Health Assessment

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Neruo

Although a full mental status exam may not be required, the examiner must address the four main headings during history and physical exam. These headings are

appearance, behavior, cognition, and thought processes

Mr. Willowby is a 64-year-old patient who comes to the clinic for a scheduled appointment. Which of the following most accurately describes a patient's appearance?

A) Tense posture with continuous foot movement and frequent grimacing; clothing is clean; wearing light cotton tee shirt, shorts, and no shoes or coat (outdoor temperature in the low 40s); negligible body or breath odors

Memory impairment is best described as

the impaired ability to learn or recall prior learning despite absence of significant cognitive impairments.

Behaviors assessed during the mental status examination include

consciousness, facial expression, speech, and mood.

Mr. Jones, a 72-year-old gentleman, is brought to your office by his son. The son describes his father as having a sudden onset of cognitive impairment, illogical flow of ideas, and a disturbed sleep/wake cycle. Which of the following best describes this condition?

Delirium

Speech and mood fall under the category of

Behavior

Mrs. Bowen is a 67-year-old patient who comes to the clinic with her son, who is concerned about his mother's language skills. Which of the following is considered an additional test for persons with aphasia? Asking the person to

Write an original sentence

The Mini Cog specifically screens for

Dementia

Delusion is an example of an abnormality of

Thought content

Dementia can best be described as

The development of multiple cognitive deficits

A mental status assessment documents

dysfunction and how dysfunction impacts self-care

Language as a social tool coincides with a

child's readiness to play cooperatively

The development of thought process coincides with readiness for

school

When children reach approximately 7 years of age

their thinking becomes more logical and systematic and they are able to reason and understand

Aphasia is best described as

a language disturbance

Mr. Reiman is a 67-year-old patient who comes to your office with his daughter. The daughter states that her father has intact reading comprehension, impaired writing skills, and uses only nouns in speech. Which of the following best identifies this condition

Brocha's aphasia ( Expressive)

Wernicke's aphasia is ______ aphasia

Receptive

Testing the deep tendon reflexes gives the examiner specific information regarding the intactness of the

reflex arc at specific levels in the spinal cord

When testing the DTRs of a 74-year-old male with a history of contracting polio at the age of 6, which of the following responses would be expected?

Absent reflexes

Mr. McKnight is a 37-year-old patient who presents to your office with a complaint of unsteady gait. When you are testing the quadriceps reflex, which of the following is an expected response

Extension of the lower leg

Mr. Bryan is a 57-year-old patient who comes to you with his wife. His wife notes that he has had an unsteady gait for the last few days. When you are testing the DTRs of an individual, the concept of reinforcement may become important and is best described by which of the following?

If you are unable to initiate a DTR, have the individual perform an isometric exercise in a muscle group away from the one being tested.

Mrs. Bowers brings her newborn daughter in for her first post-hospital visit. On examination, you note the presence of primitive reflexes. The presence of primitive reflexes in a newborn is indicative of which of the following?

Immaturity of the nervous system

Which of the following concepts should guide your assessment of the newborn related to a sensory exam

Infants generally have a reduced ability to perceive sensory stimulus and require a stronger stimulus to initiate a response

When observing a toddler get up from a lying position, you note that he positions himself on all four extremities and then climbs up himself until he is upright. Your impression related to this observation is

Child needs screened for muscular dystrophy

Mr. Brooks is a 51-year-old patient who presents to your office for a follow-up examination. Which of the following procedures is specifically associated with testing cerebellar function?

Rapid alternating movements

Use of the Glasgow Coma Scale will provide the health care provider with which of the following pieces of information?

Measure of the LOC

Mr. Williams presents for evaluation after sustaining an injury to Wernicke's area. On examination you determine that the patient may hear sound, but is unable to make any meaning out of it. This is identified as _______ aphasia.

Receptive

Which of the following areas in the frontal lobe is responsible for mediating motor speech?

Broca's area

The extrapyramidal system is located in which of the following parts of the brain?

The basal ganglia

The three component structures of the brain that compose the brain stem are the

midbrain, pons, and medulla.

Along with serving as the main pathway for ascending and descending fiber tracts that connect the spinal nerves to the brain, the spinal cord specifically:

mediates reflexes

The concept of the left cerebral cortex controlling the right side of the body and vice versa is known as:

crossed representation

The sensory pathways in the spinal cord consist of which two tracts?

Spinothalamic and posterior columns

The complex motor system that coordinates movement, maintains equilibrium, and helps maintain posture is identified as the:

Cerebellum

The vagus cranial nerve differs from the other cranial nerves in which of the following ways?

It innervates organs outside the head and neck.

A dermatome is characterized by which of the following?

A circumscribed area of skin that is supplied by a particular spinal cord segment via a spinal nerve

Dermatomes overlap in order to do which of the following?

Allow for sensations to be felt when a nerve that innervates the dermatome is severed

Of the following paired terms, which one states a type of reflex arc followed by its corresponding response?

Superficial-abdominal

In the newborn infant, motor activity is under the control of the

Spinal cord and medulla

Which of the following sequences best describes the order in which the myelinization process occurs in the motor and sensory development of an infant?

Head, neck, trunk, extremities

The loss of neurons in the brain and spinal cord of older adults results in which of the following?

A decrease in weight and volume of the affected structures

The corneal reflex is a test of which two cranial nerves?

Trigeminal and facial

Muscle tone is best described as which of the following?

The normal degree of tension (contraction) in a voluntarily relaxed muscle

Ms. Parsons is a 43-year-old patient with multiple sclerosis. On examination you note involuntary muscle movements. In your documentation this would be described by which of the following terms?

Athetosis

An individual with cerebellar disease may demonstrate dysdiadochokinesia, which is characterized by:

slow, clumsy, and sloppy movements when performing rapid alternating hand movements.

Mr. Sanchez is a 62-year-old patient who presents for a follow-up examination. Which of the following maneuvers will test the spinothalamic tract for pain perception?

Asking the individual to identify when the skin is being touched with the sharp or dull end of a pin/broken tongue blade

Ms. Wilson is a 46-year-old patient who presents for a neurologic examination. During the examination you note clonus when testing deep tendon reflexes. This is characterized by a(n):

set of short, jerking contractions of the same muscle.

Which of the following is a true statement regarding superficial reflexes?

The receptors are in the skin rather than the muscles.

You are examining a 2-month-old male infant for his routine examination. Which of the following manifestations may indicate potential developmental alterations in infants?

Persistence of reflex behavior beyond its expected time frame

Which of the following considerations should the examiner keep in mind when testing the neurologic system of the aging adult?

The aging individual may need stronger stimuli to elicit appropriate responses.

An individual who sustains an injury to Broca's area in the frontal lobe will experience which of the following?

Expressive aphasia

Automatic associated movements of the body are under the control and regulation of:

the basal ganglia.

The area of the brain that contains all the ascending and descending fiber tracts that connect the brain and the spinal cord is the:

Medulla

Which of the following statements is correct regarding the concept of crossed representation of the CNS?

The right cerebral cortex receives input from and controls activities of the left side of the body.

The posterior dorsal columns are responsible for transmitting the sensations of:

vibration, position, and fine touch.

Which of the following statements is correct in regard to upper and lower motor neurons?

Amyotrophic lateral sclerosis is an example of a lower motor neuron disorder.

An area of the body that is supplied mainly from one spinal segment through a particular spinal nerve is identified as a:

Dermatome

Which of the following statements is true regarding the reflex arc?

The reflex arc operates below the level of conscious control to allow for a quick response to

Which of the following processes is necessary for adequate development of the neurologic system to occur in the infant?

Myelinization of nerves

Mrs. Walker is a 69-year-old female patient who presents for a follow-up examination. Which of the following processes is considered an expected age-related change associated with older adults?

A decrease in weight and volume of the brain and spinal cord

Mr. Walker is a 45-year-old diabetic patient. During the course of your obtaining a neurologic history, the individual indicates experiencing some numbness and tingling in the extremities. This would be documented as:

Paresthesia

Mr. Shea is a 50-year-old patient with chronic obstructive pulmonary disease and a history of smoking two packs per day. On examination, which of the following alterations related to cranial nerve function would you expect to be a response?

Loss of smell bilaterally

You are examining extraocular movement of a 45-year-old female patient. During your assessment, you note that there are some back-and-forth oscillations of the eyes in the extreme lateral gaze. Your impression of this response is:

this is an expected response during this exam and the movement of the eyes during this procedure

Cranial nerve V is composed of which of the following three divisions?

A) Ophthalmic, maxillary, and mandibular

Mrs. Stephens is a 37-year-old patient who presents for a follow-up examination. The sensory component of cranial nerve VII is tested in which of the following ways?

Having the individual identify specific tastes on the tongue

Mrs. Bowers is a 63-year-old patient. On examination you need to test position sensation. In testing position sensation, the examiner moves the individual's:

finger/toe up or down.

Mrs. Garvin is a 55-year-old patient who presents for a follow-up examination. During your examination you simultaneously touch the individual in two distinct areas of the body and ask how many stimuli are present. You are testing:

extinction phenomenon.

Flexion

Bending limb at joint

Extension

straightening a limb at joint

Abduction

Moving away from midline

Pronation

turn forearm so palm is down

Supintaion

Turn forearm so palm is up

Circumduction

moving arm in circle around shouler

Inversion

Moving sole of foot inward at ankle

Eversion

Moving sole of foot outward at ankle

Rotation

Moving head around in central axis

Protraction

moving body part forward and parallel to ground

Retraction

Moving body part backward and parallel to ground

Elevation

raising of a body part

Depression

Lowering a body part

Intervertebral disk

cushion spine like a shock absorber and help it move

Kyphosis

Enhanced thoracic cuve. Common in elderly

Lordosis

pronouced lumbar curve. Obese pregnant

Knee

largest joint

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