While testing rapid alternating movements, on a 29-year-old with complaints of "always dropping things and falling down," they are unable to pat both knees. The response is extremely slow, and the patient frequently misses. Which rationale is expected?
Inability to understand directions
Lesion of cranial nerve IX
Dysfunction of the cerebellum
Vestibular disease
The Correct Answer is C
A. Inability to understand directions: If the patient could follow other instructions during the assessment, inability to understand directions is unlikely. Cognitive comprehension issues would affect multiple parts of the neurological exam, not just rapid alternating movements.
B. Lesion of cranial nerve IX: Cranial nerve IX (glossopharyngeal) is involved in swallowing and gag reflex, not coordination of limb movements. Lesions here would not explain difficulty with rapid alternating movements.
C. Dysfunction of the cerebellum: The cerebellum coordinates voluntary movements, balance, and fine motor control. Slowness, frequent misses, and inability to perform rapid alternating movements indicate cerebellar impairment, consistent with the patient’s complaints of dropping objects and falling.
D. Vestibular disease: Vestibular dysfunction affects balance and spatial orientation, causing vertigo or unsteadiness. While it may contribute to falling, it does not directly impair rapid alternating limb movements in the manner described.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. not palpable: In healthy adults, most lymph nodes are not palpable because they are small and embedded within surrounding tissues. Palpable nodes often indicate infection, inflammation, or malignancy, making non-palpable nodes the expected finding.
B. large, firm, and fixed to the tissue: Large, fixed, and firm lymph nodes are concerning for malignancy or chronic disease. These characteristics are abnormal and require further investigation, not a normal finding in a healthy adult.
C. rubbery, discrete, and mobile: Rubbery, mobile lymph nodes can be seen in conditions such as lymphoma or after infections. While mobility is less concerning, rubbery enlargement is not considered a normal feature in a healthy individual.
D. shotty: Shotty nodes feel like small beads under the skin and are often associated with past or resolved infections. While sometimes benign, they are not the expected finding in a healthy adult without underlying pathology.
Correct Answer is C
Explanation
A. It is only useful in patients who are overweight: Nutritional assessment is valuable for all patients, not just those who are overweight, because it helps identify deficiencies, excesses, or risks in nutrition.
B. It provides the nurse with physical finding related to all the systems: While nutrition affects multiple body systems, the purpose of a nutritional assessment is to evaluate dietary intake, habits, and risk of malnutrition rather than serve as a full systemic physical exam.
C. It identifies patients who are at risk of malnutrition: The primary goal of nutritional assessment is to detect individuals at risk for malnutrition or those already malnourished, guiding early interventions to prevent complications.
D. Nutritional assessment can only be thoroughly done by a dietitian: Nurses are trained to perform nutritional assessments as part of comprehensive patient care, though dietitians may be consulted for more detailed evaluations or complex cases.
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