ATI LPN
Neurological Assessment Questions Questions
Question 1 of 5
A 30-year-old female presents with muscle weakness in the lower extremities and palpitations. Her symptoms have been progressively worse over the course of a 2 weeks. She reports to be in great health, but had a period of abdominal pain and diarrhea approximately 5 weeks ago. Her temperature is 98.9 deg F (37.2 deg C), blood pressure 117/82 mmHg, pulse is 102/min, and respirations are 16/min. On physical exam, there is 4-/5 muscle strength throughout the lower extremities. Bilateral patellar reflexes are 1+ and ankle reflexes are absent. Lumbar puncture was performed, and results are pending. Part 1: What is the most likely diagnosis?
Correct Answer: B
Rationale: Progressive weakness post-GI illness, reduced reflexes, and palpitations (possibly autonomic involvement) suggest Guillain-Barre syndrome, an acute demyelinating neuropathy. Polymyositis involves proximal weakness without reflex loss, hypokalemia causes generalized weakness with normal reflexes, and myasthenia gravis is fatiguable.
Question 2 of 5
A 72-year-old male is brought by his wife due to unexplained weakness and fatigue. She describes his movements as 'sluggish', and is concerned that he may be depressed. The patient reports difficulty with buttoning his shirt, and double clicking the mouse when using his computer. He states that the recent death of his mother has been difficult to accept, and has noticed his foods don't smell the same, and has been having difficulty with sleep. He does not smoke, but drinks 2-3 beers per week. He says his father suffers from a hand tremor, and his mother passed away from pancreatic cancer. On physical exam, a tremor affecting the right hand improves with purposeful movement. There is an increased resistance to passive movement at the right wrist joint. Which of the following is the best initial treatment?
Correct Answer: C
Rationale: Bradykinesia, rigidity, and rest tremor (improving with action) with anosmia suggest Parkinson’s disease. Levodopa is the initial treatment, replenishing dopamine. Primidone is for essential tremor.
Question 3 of 5
A 62-year-old man is brought to the emergency department by his wife because 'he's been acting strangely.' She noticed that during social gatherings he would not say much, and would mostly sit by himself. He barely bathes. When left in place he would stay there until he is told to move. He would not seek his favorite activities including watching football but when sat in front of the TV he seemed to enjoy it. On the Montreal Cognitive Assessment (MoCA) testing, he could not complete the trails testing, his clock was disorganized, and he named only 3 items starting with the letter 'F' in 60 seconds. His free recall was poor but improved with cuing. His visuospatial functioning was relatively spared. He had paratonia, but no other abnormalities on motor exam. Magnetic resonance imaging of the brain showed frontal atrophy, but no other focal abnormalities. Which of the following is most likely the diagnosis?
Correct Answer: C
Rationale: Apathy, disinhibition, and executive dysfunction with frontal atrophy suggest behavioral variant frontotemporal dementia. Alzheimer’s affects memory more, depression lacks atrophy, and Parkinson’s involves motor symptoms.
Question 4 of 5
The central communication conduit between the brain and the rest of the body is the
Correct Answer: C
Rationale: The spinal cord serves as the primary pathway for signals between the brain and the body, connecting the central nervous system (CNS) to the peripheral nervous system (PNS). The brain stem regulates vital functions, but the spinal cord is the conduit.
Question 5 of 5
The gap between the transmitting and receiving neurons in a chemical synapse is known as the
Correct Answer: D
Rationale: The synaptic cleft is the small space between the presynaptic and postsynaptic neurons where chemical transmission occurs.