The nurse is testing for motor functioning by having the client lie down and slide the heel of the right foot down the left shin and then slide the heel of the left foot down the right shin. Which response by the patient would indicate that there may be cerebellar dysfunction?

Rapid oscillations of the ankle

Deviation of the heel to one side

Pain and flexion in the knee

The client reports paresthesia

Answer and Explanation

The Correct Answer is B

Choice A reason: Rapid ankle oscillations might suggest tremor, possibly basal ganglia issues, not cerebellar dysfunction. The heel-shin test assesses coordination, where cerebellar damage causes drift, not rhythmic shaking, making this less indicative of the target pathology here.
Choice B reason: Heel deviation to one side in the heel-shin test signals cerebellar dysfunction, impairing coordination. The cerebellum fine-tunes movement; damage causes ataxia, leading to inaccurate sliding, making this the key sign of cerebellar issues accurately.
Choice C reason: Pain and knee flexion suggest joint or nerve issues, not cerebellar dysfunction. This test evaluates smooth motion, not pain response; cerebellar problems show ataxia, not discomfort, disconnecting this from the intended motor assessment fully.
Choice D reason: Paresthesia (tingling) indicates sensory nerve issues, not cerebellar motor control. The cerebellum coordinates movement, not sensation; this response misses the coordination focus of the heel-shin test, excluding it as a cerebellar sign here entirely.

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Correct Answer is C

Explanation

Choice A reason: The base of the skull houses occipital nodes, not submental ones, which drain the lower face. Palpating here misses the submental region, irrelevant to sinus or throat infections, misaligning with lymphatic drainage patterns in this case.

Choice B reason: The angle of the jaw targets submandibular nodes, not submental, which sit midline under the chin. This area drains the jaw and mouth but not specifically the submental zone tied to the client’s symptoms directly.

Choice C reason: Behind the chin tip is the submental node location, draining the lower lip, tongue, and anterior mouth. With sinus and throat infection, this spot is key for detecting lymphadenopathy linked to the client’s fever and elevated WBC.

Choice D reason: Behind the ears assesses postauricular nodes, unrelated to submental drainage of the chin and mouth. This misses the infection’s likely lymphatic response, focusing on a region not typically involved in sinus or throat pathology here.

A. Macular degeneration B. Recent eye trauma C. Bilateral cataracts D. Narcotic use

Correct Answer is D

Explanation

Choice A reason: Macular degeneration impairs central vision, not pupil size. Pinpoint pupils and lethargy suggest systemic effects, not retinal aging, making this unrelated to the neurological and ocular findings in this emergency setting entirely and fully here.
Choice B reason: Eye trauma may dilate pupils from injury, not pinpoint them. Lethargy and change per the significant other point to systemic causes, not local trauma, excluding this as the likely explanation for this presentation comprehensively here.
Choice C reason: Bilateral cataracts cloud lenses, not affecting pupil size or alertness. Pinpoint pupils with lethargy suggest a neurological cause, not lens opacity, rendering this irrelevant to the acute change observed in this client fully here.
Choice D reason: Narcotic use, like opioids, causes pinpoint pupils via cranial nerve III stimulation and lethargy from CNS depression. This matches the sudden change and symptoms, making it the most likely interpretation in this emergency case accurately here.

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The nurse is testing for motor functioning by having the client lie down and slide the heel of the right foot down the left shin and then slide the heel of the left foot down the right shin. Which response by the patient would indicate that there may be cerebellar dysfunction?

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Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

Correct Answer is D

Explanation

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