Hinkle Chapter 65: Assessment of Neurologic Function

To evaluate a client's cerebellar function, a nurse should ask

"Do you have any problems with balance?"

How many pairs of coccygeal nerves are contained within the spinal column?

1

How many pairs of thoracic nerves are contained within the spinal column?

12

How many pairs of lumbar and sacral nerves are contained within the spinal column?

5

When more than 20 mL of CSF is removed during a lumbar puncture, the patient is positioned supine for

6 hours

How many pairs of cervical nerves are contained within the spinal column?

8

What is performed to obtain samples of CSF from the subarachnoid space for laboratory examination and to measure CSF pressure

A lumbar puncture (spinal tap)

What major transmitter of the parasympathetic nervous system stimulates the vagal nerve to slow the heart rate?

Acetylcholine

Which neurotransmitter is deficient in myasthenia gravis?

Acetylcholine

The nurse evaluates motor response in a comatose or unconscious client by

Administering a painful stimulus

This term refers to the inability to recognize objects through a particular sensory system

Agnosia

The term that refers to a client's inability to identify a familiar object by touch after head injury to the parietal lobe

Astereognosis

This term refers to the inability to coordinate muscle movements, resulting in difficulty walking

Ataxia

Lesions in the temporal lobe may result in this type of agnosia

Auditory

A client experienced a stroke that damaged the hypothalamus. The nurse should anticipate that the client will have problems with

Body Temperature Control

What portion of the brain is most likely to cause an inability to breathe?

Brain Stem

The cause of post-lumbar puncture headaches

Cerebral spinal fluid leakage at the puncture site

What is it called when reflexes are hyperactive when the foot is abruptly dorsiflexed

Clonus

What does the nurse recognize as a parasympathetic effect when assessing the pupils of a patient who has had a head injury?

Constricted pupils

This neurotransmitter inhibits pain transmission

Enkephalin

The trochlear nerve (IV) controls which function?

Eye muscle movement

What would the nurse document when the client makes no motor response to stimuli?

Flaccidity

This lobe of the brain is responsible for concentration and abstract thought

Frontal

Which lobe affects personality and affect?

Frontal

Cranial nerve IX is also known as

Glossopharyngeal

Term to describe when a client's feet make a half circle during ambulation

Helicopod

A client is admitted to an acute care facility with a suspected dysfunction of the lower brain stem. The nurse should monitor this client closely for:

Hypoxia

Which cranial nerve effects smell?

I or Olfactory

Which cranial nerve is the nurse assessing when they ask the patient to cover one nostril at a time to see if the patient can smell coffee, alcohol, and mint?

I or Olfactory

Which cranial nerve is the nurse testing when using the Snellen eye chart?

II or Optic

What cranial nerve is affected with decreased visual fields?

II or optic

Extraocular eye movement, eyelid elevation, and pupil constriction are functions of this cranial nerve

III or Oculomotor

The nurse should instruct the client to refrain from eating and drinking with impairment of these 2 nerves

IX or Glossopharyngeal and X or Vagus

To determine when the client is ready for a liquid diet, the nurse assesses cranial nerves

IX or Glossopharyngeal and X or Vagus

Swallowing is a motor function of Which cranial nerves?

IX or Glossopharyngeal and X or the vagus

Upper motor neuron lesions cause

Increased muscle tone, hyperactive and abnormal reflexes

The patient is exhibiting signs of expressive aphasia with numbness/tingling and weakness of the right arm and leg

Left frontoparietal region (Broca's area)

This structure of the brain transmits motor impulses from the brain to the spinal cord, and sensory impulses from the peripheral sensory neurons to the brain

Medulla oblongata

client responds to painful stimuli with decerebrate posturing. This finding indicates damage to which part of the brain?

Midbrain

How does the nurse assess a patient for neck rigidity correctly?

Moving the head and chin toward the chest

This lobe contains your primary visual cortex

Occipital

The cerebral cortex is located

On the surface of the cerebrum

This lobe analyzes sensory information such as pressure, vibration, pain, and temperature and is responsible for spatial relationships

Parietal

This lobe is the primary sensory cortex. It is essential to a person's awareness of his body in space, as well as orientation in space and spatial relations.

Parietal

What disorder caused by a lesion in the basal ganglia?

Parkinson's Disease

The priority nursing intervention that should be provided after a lumbar puncture

Position the client flat for at least 3 hours

A patient is scheduled for myelography using metrizamide (a water-soluble contrast dye). After the test, the nurse should place the client in which position?

Semi fowlers

A patient has been diagnosed with damage to Broca's area of the left frontal lobe. What would the nurse assess to document the extent of the damage?

Speech

Which nervous system regulates the expenditure of energy?

Sympathetic

This lobe contains the auditory receptive areas located around the temples

Temporal

This test measures the hearing acuity precisely

The Audiometric test

These tests help to identify types of hearing loss

The Rinne test and the Weber test

This test is used to evaluate a person's ability to sustain balance

The Romberg test - close eyes and stand erect

This part of the brain is largely responsible for coordination of all movement

The cerebellum

Reflexes in the body are centered in

The spinal cord

What is the function of the medulla oblongata?

Transmits motor impulses from the brain to the spinal cord

Chewing is a function of which cranial nerve?

V or Trigeminal

The patient is experiencing difficulty chewing. Which cranial nerve does this indicate damage to?

V or Trigeminal

This cranial nerve innervates the forehead, cheeks, and jaw

V or Trigeminal

What cranial nerve does the nurse understand can cause facial pain?

V or Trigeminal

Incurring damage to which cranial nerve can cause episodes of double vision?

VI or Abducens

Which cranial nerve controls lateral eye movement?

VI or Abducens

This cranial nerve affects symmetry of facial expression and muscle movement in the face, along with salivation and tearing, taste, and sensation in the ear.

VII or Facial

The Romberg test is related to cranial nerve

VIII or Acoustic

The whisper test is used to assess which cranial nerve?

VIII or Acoustic

This cranial nerve is tested by listening to a ticking watch

VIII or Acoustic

Damage to which cranial nerve results in loss of gag reflex?

X or Vagus

Having the client say "ah" tests which cranial nerve?

X or the vagus nerve

This cranial nerve allows you to shrug your shoulders and turn your head against resistance

XI or Spinal accessory

When asking a patient to stick out their tongue, which cranial nerve are you evaluating?

XII or Hypoglossal

Which diagnostic test does the nurse anticipate to monitor the status of a cerebral aneurysm?

cerebral angiography

During an acute crisis, the nurse should check which reflex response to rapidly assess brain stem function

corneal reflex response

Lower motor neuron lesions cause

flaccidity, muscle atrophy, decreased muscle tone, and loss of voluntary control

To assess the function of cranial nerve XII (hypoglossal), the nurse should assess the client's ability to

stick out the tongue and move it rapidly from side to side and in and out.