ATI LPN
Neurological Assessment Questions Questions
Question 1 of 5
Which of the following is a sign of increased intracranial pressure?
Correct Answer: D
Rationale: Increased intracranial pressure (ICP) often manifests as irritability, along with headache, vomiting, and altered consciousness. Hypotension (likely a typo for hypertension) is a late sign with bradycardia (Cushing’s triad), not tachycardia. Tinnitus is unrelated to ICP.
Question 2 of 5
A 31-year-old female presents with throbbing right-sided headache that she rates as 8/10 in intensity. She states her pain began approximately 12 hours ago, and is accompanied by nausea. She finds some relief when sitting in a quiet, dark room. She reports that prior to the onset of her headache, she noticed a 'bright spot' in her left lateral vision that later expanded to form a crescent with 'zigzagging' lines of color that has made her feel as if she was 'blind.' This lasted 30 minutes and then resolved, and was followed by the headache. She experiences similar episodes approximately once every two months. Physical exam is completely normal. Which of the following is the most appropriate initial step in management?
Correct Answer: B
Rationale: Migraine with aura (visual scotoma) and throbbing headache with nausea/photophobia responds acutely to triptans (e.g., sumatriptan). Ondansetron treats nausea, propranolol is prophylactic, and verapamil is for cluster headaches.
Question 3 of 5
A 72-year-old male is brought by his wife due to unexplained weakness and fatigue. She describes his movements as 'sluggish', and is concerned that he may be depressed. The patient reports difficulty with buttoning his shirt, and double clicking the mouse when using his computer. He states that the recent death of his mother has been difficult to accept, and has noticed his foods don't smell the same, and has been having difficulty with sleep. He does not smoke, but drinks 2-3 beers per week. He says his father suffers from a hand tremor, and his mother passed away from pancreatic cancer. On physical exam, a tremor affecting the right hand improves with purposeful movement. There is an increased resistance to passive movement at the right wrist joint. Which of the following is the best initial treatment?
Correct Answer: C
Rationale: Bradykinesia, rigidity, and rest tremor (improving with action) with anosmia suggest Parkinson’s disease. Levodopa is the initial treatment, replenishing dopamine. Primidone is for essential tremor.
Question 4 of 5
A 62-year-old man is brought to the emergency department by his wife because 'he's been acting strangely.' She noticed that during social gatherings he would not say much, and would mostly sit by himself. He barely bathes. When left in place he would stay there until he is told to move. He would not seek his favorite activities including watching football but when sat in front of the TV he seemed to enjoy it. On the Montreal Cognitive Assessment (MoCA) testing, he could not complete the trails testing, his clock was disorganized, and he named only 3 items starting with the letter 'F' in 60 seconds. His free recall was poor but improved with cuing. His visuospatial functioning was relatively spared. He had paratonia, but no other abnormalities on motor exam. Magnetic resonance imaging of the brain showed frontal atrophy, but no other focal abnormalities. Which of the following is most likely the diagnosis?
Correct Answer: C
Rationale: Apathy, disinhibition, and executive dysfunction with frontal atrophy suggest behavioral variant frontotemporal dementia. Alzheimer’s affects memory more, depression lacks atrophy, and Parkinson’s involves motor symptoms.
Question 5 of 5
The central communication conduit between the brain and the rest of the body is the
Correct Answer: C
Rationale: The spinal cord serves as the primary pathway for signals between the brain and the body, connecting the central nervous system (CNS) to the peripheral nervous system (PNS). The brain stem regulates vital functions, but the spinal cord is the conduit.