Which behavior causes the nurse to report a positive Romberg test?
The patient cannot touch his nose with eyes closed.
The patient sways from side to side.
The patient complains of dizziness.
The patient cannot keep his eyes closed.
The Correct Answer is B
A. Inability to touch the nose with eyes closed is part of the finger-to-nose test, not the Romberg test.
B. A positive Romberg test is indicated when the patient sways or loses balance while standing with feet together and eyes closed. This suggests a problem with proprioception or the vestibular system.
C. Dizziness may occur during the test but does not constitute a positive result unless accompanied by swaying or imbalance.
D. The patient being unable to keep eyes closed is not a criterion for a positive Romberg test. The test evaluates balance, not voluntary eye closure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. In Buck traction, the child’s heels should not be pressed against the foot of the bed, as this disrupts the traction forceand may lead to skin breakdown or impaired circulation. The body must remain in proper alignment, and the child should be positioned so that traction can pull effectively.
B. Elevating the head of the bed up to 20 degreesis acceptable to promote comfort and prevent respiratory complications without affecting traction.
C. Ropes must be aligned properly on pulleysto ensure smooth traction force. This is a correct observation.
D. Weights should hang freelyat all times to maintain consistent traction; this is the correct setup.
Correct Answer is A
Explanation
A. The hypoglossal nerve (cranial nerve XII) controls tongue movements, so asking the patient to move the tongue side to side tests its function.
B. Checking air movement through each nostril assesses the olfactory nerve (cranial nerve I).
C. Asking the patient to shrug the shoulders tests the accessory nerve (cranial nerve XI).
D. Asking the patient to wrinkle the forehead tests the facial nerve (cranial nerve VII).
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