Exam View - Chapter 23 - Anatomy: Seidel\'S Guide To Physical Examination: Neurological System PDF

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Download Exam View - Chapter 23 - Anatomy: Seidel'S Guide To Physical Examination: Neurological System PDF

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Chapter 23: Neurologic System Ball: Seidel’s Guide to Physical Examination, 9th Edition MULTIPLE CHOICE 1. The autonomic nervous system coordinates which of the following? a. High-level cognitive function b. Balance and affect c. Internal organs of the body d. Balance and equilibrium ANS: C

The autonomic nervous system coordinates the internal environment of the body by the sympathetic and systems. The other options are associated with the cerebral cortex; its function consists of determining in motor function. DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 2. The major function of the sympathetic nervous system is to: a. orchestrate the stress response. b. coordinate fine motor movement. c. determine proprioception. d. perceive stereognosis. ANS: A

Stimulation of the sympathetic branch of the autonomic nervous system prepares the body for emergenc response). The cerebellum plays a key role in the coordination of fine motor movements. Recognition of of body position (proprioception) are dependent on the parietal lobe. Stereognosis is the ability to percei solid objects by touch and is not under sympathetic control. DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 3. The parasympathetic nervous system maintains the day-to-day function of: a. digestion. b. response to stress. c. lymphatic supply to the brain. d. lymphatic drainage of the brain. ANS: A

The parasympathetic division functions in a complementary and counterbalancing manner to conserve b day-to-day body functions, such as digestion and elimination. DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 4. Cerebrospinal fluid serves as a: a. nerve impulse transmitter. b. red blood cell conveyer. c. shock absorber. d. mediator of voluntary skeletal movement. ANS: C

Cerebrospinal fluid circulates between an interconnecting system of ventricles in the brain and around th serving as a shock absorber. DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 5. Diabetic peripheral neuropathy will likely produce: a. hyperactive ankle reflexes.

b. c. d.

diminished pain sensation. exaggerated vibratory sense. hypersensitive temperature perception.

ANS: B

6. The thalamus is the major integration center for the perception of: a. speech. b. olfaction. c. pain. d. thoughts. ANS: C

The thalamus is the major integrating center for the perception of various sensations such as pain and tem relay center between the basal ganglia and cerebellum. The reception of speech and interpretation of spe Wernicke area. The olfactory sense is processed in the parietal lobe. The cerebrum holds memories, allo you to imagine and think. DIF: Cognitive Level: Remembering (Knowledge) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 7. The awareness of body position is known as: a. proprioception. b. graphesthesia. c. stereognosis. d. two-point discrimination. ANS: A

Recognition of body parts and awareness of body position are known as proprioception. This is depende other options are assessment techniques that test for sensory impairment. DIF: Cognitive Level: Remembering (Knowledge) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 8. Which area of the brain maintains temperature control? a. Epithalamus b. Thalamus c. Abducens d. Hypothalamus ANS: D

The hypothalamus is the major processing center of internal stimuli for the autonomic nervous system. I control, water metabolism, body fluid osmolarity, feeding behavior, and neuroendocrine activity. The ep body and is responsible for sexual development and behavior. The thalamus conveys all sensory impulse from the cerebrum before their distribution to appropriate associative sensory areas. The abducens is the motor function responsible for lateral eye movement. DIF: Cognitive Level: Remembering (Knowledge) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 9. If a patient cannot shrug his or her shoulders against resistance, which cranial nerve (CN) requires furthe a. CN I, olfactory b. CN V, trigeminal c. CN IX, glossopharyngeal d. CN XI, spinal accessory ANS: D

CN XI is responsible for the motor ability to shrug the shoulders. CN I is associated with smell reception is associated with opening of the jaw, chewing, and sensation of the cornea, iris, conjunctiva, eyelids, fo ear, and facial skin. CN IX is associated with swallowing function, sensation of the nasopharynx, gag re salivary glands, carotid reflex, and swallowing. DIF: Cognitive Level: Remembering (Knowledge) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 10. Motor maturation proceeds in an orderly progression from: a. peripheral to central. b. head to toe. c. lateral to medial. d. pedal to cephalic.

ANS: B

Motor maturation proceeds in a cephalocaudal direction. Motor control of the head and neck develops fi and extremities The other choices are incorrect because they relate the maturation sequence inappropria

11. Normal changes of the aging brain include: a. increased velocity of nerve conduction. b. diminished perception of touch. c. increased total number of neurons. d. diminished intelligence quotient. ANS: B

Sensory perceptions of touch and pain are diminished by aging. The velocity of nerve impulse conductio stimuli take longer. The number of cerebral neurons is thought to decrease by 1% a year, beginning at 50 vast number of reserve cells inhibits the appearance of clinical signs. DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 12. The area of body surface innervated by a particular spinal nerve is called a: a. dermatome. b. nerve pathway. c. spinal accessory area. d. cutaneous zone. ANS: A

The sensory and motor fibers of each spinal nerve supply and receive information to a segment of skin k Nerve pathway and spinal accessory area refer to nerve routes. Cutaneous zone refers to a skin area that information and normal exogenous thermal information at the same time. DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 13. A neurologic past medical history should include data about: a. allergies. b. circulatory problems. c. educational level. d. immunizations. ANS: B

The neurologic past medical history should include data concerning neurovascular problems such as stro surgery. The other answers are not pertinent medical information for the neurologic past medical history DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 14. Which is the technique most often used for evaluating the neurologic system? a. Auscultation b. Inspection c. Palpation d. Percussion ANS: B

The evaluation tool of inspection is used most often. Inspection of gait and response to questions can pro neurologic system function. DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 15. When assessing superficial pain, touch, vibration, and position perceptions, you are testing: a. cerebellar function. b. emotional status. c. sensory function. d. tendon reflexes. ANS: C

Superficial pain, touch, vibration, and position perceptions are sensory functions. DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation

16. You are initially evaluating the equilibrium of Ms. Q. You ask her to stand, with her feet together and ar

her balance. Ms. Q has a positive:

17. The finger to nose test allows assessment of: a. coordination and fine motor function. b. point location. c. sensory function. d. stereognosis. ANS: A

To perform the finger to nose test, the patient closes both eyes and touches his or her nose with the index while gradually increasing the speed. This tests coordination and fine motor skills. All the other choices without motor function. DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 18. You are performing a two-point discrimination test as part of a well physical examination. The area with

points in the shortest distance is the: a. back. b. palms. c. fingertips. d. upper arms. ANS: C

The fingertips can discern two points with a minimal distance of 2 to 8 mm, the back, 40 to 70 mm, the p upper arms, 75 mm. DIF: Cognitive Level: Applying (Application) OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation 19. As Mr. B enters the room, you observe that his gait is wide-based and he staggers from side to side whil

would document Mr. B’s pattern as: a. dystonic ataxia. b. cerebellar ataxia. c. steppage gait. d. tabetic stamping. ANS: B

A cerebellar gait (cerebellar ataxia) occurs when the patient’s feet are wide-based, with a staggering gait side, often accompanied by swaying of the trunk. Dystonic ataxia is jerky dancing movements that appe gait is noted when the hip and knee are elevated excessively high to lift the plantar-flexed foot off the gr down with a slap and the patient is unable to walk on the heels. Tabetic stamping occurs when the legs a lifted high, and forcibly brought down with each step; in this case, the heel stamps on the ground. DIF: Cognitive Level: Understanding (Comprehension) OBJ: Nursing process—assessment MSC: Safe and Effective Care: Management of Care 20. Deep pressure tests are used mostly for patients who are experiencing: a. absent superficial pain sensation. b. gait and stepping disturbances. c. lordosis, osteoporosis, or arthritis. d. tonic neck or torso spasms. ANS: A

Deep pressure sensation is tested by squeezing the trapezius, calf, or biceps muscle, thus causing discom sensation is not intact, further assessments of temperature and deep pressure sensation are performed. DIF: Cognitive Level: Applying (Application) OBJ: Nursing process—assessment MSC: Safe and Effective Care: Management of Care 21. Vibratory sensory testing should be routinely done for the patient with: a. Parkinson disease. b. diabetes. c. cerebral palsy. d. Guillain-Barré syndrome.

ANS: B

Diabetic neuropathy must be routinely assessed in all diabetic patients. In moderate to severe cases, decr sensation occurs below the knees, which should be assessed with a tuning fork. The other choices do no...