ATI LPN
Medical-Surgical Nursing Neurological System Questions
Question 1 of 5
A 33-year-old female presents with drooping of her eyelid that seem to occur while reading or watching television. This appears to get worse later in the day. She also reports that at times she sees 'double.' A few weeks ago, she was prescribed an antibiotic medication for a urinary tract infection. She does not recall the name of the antibiotic. On physical exam, bilateral ptosis, with the left affected more than the right is seen. Pupillary function intact. A glove is filled with ice, and subsequently applied to the patient's eyelid. After two minutes, the patient's ptosis has improved. Which of the following is most likely to yield rapid symptom improvement?
Correct Answer: C
Rationale: Fatiguable ptosis and diplopia worsening later in the day, with improvement after ice application (reducing acetylcholine breakdown), suggest myasthenia gravis. Acetylcholinesterase inhibitors (e.g., pyridostigmine) provide rapid symptomatic relief by increasing acetylcholine availability at the neuromuscular junction.
Question 2 of 5
A 31-year-old woman is brought to the emergency department by her partner due to a convulsive episode after an argument. Her partner described the convulsive episode as being abrupt in onset, with asynchronous limb movements, and pelvic thrusting. The patient's eyes were closed throughout the episode and was unresponsive. The event lasted approximately 10-15 minutes, and would consist of bursts of movement followed by pauses, occurring in a stopping-and-starting fashion. The convulsive episode ended abruptly, with complete recovery. The patient said that during the event, she could sometimes hear what people were saying, but was unable to respond. She says she has seizures 2-3 times per week. Physical examination is unremarkable. On videoelectroencephalogram (video-EEG), one of her typical events is recorded, without any abnormality on scalp EEG. What is the most appropriate treatment for this disorder?
Correct Answer: C
Rationale: Prolonged, asynchronous movements with awareness and normal EEG suggest psychogenic non-epileptic seizures (PNES), often stress-related. Cognitive-behavioral therapy addresses underlying psychological triggers.
Question 3 of 5
A 68-year-old man is brought to the Emergency Department immediately after a witnessed generalized tonic-clonic seizure. Prior to this seizure event, he had approximately 2 months of bifrontal headache that worsened when coughing or bending over. He also has worsening balance, resulting in 2 falls over the course of a few weeks. Medical history is significant for Myasthenia Gravis treated with oral prednisone for chronic immunotherapy. Social history is significant for smoking 1/2 a pack of cigarettes per day for 40 years and recent travel to South America. On physical examination, the patient is responsive but confused, has bilateral tongue laceration, with left pronator drift and slow foot-taps on the left side. Magnetic resonance imaging (MRI) of the brain is shown. Which of the following is most likely the diagnosis?
Correct Answer: C
Rationale: Seizure, headache worsening with Valsalva, and focal deficits with a smoking history suggest a brain metastasis, likely from lung cancer. Glioblastoma is primary, abscess involves fever, and lymphoma is less likely without immunosuppression.
Question 4 of 5
The brain is protected by:
Correct Answer: D
Rationale: The brain is safeguarded by the meninges (membranes), cerebrospinal fluid (cushion), and the skull (bony structure), all working together.
Question 5 of 5
Once the threshold potential is reached,
Correct Answer: C
Rationale: Reaching the threshold triggers rapid Na⁺ channel opening, making an action potential unavoidable due to the all-or-none principle.