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APEA NURSING NR 509

APEA NURSING NR 509

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APEA NURSING NR 509

APEA NURSING NR 509

Question:

A transient ischemic attack is:

a transient episode of neurologic dysfunction by focal brain, spinal cord, or retinal ischemia, without acute infarction.   Correctan infarction of the central nervous system tissue that may be silent or symptomatic.the abrupt onset of motor or sensory deficits.  Incorrectfocal or asymmetric weaknesses caused by central and peripheral nerve damage.

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Explanation:

TIA is now defined as “a transient episode of neurological dysfunction caused by focal brain, spinal cord, or retinal ischemia, without acute infarction.” Ischemic stroke is “an infarction of central nervous system tissue” that may be symptomatic or silent. The other terms are not related to the new definitions.

Question:

A patient is asked to visually follow a finger through the cardinal fields of gaze. Which cranial nerves are being assessed?

 

III, IVIII, IV, VI  CorrectV, VI, VII APEA NURSING NR 509

 

Explanation:

Visually following a finger through the cardinal fields of gaze is one way to assess the oculomotor (CN III), trochlear (CN IV) and abducens (CN VI) nerves. CN I is the olfactory nerve and assesses smell. CN II is the optic nerve and assesses visual acuity. CN V is the trigeminal nerve and assesses both sensory and motor functions.

Question:

Uncontrolled electrical activity in the brain, which may produce minor physical signs, thought disturbances, or disturbed motor activity is:

 

dystonia.bradykinesia.tremor.seizure.  Correct

 

Explanation:

A seizure is an uncontrolled electrical activity in the brain which may produce minor physical signs, thought disturbances, or disturbed motor activity, or a combination of symptoms. Dystonia is a neurological disorder that causes involuntary muscle spasms and twisting of the limbs. Bradykinesia is the term used to describe the impaired ability to adjust to one’s body position. This symptom is noted in patients who have Parkinson’s disease. A rhythmic oscillatory movement of a body part resulting from the contraction of opposing muscle groups is a tremor.

Question:

When evaluating the sensory system, testing the posterior columns tract would include assessing sensations of:

 

position and vibration.  Correctpain and temperature.deep touch.  Incorrectdiscriminative sensations.

 

Explanation:

When evaluating the sensory system, testing the spinothalamic tracts would include assessing sensations of pain and temperature. Assessing position and vibration evaluate the posterior columns. Light touch assesses both the spinothalamic and posterior column tracts. To assess discriminative sensation, both the spinothalamic and posterior columns tracts as well as the cortex would be assessed.

Question:

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.  Incorrecthirsutism.Arnold -Chiari malformation. spina bifida occulta.  Correct

 

APEA NURSING NR 509 Explanation:

There are four types of spina bifida: occulta, closed neural tube defects, meningocele, and myelomeningocele. Occulta is the mildest and most common form in which one or more vertebrae are malformed. The name “occulta,” which means “hidden,” indicates that a layer of skin covers the malformation, or opening in the vertebrae. This form of spina bifida, present in 10-20 percent of the general population, rarely causes disability or symptoms. Closed neural tube defects are often recognized early in life due to an abnormal tuft or clump of hair or a small dimple or birthmark on the skin at the site of the spinal malformation. Meningocele and myelomeningocele generally involve a fluid-filled sac—visible on the back—protruding from the spinal canal. In meningocele, the sac may be covered by a thin layer of skin. In most cases of myelomeningocele, there is no layer of skin covering the sac and an area of abnormally developed spinal cord tissue is usually exposed. Hirsutism is an excessive amount of hair on the body usually caused by a hormonal imbalance. An Arnold-Chiari malformation is a cyst-like formation in the fourth ventricle, cerebellum or brainstem.

Question:

A female patient complains of weakness in her arm when combing her hair. This finding could be suggestive of which type of weakness pattern?

 

Proximal  CorrectDistal  IncorrectSymmetricAsymmetric

 

Explanation:

To identify proximal weakness, ask about difficulty with movements such as combing hair, reaching up to a shelf, getting up out of a chair, or climbing a high step.

Question:

What geriatric condition is characterized by normal alertness but progressive global deterioration of cognition in multiple domains?

 

DeliriumCognitive impairmentParkinson’s diseaseAlzheimer’s disease  Correct APEA NURSING NR 509

 

Explanation:

Alzheimer’s disease is a geriatric condition in which normal alertness is present but progressive global deterioration of cognition occurs in multiple domains, including short-term memory, but with sparing of memory for remote events, subtle language errors, visuospatial perceptual difficulties, and changes in executive function, or the ability to perform sequential tasks such as instrumental activities of daily living (IADLs). Delirium is a serious disturbance in a person’s mental abilities that results in a decreased awareness of one’s environment and confused thinking. Cognitive impairment is an intermediate stage between the expected cognitive decline of normal aging and the more serious decline of dementia. Parkinson’s disease is a progressive disorder of the nervous system that affects movement.

Question:

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 position sense?

 

Motor systemCerebellar systemVestibular system  IncorrectSensory system  Correct

 

Explanation:

Coordination of muscle movement requires that four areas of the nervous system function in an integrated way: motor system for muscle strength, cerebellar system for rhythmic movements and steady posture, vestibular system for balance and coordinating eye, head, and body movements, and sensory system for position sense.

Question:

A band of skin innervated by the sensory root of a single spinal nerve is termed a:

 

peripheral nerve field.dermatome.  Correctsynapseasterixis.

 

Explanation:

A band of skin innervated by the sensory root of a single spinal or dorsal nerve root is termed a dermatome. A peripheral nerve field refers to an area of the skin innervated by a single nerve and is described as cutaneous nerve distribution. A synapse is a structure that permits a neuron to pass an electrical or chemical signal to another cell. Asterixis refers to an abnormal tremor consisting of involuntary jerking movements, especially in the hands, frequently occurring with impending hepatic coma and other forms of metabolic encephalopathy. This is also known as flapping tremor. APEA NURSING NR 509

Question:

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.  Correctan orthopedic referral.

 

Explanation:

A baby typically should be able to control the neck muscles by around 4 months of age, so that when pulling from a lying to a sitting position the head should remain in line with the torso and not flop back. Delays in reaching this developmental milestone have been observed in premature babies and in those with cerebral palsy; all others should be referred to a pediatric neurologist for further evaluation. The other choices do not address the issue or the cause. Early interventions result in better outcomes.

Question:

Hyperalgesia refers to:

 

decreased sensitivity to pain.increased sensitivity to pain.  Correctabsence 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:

Brief, repetitive, stereotyped, coordinated movements occurring at irregular intervals are consistent with:

 

facial tics.  Correctdystonic movements.athetoid movements.oral-facial dyskinesias.  Incorrect

 

Explanation:

Facial tics are brief, repetitive, stereotyped, coordinated movements occurring at irregular intervals. Examples include repetitive winking, grimacing, and shoulder shrugging. Dystonic movements are similar to athetoid movements, but often involve larger portions of the body, including the trunk. Grotesque, twisted postures may result. Athetoid movements are slower and more twisting and writhing than choreiform movements, and have a larger amplitude. They most commonly involve the face and the distal extremities. Oral–facial dyskinesias are rhythmic, repetitive, bizarre movements that chiefly involve the face, mouth, jaw, and tongue: grimacing, pursing of the lips, protrusions of the tongue, opening and closing of the mouth, and deviations of the jaw. These are involuntary movements.

Question:

When a patient complains of severe headaches that have worsened over the last few weeks but she has no other symptoms, a most likely diagnosis would be:

 

sinusitis.a tumor.  Correctsubarachnoid hemorrhage.  Incorrectan abscess.

 

Explanation:

The most important attributes of headaches are chronologic pattern and severity. Changing or progressively severe headaches increase the likelihood of tumor, abscess, or other masses. Extremely severe headaches suggest subarachnoid hemorrhage or meningitis and these headaches require immediate intervention because they worsen rapidly, not over a “few weeks”. Sinusitis does cause headache but these headaches are not usually severe.

Question:

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)  IncorrectCranial Nerve V (CN V)  CorrectCranial Nerve X (CN X)

 

Explanation:

Touching the cornea and assessing for a reflex assesses cranial nerve V.

Question:

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.  Incorrectpoint localization.  Correct

 

Explanation:

Graphesthesia, or number identification is the ability to identify a number when drawn in the hand of a patient whose eyes are closed. A discriminative sensation, stereognosis, is the ability to identify an object by feeling. The ability to identify an object touching 2 areas simultaneously is termed two-point discrimination. Point localization refers to the ability of the patient to identify the area of the body that was touched when his eyes were closed.

Question:

When assessing the cranial nerves, the nurse practitioner observes that the soft palate does not rise when the patient is instructed to say “ah”. This finding could be suggestive of a bilateral lesion in which cranial nerve?

 

Cranial Nerve V (CN V)Cranial Nerve VII (CN VII)Cranial Nerve IX (CN IX)Cranial Nerve X (CN X)  Correct

 

Explanation:

Failure of the soft palate to rise when the patient is instructed to say “ah” or yawn could be suggestive of a bilateral lesion in cranial nerve X (CN X)-vagus nerve.

Question:

The level of consciousness that refers to the patient that remains unarousable with eyes closed without evidence of response to inner need or external stimuli is said to be in:

 

an obtunded state.a comatose state.  Correcta lethargic state.a stuporous state.

 

Explanation:

A patient that remains unarousable with eyes closed without evidence of response to inner need or external stimuli is a comatose patient. An obtunded patient opens his eyes, looks at the person speaking to him but responds slowly and appears confused. Lethargy refers to the patient that appears drowsy but can open his eyes, respond to questions, then fall back to sleep. A stuporous patient arouses from sleep only after painful stimuli.

Question:

Having the patient shrug his shoulders and elicit neck movements would be testing Cranial Nerve:

 

VI.VII.IX.XI.  Correct

 

Explanation:

Cranial Nerve XI is the spinal accessory nerve and is responsible for proper functioning of the shoulder and neck muscles. When the trapezius is paralyzed, the shoulder droops and the scapula is displaced downward and laterally. Weakness with atrophy and fasciculations indicates a peripheral nerve disorder. CN VI tests extraocular movements; CN VII tests hearing; and CN IX and X test swallowing and the gag reflex. APEA NURSING NR 509

Question:

The Glasgow coma scale assesses:

 

cranial nerve response.pupillary response.motor response.  Correctauditory response.

 

Explanation:

Based on motor responsiveness, verbal performance, and eye opening to appropriate stimuli, the Glasgow Coma Scale was designed and should be used to assess the depth and duration of coma and impaired consciousness. This scale helps to gauge the impact of a wide variety of conditions such as acute brain injury due to traumatic and/or vascular injuries or infections, metabolic disorders such as hepatic or renal failure, hypoglycemia, or diabetic ketoacidosis. Cranial nerve, auditory, and pupillary responses are not included in the come scale assessment.

Question:

Discriminative sensations include all of the following except:

 

astereognosis.stereognosis.graphesthesia.deep tendon reflexes  Correct

 

Explanation:

Discriminative sensations test the ability of the sensory cortex to correlate, analyze, and interpret sensations. These include: stereognosis, graphesthesia, two-point identification, point localization, and extinction. Deep tendon reflexes evaluate the spinal nerve roots and usually include C5, C6, C7, L4, and S1.

Question:

Symmetric weakness of the distal muscles of the legs suggests a:

 

polyneuropathy.  Correctmyopathy.sensory neuropathy.cerebellar disease.  Incorrect

 

Explanation:

Polyneuropathy would present as symmetric weakness in the distal muscles. Symmetric weakness of the proximal muscles of the legs suggests a myopathy. Nystagmus, dysarthria, hypotonia, and ataxia would be characteristic of cerebellar disease. Sensory neuropathy usually presents as numbness, tingling, and pain.

Question:

The thalamus and the basal ganglion are located in the:

 

spinal cord.peripheral nervous system.white matter.gray matter.  Correct

 

Explanation:

Deep in the brain lie additional clusters of gray matter. These include the basal ganglia, which affect movement, and the thalamus and the hypothalamus structures in the diencephalon. The thalamus processes sensory impulses and relays them to the cerebral cortex. APEA NURSING NR 509.

Question:

The most common cause of viral encephalitis in children is:

 

Herpes simplex virus Type IIPicornavirusEnteroviruses  IncorrectHerpes simplex virus Type I  Correct

 

Explanation:

Herpes simplex Type I is the most common cause of viral encephalitis in children. The other choices are incorrect.

Question:

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’s sign.the straight-leg raise.  Correctthe plantar response.the ankle reflex.  Incorrect

 

Explanation:

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 the straight leg raise and is used to evaluate sciatica. It is positive if there is pain down the back of the leg below the knee. Ipsilateral calf wasting and weak ankle dorsiflexion may be present.

Question:

With the adult patient lying supine, the nurse practitioner flexes the patient’s neck while observing the hips and knees. Flexion of both hips and knees was noted. This is a positive:

 

Brudzinski’s sign.  CorrectKernig’s sign.nuchal rigidity sign.Babinski’s sign.

 

Explanation:

To elicit Brudzinski’s sign, flex the neck. Flexion of both the hips and knees is positive for Brudzinski’s sign. To test for Kernig’s sign, flex the patient’s leg at both the hip and the knee and then straighten the knee. Pain and increased resistance to extending the knee are positive for Kernig’s sign. With the patient lying supine, the nurse practitioner places her hands behind the patient’s head while flexing his neck forward so that his chin touches his chest. Neck stiffness with resistance to flexion is noted. This is positive for nuchal rigidity and suggestive of meningeal inflammation from meningitis or subarachnoid hemorrhage. To elicit the Babinski response, stroke the lateral aspect of the sole from the heel to the ball of the foot with the end of an applicator stick; plantar flexion is normal. Dorsiflexion of the big toe is a positive Babinski’s sign.

Question:

When a two-week-old infant presents with irritability, poor appetite, and rapid head growth with distended scalp veins, one should consider:

 

hydrocephalus.  Correctmeningitis.cerebral palsy.Reye’s syndrome. APEA NURSING NR 509.

 

Explanation:

The combination of signs is strongly suggestive of hydrocephalus: shrill with high-pitched cry, irritability, tense and bulging fontanels due to the increased amount of CSF being produced or not being absorbed. Meningitis would include signs of sepsis/infection. The manifestations of cerebral palsy vary but may include: persistence of primitive reflexes, delayed gross motor development, and a lack of progression through developmental milestones. Reye’s syndrome is associated with an antecedent viral infection with symptoms of malaise, nausea, and vomiting, progressive neurological deterioration occurs.

Question:

A term used to describe muscle wasting or loss of muscle bulk is:

 

hypertrophy.muscular atrophy.  Correctpseudohypertrophy.muscle weakness.

 

Explanation:

A term used to describe muscle wasting or loss of muscle bulk is muscular atrophy. Hypertrophy refers to an increase in bulk of the muscle with proportionate strength. An increase in muscular bulk with diminished strength is known as pseudohypertrophy. Muscular weakness is a term used to describe a lack of strength or firmness in a muscle.

Question:

Which one of the following senses is most often affected in patients on long-term antibiotic therapy?

 

TouchTasteSmellHearing  Correct

 

Explanation:

Many antibiotics can produce varying degrees of ototoxicity. The other senses are rarely, if ever, affected by long – term antibiotic use.

Question:

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 firstMoves about by crawling on the abdomen or all four extremitiesGenerally meets motor developmental milestones on schedulePresence of crossed or touching knees  Correct

 

Explanation:

Cerebral palsy (CP) is a group of disorders that can involve the brain and nervous system functions, such as movement, learning, hearing, seeing, and thinking. There are several different types of cerebral palsy, including spastic, dyskinetic, ataxic, hypotonic, and mixed. Symptoms usually depend on the type and can be seen before a child is 2 years old, and sometimes as early as 3 months. Symptoms may include delays in reaching and in developmental stages such as sitting, rolling, crawling, or walking, or abnormal gait. Arms may be tucked in toward the sides, knees may be crossed or touching, legs may make “scissor” movements, and child may walk on toes. Additionally, newborn reflexes may persist beyond the expected time frame for their disappearance.

Question:

The principal muscles involved when closing the mouth are innervated by which Cranial nerve?

 

Cranial nerve III (CN III)Cranial nerve V (CN V)  CorrectCranial nerve VII (CN VII)  IncorrectCranial nerve XII (CN XII)

 

Explanation:

The muscles responsible for closing the mouth are innervated by Cranial nerve V (trigeminal nerve). Cranial nerve V innervates the masseter, the temporalis, and the internal pterygoids.

Question:

The term used to describe involuntary muscle spasms and twisting of the limbs is:

 

dystonia.  Correctbradykinesia.akinesia.  Incorrectdyskinesia.

 

Explanation:

Dystonia is a neurological disorder that causes involuntary muscle spasms and twisting of the limbs. Bradykinesia is the term used to describe the impaired ability to adjust to one’s body position. This symptom is noted in patients who have Parkinson’s disease. The absence or loss of control of voluntary muscle movements is akinesia. Dyskinesia is defined as the presence of involuntary muscle movements such as tics or chorea. These movements can be seen in children who have rheumatic fever.

Question:

Postural tremors appear when the affected part is:

 

at rest.moving voluntarily. is actively maintaining a posture.  Correctgetting closer to its target.

 

Explanation:

Tremors are rhythmic oscillatory movements. Postural tremors appear when the affected part is actively maintaining a posture. Examples include the fine rapid tremor of hyperthyroidism, the tremors of anxiety and fatigue, and benign essential tremor. The other choices are not consistent with postural tremors.

Question:

A patient presents with sweating, tremors, palpitations, hunger, and confusion. This patient is most likely experiencing:

 

a syncopic event.hypoglycemia.  Correctpostural hypotension.hypocapnia.

 

Explanation:

A patient presenting with sweating, tremors, palpitations, hunger, headache, abnormal behavior, confusion, could be experiencing classic symptoms of hypoglycemia. Syncope could present with nausea and vomiting, dizziness, and possible fainting. Postural hypotension usually occurs after one stands up. Usually there are no prodromal symptoms. The blood pressure returns to normal when the patient lies down. Hypocapnia is decreased carbon dioxide and symptoms include dyspnea, palpitations, chest discomfort, numbness and tingling in the hands and around the mouth lasting for several minutes. Consciousness is maintained.

Question:

Most peripheral nerves contain afferent and efferent fibers. The term afferent refers to:

 

the cranial nerve fibers.spinal nerve fibers.sensory nerve fibers.  Correctmotor nerve fibers.

 

Explanation:

The peripheral nervous system includes spinal and peripheral nerves that carry impulses to and from the cord. Spinal nerve fibers co-mingle with similar fibers from other levels in plexuses outside the cord, from which peripheral nerves emerge. Most peripheral nerves contain both sensory (afferent) and motor (efferent) fibers.

Question:

During this type of seizure activity, the patient loses consciousness suddenly, sometimes with a cry, and the body stiffens into tonic extensor rigidity. Breathing stops, and the person becomes cyanotic. A clonic phase of rhythmic muscular contraction follows. This type of seizure activity is referred to as a:

 

focal seizure with impairment of consciousness.Jacksonian seizure.focal seizure that become generalized. grand mal seizure.  Correct

 

Explanation:

During a grand mal seizure the person loses consciousness suddenly, sometimes with a cry, and the body stiffens into tonic extensor rigidity. Breathing stops, and the person becomes cyanotic. A clonic phase of rhythmic muscular contraction follows. Focal seizures that become generalized are partial seizures that resemble tonic-clonic seizures. The patient may recall the aura and a unilateral neurologic deficit is present during the postictal period. Focal seizures with impairment of consciousness the person appears confused. Automatisms include automatic motor behaviors such as chewing, smacking the lips, walking about, and unbuttoning clothes. Tonic and then clonic movements that start unilaterally in the hand, foot, or face and spread to other body parts on the same side with the patient remaining conscious are known as Jacksonian seizures.

Question:

When assessing plantar reflexes, the nurse practitioner strokes the lateral aspect of the sole from the heel to the ball of the right foot. Absence of movement of the big toe is noted. This finding could be suggestive of a pathologic lesion in which segmented level of the spine?

 

Thoracic 8, 9, and 10Thoracic 10, 11, and 12Lumbar 5 and Sacral 1  CorrectSacral 2, 3, and 4

 

Explanation:

Superficial (cutaneous) reflexes and their corresponding spinal segments include the following: Abdominal reflexes: upper thoracic 8, 9, 10 and lower thoracic 10, 11, 12; Plantar: lumbar 5 and sacral 1; and Anal: sacral 2, 3, 4.

Question:

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 .  Correctcerebellum lesion.

 

Explanation:

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 corticospinal lesion originating in the contralateral hemisphere. An upward drift would be indicative of a lesion in the cerebellum. This test is called the Test for Pronator Drift and is used to test for upper motor neuron disease. APEA NURSING NR 509.

Question:

When evaluating a patient for weakness of the upper extremities, bilateral distal weakness is noted. This finding could be suggestive of:

 

alcohol myopathy.polyneuropathy.  Correctmyositis.neuromuscular junction disorders.  Incorrect

 

Explanation:

Bilateral predominantly distal weakness suggests a polyneuropathy, as in diabetes. Proximal limb weakness, usually symmetric and without sensory loss, occurs in myopathies from alcohol, glucocorticoids, and inflammatory muscle disorders like myositis and dermatomyositis. In the neuromuscular junction disorder myasthenia gravis, there is proximal, typically asymmetric weakness that gets worse with effort.

Question:

Ptosis of the left eye would be suggestive of damage to which cranial nerve?

 

Cranial Nerve II (CN II)Cranial Nerve III (CN III)  CorrectCranial Nerve IV (CN IV)Cranial Nerve V (CN V)

 

Explanation:

Ptosis of the left eye would be suggestive of 3rd nerve palsy (CN III)-Oculomotor nerve.

Question:

While palpating the temporal and masseter muscles, the patient is asked to clench his teeth and move his jaw from side to side. This maneuver would be assessing which cranial nerve?

 

Cranial Nerve III (CN III)Cranial Nerve IV (CN IV)Cranial Nerve V (CN V)  CorrectCranial Nerve VII (CN VII)  Incorrect

 

Explanation:

Palpation of the temporal and masseter muscles, when the patient clenches his teeth and moves his jaw from side to side. This maneuver assesses the Trigeminal nerve and cranial nerve (CN V).

Question:

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’s sign.Kernig’s sign.nuchal rigidity sign.Babinski’s sign.  Correct

 

Explanation:

To elicit Babinski sign, stroke the lateral aspect of the sole from the heel to the ball of the foot with the end of an applicator stick. Plantar flexion is normal. Dorsiflexion of the big toe is a positive Babinski’s sign. To elicit Brudzinski’s sign, flex the neck. Flexion of both the hips and knees is positive for Brudzinski’s. To test for Kernig’s sign, flex the patient’s leg at both the hip and the knee and then straighten the knee. Pain and increased resistance to extending the knee are positive for a Kernig’s sign. 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 positive nuchal rigidity and suggestive of meningeal inflammation from meningitis or subarachnoid hemorrhage.

Question:

An ambulatory child with spastic cerebral palsy needs a diet:

 

high in potassium.low in fiber.low in sodium.high in calories.  Correct

 

Explanation:

Every child’s nutrient needs must be assessed individually. It is important to take a number of factors into consideration when estimating energy needs: age, activity level, growth rate, and muscle tone. A child with spastic cerebral palsy (CP) who is not ambulatory will likely have lower energy requirements than a child with spastic CP who is ambulatory. A child with ambulatory spastic CP needs a diet high in calories to provide for increased metabolic needs secondary to energy lost through spastic movements and tremors. Foods rich in fiber are needed to prevent constipation and other gastrointestinal problems associated with cerebral palsy. Diet with balanced electrolytes is preferred.

Question:

The part of the brain that relays sensory information between brain regions and controls many autonomic functions of the peripheral nervous system is known as the:

 

cerebrum.brainstem.  Incorrectcerebellum.diencephalon.  Correct

 

Explanation:

The diencephalon relays sensory information between brain regions and controls many autonom

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