ATI LPN
Neurological Questions Questions
Question 1 of 5
What are the manifestations of a ruptured cerebral aneurysm?
Correct Answer: B
Rationale: A ruptured cerebral aneurysm typically presents with a sudden, severe headache ('thunderclap headache') due to subarachnoid hemorrhage. Loss of consciousness is common, not maintained, and deficits are not transient or gradual.
Question 2 of 5
A 29-year-old female lawyer presents with sharp, shock-like stabbing pain in her right jaw. She has experienced this pain for the past week, and occur approximately 15 times a day, with each episode lasting a few seconds. She notices that at times brushing her teeth, or smiling can trigger her pain. She has tried acetaminophen and ibuprofen, but these have not provided any relief. She has not experienced these symptoms before, but recalls a period of transient right arm weakness lasting a few days approximately 8 months ago, that she assumed was related to a 'pinched nerve.' She reports to experience stress due to an upcoming case that can benefit her career. On physical exam, touching the right maxillary region reproduces the pain. There are no focal neurological deficits. What is the most appropriate initial treatment?
Correct Answer: A
Rationale: Brief, shock-like jaw pain triggered by touch suggests trigeminal neuralgia. Carbamazepine is the first-line treatment, stabilizing nerve membranes. Sumatriptan is for migraines, oxycodone is inappropriate, and gabapentin is second-line.
Question 3 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 4 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 5 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.