A 50 year old woman is visiting the clinic for "weakness in my left arm and leg for the past week." The nurse will perform which type of neurological examination?

Screening neurological examination

Neurological recheck examination

Complete neurological examination

Glasgow Coma Scale

Answer and Explanation

The Correct Answer is C

A. Screening neurological examination: A screening exam is used for individuals without significant neurological complaints to detect any gross deficits. Since this patient has new, specific weakness, a screening exam would not be sufficient.

B. Neurological recheck examination: Recheck examinations are performed for patients with known neurological deficits to monitor changes over time. This patient is presenting with a new symptom, so a recheck is not appropriate.

C. Complete neurological examination: A complete neurological examination is indicated for patients with new or significant neurological symptoms. It involves a thorough assessment of mental status, cranial nerves, motor function, sensory function, reflexes, coordination, and gait to identify the cause and extent of deficits.

D. Glasgow Coma Scale: The Glasgow Coma Scale is used to assess the level of consciousness in patients with altered mental status or head trauma. It does not provide a full evaluation of focal neurological deficits like limb weakness.

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Correct Answer is C

Explanation

A. Inability to understand directions: If the patient could follow other instructions during the assessment, inability to understand directions is unlikely. Cognitive comprehension issues would affect multiple parts of the neurological exam, not just rapid alternating movements.

B. Lesion of cranial nerve IX: Cranial nerve IX (glossopharyngeal) is involved in swallowing and gag reflex, not coordination of limb movements. Lesions here would not explain difficulty with rapid alternating movements.

C. Dysfunction of the cerebellum: The cerebellum coordinates voluntary movements, balance, and fine motor control. Slowness, frequent misses, and inability to perform rapid alternating movements indicate cerebellar impairment, consistent with the patient’s complaints of dropping objects and falling.

D. Vestibular disease: Vestibular dysfunction affects balance and spatial orientation, causing vertigo or unsteadiness. While it may contribute to falling, it does not directly impair rapid alternating limb movements in the manner described.

A. Pulled in at the base of the cone of light. B. Pearly grey and slightly concave. C. Light pink with a slight bulge. D. Whitish, with a small fleck of light in the superior portion.

Correct Answer is B

Explanation

A. Pulled in at the base of the cone of light: Retraction of the tympanic membrane, where it appears pulled inward, often indicates eustachian tube dysfunction or negative middle ear pressure. This is not considered a normal finding during ear examination.

B. Pearly grey and slightly concave: A normal tympanic membrane is pearly gray in color, translucent, and positioned slightly concave with the cone of light visible. This appearance indicates a healthy ear with no evidence of infection or fluid buildup.

C. Light pink with a slight bulge: A tympanic membrane that appears pink and bulging is usually associated with otitis media or fluid accumulation. This finding suggests infection or inflammation, not a normal ear examination result.

D. Whitish, with a small fleck of light in the superior portion: A whitish tympanic membrane often indicates scarring or tympanosclerosis, which results from repeated infections or trauma. This would not be considered a normal finding in an otherwise healthy ear.

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A 50 year old woman is visiting the clinic for "weakness in my left arm and leg for the past week." The nurse will perform which type of neurological examination?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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