When the nurse asks a 68-year-old patient to stand with his feet together and arms at his side with his eyes closed, he starts to sway and moves his feet farther apart. The nurse would document this finding as:

Positive Romberg sign.

Ataxia.

Lack of coordination.

Negative Homans sign.

Answer and Explanation

The Correct Answer is A

A.   A positive Romberg test occurs when a person loses balance or sways when standing with their eyes closed, indicating a problem with proprioception or balance.
B.   Ataxia refers to a lack of coordination or motor control, but the Romberg sign specifically tests balance and proprioception, which is different from ataxia.
C.   Lack of coordination may be part of ataxia or other neurological issues, but the Romberg sign specifically refers to balance issues when eyes are closed.
D.   The Homans sign is used to test for deep vein thrombosis (DVT) and is not relevant to the test for balance and proprioception described in the scenario.

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Correct Answer is C

Explanation

A. The brainstem controls basic life functions but is not primarily responsible for balance.
B. The cerebellum is directly involved in maintaining balance and coordination. Issues with the cerebellum would likely cause unsteadiness and difficulty in maintaining balance.
C. The extrapyramidal system influences motor control but is less directly responsible for balance compared to the cerebellum.
D. The thalamus acts as a relay center for sensory and motor signals but does not specifically control balance.

A. Hormonal changes causing vasodilation resulting in hypotension B. Atrophy of the muscles causing venous insufficiency C. Peripheral blood vessels become more rigid producing a rise in systolic blood pressure. D. Narrowing of the inferior vena cava causing, bilateral lower extremities varicosities

Correct Answer is C

Explanation

A. Hormonal changes can occur, but they typically do not cause significant vasodilation or hypotension in the elderly.
B. Atrophy of the muscles causing venous insufficiency. While venous insufficiency can occur in aging, muscle atrophy is not the primary factor in this issue.
C. Peripheral blood vessels become more rigid producing a rise in systolic blood pressure. This is a common and expected finding in the elderly due to arteriosclerosis, leading to increased systolic blood pressure.
D. The inferior vena cava does not typically narrow with age, and varicosities are more likely due to vein elasticity changes, not narrowing.

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When the nurse asks a 68-year-old patient to stand with his feet together and arms at his side with his eyes closed, he starts to sway and moves his feet farther apart. The nurse would document this finding as:

Nursing Test Bank

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