Symptoms and Tests for Neural Conditions - NCLEX-PN
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An unconscious patient exhibits stiffly extended arms that are also adducted with the wrists hyperpronated. The nurse recognizes this presentation to be __________.
An unconscious patient exhibits stiffly extended arms that are also adducted with the wrists hyperpronated. The nurse recognizes this presentation to be __________.
Decerebrate positioning is an involuntary response of abduction, extension, and hyperpronation of the upper extremities due to noxious stimuli. There also is hyperextension of the lower extremities and the feet are plantarflexed. Decorticate positioning involves "mummy baby" posture - elbows, wrists, and fingers flexed, and legs extended and rotated medially. The Babinski reflex involves the extension of the big toe following stimulation of the sole of the foot. The crossed extensor reflex is also known as the withdrawal reflex, which involves the differential flexion and relaxation of muscles in the withdrawal of a limb. Vestibulospinal reflexes involve the use of vestibular organs and skeletal muscle to maintain balance, posture, and coordination.
Decerebrate positioning is an involuntary response of abduction, extension, and hyperpronation of the upper extremities due to noxious stimuli. There also is hyperextension of the lower extremities and the feet are plantarflexed. Decorticate positioning involves "mummy baby" posture - elbows, wrists, and fingers flexed, and legs extended and rotated medially. The Babinski reflex involves the extension of the big toe following stimulation of the sole of the foot. The crossed extensor reflex is also known as the withdrawal reflex, which involves the differential flexion and relaxation of muscles in the withdrawal of a limb. Vestibulospinal reflexes involve the use of vestibular organs and skeletal muscle to maintain balance, posture, and coordination.
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A client admitted to the neuro intensive care unit is having his level of responsiveness assessed by the nurse on duty. Her findings include eyes opening to verbal command, is disoriented but can converse, and obeys commands.
What is this client's Glasgow Coma Scale score?
A client admitted to the neuro intensive care unit is having his level of responsiveness assessed by the nurse on duty. Her findings include eyes opening to verbal command, is disoriented but can converse, and obeys commands.
What is this client's Glasgow Coma Scale score?
The score of this client includes: eye open response is a 
, best verbal response is 
and best motor response is 
.
The score of this client includes: eye open response is a
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Swaying or inability to maintain balance while standing with the eyes closed is considered a positive finding in what test?
Swaying or inability to maintain balance while standing with the eyes closed is considered a positive finding in what test?
Romberg's test is an evaluation of both proprioception and vestibular function. The patient is asked to stand with eyes open, then to close their eyes and remain still. Any tilting or loss of balance is considered to be a sign of either proprioceptive or vestibular impairment, and should be evaluated further.
Gait test assesses for gait abnormalities. Rapidly alternating movement test is done with the patient seated with their hands on their thighs. They are asked to rapidly turn their hands over, then return them palms down to their thighs 10 times. This test is evaluating for dysdiadochokinesis, or inability to perform rapidly alternating movements. Ataxia, or the loss of control of bodily movements, is not a specific test, but rather a clinical finding.
Romberg's test is an evaluation of both proprioception and vestibular function. The patient is asked to stand with eyes open, then to close their eyes and remain still. Any tilting or loss of balance is considered to be a sign of either proprioceptive or vestibular impairment, and should be evaluated further.
Gait test assesses for gait abnormalities. Rapidly alternating movement test is done with the patient seated with their hands on their thighs. They are asked to rapidly turn their hands over, then return them palms down to their thighs 10 times. This test is evaluating for dysdiadochokinesis, or inability to perform rapidly alternating movements. Ataxia, or the loss of control of bodily movements, is not a specific test, but rather a clinical finding.
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A 46-year-old patient presents with dysdiadochokinesis (an inability to perform rapidly alternating movements). What condition is the most common cause of dysdiadochokinesis in adults?
A 46-year-old patient presents with dysdiadochokinesis (an inability to perform rapidly alternating movements). What condition is the most common cause of dysdiadochokinesis in adults?
In adults, the most common cause of dysdiadochokinesia is multiple sclerosis.
Cerebellar lesion is the most common cause of this finding in children. This symptom is not a normal finding in Parkinson's disease, or in pontine gliomas (tumors of the pons), though neurological impairment or ataxia itself may make rapidly alternating movements difficult.
In adults, the most common cause of dysdiadochokinesia is multiple sclerosis.
Cerebellar lesion is the most common cause of this finding in children. This symptom is not a normal finding in Parkinson's disease, or in pontine gliomas (tumors of the pons), though neurological impairment or ataxia itself may make rapidly alternating movements difficult.
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A 26-year-old woman presents to urgent care after a bike accident in which she got "a bad bump on the head." She was not wearing a helmet. She must now be assessed for increased intracranial pressure. All of the following are signs of increased intracranial pressure except __________.
A 26-year-old woman presents to urgent care after a bike accident in which she got "a bad bump on the head." She was not wearing a helmet. She must now be assessed for increased intracranial pressure. All of the following are signs of increased intracranial pressure except __________.
Increased intracranial pressure can be chronic or acute. The nurse must assess for pupilary response, level of consciousness, and quality of headache if present, in addition to motor response.
Migraine aura that persists after headache has resolved should be evaluated for stroke, transient ischemic attack, or arteriovenous malformation.
Increased intracranial pressure can be chronic or acute. The nurse must assess for pupilary response, level of consciousness, and quality of headache if present, in addition to motor response.
Migraine aura that persists after headache has resolved should be evaluated for stroke, transient ischemic attack, or arteriovenous malformation.
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Which of the following terms denotes neurological impairment of the ability to speak or understand language?
Which of the following terms denotes neurological impairment of the ability to speak or understand language?
Aphasia is the term for neurological impairment of a person's ability to speak or understand language.
The other terms listed all denote various deficiencies:
- Ataxia is a loss or lack of coordinated motor function.
- Apraxia describes a lack of motor planning or inability to execute a specific intentional movement.
- Dysmetria is an inability to judge distance when attempting movements such as grasping at a nearby object
Aphasia is the term for neurological impairment of a person's ability to speak or understand language.
The other terms listed all denote various deficiencies:
- Ataxia is a loss or lack of coordinated motor function.
- Apraxia describes a lack of motor planning or inability to execute a specific intentional movement.
- Dysmetria is an inability to judge distance when attempting movements such as grasping at a nearby object
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The nurse cares for a patient who is prescribed phenytoin for seizures. Which of the following serum drug levels would most concern the nurse?
The nurse cares for a patient who is prescribed phenytoin for seizures. Which of the following serum drug levels would most concern the nurse?
The therapeutic serum phenytoin level is between 
.
would be below the therapeutic level and may be due to non-compliance by the client or increased metabolism of the drug. The other options are within the listed therapeutic range.
The therapeutic serum phenytoin level is between
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Which of the following is a term for an abnormal surge or excess of electrical activity in the brain?
Which of the following is a term for an abnormal surge or excess of electrical activity in the brain?
A seizure is defined as an abnormal surge or excess of electrical activity in the brain. This can result in partial or total loss of consciousness, and may cause muscular spasms, twitches, or other types of dyskinesia (disorders of movement). Spasms, twitches, and dyskinesias are not always caused by seizure disorders, however - they may be caused by a wide range of neuromuscular dysfunctions.
A seizure is defined as an abnormal surge or excess of electrical activity in the brain. This can result in partial or total loss of consciousness, and may cause muscular spasms, twitches, or other types of dyskinesia (disorders of movement). Spasms, twitches, and dyskinesias are not always caused by seizure disorders, however - they may be caused by a wide range of neuromuscular dysfunctions.
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The term "positive symptoms" in schizophrenia refers to which of the following?
The term "positive symptoms" in schizophrenia refers to which of the following?
Positive symptoms in schizophrenia are any symptoms of cognitive excess or disordered thinking. These include delusions, such as delusions of grandeur or persecution, hallucinations, and disorganized speech or behavior.
Positive symptoms in schizophrenia are any symptoms of cognitive excess or disordered thinking. These include delusions, such as delusions of grandeur or persecution, hallucinations, and disorganized speech or behavior.
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Schizophrenic individuals frequently have abnormally high levels of what signaling molecule?
Schizophrenic individuals frequently have abnormally high levels of what signaling molecule?
While many people with schizophrenia do seem to have dysfunctions in multiple signaling molecules, excess levels of dopamine have been clearly associated with this disorder.
While many people with schizophrenia do seem to have dysfunctions in multiple signaling molecules, excess levels of dopamine have been clearly associated with this disorder.
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Hank is a schizophrenic 46 year old male. He experiences a persistent belief that a particular television commercial actor is addressing him directly, and that the commercial was created specifically to communicate with him. What type of delusion is Hank experiencing?
Hank is a schizophrenic 46 year old male. He experiences a persistent belief that a particular television commercial actor is addressing him directly, and that the commercial was created specifically to communicate with him. What type of delusion is Hank experiencing?
The belief that general or innocuous events exist specifically for or relate specifically to an individual is called a delusion of reference. Examples include belief that a billboard or television commercial is attempting to communicate directly to an individual, the ascribing of significance to random coincidences, or the observation of coded signals or signs in the general environment.
The belief that general or innocuous events exist specifically for or relate specifically to an individual is called a delusion of reference. Examples include belief that a billboard or television commercial is attempting to communicate directly to an individual, the ascribing of significance to random coincidences, or the observation of coded signals or signs in the general environment.
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Charlotte is a 19 year old female with new onset of paranoia and auditory hallucinations. She has a positive family history for schizophrenia. Recently she admitted to her nurse that she can “hear” what other people are thinking. As she describes it, this does not come in the form of sound, but is communicated directly to her brain. Charlotte is likely experiencing which of the following?
Charlotte is a 19 year old female with new onset of paranoia and auditory hallucinations. She has a positive family history for schizophrenia. Recently she admitted to her nurse that she can “hear” what other people are thinking. As she describes it, this does not come in the form of sound, but is communicated directly to her brain. Charlotte is likely experiencing which of the following?
The belief that other people can hear one's thoughts is described by the term thought broadcasting. This is a common symptom in schizophrenia. It is differentiated from telepathy in that thought broadcasting, there is a delusion that thoughts can be heard by anyone, while telepathy is generally non-verbal communication between specific individuals, and may be receptive as well as projective. Auditory hallucinations are false perceptions of sounds (or internal thought perceived at emanating from another source), while delusions of persecution can take many forms but generally include a degree of paranoia or feeling of being targeted for harm or attack.
The belief that other people can hear one's thoughts is described by the term thought broadcasting. This is a common symptom in schizophrenia. It is differentiated from telepathy in that thought broadcasting, there is a delusion that thoughts can be heard by anyone, while telepathy is generally non-verbal communication between specific individuals, and may be receptive as well as projective. Auditory hallucinations are false perceptions of sounds (or internal thought perceived at emanating from another source), while delusions of persecution can take many forms but generally include a degree of paranoia or feeling of being targeted for harm or attack.
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Which of the following conditions can decrease sensitivity to sweet and bitter tastes?
Which of the following conditions can decrease sensitivity to sweet and bitter tastes?
Depression has been linked with alterations in taste sensation, including decreased sensitivity to sweetness. This may contribute in some part to the high consumption of sweet foods in certain individuals experiencing a depressive episode. None of the other conditions listed have been correlated with alterations in taste receptor function.
Depression has been linked with alterations in taste sensation, including decreased sensitivity to sweetness. This may contribute in some part to the high consumption of sweet foods in certain individuals experiencing a depressive episode. None of the other conditions listed have been correlated with alterations in taste receptor function.
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You are an emergency department nurse taking care of a 16-year old female who complains of fatigue and syncope. You learn that she has only been drinking water for the last two weeks and has only been eating a piece of bread per day for the last four weeks, as she is worried that her classmates may make fun of her for "being too fat" during her upcoming dance. Her BMI is 14. Which of the following is the most likely diagnosis?
You are an emergency department nurse taking care of a 16-year old female who complains of fatigue and syncope. You learn that she has only been drinking water for the last two weeks and has only been eating a piece of bread per day for the last four weeks, as she is worried that her classmates may make fun of her for "being too fat" during her upcoming dance. Her BMI is 14. Which of the following is the most likely diagnosis?
The correct answer is "Anorexia nervosa." This is the correct answer because in this patient, who is a young female, which is the most commonly encountered demographic for eating disorders, she notes that she has been drastically restricting her intake of food, that she has body dysmorphic thoughts (e.g. thinking that she is "too fat" despite that her BMI is 14), and we learn that her BMI is 14. A diagnosis of anorexia can be made if a patient is restricting their eating or drinking intentionally, and/or is participating in purge behavior, and has a BMI less than 17.5, as in this patient.
Should this patient have presented in an identical manner, but her BMI been greater than 17.5, by definition, the correct answer would be bulimia nervosa. Given her BMI though, bulimia nervosa is not correct. There is no evidence of binge-eating behavior in this patient either, making that answer incorrect.
While generalized anxiety disorder and/or major depressive disorder are often co-morbid in patients with eating disorders, there is not enough evidence in the example to suggest either diagnosis for this patient.
The correct answer is "Anorexia nervosa." This is the correct answer because in this patient, who is a young female, which is the most commonly encountered demographic for eating disorders, she notes that she has been drastically restricting her intake of food, that she has body dysmorphic thoughts (e.g. thinking that she is "too fat" despite that her BMI is 14), and we learn that her BMI is 14. A diagnosis of anorexia can be made if a patient is restricting their eating or drinking intentionally, and/or is participating in purge behavior, and has a BMI less than 17.5, as in this patient.
Should this patient have presented in an identical manner, but her BMI been greater than 17.5, by definition, the correct answer would be bulimia nervosa. Given her BMI though, bulimia nervosa is not correct. There is no evidence of binge-eating behavior in this patient either, making that answer incorrect.
While generalized anxiety disorder and/or major depressive disorder are often co-morbid in patients with eating disorders, there is not enough evidence in the example to suggest either diagnosis for this patient.
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An unconscious patient exhibits stiffly extended arms that are also adducted with the wrists hyperpronated. The nurse recognizes this presentation to be __________.
An unconscious patient exhibits stiffly extended arms that are also adducted with the wrists hyperpronated. The nurse recognizes this presentation to be __________.
Decerebrate positioning is an involuntary response of abduction, extension, and hyperpronation of the upper extremities due to noxious stimuli. There also is hyperextension of the lower extremities and the feet are plantarflexed. Decorticate positioning involves "mummy baby" posture - elbows, wrists, and fingers flexed, and legs extended and rotated medially. The Babinski reflex involves the extension of the big toe following stimulation of the sole of the foot. The crossed extensor reflex is also known as the withdrawal reflex, which involves the differential flexion and relaxation of muscles in the withdrawal of a limb. Vestibulospinal reflexes involve the use of vestibular organs and skeletal muscle to maintain balance, posture, and coordination.
Decerebrate positioning is an involuntary response of abduction, extension, and hyperpronation of the upper extremities due to noxious stimuli. There also is hyperextension of the lower extremities and the feet are plantarflexed. Decorticate positioning involves "mummy baby" posture - elbows, wrists, and fingers flexed, and legs extended and rotated medially. The Babinski reflex involves the extension of the big toe following stimulation of the sole of the foot. The crossed extensor reflex is also known as the withdrawal reflex, which involves the differential flexion and relaxation of muscles in the withdrawal of a limb. Vestibulospinal reflexes involve the use of vestibular organs and skeletal muscle to maintain balance, posture, and coordination.
Compare your answer with the correct one above
A client admitted to the neuro intensive care unit is having his level of responsiveness assessed by the nurse on duty. Her findings include eyes opening to verbal command, is disoriented but can converse, and obeys commands.
What is this client's Glasgow Coma Scale score?
A client admitted to the neuro intensive care unit is having his level of responsiveness assessed by the nurse on duty. Her findings include eyes opening to verbal command, is disoriented but can converse, and obeys commands.
What is this client's Glasgow Coma Scale score?
The score of this client includes: eye open response is a , best verbal response is and best motor response is .
The score of this client includes: eye open response is a
Compare your answer with the correct one above
Swaying or inability to maintain balance while standing with the eyes closed is considered a positive finding in what test?
Swaying or inability to maintain balance while standing with the eyes closed is considered a positive finding in what test?
Romberg's test is an evaluation of both proprioception and vestibular function. The patient is asked to stand with eyes open, then to close their eyes and remain still. Any tilting or loss of balance is considered to be a sign of either proprioceptive or vestibular impairment, and should be evaluated further.
Gait test assesses for gait abnormalities. Rapidly alternating movement test is done with the patient seated with their hands on their thighs. They are asked to rapidly turn their hands over, then return them palms down to their thighs 10 times. This test is evaluating for dysdiadochokinesis, or inability to perform rapidly alternating movements. Ataxia, or the loss of control of bodily movements, is not a specific test, but rather a clinical finding.
Romberg's test is an evaluation of both proprioception and vestibular function. The patient is asked to stand with eyes open, then to close their eyes and remain still. Any tilting or loss of balance is considered to be a sign of either proprioceptive or vestibular impairment, and should be evaluated further.
Gait test assesses for gait abnormalities. Rapidly alternating movement test is done with the patient seated with their hands on their thighs. They are asked to rapidly turn their hands over, then return them palms down to their thighs 10 times. This test is evaluating for dysdiadochokinesis, or inability to perform rapidly alternating movements. Ataxia, or the loss of control of bodily movements, is not a specific test, but rather a clinical finding.
Compare your answer with the correct one above
A 46-year-old patient presents with dysdiadochokinesis (an inability to perform rapidly alternating movements). What condition is the most common cause of dysdiadochokinesis in adults?
A 46-year-old patient presents with dysdiadochokinesis (an inability to perform rapidly alternating movements). What condition is the most common cause of dysdiadochokinesis in adults?
In adults, the most common cause of dysdiadochokinesia is multiple sclerosis.
Cerebellar lesion is the most common cause of this finding in children. This symptom is not a normal finding in Parkinson's disease, or in pontine gliomas (tumors of the pons), though neurological impairment or ataxia itself may make rapidly alternating movements difficult.
In adults, the most common cause of dysdiadochokinesia is multiple sclerosis.
Cerebellar lesion is the most common cause of this finding in children. This symptom is not a normal finding in Parkinson's disease, or in pontine gliomas (tumors of the pons), though neurological impairment or ataxia itself may make rapidly alternating movements difficult.
Compare your answer with the correct one above
A 26-year-old woman presents to urgent care after a bike accident in which she got "a bad bump on the head." She was not wearing a helmet. She must now be assessed for increased intracranial pressure. All of the following are signs of increased intracranial pressure except __________.
A 26-year-old woman presents to urgent care after a bike accident in which she got "a bad bump on the head." She was not wearing a helmet. She must now be assessed for increased intracranial pressure. All of the following are signs of increased intracranial pressure except __________.
Increased intracranial pressure can be chronic or acute. The nurse must assess for pupilary response, level of consciousness, and quality of headache if present, in addition to motor response.
Migraine aura that persists after headache has resolved should be evaluated for stroke, transient ischemic attack, or arteriovenous malformation.
Increased intracranial pressure can be chronic or acute. The nurse must assess for pupilary response, level of consciousness, and quality of headache if present, in addition to motor response.
Migraine aura that persists after headache has resolved should be evaluated for stroke, transient ischemic attack, or arteriovenous malformation.
Compare your answer with the correct one above
Which of the following terms denotes neurological impairment of the ability to speak or understand language?
Which of the following terms denotes neurological impairment of the ability to speak or understand language?
Aphasia is the term for neurological impairment of a person's ability to speak or understand language.
The other terms listed all denote various deficiencies:
- Ataxia is a loss or lack of coordinated motor function.
- Apraxia describes a lack of motor planning or inability to execute a specific intentional movement.
- Dysmetria is an inability to judge distance when attempting movements such as grasping at a nearby object
Aphasia is the term for neurological impairment of a person's ability to speak or understand language.
The other terms listed all denote various deficiencies:
- Ataxia is a loss or lack of coordinated motor function.
- Apraxia describes a lack of motor planning or inability to execute a specific intentional movement.
- Dysmetria is an inability to judge distance when attempting movements such as grasping at a nearby object
Compare your answer with the correct one above