ATI LPN
Medical-Surgical Nursing Neurological System Questions
Question 1 of 5
A 70-year-old male presents with numbness of the left upper and lower extremity, as well as the right side of his face. He also reports dizziness and difficulty with swallowing. He was last seen normal approximately 6 hours ago. Two weeks ago he experienced acute head trauma due to a fall while jogging. No intracranial bleed was noted in the head CT performed at the time. Past medical history is significant for hypertension and hypercholesterolemia. His temperature is 100.4 deg F (38 deg C), blood pressure 180/102 mmHg, pulse is 97/min, and respirations are 16/min. Blood glucose level is 312 mg/dL. Physical exam is significant for ptosis and miosis (Horner's syndrome) on the right side. Nystagmus on rightward gaze. Uvula is displaced towards the left, and there is paralysis of the right-sided vocal cord. Right-sided hemisensory loss is noted in the trunk and extremities. There is also sensory loss on the right-sided face. Non-contrast CT shows no intracranial bleed. Which of the following is the best next step in management?
Correct Answer: C
Rationale: Lateral medullary syndrome (Wallenberg) with hyperglycemia (312 mg/dL) suggests stroke. Correcting glucose with insulin is critical as hyperglycemia worsens outcomes; alteplase is past the window (6 hours), and labetalol is secondary.
Question 2 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 3 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 4 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.
Question 5 of 5
The uniformity in the way nerve cells function within the animal kingdom
Correct Answer: B
Rationale: Conserved neuron function across animals suggests it evolved early, enabling complex nervous systems to build upon this foundation.