Which of these is an unexpected finding for a neurological system assessment?
Facial droop
Ability to swallow with no cough
Eyes open spontaneously
Speech is understandable
The Correct Answer is A
Choice A reason: Facial droop is an unexpected neurological finding, often indicating cranial nerve VII (facial nerve) dysfunction, as seen in stroke or Bell’s palsy. It disrupts symmetrical muscle movement, signaling potential brain or nerve pathology. This abnormality requires urgent evaluation to determine underlying causes like ischemia or inflammation.
Choice B reason: Swallowing without coughing is a normal finding, reflecting intact cranial nerves IX and X. Dysphagia or coughing during swallowing would suggest neurological impairment, but this choice indicates expected function, making it a typical result in a neurological assessment of swallowing capability.
Choice C reason: Spontaneous eye opening is a normal finding, indicating intact brainstem and cranial nerve function, particularly cranial nerve III. It is expected in conscious patients and does not suggest neurological dysfunction, unlike failure to open eyes, which could indicate coma or severe impairment.
Choice D reason: Understandable speech is a normal finding, reflecting coordinated function of cranial nerves and brain regions like Broca’s area. Slurred or incoherent speech would be abnormal, but this choice indicates expected neurological performance, not an unexpected outcome in a standard assessment.
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Correct Answer is B
Explanation
Choice A reason: Dysesthesia refers to abnormal sensations, often painful, like burning or aching, due to nerve damage. While related to sensory nerve dysfunction, it does not specifically describe the pins and needles sensation, which is better characterized by paresthesia, making this term less precise for the patient’s complaint.
Choice B reason: Paresthesia describes abnormal sensations like pins and needles, typically from nerve compression or irritation, as in carpal tunnel syndrome. It accurately captures the patient’s reported left-hand sensation, aligning with clinical terminology for documenting transient or chronic sensory nerve disturbances, making it the appropriate term.
Choice C reason: Proprioception is the sense of body position, mediated by sensory receptors in muscles and joints, not related to pins and needles sensations. It involves spatial awareness, not cutaneous sensory abnormalities, so this term is irrelevant to the patient’s sensory complaint in the left hand.
Choice D reason: A sprain is a ligament injury, causing pain and swelling, not sensory disturbances like pins and needles. It is a musculoskeletal issue, unrelated to neurological symptoms of nerve irritation, making this term inappropriate for documenting the patient’s sensory nerve-related complaint.
Correct Answer is B
Explanation
Choice A reason: Painful urination, or dysuria, involves discomfort during voiding, often due to urinary tract infections or inflammation. It is not synonymous with nocturia, which specifically refers to frequent nighttime urination. Dysuria requires distinct clinical evaluation, including urinalysis, to identify causes like bacterial infection or urethral irritation, making this an incorrect description of the patient’s complaint.
Choice B reason: Nocturia is the medical term for frequent urination at night, disrupting sleep. In elderly patients, it may result from reduced bladder capacity, overactive bladder, or conditions like benign prostatic hyperplasia. This matches the patient’s complaint, as it directly addresses the symptom without implying unrelated issues like pain or incontinence, making it the accurate choice.
Choice C reason: Bladder incontinence involves involuntary urine leakage, distinct from nocturia, which is voluntary urination at night. Incontinence may stem from neurological disorders or weakened pelvic muscles but does not describe the patient’s symptom of frequent nighttime voiding. This choice is incorrect, as it misaligns with the clinical presentation described.
Choice D reason: An inability to void, or urinary retention, is the opposite of nocturia, where the patient voids frequently. Retention may result from obstructions like an enlarged prostate or neurological issues, requiring catheterization or imaging for diagnosis. This choice does not reflect the patient’s symptom of active, frequent urination at night.
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