Ch. 14 Test Bank - Gould\'s Ch. 14 Test Bank PDF

Preview

Summary

Gould's Ch. 14 Test Bank...

Description

Chapter 14: Neurological Disorders Test Bank MULTIPLE CHOICE 1. Through what area does the cerebrospinal fluid circulate around the brain and spinal cord? a.

Between the double layers of the dura mater

b.

In the subdural space

c.

In the subarachnoid space

d. ANS: C REF: 327

Through the arachnoid villi

2. Which of the following is the usual location of language centers? a.

Left hemisphere

b.

Right hemisphere

c.

Brainstem

d. ANS: A REF: 329

Hypothalamus

3. What would be the effect of damage to the auditory association area in the left hemisphere? a.

Loss of hearing in both ears

b.

Inability to understand what is heard

c.

Loss of hearing in the left ear

d. ANS: B REF: 329

Inability to determine the source of the sound

4. Which of the following applies to the corticospinal tract? a.

It is an ascending tract.

b.

The nerve fibers conduct sensory impulses.

c.

It is an extrapyramidal tract.

d. ANS: D REF REF: 332

It is a pyramidal tract for efferent impulses.

5. What is a major function of the limbic system? a.

Overall control of fluid balance

b.

Required for logical thinking, reason, and decision making

c.

Determines emotional responses

d. ANS: C REF: 330

Responsible for artistic and musical talents

6. Where are 1-adrenergic receptors located? a.

Bronchiolar walls

b.

Arteriolar walls

c.

Cardiac muscle

d. ANS: C REF: 337

Glands of the intestinal tract

7. What does a vegetative state refer to? a.

Depression of the reticular activating system (RAS) and inability to initiate action

b.

Loss of awareness and intellectual function but continued brainstem function

c.

Continuing intellectual function but inability to communicate or move

d. Disorientation and confusion with decreased responsiveness ANS: B REF: 338-339 8. Which of the following conditions is NOT part of the criteria for a declaration of brain death? a.

No activity on EEG

b.

Absence of all reflexes

c.

No spontaneous respirations

d. ANS: D REF: 339

Presence of any head injury

9. What is the best definition of aphasia? a.

The inability to comprehend or express language appropriately

b.

Difficulty swallowing

c.

Loss of the visual field contralateral to the area of damage

d. ANS: A REF: 340

The inability to articulate words clearly

10. What is an early indicator of increased intracranial pressure? a.

Papilledema

b.

Bilateral fixed dilated pupils

c.

Decreasing responsiveness

d. ANS: C REF: 342

Rapid heart rate

11. What is the rationale for vomiting in a patient who has increased intracranial pressure? a.

Chemoreceptors responding to changes in the blood

b.

Pressure extending to spinal nerves

c.

Pressure on the emetic center in the medulla

d. ANS: C REF: 342

Stimuli to the hypothalamic center for hunger and thirst

12. What is the typical change in blood pressure in a patient who has increased intracranial pressure? a.

Erratic diastolic pressure

b.

Decreasing systolic pressure

c.

Systolic and diastolic pressures decreasing proportionately

d. ANS: D REF: 342

Increasing pulse pressure

13. The largest category of primary malignant brain tumors that arise from cells in the central nervous system (CNS) are called: a.

gliomas.

b.

sarcomas.

c.

lymphomas.

d. ANS: A REF: 345

myelomas.

14. Which of the following causes papilledema? a.

Increased pressure of cerebrospinal fluid (CSF) at the optic disc

b.

Increased intraocular pressure

c. d. ANS: A REF: 342

Pressure on the oculomotor nerve Pressure on the optic chiasm

15. What is the effect of an enlarging brain abscess on cardiovascular activity? a.

Increased heart rate and systemic vasodilation

b.

Low blood pressure and irregular heart and respiratory rates

c.

Systemic vasoconstriction and slower heart rate

d. ANS: C REF: 342

Immediate depression of the cardiac control centers

16. As intracranial pressure rises, the pupil of the eye, ipsilateral to the lesion, becomes dilated and unresponsive to light because of pressure on the: a.

optic nerve.

b.

peripheral nervous system (PNS) fibers in cranial nerve III.

c.

sympathetic nervous system (SNS) nerve to the eye.

d. ANS: B REF: 342

occipital lobe.

17. Which of the following characteristics indicates that the CSF is normal? a.

Cloudy and pale yellow color

b.

Presence of erythrocytes

c.

Presence of numerous leukocytes

d. ANS: D REF: 327

Clear and colorless fluid

18. Which of the following statements is TRUE about malignant brain tumors? a.

Most brain tumors arise from malignant neurons.

b.

Primary brain tumors rarely metastasize outside the CNS.

c.

The blood-brain barrier prevents secondary brain tumors.

d. ANS: B REF: 345

Brainstem tumors do not manifest signs until they are quite large.

19. Secondary brain tumors usually arise from:

a.

severe head trauma.

b.

metastasized breast or lung tumors.

c.

exposure to carcinogenic agents.

d. ANS: B REF: 345

exposure to radiation.

20. Why are focal or generalized seizures sometimes an early indication of a brain tumor? a.

Surrounding inflammation stimulates neurons to discharge spontaneously.

b.

Malignant tumors cause alkalosis, exciting the CNS.

c.

Systemic effects of the brain tumor may cause seizures.

d. ANS: A REF: 345

Metabolic effects of cancer change blood chemistry to trigger seizures.

21. Which of the following is a TRUE statement about transient ischemic attacks (TIAs)? a.

They usually cause necrosis and permanent brain damage.

b.

They may be caused by rupture of an aneurysm or a damaged artery.

c.

They usually indicate systemic hypertension.

d. ANS: D REF: 346

They can warn of potential cerebrovascular accidents.

22. What is the probable source of an embolus causing a cerebrovascular accident (CVA)? a.

Right ventricle of the heart

b.

Femoral vein

c.

Common carotid artery

d. ANS: C REF: 347

Pulmonary artery

23. Collateral circulation is most likely to be present when a CVA results from: a.

rupture of a cerebral artery.

b.

an embolus.

c.

atherosclerosis.

d. ANS: C REF: 347

vasospasm in the cerebral circulation.

24. All of the following apply to CVA EXCEPT:

a.

the common cause is an atheroma with thrombus.

b.

maximum necrosis and infarction develop within several hours of onset.

c.

warning signs may appear with partial obstruction of the artery.

d. increasing neurological deficits usually develop during the first few days. ANS: B REF: 346-347 25. Signs and symptoms of a stroke depend upon: a.

location of obstruction, size of artery, and area affected.

b.

duration of the blockage, distance from the heart, and type of obstruction.

c.

health of the victim, area affected, and collateral circulation.

d. ANS: A REF: 348

size of the obstruction, condition of the heart, and duration of blockage.

26. In the weeks following CVA, why might some neurological function return? 1. Presence of collateral circulation 2. Immediate therapy to dissolve thrombi and maintain perfusion 3. Reduced inflammation in the area 4. Development of alternative neuronal pathways a.

1 only

b.

2 only

c.

1, 3

d.

2, 3, 4

e. ANS: E REF: 347

1, 2, 3, 4

27. Which of the following statements about berry aneurysms in the brain is NOT true? a.

They usually develop at points of bifurcation in the circle of Willis.

b.

They are usually asymptomatic for many years.

c.

CSF remains free of blood.

d. ANS: C REF: 349-350

Following rupture, blood appears in the subarachnoid space.

28. In a case of bacterial meningitis, where does swelling and purulent exudate form?

a.

In the pia mater, arachnoid, and surface of the entire brain

b.

In the dura mater and epidural space

c.

At the site of the injury or entry point of the microbes

d. ANS: A REF: 350

Primarily around the spinal cord

29. What are significant signs of acute bacterial meningitis? a.

Severe headache, nuchal rigidity, and photophobia

b.

Fatigue and lethargy, fever, and anorexia

c.

Focal signs, such as progressive paralysis in a limb

d. ANS: A REF: 351

Ascending paralysis beginning in the legs

30. In many types of encephalitis, such as St. Louis encephalitis, how are the viruses transmitted? a.

Carriers

b.

Mosquito and tick bites

c.

Respiratory droplet

d. ANS: B REF: 352

Septic emboli in the circulation

31. All of the following apply to tetanus infection EXCEPT: a.

it is caused by an anaerobic, spore-forming bacillus.

b.

the exotoxin causes strong skeletal muscle spasms.

c.

death usually results from respiratory failure.

d. ANS: D REF: 353

signs of fever, vomiting, stiff neck, and paralysis.

32. In cases of Guillain-Barr syndrome, what does the pathophysiology include? a.

Damage and loss of function in the motor neurons of the spinal cord and medulla

b.

Encephalopathy, with disorientation, headache, and coma

c.

Infection and inflammation of the motor cortex

d. ANS: D REF: 354

Inflammation and demyelination of peripheral nerves, leading to ascending paralysis

33. How does a depressed skull fracture cause brain damage? a.

A bone fragment penetrates and tears brain tissue.

b.

A section of the skull is missing, leaving the brain unprotected.

c.

A section of skull bone is displaced below the level of the skull, causing pressure on the brai

d.

Many fracture lines are present, causing instability.

e. ANS: C REF: 355

The contrecoup injury is the cause of brain damage.

34. Following a head injury, what is the most likely cause of secondary damage to the brain? a.

Hematoma or infection

b.

Laceration by foreign objects

c.

Hypoxia or acidosis

d. ANS: A REF: 357

Tearing of blood vessels as the brain rotates across the inside of the skull

35. An epidural hematoma is located between the: a.

dura mater and the arachnoid mater.

b.

dura mater and the skull.

c.

arachnoid mater and the pia mater.

d. ANS: B REF: 358

pia mater and the brain.

36. What does the term otorrhea mean? a.

Bleeding from the nose.

b.

CSF leaking from the ear.

c.

Torn meninges but no skull fracture.

d. ANS: B REF: 358

Hemorrhage from the ear.

37. Vertebral fractures are classified as: a.

simple, compression, wedge, dislocation.

b.

compound, open, closed, shattered.

c.

complex, torsion, open, multiple.

d.

pressure, complex, simple, variable.

ANS: A REF: 359 38. Following a spinal injury at C5, what is the expected effect during the period of spinal shock? a.

Spastic paralysis below the level of the injury

b.

Urinary incontinence

c.

Possible periods of apnea

d. ANS: C REF: 360

Normal blood pressure

39. Following an injury at L2 to L3, what would indicate recovery from spinal shock? a.

Spastic paraplegia

b.

Urinary retention

c.

Labile body temperature

d. ANS: A REF: 361

Increased sensation in the legs

40. What are the signs of autonomic dysreflexia in a person with cervical spinal injury? a.

Unexpected drop in blood pressure and apnea

b.

Sudden marked increase in blood pressure with bradycardia

c.

Hyperreflexia in the arms and legs

d. ANS: B REF: 362

Urinary and bowel incontinence

41. Expressive aphasia is most likely to result from damage to: a.

the left frontal lobe.

b.

the left temporal lobe.

c.

the right motor cortex.

d. ANS: A REF: 340

Wernickes area.

42. What is the usual result of damage to the right occipital lobe? a.

Left eye is blind

b.

Loss of left visual field

c.

Right eye is blind

d. ANS: B REF: 341

Visual loss in the medial half of each eye

43. How does the heart rate change as intracranial pressure increases? a.

Rate decreases

b.

Rate increases

c.

No change in rate

d. ANS: A REF: 342

Irregular heart rate

44. Which statement best describes herniation resulting from increased intracranial pressure? a.

Movement of brain tissue into ventricles

b.

Movement of brain stem upward

c.

Pushing of excess CSF and blood down around the spinal cord

d. Displacement of brain tissue downward toward the spinal cord ANS: D REF: 342 | 344 45. Which type of cerebrovascular accident (CVA) has the poorest prognosis? a.

CVA caused by thrombus

b.

Hemorrhagic CVA

c.

Embolic CVA

d. ANS: B REF: 347

No difference among types

46. Which of the following factors predispose(s) an individual to a CVA? 1. Hypertension 2. Smoking cigarettes 3. History of coronary artery disease 4. Diabetes mellitus a.

1, 3

b.

1, 2, 4

c.

2, 4

d.

1, 2, 3, 4

ANS: D REF: 348 47. What are the significant early signs of a ruptured cerebral aneurysm? a.

Impaired speech and muscle weakness

b.

Severe headache, nuchal rigidity, and photophobia

c.

Abnormal sensations and tremors

d. ANS: B REF: 350

Vomiting and visual abnormalities

48. The stroke scale used to rapidly diagnose a stroke includes: a.

capacity for speech, level of consciousness, motor skills, eye movements.

b.

motor skills, spatial awareness, time awareness, facial recognition.

c.

short-term memory, cognitive skills, speech, name recognition.

d. ANS: A REF: 348

hand-eye coordination, problem solving, ability to stand or walk, consciousness.

49. With regard to meningitis, choose the correct combination of microbe and the age group commonly affected. a.

E. coli: elderly

b.

H. influenzae: neonate

c.

N. meningitides: children and youth

d. ANS: C REF: 350

S. pneumoniae: young children

50. Which of the following statements applies to a lumbar puncture? a.

It is usually performed at L3-L4.

b.

Fluid is withdrawn from the epidural space.

c.

It can be used to confirm any diagnosis.

d. ANS: A REF: 344

The tissue seals up immediately after puncture.

51. Which signs are indicative of post-polio syndrome? a.

Progressive spastic paralysis

b.

Ascending flaccid paralysis

c.

Progressive fatigue and weakness

d. ANS: C REF: 354

Increasing numbness and paresthesias

52. Which of the following does NOT apply to Reyes syndrome? a.

There is no permanent damage in the body. It is precipitated by a combination of viral infection and administration of acetylsalicylic acid

b.

(ASA).

c.

Cerebral edema develops.

d. Liver damage is common. ANS: A REF: 354 53. Which type of fracture typically occurs at the base of the skull? a.

Depressed

b.

Contrecoup

c.

Comminuted

d. ANS: D REF: 355

Basilar

54. The primary reason for seizures frequently occurring with head injuries is: a.

presence of blood irritates the neurons.

b.

otorrhea or rhinorrhea changes intracranial pressure.

c.

inflammatory response causes general hypoxia.

d. ANS: A REF: 357

CNS is depressed.

55. Brain injury where the brain is injured when it bounces off of the skull due to sudden acceleration or deceleration is referred to as a/an: a.

linear fracture

b.

contusion

c.

basilar injury

d. ANS: D REF: 355

contrecoup injury

56. The rabies virus is usually transmitted by: a.

respiratory droplets.

b.

insects such as mosquitoes.

c.

bites from infected animals.

d. ANS: C REF: 353

the fecal-oral route.

57. Common manifestations of rabies infection include: a.

headache, foaming at the mouth, and difficulty swallowing.

b.

difficulty walking and coordinating movements.

c.

decrease...