NURS 6614 Final (2)
Neuro + Psychosocial
Terms in this set (23)
A 25 year female comes to your clinic with the chief complaint of new onset headache. What will you include in your history of present illness?
Location of pain, duration of pain, description of pain, triggers
You decide to treat a 25 year old female for stress headache. What medication below is your first choice?
Tylenol 325mg 2 tablets q 6 hours prn
A female patient comes to your clinic with complaints of headache. The headache is described as unilateral; throbbing or pulsatile. There was no preceding aura but she states mild dizziness with the headache. She denies acute visual changes, nausea, vomiting & photophobia. She states noises bothered her most.On a scale of 1 - 10 she states the headache was 7 but it disrupted her daily activities enough to make an appointment with you. The headache lasted several hours. When asked about her current medications, she states that she recently began taking birth control pills. You forget to ask about a family history so you do not have this information at the current time. You are developing your differential diagnoses. Of the differential diagnoses below, which one do you most suspect?
patient comes to your clinic with the chief complaint of hand tremor and some balance problems. You want to differentiate between a benign essential tremor and Parkinsonism since he has neither diagnosis on record. What information do you need to collect?
Family history, evidence of rigidity, bradykinesia & postural instability
You want to do a gait assessment in a patient. What will you assess and document?
Description of step when walking, movements of arms, steadiness when turning
You perform a physical exam that includes testing for muscle strength. You are testing the left arm. You have the patient move the joint through its range of motion. Then, you have the patient attempt to move against your resistance while you palpate the contracting muscle. You find normal strength in the left arm. How will you document the left arm muscle strength in your documentation?
Muscle strength grade 5 normal strength
You are seeing a new clinic patient who is 88 years of age in your afternoon schedule. He is accompanied by his daughter who requests to speak with you. She states that her father is still driving but has had several occasions where he forgets directions and gets lost in his local community. Her brother is asking that you take his driving license away. What is your course of action today?
Administer the Montreal Cognition Assessment (MoCA) and Beck Depression Inventory
Your 40 year old patient is becoming more irritable and showing cognitive defects. Your family history reveals that his father died at age 40 and the patient stated that his "mind just went" & he could not walk starting at age 30. You request his father's medical record and find out that his death certificate stated Huntington Disease. What do you know about this disease that will help you to treat your patient?
There is a gradual onset & progression of chorea and dementia or behavioral change. The responsible gene is identified on chromosome 4. Clinical onset is usually between 30 and 50 years of age.There is no cure for the disease.
Your patient comes for an annual visit and notes his legs have started "twitching" at night. Sometimes they feel like they shake. What do you know about restless leg syndrome?
May be seen in iron deficiency anemia, peripheral neuropathy (especially diabetic); there may be a hereditary basis
When caring for a patient with a recent transient ischemic attack, you consider that:
Long term antiplatelet therapy is indicated.
Cranial Nerves III, IV, and VI
Extraocular eye movements
Ability to identify an object placed in the hand with eyes closed.
Ability to maintain balance with eyes closed, extended arms with palms up
Risk factors for cerebovascular accident include all the following except:
A 68 year old man presents with new onset of headaches. He describes the pain as bilateral frontal and occipital and worst when he arises in the morning and with coughing. He feels much better by mid-afternoon. The history is most consistent with headache caused by
A 40 year old patient presents with a 5-week history of recurrent headaches that awaken him during the night. The pain is severe, lasts about 1 hour, and is located behind his left eye.. Additional symptoms include lacrimation and watery nasal discharge. His physical exam is within normal limits. The most likely diagnosis:
You examine a 29 year old woman who has a sudden onset of right-sided facial asymmetry. She is unable to tightly close her right eyelid, frown, or smile on the affected side. Her examination is otherwise unremarkable. This may represent paralysis of CN:
In tension-type headaches, which of the following is true?
The pain is typically described as "vice-like" in quality.
a 34-year-old woman has recently been diagnosed with multiple sclerosis (MS). When providing primary care for this patient, you consider that MS:
Is often seen with a variable pattern of exacerbations and remissions.
Which of the following is most consistent with findings in patients with Parkinson's disease?
Tremor at rest, shuffling gait, and bradykinesia.
Treatment options for the adult with seizures include all of the following except:
A 42-year-old female patient is seen in your office for complaints of dizziness. She states she feels like the room is spinning around her. She reports rapid position changes as an aggravating factor. The symptoms last from 10-15 seconds then disappear. She denies history of palpitations, syncope, or feeling of light headedness. Her symptoms are consistent with:
Benign positional vertigo