NR 509 APEA EXAM – RANDOM PAPERS
Question:
A transient ischemic attack is:
a transient episode of neurologic dysfunction by focal brain, spinal cord, or retinal ischemia, without
acute infarction. Correctan infarction of the central nervous system tissue that may be silent or
symptomatic.the abrupt onset of motor or sensory deficits. Incorrectfocal or asymmetric weaknesses
caused by central and peripheral nerve damage.
Explanation:
TIA is now defined as “a transient episode of neurological dysfunction caused by focal brain, spinal cord,
or retinal ischemia, without acute infarction.” Ischemic stroke is “an infarction of central nervous system
tissue” that may be symptomatic or silent. The other terms are not related to the new definitions.
Question:
A patient is asked to visually follow a finger through the cardinal fields of gaze. Which cranial nerves are
being assessed?
III, IVIII, IV, VI CorrectV, VI, VII
Explanation:
Visually following a finger through the cardinal fields of gaze is one way to assess the oculomotor (CN
III), trochlear (CN IV) and abducens (CN VI) nerves. CN I is the olfactory nerve and assesses smell. CN II is
the optic nerve and assesses visual acuity. CN V is the trigeminal nerve and assesses both sensory and
motor functions.
Question:
Uncontrolled electrical activity in the brain, which may produce minor physical signs, thought
disturbances, or disturbed motor activity is:
,dystonia.bradykinesia.tremor.seizure. Correct
Explanation:
A seizure is an uncontrolled electrical activity in the brain which may produce minor physical signs,
thought disturbances, or disturbed motor activity, or a combination of symptoms. Dystonia is a
neurological disorder that causes involuntary muscle spasms and twisting of the limbs. Bradykinesia is
the term used to describe the impaired ability to adjust to one's body position. This symptom is noted in
patients who have Parkinson's disease. A rhythmic oscillatory movement of a body part resulting from
the contraction of opposing muscle groups is a tremor.
Question:
When evaluating the sensory system, testing the posterior columns tract would include assessing
sensations of:
position and vibration. Correctpain and temperature.deep touch. Incorrectdiscriminative sensations.
Explanation:
When evaluating the sensory system, testing the spinothalamic tracts would include assessing
sensations of pain and temperature. Assessing position and vibration evaluate the posterior columns.
Light touch assesses both the spinothalamic and posterior column tracts. To assess discriminative
sensation, both the spinothalamic and posterior columns tracts as well as the cortex would be assessed.
Question:
Physical exam of a well two-week-old infant reveals a little dimple with a small amount of hair just above
the sacral area. This could be:
an unusual finding but within normal limits. Incorrecthirsutism.Arnold -Chiari malformation. spina bifida
occulta. Correct
Explanation:
There are four types of spina bifida: occulta, closed neural tube defects, meningocele, and
myelomeningocele. Occulta is the mildest and most common form in which one or more vertebrae are
malformed. The name “occulta,” which means “hidden,” indicates that a layer of skin covers the
,malformation, or opening in the vertebrae. This form of spina bifida, present in 10-20 percent of the
general population, rarely causes disability or symptoms. Closed neural tube defects are often
recognized early in life due to an abnormal tuft or clump of hair or a small dimple or birthmark on the
skin at the site of the spinal malformation. Meningocele and myelomeningocele generally involve a
fluid-filled sac—visible on the back—protruding from the spinal canal. In meningocele, the sac may be
covered by a thin layer of skin. In most cases of myelomeningocele, there is no layer of skin covering the
sac and an area of abnormally developed spinal cord tissue is usually exposed. Hirsutism is an excessive
amount of hair on the body usually caused by a hormonal imbalance. An Arnold-Chiari malformation is a
cyst-like formation in the fourth ventricle, cerebellum or brainstem.
Question:
A female patient complains of weakness in her arm when combing her hair. This finding could be
suggestive of which type of weakness pattern?
Proximal CorrectDistal IncorrectSymmetricAsymmetric
Explanation:
To identify proximal weakness, ask about difficulty with movements such as combing hair, reaching up
to a shelf, getting up out of a chair, or climbing a high step.
Question:
What geriatric condition is characterized by normal alertness but progressive global deterioration of
cognition in multiple domains?
DeliriumCognitive impairmentParkinson's diseaseAlzheimer's disease Correct
Explanation:
Alzheimer's disease is a geriatric condition in which normal alertness is present but progressive global
deterioration of cognition occurs in multiple domains, including short-term memory, but with sparing of
memory for remote events, subtle language errors, visuospatial perceptual difficulties, and changes in
executive function, or the ability to perform sequential tasks such as instrumental activities of daily living
(IADLs). Delirium is a serious disturbance in a person's mental abilities that results in a decreased
awareness of one's environment and confused thinking. Cognitive impairment is an intermediate stage
between the expected cognitive decline of normal aging and the more serious decline of dementia.
Parkinson's disease is a progressive disorder of the nervous system that affects movement.
, Question:
When assessing coordination of muscle movement, four areas of the nervous system function in an
integrated way. These areas include the motor, cerebellar, the vestibular, and the sensory systems.
Which system coordinates position sense?
Motor systemCerebellar systemVestibular system IncorrectSensory system Correct
Explanation:
Coordination of muscle movement requires that four areas of the nervous system function in an
integrated way: motor system for muscle strength, cerebellar system for rhythmic movements and
steady posture, vestibular system for balance and coordinating eye, head, and body movements, and
sensory system for position sense.
Question:
A band of skin innervated by the sensory root of a single spinal nerve is termed a:
peripheral nerve field.dermatome. Correctsynapseasterixis.
Explanation:
A band of skin innervated by the sensory root of a single spinal or dorsal nerve root is termed a
dermatome. A peripheral nerve field refers to an area of the skin innervated by a single nerve and is
described as cutaneous nerve distribution. A synapse is a structure that permits a neuron to pass an
electrical or chemical signal to another cell. Asterixis refers to an abnormal tremor consisting of
involuntary jerking movements, especially in the hands, frequently occurring with impending hepatic
coma and other forms of metabolic encephalopathy. This is also known as flapping tremor.
Question:
An 8-month-old with a significant head lag would suggest the need for:
exercises that strengthen the neck muscles.a follow-up visit in 2 months.a neurological
evaluation. Correctan orthopedic referral.