Test Bank For Primary Care, Art and Science of Advanced Practice Nursing 4th Edition by Dunphy

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Test Bank For Primary Care, Art and Science of Advanced Practice Nursing 4th Edition by Dunphy

Chapter 6. Neurological Problems

Multiple Choice

Identify the choice that best completes the statement or answers the question.

____ 1. Which statement about confusion is true?

a.	Confusion is a disease process.
b.	Confusion is always temporary.
c.	Age is a reliable predictor of confusion.
d.	Polypharmacy is a major contributor to confusion in older adults.

____ 2. Sondra’s peripheral vestibular disease causes dizziness and vertigo. Which of the following medications will help to decrease edema in the labyrinth of the ear?

a.	Meclizine
b.	Diphenhydramine
c.	Diamox
d.	Promethazine

____ 3. The hallmark of an absence seizure is:

a.	No activity at all
b.	A blank stare
c.	Urine is usually voided involuntarily
d.	The attack usually lasts several minutes

____ 4. How often should drug levels be monitored when a seizure medication has controlled the seizures, and the drug level is adequate?

a.	Every 3 months
b.	Every 6 months
c.	Annually
d.	Whenever there is a problem

____ 5. Which of the following persons fits the classic description of a patient with multiple sclerosis (MS)?

a.	A teenage male
b.	A 65-year-old male
c.	A 25-year-old female
d.	A 60-year-old female

____ 6. Which of the following is a specific test to MS?

a.	Magnetic resonance imaging (MRI)
b.	Computed tomography (CT) scan
c.	A lumbar puncture
d.	There is no specific test.

____ 7. Which drug for Alzheimer’s disease should be administered beginning at the time of diagnosis?

a.	Cholinesterase inhibitors
b.	Anxiolytics
c.	Antidepressants
d.	Atypical antipsychotics

____ 8. Which hematoma occurs along the temporal cranial wall and results from tears in the middle meningeal artery?

a.	Epidural hematoma
b.	Subdural hematoma
c.	Subarachnoid hematoma
d.	Intraparenchymal hemorrhage

____ 9. Which cranial nerve is affected in a patient with a cerebrovascular accident who has difficulty chewing?

a.	CN V
b.	CN VII
c.	CN IX
d.	CN X

____ 10. Which statement best describes a carotid bruit?

a.	It is felt with the middle three fingers over the carotid artery.
b.	A bruit becomes audible when the lumen is narrowed to 1 mm or less.
c.	A low-pitched bruit is a medical emergency.
d.	The higher the pitch of the bruit, the higher the degree of stenosis.

____ 11. Which patient is more likely to have a cluster headache?

a.	A female in her reproductive years
b.	A 40-year-old African American male
c.	A 55-year-old female who drinks 10 cups of coffee daily
d.	A 45-year-old male awakened at night

____ 12. Inattention and a sleep-wake cycle disturbance are the hallmark symptoms of?

a.	Dementia
b.	Alzheimer’s disease
c.	Parkinson’s disease
d.	Delirium

____ 13. Which type of meningitis is more benign, self-limiting, and caused primarily by a virus?

a.	Purulent meningitis
b.	Chronic meningitis
c.	Aseptic meningitis
d.	Herpes meningitis

____ 14. Which is the most sensitive neuroimaging test to evaluate patients with encephalitis?

a.	MRI
b.	CT
c.	Electroencephalogram (EEG)
d.	An initial lumbar puncture

____ 15. What is usually the first sign or symptom that a patient would present with that would make you suspect herpes zoster?

a.	A stabbing pain on one small area of the body
b.	A vesicular skin lesion on one side of the body
c.	A pain that is worse upon awakening
d.	A lesion on the exterior ear canal

____ 16. Gabby, aged 22, has Bell’s palsy on the right side of her face. Her mouth is distorted, and she is concerned about permanent paralysis and pain. What do you tell her?

a.	“Most patients have complete recovery in 3 to 6 months.”
b.	“Unfortunately, you’ll probably have a small amount of residual damage.”
c.	“Don’t worry, I’ll take care of everything.”
d.	“You may have a few more episodes over the course of your lifetime but no permanent damage.”

____ 17. Sam, aged 65, is started on L-dopa for his Parkinson’s disease (PD). He asks why this is necessary. You tell him:

a.	“L-dopa is neuroprotective.”
b.	“The primary goal of therapy is to replace depleted stores of dopamine.”
c.	“This is the only drug that can provide symptomatic benefit.”
d.	“This is the initial monotherapy drug.”

____ 18. Which of the following signs is seen in a patient with more advanced PD?

a.	Resting tremor
b.	Bradykinesia
c.	Rigidity
d.	Postural instability

____ 19. Which of the following is the most commonly experienced symptom of migraine?

a.	Light sensitivity
b.	Pulsatile pain
c.	Sound sensitivity
d.	Experiencing an aura

____ 20. Which of the following characteristics differentiates peripheral vertigo from central vertigo?

a.	The duration of central vertigo is shorter than that of peripheral vertigo.
b.	There is an auditory-associated symptom with peripheral vertigo and a visual-associated symptom with central vertigo.
c.	Central vertigo is positional, and peripheral vertigo is not.
d.	The onset of central vertigo is more sudden than that of peripheral vertigo.

____ 21. Carotid endarterectomy should be considered only for symptomatic patients with greater than what percentage of stenosis?

a.	Greater than 25%
b.	Greater than 50%
c.	Greater than 75%
d.	Only for 100% occlusion

____ 22. What antiplatelet agent is most widely used for secondary prevention of stroke?

a.	Aspirin
b.	Ticlopidine
c.	Clopidogrel
d.	Aspirin and clopidogrel

____ 23. Which adjunctive diagnostic test should be used in the work-up of a patient with suspected Creutzfeldt-Jakob disease or transient epileptic amnesia?

a.	MRI
b.	CT
c.	Cerebrospinal fluid analysis
d.	EEG

____ 24. Which herbal preparation may cause delirium and should be avoided in an elderly patient?

a.	Sam-e
b.	Saint John’s Wort
c.	Melatonin
d.	Saw Palmetto

____ 25. Which of the following activities is part of the functional activities questionnaire?

a.	Asking the patient to unravel a Rubik’s cube
b.	Determining if the patient can drive on the highway
c.	Asking the patient about a news event from the current week
d.	Seeing if the patient can keep his or her home clean

____ 26. About 90% of all headaches are?

a.	Tension
b.	Migraine
c.	Cluster
d.	Without pathological cause

____ 27. Which statement is true regarding driving and patients with a seizure disorder?

a.	Once diagnosed with a seizure disorder, patients must never drive again.
b.	After being seizure free for 6 months, patients may drive.
c.	Each state has different laws governing driving for individuals with a seizure disorder.
d.	These persons may drive but never alone.

____ 28. Julie has relapsing-remitting muscular sclerosis. She has not had a good response to interferon. Which medication might help given intravenously once a month?

a.	Glatiramer acetate
b.	Natalizumab
c.	Fingolimod
d.	Glucocorticoids

____ 29. The ‘freezing phenomenon’ is a cardinal feature of?

a.	Parkinson’s disease
b.	Alzheimer’s disease
c.	A CVA
d.	Bell’s palsy

____ 30. A ratchet-like rhythmic contraction, especially in the hand, during passive stretching is known as?

a.	Spinothalamic dysfunction
b.	Ratcheting
c.	Cogwheeling
d.	Hand tremors

____ 31. Clinical features of insidious onset, slow progression, and a lack of other findings to explain the symptoms are fairly diagnostic of which condition?

a.	Guillain-Barré syndrome
b.	Parkinson’s disease
c.	Alzheimer’s disease
d.	Huntington’s disease

____ 32. Which condition is characterized by the impaired ability to learn new information along with either a cognitive disturbance in language, function, or perception?

a.	Guillain-Barré syndrome
b.	Parkinson’s disease
c.	Alzheimer’s disease
d.	Delirium

____ 33. A score of 20 to 25 on this test indicates early-stage Alzheimer’s disease:

a.	SLUMS
b.	MoCA
c.	FAST
d.	MMSE

____ 34. Intravenous thrombolytic therapy following an ischemic CVA should be given within how many hours of symptom onset?

a.	1 hour
b.	3 hours
c.	6 hours
d.	12 hours

____ 35. When administered at the beginning of an attack, oxygen therapy may help this kind of headache?

a.	Tension
b.	Migraine
c.	Cluster
d.	Stress

Chapter 6. Neurological Problems

Answer Section

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