The nurse is conducting a focused neurologic assessment on an 81-year-old client. What finding below is an age-related neurologic change?
Impaired judgment.
Loss of remote memory.
Tremors accompanying intentional movement.
Lack of sensation in distal extremities.
The Correct Answer is D
Choice A reason: Impaired judgment suggests frontal lobe pathology, like dementia, not normal aging. Age-related changes slow processing, not executive function, making this a disease sign, not a typical neurological shift in an 81-year-old fully here.
Choice B reason: Loss of remote memory indicates Alzheimer’s, not normal aging. Aging may slow recall, but long-term memory typically persists, excluding this as an expected age-related change in this neurological assessment entirely and accurately here.
Choice C reason: Intention tremors signal cerebellar disease, like Parkinson’s, not aging. Normal aging may reduce fine motor speed, but not cause action tremors, distinguishing this as pathological, not a standard age-related finding fully here.
Choice D reason: Reduced distal sensation, from nerve conduction slowing, is a common age-related change. Aging thins myelin, impairing peripheral nerves, making this the expected finding in an 81-year-old’s neurological exam accurately and comprehensively here.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Loss of tactile sensation ties to parietal lobe damage, not frontal. A frontal contusion affects executive function and speech, not sensory processing, making this finding less likely given the injury’s location in this trauma scenario fully.
Choice B reason: Difficulty speaking, like Broca’s aphasia, is common with frontal lobe contusions, as this area houses speech production centers. Post-accident, this aligns with damage to motor speech pathways, making it the most probable finding here accurately.
Choice C reason: Blurred vision relates to occipital or optic nerve injury, not frontal lobe. A contusion here impacts cognition or speech, not visual processing, rendering this less expected than speech issues in this head injury context entirely.
Choice D reason: Inability to hear high-pitched sounds involves cranial nerve VIII or temporal lobe, not frontal. This contusion affects behavior and speech, not auditory function, excluding this as a primary finding in this frontal damage case fully.
Correct Answer is A
Explanation
Choice A reason: Tonsils touching the uvula indicate 4+ grading, where they obstruct over 75% of the oropharynx. This severe enlargement, with sore throat, fits the highest scale, reflecting significant inflammation or infection impacting airway and swallowing, accurately documented here.
Choice B reason: 1+ tonsils are slightly enlarged, less than 25% of the oropharynx, visible but not near the uvula. This underestimates the finding of tonsils contacting the uvula, misrepresenting the degree of obstruction and inflammation present in this case entirely.
Choice C reason: 2+ tonsils occupy 25-50% of the oropharynx, not touching the uvula. This moderate grade doesn’t match the observed contact, understating the severity of enlargement and potential airway compromise noted during the inspection clearly and significantly.
Choice D reason: 3+ tonsils cover 50-75% of the oropharynx, nearing but not contacting the uvula. This is close but inaccurate, as the finding shows full contact, warranting the higher 4+ grade for precise documentation of this advanced tonsillar size fully.
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