During an initial psychiatric evaluation on a 65-year-old man who is new to the practice, the patient expresses concern about his left foot "shaking." One of the differential diagnoses for dementia of Alzheimer’s type is Parkinson's disease. Which physical exam finding would be expected?
No tremor is evident when the patient is asked to kick his leg.
Tremor is present when resting and when moving the leg.
Tremor is only present when the patient is moving his leg.
Tremor is worse when the patient is moving, but it is present when resting.
The Correct Answer is B
Choice A reason: Parkinsonian tremor is not absent at rest; a lack of tremor would be inconsistent with early Parkinson's disease.
Choice B reason: Resting tremor is a hallmark feature of Parkinson’s disease, often unilateral initially, and can continue even during voluntary movement, which fits the patient’s presentation.
Choice C reason: Tremor present only during movement describes intention tremor, which is characteristic of cerebellar disorders, not Parkinson’s disease.
Choice D reason: Tremor worse with movement but present at rest does not align with the classic presentation of Parkinson’s disease, where resting tremor predominates.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: The occipital lobe primarily processes visual information; injury here would result in visual deficits rather than changes in personality.
Choice B reason: The frontal lobe is responsible for personality, executive functioning, judgment, and emotional regulation. Damage to this area, such as from a traumatic brain injury, can cause significant personality changes, impulsivity, and altered behavior.
Choice C reason: The parietal lobe integrates sensory information and spatial orientation. Damage would affect perception and coordination rather than personality.
Choice D reason: The temporal lobe is associated with memory, hearing, and language comprehension; injury may result in memory deficits or language problems but not dramatic personality changes.
Correct Answer is C
Explanation
Choice A reason: Mild anxiety is characterized by tension or nervousness that is noticeable but does not significantly impair daily functioning. A HAM-A score of 20 exceeds the typical cutoff for mild anxiety, suggesting more pronounced symptom severity.
Choice B reason: Minimal anxiety refers to very low levels of anxious symptoms, often with minimal physiological or cognitive impact. A score of 20 indicates a higher level of distress than would be considered minimal.
Choice C reason: Moderate anxiety includes more obvious psychological and physical symptoms that interfere somewhat with daily life. A HAM-A score of 20 falls within this range, indicating the patient has significant but not severe anxiety.
Choice D reason: Severe anxiety involves intense distress and impairment in daily functioning. A HAM-A score of 20 is below the threshold for severe anxiety, which typically starts at higher scores.
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