Neurological Assessment and Management in Older Adults, Exams of Nursing

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NSG 6420 week 9 quiz Latest Updated

An elderly patient is maintained on phenytoin therapy for a history of a seizure disorder. In addition to periodic serum drug concentrations, which of the following are needed for annual evaluation? - Correct Answer Complete blood count, liver function tests, and platelet count An elderly patient has had a CVA in the anterior cerebral circulatory system (frontal lobe). What symptoms are most likely expressed? - Correct Answer Disorders of behavior and cognition When assessing a patient who complains of a tremor, the nurse practitioner must differentiate essential tremor from the tremor of Parkinson's disease. Which of the following findings are consistent with essential tremor? - Correct Answer The tremor occurs with purposeful movements An older adult client with a history of a seizure disorder comes into the clinic for a routine check-up. Although seizure free, the client continues on long-term phenytoin treatment. The nurse practitioner would assess for which of the following long-term effects? - Correct Answer Gingival hyperplasia and nystagmus The most common neurological cause of seizures in an older adult is: - Correct Answer Stroke Mr. Andrews experienced a brief onset of right-sided weakness, slurred speech, and confusion yesterday. The symptoms have resolved. What should the nurse practitioner do? - Correct Answer Do a thorough medication review and a CT scan An older male patient is experiencing acute onset of right-sided weakness, slurred speech, and confusion. What should the nurse practitioner do promptly? - Correct Answer Evaluate for stroke and arrange transport to the hospital right away When assessing an elderly client who reports a tremor, which assessment findings would be most reliable in identifying Parkinson's disease? - Correct Answer Resting tremor, slow unsteady gait, and cogwheel resistance A middle-aged patient has been diagnosed with Parkinson's disease. What influences the nurse practitioner's decision to begin pharmacological treatment for this patient? - Correct Answer Symptoms interfering with functional ability A female patient presents to the clinic with complaints of a severe, throbbing, unilateral headache. She complains of seeing flashes of light prior to the headache. She complains of sound and light sensitivity as well as nausea. The clinician should recognize these as symptoms of: - Correct Answer Migraine headache

Which of the following is a common trigger of migraine headache? - Correct Answer All of the above A 65-year-old woman is accompanied by her daughter for a physical examination. She has mild heart failure and takes digitalis and an ACE inhibitor. As you examine the patient, you note flat affect, hand tremor, and slowed movements. The tremor is worsened at rest. There are no neurologic deficits. Hand grip, sensation of face and extremities, and lower extremity muscle strength are within normal limits and bilaterally equal. DTRs are equal bilaterally. CN II to XII are intact. The mental status exam is normal. These are key signs of: - Correct Answer Parkinson's disease A 65-year-old male complains of a headache that feels "like a knife is cutting into his head." He also reports feeling right-sided scalp and facial pain and "seeing double" at times. He has a history of hypertension and hyperlipidemia. His medications include beta blocker, statin drug, and an ACE inhibitor. On physical examination, you note palpable tenderness over the right side of the forehead. There are no neurological deficits. Vision is 20/20 with lenses. No weakness of extremities. CN II to XII are intact. The history corresponds to which of the following disorders? - Correct Answer Giant cell arteritis Which type of seizure is involved following a head injury or febrile event? - Correct Answer Isolated M. L. is a 40-year-old female that has been recently diagnosed with Multiple Sclerosis (MS). As you provide primary care for your patient you inform her that: - Correct Answer Often MS has a varying pattern of exacerbation and remissions Ms. Smith, 37-year-old, comes to the clinic today complaining of dull, throbbing bilateral headaches almost every evening. You suspect she is experiencing: - Correct Answer tension headaches The FNP is seeing Mr. Smith a 78-year-old gentleman accompanied by his wife to the health clinic. His wife reports that he has been falling down, tripping and stumbling. The FNP suspects a problem in: - Correct Answer Cerebellum Educating your patient about headache management should include information about all but: - Correct Answer Common laboratory testing for diagnosis Mr. Marshall is a 72-year-old man, with a history of hypertension, COPD and moderate dementia, who presents with 4 days of increased confusion, nighttime restlessness, visual hallucinations, and urinary incontinence. His physical exam is unremarkable except for tachypnea, a mildly enlarged prostate, inattentiveness, and a worsening of his MMSE score from a baseline of 18 to 12 today. Mr. Marshall's presentation is most consistent with an acute delirium (acute change in cognition, perceptual derangement, waxing and waning consciousness, and inattention). What is the most likely diagnosis to

frequently cause acute delirium in patients with dementia? - Correct Answer Urinary tract infection Mr. Marshall was administered the Mini-Mental State Exam (MMSE). Which of the following statements pertaining to this tool is a true statement? - Correct Answer Because Mr. Marshall has symptoms of change of mental status you are not screening The three cardinal features of Parkinson's disease are: - Correct Answer Bradykinesia, rigidity, and tremor The Mini-Cog is a short screening tool used to assess cognition. Which of the following statements pertaining to the test is a true statement? - Correct Answer The patient is asked to draw the hour and minute hands on a picture of an analog clock.