ATI LPN
Neurological Questions Questions
Question 1 of 5
A 44-year-old female presents with weakness. Her weakness becomes apparent when she picks up her youngest daughter, or when placing her nonperishable foods in the top shelf of her kitchen. She also reports difficulty when getting up from a chair. These symptoms began a few months ago, and have since worsened. On physical exam, there is an erythematous eruption on her eyelids, and erythematous papules on the dorsal aspect of her hands. Neurological examination is significant for symmetric muscle weakness of her shoulders and hips. Which of the following is most likely the diagnosis?
Correct Answer: C
Rationale: Proximal weakness with heliotrope rash (eyelids) and Gottron’s papules (hands) are pathognomonic for dermatomyositis, an inflammatory myopathy with skin involvement. Polymyositis lacks rash, myasthenia gravis is fatiguable, glucocorticoid myopathy lacks rash, and SLE involves joints more than muscles.
Question 2 of 5
A 14-year-old boy is brought to the pediatrician by his mother because of a 1-hour episode of intermittent jerking movements that began around the time he woke up this morning. He describes the movement as jerky, affecting both upper extremities and upper body, and arrhythmic. During the episode, the patient did not lose consciousness. The patient admits to sleeping approximately 4 hours per night due to upcoming final examinations. Physical examination is completely normal. Which of the following is the best initial treatment for this patient’s symptoms?
Correct Answer: A
Rationale: Morning myoclonic jerks without loss of consciousness, triggered by sleep deprivation, suggest juvenile myoclonic epilepsy. Valproic acid is effective for myoclonus and generalized seizures in JME.
Question 3 of 5
A 66-year-old man presents with fluctuating cognitive dysfunction. He is accompanied by his wife, and she reports that at times, he seems almost normal, while at other times, he is very confused and disoriented. She also reports that he has gotten lost numerous times when driving home, and he has told her that he has seen 'little children' running through their living room from time to time. Physical examination is significant for a hypophonic voice, bradykinesia and limb rigidity. Which of the following is the mechanism of action of the appropriate medication used to treat this patient’s condition?
Correct Answer: B
Rationale: Fluctuating cognition, visual hallucinations, and parkinsonism suggest dementia with Lewy bodies. Cholinesterase inhibitors (e.g., donepezil) improve cognition by enhancing acetylcholine.
Question 4 of 5
Nervous system effector cells
Correct Answer: C
Rationale: Effector cells respond to nervous system signals; muscle cells contract and gland cells secrete, executing motor outputs, unlike sensory cells which detect stimuli.
Question 5 of 5
The signal that crosses a synapse is stopped when
Correct Answer: D
Rationale: Synaptic transmission ends when neurotransmitters are degraded (e.g., by enzymes like acetylcholinesterase) or reuptaken into the presynaptic neuron.