Neurological Disorders Practice Questions

A 52 year old patient presents with an acute drooping upper right eyelid. She states that the right side of her face feels numb. Stroke has been ruled out. Based on the most likely etiology, how should she be managed? A. Steroids plus an antiviral agent B. Immediate referral to the ER C. Antiviral agent only D. Steroids only

A

Mini mental status exam helps to identify patients who have symptoms of: A. cognitive impairment B. depression C. behavioral changes D. stroke

A

A 60 year old has anosmia. Which cranial nerve must be assessed? A. I B. II C. V D. X

A anosmia=inability to smell

A 72 year old patient with history of polymyalgia rheumatica complains of new onset, unilateral headache and visual changes. Her sedimentation rate is elevated. Her neurologic exam is otherwise normal. What is the most likely reason for her symptoms? A. Transient ischemic attack B. Temporal arteritis C. Meningitis D. CVA

B

A 75 year old is diagnosed with essential tremor. What is the most commonly used medication to treat this? A. Carbidopa B. Long-acting propranolol C. Phenobarbital D. Gabapentin

B

A patient who had an embolic stroke has recovered and is performing all of her activities of daily living. Taking aspirin for stroke prevention is an example of: A. primary prevention B. secondary prevention C. tertiary prevention D. quarternary prevention

B

A patient with migraine headaches and hypertension should receive which medication class with caution? A. Beta blockers B. Triptans C. Pain medications D. ACE inhibitors

B

Which of the following are diagnostic criteria for migraine headache without aura? A. Pain is episodic during the headache B. Pain lasts 4-72 hours C. There are underlying neurologic abnormalities D. Photophobia must be present

B

Which symptom below is true of cluster headaches but not migraine headaches? A. It is more common in females B. The length of the headache duration is about 30-90 minutes C. The most common characteristic is family history D. Sunlight is a common trigger

B

A 70 year old exhibits a unilateral resting tremor. This likely indicates: A. intention tremor B. alcohol withdrawal C. Parkinson's disease D. benign essential tremor

C

A neurologic disease that produces demyelination of the nerve cells in the brain and spinal cord is: A. Parkinson's disease B. late stage Lyme disease C. multiple sclerosis D. amyotrophic lateral sclerosis

C

A patient complains of right leg numbness and tingling following a back injury. He has a diminished right patellar reflex and his symptoms are progressing to both legs. What test should be performed? A. Lumbar Xrays B. Lumbar CT scan C. Lumbar MRI D. Lumbar MRI w/ contrast

C

A patient is examined and found to have a positive Kernig's and Brudzkinski's signs. What is the most likely diagnosis? A. Hepatitis B. Encephalitis C. Meningitis D. Pneumonitis

C

A patient who is 82 years old is brought into the clinic. His wife states that he was working in his garden today and became disoriented and had slurred speech. She helped him back into the house, gave him cool fluids, and within 15 minutes his symptoms resolved. He appears in his usual state of health when he is examined. He states that although he was scared by the event, he feels fine now. How should the NP proceed? A. Prescribe an aspirin daily B. Re-examine him tomorrow C. Send him to the ER D. Order an EKG

C

A typical description of sciatica is: A. deep and aching B. worse with lying down C. burning and sharp D. precipitated by coughing

C

Asking the patient to visually follow a finger through the cardinal fields of gaze assesses which cranial nerve? A. I B. II C. III D. V

C

What recommendation should be made to an older adult who is diagnosed with mild dementia? A. Driving will probably not increase your risk of an accident B. The healthcare provider should recommend that the patient stop driving today C. The healthcare provider should recommend assessment of driving to determine the risk of an accident D. The patient may continue driving as long as he feels comfortable

C

Which finding in a patient with migraine headache symptoms would compel the examiner to order an imaging study? A. First occurrence with typical migraine symptoms B. Nausea and photophobia C. Rapidly increasing intensity of headache D. Fully reversible speech disturbance

C

A 62 year old female patient presents to the clinic with very recent onset of intermittent but severe facial pain over the right cheek. She is diagnosed with trigeminal neuralgia. What assessment finding is typical of this? A. Pain is much worse with sticking her tongue out B. Pain is better with light touch over the affected area C. Pain is relieved with NSAIDs D. Pain may be triggered with light touch of the right cheek

D

A 70 year old male patient is diagnosed w/ vertigo. Which choice below indicates that the vertigo is more likely to be of central etiology? A. Brief duration B. Nystagmus present C. N/V D. Persistent symptoms

D

A patient is diagnosed with carpal tunnel syndrome. Which finger is not affected by carpal tunnel syndrome? A. Thumb B. Second finger C. Fourth finger D. Fifth finger

D

A patient who is 60 years old complains of low back pain for the last 5-6 weeks. She states that the severity is about 4/10 and that she gets no relief from sitting, standing, or lying. The NP should consider: A. sciatica B. ankylosing spondylitis C. disk disease D. systemic illness

D

A young male patient with a herniated disk reports bilateral sciatica and leg weakness. If he calls the NP with complaints of urinary incontinence, what should be suspected? A. Opioid overuse B. Medial or lateral herniation C. Rupture of the disk D. Cada equina syndrome

D

All of the following characteristics may be found in an older adult with dementia. Which one is common in a patient with Alzheimer's disease, but uncommon in a patient with another type of dementia? A. Visual hallucinations B. Personality change C. Abrupt onset D. Indifference

D

Mr. Williams has moderate cognitive deficits attributed to Alzheimer's disease and has been started on a cholinesterase inhibitor. The purpose of this drug is to: A. decrease agitation B. increase anticholinergic stimulation of the brain C. improve depression D. slow progression of his cognitive deficits

D

Which of the following would NOT be part of the differential diagnosis for an 84 year old patient with dementia symptoms? A. Tumor B. Cerebral hemorrhage C. Cerebral infarct D. Normal aging process

D