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ADVANCED PATHOPHYSIOLOGY WK 3 CHAPTER 13 Structure and Function of the Neurologic System 1. When a patient asks what the somatic nervous system controls, how should the nurse respond? It controls: ... a. the heart. b. the spinal cord. c. skeletal muscle. d. smooth muscle organs. 2. A nurse is preparing to teach about nerves. Which information should the nurse include? The axon leaves the cell body at the: a. axon hillock. b. Nissl body. c. node of Ranvier. d. myelin sheath. 3. When a student asks in which region of the neuron do nerve impulses travel the fastest, how should the nurse respond? The: a. large axon. b. axon hillock. c. cell body. d. dendrites. 4. A neurologist is teaching the staff about motor neurons. Which structural classification identifies motor neurons? a. Unipolar b. Pseudounipolar c. Bipolar d. Multipolar 5. An experiment looking at an isolated neuron revealed a sensory nerve with one process containing a dendritic portion extending away from the CNS and an axon extending toward the CNS. Which of the following classifications would this neuron fall into? a. Bipolar b. Multipolar c. Pseudounipolar d. Interpolar 6. A cell was isolated from the CNS. A researcher revealed that its main function was to clear cellular debris. What type of cell is the researcher studying? a. Astrocyte b. Ependymal cell c. Microglia d. Schwann cell 7. Which neurons have the capacity for regeneration? a. Unmyelinated neurons in the brain b. Myelinated neurons in the spinal cord c. Myelinated peripheral neurons d. Postganglionic motor neurons 8. When a presynaptic neuron is stimulated in a patient's body by an electrical current, neurotransmitters are released from the: a. synapse. b. synaptic bouton. c. synaptic cleft. d. receptor. 9. Neurotransmitters interact with the postsynaptic membrane by binding to which structure? a. Receptor b. Nissl body c. Glial cell d. Neurofibril 10. If a neuron's membrane potential is held close to the threshold potential by excitatory postsynaptic potentials (EPSPs), the neuron is said to be: a. hyperpolarized. b. facilitated. c. integrated. d. inhibited. 11. A patient brought to the emergency room (ER) with severe burns is requesting something for the excruciating pain and is medicated with morphine, which blocks which of the following neurotransmitters, thus reducing the pain? a. Enkephalin b. Dopamine c. Acetylcholine d. Substance P 12. A 19-year-old college student reports to his primary care provider that he cannot stay awake in class regardless of how much sleep he gets. Under-stimulation of which area of the brain is likely the site of the problem? a. Corpora quadrigemina b. Reticular activating system c. Cerebellum d. Hypothalamus 13. After rehabilitation for severe brain damage following a motor vehicle accident, a patient reports that her thought processes and ability to concentrate are impaired. Which area does the nurse suspect is damaged? a. Thalamus b. Limbic c. Prefrontal d. Occipital 14. A neurologist is teaching about the region responsible for motor aspects of speech. Which area is the neurologist discussing? a. Wernicke area b. Broca area c. Brodmann area 4 d. Brodmann area 6 15. A patient is looking at a picture of the brain and points to the convolutions on the surface of the cerebrum. The nurse should tell the patient these are called: a. sulci. b. fissures. c. reticular formations. d. gyri. 16. Where is the primary visual cortex of the brain located? a. Frontal lobe b. Temporal lobe c. Occipital lobe d. Parietal lobe 17. A nurse is preparing to teach about functions to maintain homeostasis and instinctive behavioral patterns. Which area of the brain is the nurse discussing? a. Thalamus b. Medulla c. Cerebellum d. Hypothalamus 18. When a nurse is teaching about the transverse fiber tract that connects the two cerebral hemispheres, what term should the nurse use? a. Peduncle b. Corpus callosum c. Basal ganglia d. Pons 19. A student nurse asks the nurse what controls reflex activities concerned with heart rate and blood pressure. What is the nurse's best response? These reflex activities are controlled by the: a. medulla oblongata. b. pons. c. midbrain. d. cerebrum. 20. Blockage of which of the following would cause hydrocephalus? a. Cerebral aqueduct b. Inferior colliculi c. Red nucleus d. Tegmentum 21. A patient presents with altered respiratory patterns following head trauma. Based on the symptoms, which of the following areas does the nurse suspect is injured? a. Cerebrum b. Cerebellum c. Midbrain d. Reticular formation 22. A nurse recalls that characteristics of upper motor neurons include: a. directly innervating muscles. b. influencing and modifying spinal reflex arcs. c. cell bodies located in the gray matter of the spinal cord. d. dendritic processes extending out of the CNS. 23. A nurse is teaching about the area of the spinal cord that contains cell bodies involved in the autonomic nervous system. Which of the following areas is the nurse discussing? a. Anterior horn b. Ventral horn c. Lateral horn d. Dorsal horn 24. A neurologist is teaching about sensory pathways. Which information should the neurologist include? Sensory pathways in the spinal cord to the thalamus are included in the: a. corticospinal tract. b. pyramids. c. spinothalamic tract. d. anterior column. 25. A nurse is discussing the membrane that separates the cerebellum from the cerebrum. What term should the nurse use to describe this membrane? a. Tentorium cerebelli b. Falx cerebri c. Arachnoid membrane d. Temporal lobe 26. What term should the nurse use when talking about the outermost membrane surrounding the brain? a. Dura mater b. Arachnoid mater c. Pia mater d. Falx cerebri 27. Cerebrospinal fluid (CSF) can accumulate around the brain when there is injury to the sites of CSF reabsorption, which are called the: a. arachnoid villi. b. epidural foramina. c. lateral apertures. d. choroid plexuses. 28. Which structure ensures collateral blood flow from blood vessels supplying the brain? a. Carotid arteries b. Basal artery c. Circle of Willis d. Vertebral arteries 29. What type of cell supports the forming of the blood-brain barrier (BBB)? a. Endothelial b. Schwann c. Oligodendrocyte d. Astrocyte 30. When a patient's vagus nerve is stimulated, what does the nurse expect to observe? a. Increased gastrointestinal activity b. Increased heart rate c. Pupil constriction d. Vasoconstriction 31. A patient suffers from head trauma that affects cranial nerve I. Which of the following symptoms would the nurse expect? a. Visual disturbances b. Loss of sense of smell c. Loss of ability to taste d. Hearing disturbances 32. Which neurotransmitter is released when a patient's parasympathetic motor neurons are stimulated? a. Epinephrine b. Serotonin c. Acetylcholine d. Substance P 33. Which action will occur when a patient's α1-receptors are stimulated? a. Dilation of the coronary arteries b. Vasoconstriction of arteries c. Increase in the strength of myocardial contraction d. Decrease in the rate of myocardial contraction 34. A patient begins taking a new drug that causes pupil dilation, vasoconstriction, decreased gastrointestinal motility, and goose bumps. Which of the following receptors are activated? a. α1 b. Α2 c. β1 d. Β2 35. The nurse is assessing the patient with a pen light. The integrity of which cranial nerve is being evaluated? a. Olfactory b. Vagus c. Oculomotor d. Trigeminal 36. Which of the following is a neuroglial cell? (select all that apply) a. Astrocyte b. Oligodendrocyte c. Neuron d. Ependymal cell e. Melanocyte 37. A nurse remembers the brain receives approximately ____% of the cardiac output. a. 80 b. 40 c. 20 d. 10 38. A nurse is monitoring intracranial pressure. A nurse recalls the normal upper limit of intracranial pressure is ____14___ mm Hg. 39. When a patient wants to know how many vertebrae make up the vertebral column, the nurse responds with _33____. 40. Which is an insulating substance for the neuron? a. Schwann cells b. Myelin c. Neuroglial cells d. Nodes of Ranvier 41. Which part of the brain contains all cell bodies and dendrites of neurons? a. Gyri b. Sulci c. White matter d. Gray matter 42. It is true that the cerebellum: a. makes up fibers of the corticospinal tract. b. maintains balance or posture. c. controls respiration. d. contains cranial nerves V through VIII. 43. The meninges surrounding the brain comprise the: (select all that apply) Select all that apply. a. dura mater. b. anterior fossa. c. pia mater. d. endosteal layer. e. anterior horn. 44. The central nervous system contains the: a. brain. b. somatic nervous system. c. afferent pathways. d. cranial nerves. 45. When a patient experiences a brain injury and the medulla oblongata is affected, it is reasonable to expect the client will experience: (select all that apply) Select all that apply. a. heart rate changes. b. alterations in respirations. c. altered blood pressure. d. alterations in balance and posture. e. problems in swallowing. 46. Successive, rapid impulses received from a single neuron on the same synapse best describes: a. temporal summation. b. spatial summation. c. actuation. d. facilitation. 47. Which structure is involved in pain transmission? a. Posterior horn b. Substantia gelatinosa c. Anterior horn d. Dorsal root ganglia 48. Which is a function of the thalamus? a. Major integrating center for afferent impulse b. Maintenance of internal environment c. Voluntary visual motor movements d. Movements of the auditory system 49. Which is a characteristic of Wallerian degeneration? (select all that apply) Select all that apply. a. Swelling b. Neurofilamental atrophy c. Myelin sheath shrinkage d. Axon portion degeneration e. Overproduction of axons 50. The neurotransmitter released from the postganglionic parasympathetic axon terminal is: a. acetylcholine. b. epinephrine. c. norepinephrine. d. dopamine. 51. It is true that the brain's Broca speech area: a. makes receptive responses possible. b. is responsible for motor speech. c. when traumatized results in the inability to hear. d. is found in the right cerebral hemisphere. 52. Which option is composed of endoplasmic reticulum and ribosomes? a. Nissl substances b. Dendrities c. Microfilaments d. Microtubules 53. The major divisions of the brain include: (select all that apply) Select all that apply. a. forebrain. b. cerebrum. c. midbrain. d. hindbrain. e. brainstem. 54. The midbrain contains the: a. cerebral hemisphere. b. tegmentum. c. cerebellum. d. medulla oblongata. CHAPTER 14 Pain, Temperature, Sleep, and Sensory Function 1. A patient asks the nurse where nociceptors can be found. How should the nurse respond? One location in which nociceptors can be found is the: a. skin. b. spinal cord. c. efferent pathways. d. hypothalamus. 2. A nurse is discussing an individual's conditioned or learned approach or avoidance behavior in response to pain. Which system is the nurse describing? a. Sensory-discriminative system b. Affective-motivational system c. Sensory-motivational system d. Cognitive-evaluative system 3. A patient scrapes both knees while playing soccer and reports sharp and well-localized pain. Which of the following should the nurse document to most accurately characterize the pain? a. Chronic pain b. Referred pain c. Somatic pain d. Visceral pain 4. A nurse should document on the chart that chronic pain is occurring when the patient reports the pain has lasted longer than: a. 1 month. b. 3-6 months. c. 1 year. d. 2-3 years. 5. Several years after an amputation the patient continues to sporadically feel pain in the absent hand. What type of pain should the nurse document in the chart? a. Neuropathic pain b. Visceral pain c. Phantom limb pain d. Chronic pain 6. When planning care for a child in pain, which principle should the nurse remember? The pain threshold in children is _____ that of adults. a. higher than b. more variable c. the same as d. not related to 7. When the nurse is taking a patient's temperature, which principle should the nurse remember? Regulation of body temperature primarily occurs in the: a. cerebrum. b. brainstem. c. hypothalamus. d. pituitary gland. 8. When the nurse is discussing the patient's cyclical temperature fluctuation occurring on a daily basis, what term should the nurse use? a. Thermogenesis cycle b. Thermoconductive phases c. Adaptive pattern d. Circadian rhythm 9. A nurse wants to teach about one of the primary organs responsible for heat production. Which organ should the nurse include? a. Pancreas b. Liver c. Adrenal medulla d. Heart 10. Heat loss from the body via convection occurs by: a. evaporation of electromagnetic waves. b. transfer of heat through currents of liquids or gas. c. dilation of blood vessels bringing blood to skin surfaces. d. direct heat loss from molecule-to-molecule transfer. 11. For evaporation to function effectively as a means of dissipating excess body heat, which one of the following conditions must be present? a. Moisture b. Fever c. Pyrogens d. Trauma 12. A patient received a prescription for a weight loss pill. One effect of the pills is to increase the release of epinephrine. Which of the following would be expected to also occur? a. Decreased vascular tone b. Increased skeletal muscle tone c. Increased heat production d. Decreased basal metabolic rate 13. When a patient has a fever, which of the following thermoregulatory mechanisms is activated? a. The body's thermostat is adjusted to a lower temperature. b. Temperature is raised above the set point. c. Bacteria directly stimulate peripheral thermogenesis. d. The body's thermostat is reset to a higher level. 14. Exogenous pyrogens are: a. interleukins. b. endotoxins. c. prostaglandins. d. corticotropin-releasing factors. 15. Hikers are attempting to cross the Arizona desert with a small supply of water. The temperatures cause them to sweat profusely and become dehydrated. The hikers are experiencing: a. heat cramping. b. heat exhaustion. c. heat stroke. d. malignant hyperthermia. 16. What is the physiological response when the body's core temperature is altered due to prolonged exposure to a cold environment? a. Increased respirations b. Ischemic tissue damage c. CNS excitation d. Increased cellular metabolism 17. Which finding indicates the patient is having complications from heat stroke? a. Mild elevation of core body temperatures b. Cerebral edema and degeneration of the CNS c. Spasmodic cramping in the abdomen and extremities d. Alterations in calcium uptake 18. Which condition would be treated with therapeutic hypothermia? a. Malnutrition b. Hypothyroidism c. Reimplantation surgery d. Parkinson disease 19. A patient is undergoing a sleep lab test. When the sleep lab worker notices EEG patterns with brain activity similar to the normal awake pattern, which phase of sleep is occurring? a. Non-rapid eye movement (REM) b. Fast wave c. REM d. Delta wave 20. Most memorable dreams occur during which sleep phase? a. Non-REM b. Alpha wave c. REM d. Delta wave 21. During the sleep cycle, when does loss of temperature control occur? a. Non-REM sleep b. Light sleep c. REM sleep d. Delta wave sleep 22. A 52-year-old male enters a sleep study to gather information about his sleep disturbances. He reports that his wife will not let him sleep in the bed with her until he stops snoring so loudly. He also reports feeling tired a lot through the day. When the nurse checks the chart, what is the most likely diagnosis? a. Insomnia b. Obstructive sleep apnea syndrome (OSAS) c. Somnambulism d. Jet-lag syndrome 23. A child suffers from sudden apparent arousals in which she expresses intense fear or other emotion. Her mother reports that she seems to wake screaming, but that she is difficult to waken completely. The child most likely suffers from: a. night terrors. b. parasomnia. c. somnambulism. d. enuresis episodes. 24. The ophthalmologist is teaching about the structure of the eye that prevents light from scattering in the eye. What structure is the ophthalmologist describing? a. Iris b. Pupil c. Choroid d. Retina 25. A 50-year-old diabetic patient experiences visual disturbances and decides to visit his primary care provider. After examination, the primary care provider tells the patient that the cells that allow him to see are degenerated. Which of the following structures is most likely damaged? a. Lens b. Pupil c. Cornea d. Retina REF: p. 347 26. A young child presents to the ophthalmologist for visual difficulties secondary to eye deviation. One of the child's eyes deviates inward, thereby decreasing the visual field. Which of the following diagnoses is most likely? a. Entropia b. Extropia c. Diplopia d. Nystagmus 27. A patient has increased intraocular pressure. Which diagnosis will the nurse observe on the chart? a. Glaucoma b. Ocular degeneration c. Diplopia d. Nystagmus 28. A 70-year-old patient presents to the primary care provider reporting loss of vision. A history that includes hypertension and cigarette smoking supports which visual diagnosis? a. Presbyopia b. Macular degeneration c. Strabismus d. Amblyopia 29. Which group of people is most prone to color blindness? a. Males b. Females c. Elderly persons d. Children 30. A nurse is teaching about the structure that connects the middle ear with the pharynx. Which structure is the nurse describing? a. Organ of Corti b. Eustachian tube c. Semicircular canal d. Auditory canal 31. The most common form of sensorineural hearing loss in the elderly is: a. conductive hearing loss. b. acute otitis media. c. presbycusis. d. Ménière disease. 32. A 15-year-old is diagnosed with an outer ear infection. Which of the following is most likely to cause this infection? a. Haemophilus b. Streptococcus pneumonia c. Moraxella catarrhalis d. Escherichia coli 33. The nurse would expect the patient with an alteration in proprioception to experience vertigo, which is manifested by: a. headache. b. light sensitivity. c. a sensation that the room is spinning. d. loss of feeling in the lips. 34. Which system modulates a patient's perception of pain? a. Sensory-discriminative system b. Affective-motivational system c. Cognitive-evaluative system d. Reticular-activating system 35. While planning care for infants, which principles should the nurse remember? (select all that apply) Infants have problems with thermoregulation because they: a. cannot conserve heat. b. do not shiver. c. rarely sweat. d. have decreased metabolic rates. e. have excess subcutaneous fat. 36. A patient asks the nurse how often REM sleep occurs. The nurse responds, "About every _____ minutes." a. 15 b. 30 c. 60 d. 90 37. Endogenous opioids include: (select all that apply) Select all that apply. a. enkephalins. b. endorphins. c. dynorphins. d. endomorphins. e. denkephalins. 38. A patient who was outside on a summer day and is now experiencing increased sweating and thirst, weakness, and dizziness is exhibiting signs of: a. heat cramps. b. heat exhaustion. c. hyperthermic stroke. d. malignant hyperthermia. 39. A patient who reports that "everything tastes unpleasant" is exhibiting symptoms of: a. hyposmia. b. anosmia. c. hypogeusia. d. dysgeusia. 40. A benefit of fever to human blood includes: a. decreased lymphocytic transformation. b. diminished phagocytosis. c. increased iron concentration. d. a switch to lipolysis and proteolysis. 41. Involuntary unilateral or bilateral rhythmic movement of the eyes is referred to as: a. nystagmus. b. amblyopia. c. glaucoma. d. strabismus. 42. The appropriate definition of perceptual dominance is: a. the duration of time or intensity of pain before overt pain responses are initiated. b. pain at one location that may cause an increase in threshold at another location. c. repeated exposure to a pain stimulus. d. the point at which pain is perceived. 43. It is TRUE that the specificity theory of pain: a. focuses on the attention of pain. b. focuses on previous experience of pain. c. relates the amount of pain to the amount of soft tissue injury. d. relates to the emotions exhibited toward pain. 44. Which type of hearing loss is a result of foreign body obstruction of the middle ear? a. Conductive b. Sensorineural c. Functional d. Presbycusis 45. The classification of acute pain includes: (select all that apply) Select all that apply. a. acute visceral. b. pleuritic. c. referred. d. acute somatic. e. cutaneous. 46. The appropriate term for pain that is present in an area distant from its point of origin is: a. acute pain. b. chronic pain. c. referred pain. d. somatic pain. 47. Which pair of structures regulates the complex emotional responses to pain? a. Frontal and cerebellar lobes b. Limbic and reticular system c. Thalamus and brainstem d. Midbrain and nuclei of thalamus 48. A young child presents with redness of the eyes. The parents indicate that this condition seems to be "going around" the daycare. Which is the most likely diagnosis? a. Blepharitis b. Keratitis c. Trachoma d. Conjunctivitis 49. An obese male presents to a sleep clinic complaining of difficulty sleeping. He reports that he wakes gasping for air. Which is the most likely diagnosis for this patient? a. Primary hypersomnia b. Parasomnia c. Somnambulism d. Obstructive sleep apnea 50. Which activity has been documented to increase the levels of circulating endogenous endorphins? a. Cough b. Stress c. Sleep d. Pain 51. Which mechanism does not result in heat loss? a. Increased respiration b. Conduction c. Convection d. Vasoconstriction CHAPTER 15 Alterations in Cognitive Systems, Cerebral Hemodynamics, and Motor Function 1. A neurologist explains that arousal is mediated by the: a. cerebral cortex. b. medulla oblongata. c. reticular activating system. d. cingulate gyrus. 2. A 20-year-old experiences a severe closed head injury as a result of a motor vehicle accident. Which of the following structures is most likely keeping the patient in a vegetative state (VS) 1 month after the accident? a. Cerebral cortex b. Brainstem c. Spinal cord d. Cerebellum 3. A 16-year-old's level of arousal was altered after taking a recreational drug. Physical exam revealed a negative Babinski sign, equal and reactive pupils, and roving eye movements. Which of the following diagnoses will the nurse most likely see on the chart? a. Psychogenic arousal alteration b. Metabolically induced coma c. Structurally induced coma d. Structural arousal alteration 4. The breathing pattern that reflects respirations based primarily on carbon dioxide (CO2) levels in the blood is: a. Cheyne-Stokes. b. ataxic. c. central neurogenic. d. normal. 5. A teenager sustains a severe closed head injury following an all-terrain vehicle (ATV) accident and is in a state of deep sleep that requires vigorous stimulation to elicit eye opening. How should the nurse document this in the chart? a. Confusion b. Coma c. Obtundation d. Stupor 6. A patient experiences a severe head injury hitting a tree while riding a motorcycle. Breathing becomes deep and rapid but with normal pattern. What term should the nurse use for this condition? a. Gasping b. Ataxic breathing c. Apneusis d. Central neurogenic hyperventilation 7. A patient presents to the emergency room (ER) reporting excessive vomiting. A CT scan of the brain reveals a mass in the: a. skull fractures. b. thalamus. c. medulla oblongata. d. frontal lobe. 8. For legal purposes, brain death is defined as: a. cessation of entire brain function. b. lack of cortical function. c. a consistent vegetative state (VS). d. death of the brainstem. 9. When thought content and arousal level are intact but a patient cannot communicate and is immobile, the patient is experiencing: a. cerebral death. b. locked-in syndrome. c. dysphagia. d. cerebellar motor syndrome. 10. What term is used to describe an explosive, disorderly discharge of cortical neurons? a. Reflex b. Seizure c. Inattentiveness d. Brain death 11. A patient has memory loss of events that occurred before a head injury. What cognitive disorder does the nurse suspect the patient is experiencing? a. Selective memory deficit b. Anterograde amnesia c. Retrograde amnesia d. Executive memory deficit 12. A 65-year-old patient who recently suffered a cerebral vascular accident is now unable to recognize and identify objects by touch because of injury to the sensory cortex. How should the nurse document this finding? a. Hypomimesis b. Agnosia c. Dysphasia d. Echolalia 13. A patient experiences a stroke and now has difficulty writing and producing language. This condition is most likely caused by occlusion of the: a. anterior communicating artery. b. posterior communicating artery. c. circle of Willis. d. middle cerebral artery. 14. A patient with an addiction to alcohol checked into a rehabilitation center as a result of experiencing delirium, inability to concentrate, and being easily distracted. What term would be used to document this state? a. Acute confusional state b. Echolalia c. Dementia d. Dysphagia 15. The patient is experiencing an increase in intracranial pressure. This increase results in: a. brain tissue hypoxia. b. intracranial hypotension. c. ventricular swelling. d. expansion of the cranial vault. 16. A compensatory alteration in the diameter of cerebral blood vessels in response to increased intracranial pressure is called: a. herniation. b. vasodilation. c. autoregulation. d. amyotrophy. 17. A patient is admitted to the neurological critical care unit with a severe closed head injury. When an intraventricular catheter is inserted, the intracranial pressure (ICP) is recorded at 24 mm Hg. How should the nurse interpret this reading? a. Higher than normal b. Lower than normal c. Normal d. Borderline 18. A 70-year-old patient is being closely monitored in the neurological critical care unit for a severe closed head injury. After 48 hours, signs of deterioration occur: pupils are small and sluggish, pulse pressure is widening, and heart rate is bradycardic. These clinical findings are evidence of what stage of intracranial hypertension? a. Stage 1 b. Stage 2 c. Stage 3 d. Stage 4 19. The primary care provider states that the patient is experiencing vasogenic edema. The nurse realizes vasogenic edema is clinically important because: a. it usually has an infectious cause. b. the blood-brain barrier is disrupted. c. ICP is excessively high. d. it always causes herniation. 20. The progress notes read: the cerebellar tonsil has shifted through the foramen magnum due to increased pressure within the posterior fossa. The nurse would identify this note as a description of _____ herniation. a. supratentorial b. central c. cingulated gyrus d. infratentorial 21. An infant is diagnosed with noncommunicating hydrocephalus. What is an immediate priority concern for this patient? a. Metabolic edema b. Interstitial edema c. Vasogenic edema d. Ischemic edema 22. An adult is diagnosed with communicating hydrocephalus. The form of hydrocephalus in adults is most often caused by: a. overproduction of CSF. b. intercellular edema. c. elevated arterial blood pressure. d. defective CSF reabsorption. 23. A 16-year-old male fell off the bed of a pickup truck and hit his forehead on the road. He now has resistance to passive movement that varies proportionally with the force applied. He is most likely suffering from: a. spasticity. b. paratonia. c. rigidity. d. dystonia. 24. A patient reports tiring easily, having difficulty rising from a sitting position, and the inability to stand on toes. The nurse would expect a diagnosis of: a. Parkinson disease. b. hypotonia. c. Huntington disease. d. paresis. 25. A patient has paralysis of both legs. What type of paralysis does the patient have? a. Paraplegia b. Quadriplegia c. Infraparaplegia d. Paresthesia 26. Spinal shock is characterized by: a. loss of voluntary motor function with preservation of reflexes. b. cessation of spinal cord function below the lesion. c. loss of spinal cord function at the level of the lesion only. d. temporary loss of spinal cord function above the lesion. 27. A patient has excessive movement. What disorder will the nurse see documented on the chart? a. Hypokinesia b. Akinesia c. Hyperkinesia d. Dyskinesia 28. A 40-year-old male complains of uncontrolled excessive movement and progressive dysfunction of intellectual and thought processes. He is experiencing movement problems that begin in the face and arms and eventually affect the entire body. The most likely diagnosis is: a. tardive dyskinesia. b. Huntington disease. c. hypokinesia. d. Alzheimer disease. 29. A nurse notes that a patient walks with the leg extended and held stiff, causing a scraping over the floor surface. What type of gait is the patient experiencing? a. Spastic gait b. Cerebellar gait c. Basal ganglion gait d. Scissors gait 30. A patient is admitted to the neurological critical care unit with a severe closed head injury. All four extremities are in rigid extension, the forearms are hyperpronated, and the legs are in plantar extension. How should the nurse chart this condition? a. Decorticate posturing b. Decerebrate posturing c. Dystonic posturing d. Basal ganglion posturing 31. A nurse recalls that neural systems basic to cognitive functions include _____ systems. (select all that apply) a. attentional b. memory and language c. affective d. sensory and motor e. tactile 32. The nurse is explaining clinical manifestations of alterations in the extrapyramidal system. The nurse would correctly include: (select all that apply) a. little or no paralysis of voluntary movement. b. normal or slightly increased tendon reflexes. c. positive (present) Babinski. d. presence of tremor. e. rigidity in muscle tone. 33. A patient who was admitted to a postsurgical unit 2 days ago is now demonstrating progressive restlessness and is uncharacteristically irritable. This scenario is characteristic of: a. Alzheimer disease. b. dementia. c. delirium. d. coma. 34. A patient presents with a wide-based gait in which the feet are turned outward. Staggering is noted when walking and the pelvis is held stiff. These characteristics are representative of: a. cerebellar gait. b. basal ganglion gait. c. decorticate posture. d. apraxia. 35. A patient who exhibits positioning that includes both arms being held close to the body with flexion at the elbows while legs are extended and rotated externally is demonstrating: a. decerebrate posture. b. spastic posture. c. decorticate posture. d. basal ganglion posture. 36. A patient often experiences vomiting with a central nervous system (CNS) injury when the trauma: a. impinges directly on the floor of the third ventricle. b. causes a decrease in intracranial pressure. c. involves the vestibular nuclei. d. also involves the abdominal area. 37. Criteria for determining brain death include: (select all that apply) Select all that apply. a. unresponsive coma. b. no spontaneous respiration. c. isoelectric EEG. d. pupils are reactive but unequal. e. ocular response to head turning. 38. A patient who is experiencing difficulty in recognizing a pattern's form and the nature of objects is exhibiting characteristics of: a. agnosia. b. aphasia. c. dysphasia. d. Alzheimer disease. 39. A patient has sustained a traumatic brain injury but is able to follow simple commands and can manipulate objects. The term used to describe this state is: a. coma b. vegetative c. minimally conscious d. locked-in syndrome 40. A patient diagnosed with Parkinson disease initially experiences: a. difficulty walking. b. resting tremors. c. postural instability. d. rigidity of leg muscles. 41. A patient experiencing the tonic phase of a seizure exhibits: a. muscle contraction with increased muscle tone. b. alternating contraction and relaxation of muscle. c. muscle contraction alternating with placidity. d. complete paralysis. 42. A characteristic of Alzheimer disease includes: (select all that apply) Select all that apply. a. rapid onset of symptomatology. b. short-term memory loss. c. increased irritability and agitation. d. anxiety and depression. e. remissions resulting in cognitive clarity. 43. Abnormal findings in which of the following evaluations would indicate possible neurologic dysfunction? (select all that apply) Select all that apply. a. Level of consciousness b. Pattern of breathing c. Decreased gastrointestinal motility d. Eye response e. Motor responses a,b,d,e The five categories that are critical for the evaluation process for neurologic function include: (1) level of consciousness (LOC), (2) pattern of breathing, (3) size and reactivity of pupils, (4) eye position and reflexive response, and (5) muscle motor responses. Gastrointestinal motility is not indicative of neurologic status. 44. A patient who is experiencing a loss of comprehension or the production of language is described as having: a. dysphasia. b. aphasia. c. expressive dysphasia. d. transcortical dysphasia. 45. It is correct to assume that Cheyne-Stokes respirations (CSR): a. involve a pathological pattern of crescendo-decrescendo. b. result in hypocapnia and increased ventilatory stimulus. c. cause changes in PaO2 that produce irregular breathing. d. increase PaCO2 level when overbreathing occurs. 46. A patient who reports a loss of childhood memories is describing a characteristic of: a. selective attention deficit. b. retrograde amnesia. c. anterograde amnesia. d. executive attention deficits. 47. It is TRUE that Alzheimer disease is: a. an uncommon neurologic disorder. b. not believed to have a genetic relationship. c. a result of neuronal proteins becoming distorted and tangled. d. the cause of plaques increasing nerve impulse transmission. 48. A basic neural system essential to cognitive function would include: (select all that apply) Select all that apply. a. attentional systems. b. memory systems. c. affective or emotive systems. d. sensory systems. e. language systems. 49. The term used to describe a patient who sustains a cerebrovascular accident and the limbs are paralyzed on an entire side is: a. hemiplegia. b. paraplegia. c. diplegia. d. quadriplegia. 50. A means of classifying a seizure includes: (select all that apply) Select all that apply. a. clinical manifestations. b. site of origin. c. response to therapy. d. length of activity. e. EEG correlates. 51. Pinhole-sized pupils can be a result of an overdose of: a. atropine. b. scopolamine. c. opiates. d. amphetamines. 52. A patient is diagnosed with Huntington disease. Which of the following is a TRUE statement? Huntington's disease is: a. a commonly diagnosed neurological disorder. b. a nonhereditary disease. c. also known as chorea. d. asymptomatic until the sixth decade of life. CHAPTER 16 Disorders of the Central and Peripheral Nervous Systems and the Neuromuscular Junction 1. A nurse is preparing to teach staff about the most common type of traumatic brain injury. Which type of traumatic brain injury should the nurse discuss? a. Penetrating trauma b. Diffuse axonal injury c. Focal brain injury d. Concussion 2. A coup injury resulting from a blow to the frontal portion of the skull would occur in which region of the brain? a. Frontal b. Temporal c. Parietal d. Occipital 3. What is the main source of bleeding in extradural (epidural) hematomas? a. Arterial b. Venous c. Capillary d. Sinus 4. A 69-year-old patient with a history of alcohol abuse presents to the emergency room (ER) after a month-long episode of headaches and confusion. The patient's history and symptomology support which medical diagnosis? a. Concussion b. Chronic subdural hematoma c. Epidural hematoma d. Subacute subdural hematoma 5. Immediately after being struck by a motor vehicle, a patient is unconscious, but the patient regains consciousness before arriving at the hospital and appears alert and oriented. The next morning the patient is confused and demonstrates impaired responsiveness. The patient's history and symptoms support which medical diagnosis? a. Mild concussion b. Subdural hematoma c. Extradural (epidural) hematoma d. Mild diffuse axonal injury 6. Which assessment finding by the nurse characterizes a mild concussion? a. A brief loss of consciousness b. Significant behavioral changes c. Retrograde amnesia d. Permanent confusion 7. A CT scan reveals that a patient has an open basilar skull fracture. Which major complication should the nurse observe for in this patient? a. Hematoma formation b. Meningeal infection c. Increased intracranial pressure (ICP) d. Cognitive deficits 8. A patient diagnosed with a diffuse brain injury (DBI) is at increased risk for which complication? a. Complete loss of vision b. Arrhythmia c. Acute brain swelling d. Meningitis infection 9. After falling, a patient's Glasgow Coma Scale (GCS) was 5 initially and 7 after 1 day. The patient remained unconscious for 2 weeks but is now awake, confused, and experiencing anterograde amnesia. This history supports which medical diagnosis? a. Mild diffuse brain injury b. Moderate diffuse brain injury c. Severe diffuse brain injury d. Postconcussive syndrome 10. Who is most at risk of spinal cord injury because of preexisting degenerative disorders? a. Infants b. Men c. Women d. The elderly 11. A patient is brought to the ER for treatment of injuries received in a motor vehicle accident. An MRI reveals spinal cord injury, and his body temperature fluctuates markedly. The most accurate explanation of this phenomenon is that: a. he developed pneumonia. b. his sympathetic nervous system has been damaged. c. he has a brain injury. d. he has septicemia from an unknown source. 12. Six weeks ago a patient suffered a T6 spinal cord injury. What complication does the nurse suspect when the patient develops a blood pressure of 200/120, a severe headache, blurred vision, and bradycardia? a. Extreme spinal shock b. Acute anxiety c. Autonomic hyperreflexia d. Parasympathetic areflexia 13. A patient diagnosed with a spinal cord injury experienced spinal shock lasting 15 days. The patient is now experiencing an uncompensated cardiovascular response to sympathetic stimulation. What does the nurse suspect caused this condition? a. Toxic accumulation of free radicals below the level of the injury b. Pain stimulation above the level of the spinal cord lesion c. A distended bladder or rectum d. An abnormal vagal response 14. A patient presents with acute low back pain. There is no history of trauma. An MRI reveals that the vertebra at L5 has slipped forward relative to those below it. Which of the following conditions will be documented on the chart? a. Degenerative disk disease b. Spondylolysis c. Spondylolisthesis d. Spinal stenosis 15. The majority of intervertebral disk herniations occur between which vertebral levels (cervical, C; thoracic, T; lumbar, L; sacral, S)? a. C1-C3 b. T1-T4 c. T12-L3 d. L4-S1 16. A 30-year-old white male recently suffered a cerebrovascular accident. Which of the following is the most likely factor that contributed to his stroke? a. Age b. Gender c. Diabetes d. Race 17. Which of the following would increase a patient's risk for thrombotic stroke? a. Hyperthyroidism b. Hypertension c. Anemia d. Dehydration 18. Of the following groups, who are at highest risk for a cerebrovascular accident (CVA)? a. Blacks over 65 years of age b. Whites over 65 years of age c. Blacks under 65 years of age d. Whites under 65 years of age 19. A 72-year-old patient demonstrates left-sided weakness of upper and lower extremities. The symptoms lasted less than an hour and resolved with no evidence of infarction. The patient most likely experienced a(n): a. stroke in evolution. b. arteriovenous malformation. c. transient ischemic attack. d. cerebral hemorrhage. 20. A major contributing process in CVAs is the development of atheromatous plaques in cerebral circulation. Where do these plaques most commonly form? a. In the larger veins b. Near capillary sphincters c. In cerebral arteries d. In the venous sinuses 21. A 60-year-old patient with a recent history of head trauma and a long-term history of hypertension presents to the ER for changes in mental status. MRI reveals that the patient has experienced a subarachnoid hemorrhage. What does the nurse suspect caused this type of stroke? a. Rheumatic heart disease b. Thrombi c. Aneurysm d. Hypotension 22. A 75-year-old patient experienced a lacunar stroke. When looking through the history of the patient's chart, which of the following would the nurse expect to find? a. An embolus b. An ischemic lesion c. A hemorrhage d. An aneurysm 23. Upon autopsy of a 25-year-old, abnormalities in the media of the arterial wall and degenerative changes were detected. Which of the following would most likely accompany this finding? a. Fusiform aneurysm b. Saccular aneurysm c. Arteriovenous malformation d. Thrombotic stroke 24. A 48-year-old patient presents at the ER reporting an acute severe headache, nausea, photophobia, and nuchal rigidity. Which medical diagnosis is supported by these signs and symptoms? a. Diffuse brain injury b. Subarachnoid hemorrhage c. Epidural hematoma d. Classic concussion 25. A 65-year-old patient diagnosed with a subarachnoid hemorrhage secondary to uncontrolled hypertension appears drowsy and confused with pronounced focal neurologic deficits. This symptomology would place this hemorrhage at which grade? a. I b. II c. III d. IV 26. A patient presents to a primary care provider reporting fever, headache, nuchal rigidity, and decreased consciousness. History includes a previously treated sinusitis. Which medical diagnosis is best supported by this assessment data? a. Aseptic meningitis b. Bacterial meningitis c. Fungal meningitis d. Nonpurulent meningitis 27. Most causes of encephalitis are which of the following? a. Bacterial b. Viral c. Fungal d. Toxoid 28. A 15-month-old child from Pennsylvania was brought to the ER with symptomology that includes fever, seizure activity, cranial palsies, and paralysis. Which form of encephalitis is best supported by the available assessment data? a. Eastern equine encephalitis b. Venezuelan encephalitis c. St. Louis encephalitis d. West Nile encephalitis 29. A patient is newly diagnosed with multiple sclerosis (MS). What physiological change is causing the patient's symptoms? a. Depletion of dopamine in the central nervous system (CNS) b. Demyelination of nerve fibers in the CNS c. The development of neurofibril webs in the CNS d. Reduced amounts of acetylcholine at the neuromuscular junction 30. When a patient asks, "What is the cause of multiple sclerosis?" the nurse bases the answer on the interaction between: a. vascular and metabolic factors. b. bacterial infection and the inflammatory response. c. autoimmunity and genetic susceptibility. d. neurotransmitters and inherited genes. 31. Patient teaching is considered successful regarding myasthenia gravis when the patient identifies its cause as being: a. viral infection of skeletal muscle. b. atrophy of motor neurons in the spinal cord. c. demyelination of skeletal motor neurons. d. autoimmune injury at the neuromuscular junction. 32. Patients diagnosed with myasthenia gravis often have tumors or pathologic changes in the: a. brain. b. pancreas. c. thymus. d. lungs. 33. What are the most common primary central nervous system (CNS) tumors in adults? a. Meningiomas b. Oligodendrogliomas c. Astrocytomas d. Ependymomas 34. A patient presents with seizures. An MRI reveals a meningioma most likely originating from the: a. dura mater and arachnoid membrane. b. astrocytes. c. pia mater. d. CNS neurons. 35. The patient reports generalized muscle weakness. The health care provider orders administration of the medication edrophonium chloride (Tensilon). This medication is used in the diagnosis of: a. amyotrophic lateral sclerosis (ALS). b. myasthenia gravis. c. multiple sclerosis (MS). d. autonomic hyperreflexia. 36. Which information is basic to the assessment findings associated with a patient diagnosed with an aneurysm? a. A headache is the most common symptom. b. The majority are asymptomatic. c. Nosebleeds are an early symptom. d. Epidural hemorrhage occurs in over 80% of patients. 37. What is the most common early symptom of a brain abscess? a. Neck rigidity b. Vomiting c. Drowsiness d. Headache 38. The person at highest risk for traumatic brain injury (TBI) is: a. black and economically disadvantaged. b. male and disabled. c. female and 20 years of age. d. an economically advantaged young adult. 39. A patient is brought to the emergency room following a motor vehicle accident in which a diffuse brain injury is sustained. Which symptoms would be expected to accompany the injury? (select all that apply) Select all that apply. a. Memory deficits b. Swallowing disorders c. Agitation d. Fatigue e. Short attention span 40. A patient experiences a vertebral fracture in which the C1 vertebra is fractured into several fragments. This type of fracture can be described as: a. simple. b. compressed. c. comminuted. d. dislocation. 41. It is TRUE that spinal shock: a. is characterized by an incomplete loss of reflex function. b. involves all skeletal muscles below the level of injury. c. causes increased muscle tone below the lesion. d. results in no disruption of thermal control. 42. A patient is experiencing pain that courses over the buttocks and into the calf and ankle. This is suggestive of a herniated disk at which vertebral level? a. Cervical b. Thoracic c. Lumbar d. Coccyx 43. Which is TRUE regarding meningitis? a. Bacterial meningitis is a primary infection of the gray matter. b. Aseptic meningitis is most commonly caused by a fungus. c. Fungal meningitis is the most common form worldwide. d. Tubercular meningitis has a 90% recovery rate, if diagnosed early. 44. Which is TRUE regarding metastatic brain tumors? a. Carcinomas are disseminated to the brain from the circulation. b. One-third of metastatic tumors are located within the brain. c. Two-thirds of metastatic tumors are located in the extradural spaces. d. Tumors of the pelvis tend to involve the frontal lobe. a 45. After a fall at home, an elderly patient experiences a hematoma located on the top of the brain. The hematoma is most likely: a. subdural. b. epidural. c. extradural. d. intracerebral. 46. It is correct to assume that Grade III and Grade IV astrocytomas are: a. commonly found in the frontal lobe and cerebral hemisphere. b. generally seen more in women than in men. c. usually necrotic as a result of an absence of vascularity. d. bluish gray in color with a hard purplish center. 47. Which of the following statements is TRUE regarding grading of the astrocytoma? a. Grade I is not treated. b. Grade II is treated with radiation only. c. Grades III and IV are treated with surgery. d. Grade III is not well circumscribed. 48. Which is correct regarding hemorrhagic strokes? They: a. are the most common cause of CVA. b. account for 50% of all CVAs. c. are commonly caused by hypertension. d. are often the result of a microinfarct. 49. A trauma patient diagnosed with a brain contusion experiences changes in attention, memory, affect, and emotion. In which region of the brain is the contusion most likely located? a. Cerebral b. Frontal c. Cerebellum d.Midbrain 50. A patient is diagnosed with a meningioma. The most likely site of the tumor is the: (select all that apply) Select all that apply. a. sella turcica. b. olfactory groove. c. tuberculum sellae. d. sphenoidal wing. e. cerebellopontine angle. 51. A patient is hit in the temporal portion of his skull. Although initial loss of consciousness occurs, the patient soon awakens and is conversant. Three hours later vomiting, drowsiness, and confusion are noted. These symptoms are most likely related to which type of brain injury? a. Diffuse axonal b. Intracerebral c. Subdural d. Epidural 52. It is true that an acute cerebrovascular accident (CVA) is: a. the leading cause of disability in the United States. b. the fifth most common cause of death in the United States. c. very likely to be followed by a second stroke within 1 year. d. experienced by 2 million individuals each year. 53. A cause of a cerebral aneurysm includes: (select all that apply) Select all that apply. a. arteriosclerosis. b. heroin abuse. c. congenital anomaly. d. trauma. d. cocaine abuse. 54. A patient experiences demyelination of the peripheral nerves with sparing of the axons. This is characteristic of: a. Alzheimer disease. b. Guillain-Barré. c. myasthenia gravis. d. amyotrophic lateral sclerosis (ALS). 55. Risk factors for a CVA include: (select all that apply) Select all that apply. a. obesity. b. smoking. c. diabetes. d. arterial hypertension. e. atrial fibrillation. 56. It is TRUE that encephalitis is: a. an afebrile illness lasting 1 week. b. caused by bacteria transmission. c. a result of arthropod-borne viruses. d. caused exclusively by herpes simplex II. 57. A patient has a brain abscess with a decreased necrotic center and mature collagen. This is most consistent with which stage? a. Early cerebritis b. Late cerebritis c. Early capsule formation d. Late capsule formation 58. The most common cause of TBI is: a. motor vehicle accidents. b. falls. c. sports-related events. d. violence. 59. Which is accurate regarding subarachnoid hemorrhages? They are: a. a particular risk for individuals with an intracranial aneurysms. b. seldom experienced in individuals with hypertension. c. a result of vasospasms not caused by trauma to the head. d. rarely fatal and result in minor cognitive impairments. CHAPTER 17 Alterations of Neurologic Function in Children 1. Which reflex of infancy will disappear first? a. Stepping b. Rooting c. Palmar grasp d. Moro reflex 2. A 10-month-old infant presents for a well-baby visit. Which of the following reflexes should be present at this age? a. Stepping b. Sucking c. Landau d. Palmar grasp 3. During infancy, what is the fastest growing part of the human body? a. Spinal cord b. Limb bones c. Head d. Vertebral column 4. A nurse is preparing to teach about the most common defects of neural tube closure. Which one should the nurse discuss? a. Anterior b. Posterior c. Lateral d. Superior 5. An infant has an anterior midline defect of neural tube closure. What term will the nurse observe written on the chart? a. Anencephaly b. Myelodysplasia c. Cyclopia d. Hydrocephalus 6. What nutrient should the nurse encourage a woman in the early stages of pregnancy to consume to prevent neural tube defects? a. Protein b. Iron c. Vitamin D d. Folic acid 7. What term is used to document a herniation of brain and meninges through a defect in the occipital area of the skull? a. Encephalocele b. Meningocele c. Myelomeningocele d. Craniosynostosis 8. Which term is used to document a hernial protrusion of a saclike cyst through a defect in the posterior arch of a vertebra? a. Craniosynostosis b. Meningocele c. Encephalocele d. Myelomeningocele 9. What term is used to describe a premature closure of one or more of the cranial sutures during the first 18 months of life? a. Craniosynostosis b. Congential hydrocephalus c. Microcephaly d. Acrania 10. A baby is stillborn after 6 hours of labor. Autopsy reveals hydrocephalus caused by cystic dilation of the fourth ventricle and aqueductal compression. Which of the following is the most likely diagnosis? a. Congenital hydrocephalus b. Microcephaly c. Dandy-Walker deformity d. Macewen sign 11. What is the cause of true (primary) microcephaly? a. Viral infection b. An autosomal recessive gene c. Fetal trauma d. Hydrocephalus 12. An infant is diagnosed with congenital hydrocephalus. Which of the following characteristics would the nurse expect to find? a. Enlarged ventricles b. Decreased cerebrospinal fluid (CSF) production c. Increased resorption of CSF d. Smaller than average head circumference 13. What is the most common type of cerebral palsy? a. Ataxic b. Dystonic c. Spastic d. Mixed 14. A child is diagnosed with cerebral palsy, characterized by extreme difficulty in fine motor coordination and purposeful movement. Which of the following types of cerebral palsy is the child experiencing? a. Ataxic b. Dystonic c. Spastic d. Mixed 15. Which of the following diseases does the nurse screen for in all newborns? a. Epilepsy b. Tay-Sachs disease c. Pica d. Phenylketonuria (PKU) 16. Parents of a 3-month-old bring the infant to the emergency room (ER) after a seizure has caused muscle rigidity. Both parents are of Jewish ancestry. For what genetic disease should this infant be screened? a. Juvenile myoclonic epilepsy b. Congenital encephalopathy c. Tay-Sachs disease d. PKU 17. A 3-year-old has been diagnosed with bacterial meningitis. What should the nurse expect to find on the lab report for the most common cause of this bacterial meningitis? a. Haemophilus influenzae b. Neisseria meningitidis c. Streptococcus pneumonia d. Escherichia coli 18. It is true that viral meningitis: a. is always sudden in onset. b. often occurs with measles, mumps, or herpes. c. is effectively treated with antibiotics. d. causes increased sugar in the cerebral spinal fluid (CSF). 19. A 3-year-old Black child with a history of sickle cell disease and is now diagnosed with meningitis. Which is the most likely microorganism the nurse will find on the lab report? a. Virus b. Haemophilus influenzae type B c. Streptococcus pneumonia d. Neisseria meningitidis 20. When should the nurse assess for the vomiting and headache that are the classic symptoms of childhood brain tumors? a. Morning b. Early afternoon c. As the sun goes down and darkness begins d. During the middle of the night 21. A nurse is preparing to teach about brain tumors. Which information should the nurse include? The most common type of brain tumor in children is: a. Neuroblastoma b. Astrocytoma c. Meningioma d. Germ cell 22. What is the most common location of brain tumors in children? a. Above the cerebellum b. In the posterior fossa c. In the anterior cerebrum d. In the ventricular lining 23. A nurse recalls that the most frequent location of a neuroblastoma is the: a. retroperitoneal region. b. mediastinum. c. cervical ganglion. d. lung. 24. A 10-year-old presents with headache and seizures. CT scan reveals a tumor that is located near the pituitary gland. Which of the following is the most likely tumor type? a. Astrocytoma b. Craniopharyngioma c. Ependymoma d. Medulloblastoma 25. A newborn child is diagnosed with a vertebral arch defect, spina bifida. This condition would lead the nurse to suspect the child may have which of the following as well? (select all that apply) a. Type II Chiari malformation b. Myelomeningocele c. Meningocele d. Acrania e. Craniosynostosis 26. Assessment signs of neuroblastoma include: (select all that apply) a. weight loss. b. irritability. c. fatigue. d. fever. e. constipation. 27. The percent of retinoblastomas that are inherited as an autosomal dominant trait is ____%. 28. At birth, a newborn has separations in the skull that contain unossified membranous tissue. These structures are referred to as: a. sutures. b. fontanels. c. Schwann cells. d. myelins. 29. The appropriate term for premature closure of one or more cranial sutures during the first 18-20 months of life is: a. acrania. b. craniosynostosis. c. microcephaly. d. congenital hydrocephalus. 30. A patient diagnosed with cerebral palsy exhibits increased muscle tone, prolonged primitive reflexes, scoliosis, and contractures. These are characteristic signs of a form of cerebral palsy called: a. spastic. b. dyskinetic. c. ataxic. d. mixed variety. 31. Pathology reports indicate that a child's brain tumor developed in the vermis of the cerebellum and extended into the fourth ventricle. The tumor is most likely a(n): a. medulloblastoma. b. ependymoma. c. cerebellar astrocytoma. d. brainstem glioma. 32. A child presents with congenital hydrocephalus. Upon tapping of his skull, a resonant sound is appreciated, which is referred to as: a. Macewen sign. b. sunsetting. c. Dandy-Walker deformity. d. Arnold-Chiari malformation. 33. Environmental factors that affect the development of a fetus's neural tube include: (select all that apply) Select all that apply. a. maternal nutrition. b. maternal exposure to toxins. c. alcohol consumption by the mother. d. paternal abuse of drugs. e. birth in an urban setting. 34. A newborn develops bacterial meningitis. The most common bacteria that cause this is: a. Escherichia coli. b. Haemophilus influenzae type B. c. Neisseria meningitidis. d. Streptococcus pneumoniae. 35. An anomaly in which the soft, bony components of the skull and part of the brain are missing is called a(n): a. anencephaly. b. cyclopia. c. encephalocele. d. meningocele. 36. A patient recovering from varicella-zoster experiences obtundation, coma, and hyperventilation and is diagnosed with Reye syndrome. Which stage of the syndrome is this patient experiencing? a. Stage I b. Stage II c. Stage III d. Stage IV 37. A patient has a hernial protrusion of a saclike cyst containing meninges, spinal fluid, and a portion of the spinal cord through a deficit in the spinal column. This condition is described as a(n): a. encephalocele. b. meningocele. c. myelomeningocele. d. Arnold-Chiari malformation. [Show More]

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