ATI LPN
Quizlet Adult Medical Surgical Head Injury Monitoring Neurological Status Questions
Question 1 of 5
A previously healthy 26-year-old male is brought to the emergency department due to muscle weakness. He reports mild weakness in his legs that has progressively worsened over a few days to the point that he can barely move his legs. He has some numbness in his legs and his arms feel weak. He has recently recovered from a respiratory infection. 1/5 muscle strength is noted throughout the lower extremities, as well as absent patellar and ankle reflexes. 3 to 4-/5 muscle strength is appreciated throughout his upper extremities. A lumbar puncture is performed, which shows the following: Cell count: 4 cells/mm3, Glucose: 67 mg/dL, Protein: 187 mg/dL Gram stain: no organisms Spirometry is performed, which shows a forced vital capacity of 0.85 L. Which of the following is the best next step in management?
Correct Answer: B
Rationale: Acute progressive weakness post-infection, areflexia, and albuminocytologic dissociation (elevated protein, normal cells) on CSF suggest Guillain-Barre syndrome. A forced vital capacity of 0.85 L indicates severe respiratory compromise, making intubation the priority to prevent respiratory failure.
Question 2 of 5
A 54-year-old male presents with difficulty in eating and drinking, and worsening hand-writing. This has been stressful for him as he has been continuously working on a novel that is due for publishing in a few weeks. He notes that alcohol improves his symptoms and relieves his stress. Medical history in noncontributory. Family history is significant for similar symptoms in his father, but cannot recall the name of the diagnosis. Physical examination shows a tremor of the hand, of medium frequency that worsens with his arms outstretched. Mild titubation is also noted on exam. Which of the following is the best initial treatment option for this patient?
Correct Answer: A
Rationale: Postural tremor worsened by action, improved by alcohol, and familial history suggest essential tremor. Beta-blockers (e.g., propranolol) are the first-line treatment, reducing tremor amplitude.
Question 3 of 5
A 62-year-old man presents with progressive proximal lower extremity muscle weakness. He reports difficulty with climbing the stairs and getting up from a chair. He also reports that his mouth has been constantly dry. These symptoms began approximately 3 weeks prior to presentation. Medical history is significant for recently diagnosed small cell carcinoma of the lungs. On physical examination, there is no evidence of muscle atrophy. There is 4/5 strength bilaterally in the hip flexors and extensors, with absent patellar reflexes. When asking the patient to contract both quadriceps for 10 seconds, his patellar reflexes become 2+. Which of the following is most likely to be found on serology?
Correct Answer: B
Rationale: Proximal weakness, dry mouth, and reflex facilitation with small cell lung cancer suggest Lambert-Eaton myasthenic syndrome, associated with anti-P/Q VGCC antibodies.
Question 4 of 5
The part of the brain responsible for unconscious bodily functions is the:
Correct Answer: C
Rationale: The brain stem regulates unconscious functions like breathing, heart rate, and digestion, essential for survival.
Question 5 of 5
Action potentials relay different intensities of information due to the
Correct Answer: B
Rationale: Action potentials are all-or-none, but their frequency increases with stimulus intensity, encoding strength via rate coding.