ATI RN
Psychotropic Medications 101 Quiz Questions
Question 1 of 5
During an assessment of an 80-year-old patient, the nurse notices the following: an inability to identify vibrations at her ankle and to identify the position of her big toe, a slower and more deliberate gait, and a slightly impaired tactile sensation. All other neurologic findings are normal. The nurse should interpret that these findings indicate:
Correct Answer: C
Rationale: Rationale for Choice C (Correct Answer - Normal changes attributable to aging): 1. As people age, it is common to experience a decrease in sensory perception and motor function due to changes in the nervous system. 2. The inability to identify vibrations and position of the big toe, slower gait, and impaired tactile sensation are typical age-related changes. 3. Since all other neurologic findings are normal, it suggests these findings are likely due to normal aging processes. 4. There are no signs of acute dysfunction or specific lesions, supporting the interpretation that these findings are part of the natural aging process. Summary of other choices: A: CN dysfunction - Not supported as there are no findings indicative of cranial nerve dysfunction. B: Lesion in the cerebral cortex - Not supported as there are no signs of a specific lesion in the cerebral cortex. D: Demyelination of nerves attributable to a lesion - Not supported as there is no evidence of demyelination or lesion causing nerve damage.
Question 2 of 5
When the nurse is testing the triceps reflex, what is the expected response?
Correct Answer: C
Rationale: The correct answer is C: Extension of the forearm. During the triceps reflex test, tapping the triceps tendon should elicit a brisk extension of the forearm. This reflex is mediated by the C7 nerve root. Option A (Flexion of the hand) is incorrect as it does not involve the triceps muscle. Option B (Pronation of the hand) is incorrect as it is not the expected response of the triceps reflex. Option D (Flexion of the forearm) is incorrect as the triceps reflex specifically tests for extension, not flexion, of the forearm.
Question 3 of 5
During the assessment of an 80-year-old patient, the nurse notices that his hands show tremors when he reaches for something and his head is always nodding. No associated rigidity is observed with movement. Which of these statements is most accurate?
Correct Answer: A
Rationale: The correct answer is A. These findings are normal, resulting from aging. Tremors and nodding of the head without associated rigidity are common in older adults due to changes in the nervous system and musculoskeletal system. This is known as senile tremors or essential tremors, which are benign and not indicative of a specific disease process. Hyperthyroidism (B) typically presents with other symptoms such as weight loss, heat intolerance, and palpitations. Parkinson's disease (C) is characterized by resting tremors, rigidity, and bradykinesia. Evaluating for a cerebellar lesion (D) would involve different symptoms like ataxia and dysmetria. Thus, the most accurate statement is that these findings are normal in aging.
Question 4 of 5
In a person with an upper motor neuron lesion such as a cerebrovascular accident, which of these physical assessment findings should the nurse expect?
Correct Answer: A
Rationale: The correct answer is A: Hyperreflexia. In upper motor neuron lesions like cerebrovascular accidents, there is disruption of inhibitory signals leading to increased reflex activity. This results in hyperreflexia, where reflexes are exaggerated. This occurs due to lack of inhibition from the brain on the spinal reflex arc. The other choices are incorrect because fasciculations (B) are seen in lower motor neuron lesions, loss of muscle tone and flaccidity (C) are characteristics of lower motor neuron lesions, and atrophy and wasting of muscles (D) occur due to disuse or denervation in lower motor neuron lesions, not in upper motor neuron lesions.
Question 5 of 5
The nurse is assessing the neurologic status of a patient who has a late-stage brain tumor. With the reflex hammer, the nurse draws a light stroke up the lateral side of the sole of the foot and inward, across the ball of the foot. In response, the patient's toes fan out, and the big toe shows dorsiflexion. The nurse interprets this result as:
Correct Answer: B
Rationale: The correct answer is B: Positive Babinski sign, which is abnormal for adults. When the patient's toes fan out and the big toe dorsiflexes in response to the stroke with the reflex hammer on the sole of the foot, it indicates a positive Babinski sign. This abnormal response suggests upper motor neuron dysfunction, possibly due to the brain tumor affecting the corticospinal tract. In adults, a positive Babinski sign is indicative of pathology and not a normal finding. Summary: A: Incorrect - Negative Babinski sign is normal for adults, not applicable in this case. C: Incorrect - Clonus is characterized by rhythmic muscle contractions and is not demonstrated in the scenario described. D: Incorrect - Achilles reflex involves tapping the Achilles tendon to assess the integrity of the S1 nerve root, not relevant to the response observed in this scenario.