of developmental milestones.
Question 78:
When trying to determine the level of consciousness in a patient whose level of consciousness is altered, a lethargic patient:
opens the eyes and looks at the examiner, responds slowly, and is somewhat confused.
Inappears drowsy but opens the eyes, looks at the examiners, answers the questions, and then falls asleep.
arouses from sleep after exposure to painful stimuli, exhibits slow verbal responses, and easily lapses into an unresponsive state.
remains unarousable with eyes closed.
Question 79:
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?
Cervical 5 and 6
Cervical 6 and 7
Lumbar 2, 3, and 4
InSacral 1
Question 80:
The term used to describe the absence or loss of control of voluntary muscle movements is:
dystonia.
bradykinesia.
akinesia.
dyskinesia.
Question 81:
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:
Brudzinski'ssign.
Kernig'ssign.
nuchal rigidity sign.
Babinski's sign.
Question 82:
The part of the peripheral nervous system that regulates muscle movement and response to the sensations of pain and touch is the:
autonomic nervous system.
somatic nervous system.
sympathetic nervous system.
parasympathetic nervous system.
Question 83:
The part of the brain that coordinates all movement and helps maintain the body upright in space is the:
cerebrum.
brainstem.
cerebellum.
diencephalon.
Question 84:
The part of the brain tissue that consists of neuronal axons that are coated with myelin is the:
basalganglion.
white matter.
graymatter.
thalamus.
Question 85:
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:
subarachnoidhemorrhage.
stroke.
neurocardiogenic syncope.
In vasovagal syncope.
Question 86:
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:
graphesthesia.
stereognosis.
two point discrimination.
point localization.
Question 87:
Hyperesthesia refers to:
absence of touch sensation.
decreased sensitivity to touch.
increased sensitivity to touch.
absence of pain sensation.
Question 88:
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:
a brain tumor.
amigraine
seizureactivity
subarachnoid hemorrhage.
Question 89:
The term used to describe an abnormal tremor consisting of involuntary jerking movements, especially in the hands is:
asterixis.
sciatica.
dermatome.
stereognosis.
Question 90:
Which one of the following assesses pain, temperature, and sensation using the distal and proximal areas testing pattern?
Test the sensation in the thumbs and little fingers
Compare the sensation in the right arm to that in the left arm
InTest the sensation in the fingers and the toes
Stimulate first at an area of reduced sensation and move by progressive steps until the patient detects a change
Question 91:
The part of the brain that maintains homeostasis is the:
basalganglion.
thalamus.
hypothalamus.
cerebellum.
Question 92:
An example of tandem walking is having the patient:
walk across the room.
walk heel-to-toe.
walk on the toes, then on the heels.
walk with a shallow knee bend.
Question 93:
The central nervous system extends from the medulla into the:
midbrain.
pons.
Incerebrum.
spinal cord.
Question 94:
A patient is unable to identify the smell of an orange. This inability could reflect an abnormality in cranial nerves:
I.
II.
III.
VIII.
Question 95:
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:
considered a normal finding.
suggestive of ataxia related to dorsal column disease.
suggestive of cerebellar ataxia.
corticospinal track damage.
Question 96:
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?
Cranial Nerve II (CN II)
Cranial Nerve IV (CN IV)
Cranial Nerve V (CN V)
Cranial Nerve VII (CN VII)
Question 97:
Dysarthria refers to:
the inability to produce or understand language.
the loss of voice.
an impairment in volume of the voice.
a defect in the muscular control of the speech apparatus.
Question 98:
Disorders of speech fall into three groups that affect all of the following except the:
voice.
articulation of speech.
written language.
comprehension of language.
Question 99:
Unilateral weakness in cranial nerve V (CN V) would be suggestive of a:
bilateral hemispheric disease.
central nervous system lesions.
pontine lesion.
brainstem lesion.
Question 100:
The most common cause of viral encephalitis in children is:
Herpes simplex virus Type II
Picornavirus
Enteroviruses
Herpes simplex virus Type I
Question 101:
The principal muscles involved when closing the mouth are innervated by which Cranial nerve?
Cranial nerve III (CN III)
Cranial nerve V (CN V)
Cranial nerve VII (CN VII)
Cranial nerve XII (CN XII)
Question 102:
Intention tremors appear with movement and:
worsen with stress.
increase during sleep.
are more pronounced when maintaining a posture.
worsen as the target gets closer.
Question 103:
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?
Motor system
Cerebellar system
Vestibular system
Sensory system
Question 104:
Sudden, brief, rapid jerks, involving the trunk or limbs may be consistent with:
a myoclonic seizure.
an absent seizure
a myoclonic atonic seizure.
a focal seizure with impairment of consciousness.
Question 105:
A patient experiences difficulty rising from a sitting position without arm support. This would be suggestive of:
distal muscle weakness of the pelvic girdle and legs.
poor muscle coordination.
proximal muscle weakness of the pelvic girdle and legs.
a weak vestibular system.
Question 106:
Common physical findings in a young child with cerebral palsy include which one of the following?
Walks by placing the heels of the feet down first
Moves about by crawling on the abdomen or all four extremities
Generally meets motor developmental milestones on schedule
Presence of crossed or touching knees
Question 107:
A teenager is being assessed for possible acute marijuana usage and appears intoxicated. Findings consistent with marijuana intoxication could include:
euphoria, talkativeness, and paranoia.
mild respiratory distress, ataxia, and normal blood pressure.
drowsiness, constricted pupils, and memory impairment.
impaired judgment, anxiety, and slurred speech. In
Question 108:
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?
Cervical 5 and 6
Cervical 6 and 7
Lumbar 2, 3, and 4
Sacral 1
Question 109:
The central nervous system extends from the medulla into the:
midbrain.
pons.
cerebrum.
Inspinal cord.
Question 110:
Which nerve runs from the spine through the neck, the axilla, and into the arm?
Median nerve
Ulnarnerve
Radialnerve
Brachial plexus