Section 1. Neurological Problems

MULTIPLE CHOICE

	1.	Which statement about confusion is true?
A.	Confusion is a disease process.	
B.	Confusion is always temporary.	
C.	Age is a reliable predictor of confusion.	
D.	Polypharmacy is a major contributor to confusion in older adults.	

ANS:	D	PTS:	1

	2.	Which of the following indicates a diagnosis of dementia?
A.	Onset after an infection	
B.	Abrupt onset over a week	
C.	Difficulty with long-term memory	
D.	Hard time finding words	

ANS:	D	PTS:	1

	3.	Which of the following aspects of the patient history is a hallmark of delirium?
A.	Patient has chronic kidney disease.	
B.	Patient has had aphasia for a year.	
C.	Patient has diabetes mellitus.	
D.	Patient has been getting lost driving home.	

ANS:	A	PTS:	1

	4.	Which of the following may trigger migraines?
A.	Taking an ibuprofen for muscle pain	
B.	A cup of coffee with regular sweetener	
C.	A glass of merlot wine	
D.	Drinking a cup of green tea	

ANS:	C	PTS:	1

	5.	Sondra’s peripheral vestibular disease causes dizziness and vertigo. Which of the following medications will help to decrease edema in the labyrinth of the ear?
A.	Meclizine	
B.	Diphenhydramine	
C.	Diamox	
D.	Promethazine	

ANS:	C	PTS:	1

	6.	The hallmark of an absence seizure is:
A.	No activity at all	
B.	A blank stare	
C.	Urine is usually voided involuntarily	
D.	The attack usually lasts several minutes	

ANS:	B	PTS:	1

	7.	Which of the following persons fits the classic description of a patient with multiple sclerosis (MS)?
A.	A teenage male	
B.	A 65-year-old male	
C.	A 25-year-old female	
D.	A 60-year-old female	

ANS:	C	PTS:	1

	8.	Which of the following is a specific test to MS?
A.	Magnetic resonance imaging (MRI)	
B.	Computed tomography (CT) scan	
C.	A lumbar puncture	
D.	There is no specific test	

ANS:	D	PTS:	1

	9.	Over the course of 3 years, a patient has had two MS flares. The patient’s primary complaints during the episodes are bilateral tingling and pain in their legs, depression, and numbness in their right hand with complete recovery in between occurrences. Which MS classification fits their disease process?
A.	Clinically isolated syndrome	
B.	Relapsing-remitting	
C.	Primary progressive	
D.	Secondary progressive	

ANS:	B	PTS:	1

	10.	A patient with MS is complaining of new-onset “electric tingling” in both their arms. Which medication specifically treats these acute exacerbations?
A.	Lemtrada	
B.	Aubagio	
C.	Zanaflex	
D.	Depo-Medrol	

ANS:	D	PTS:	1

	11.	Which of the following is a risk factor for developing Alzheimer’s disease?
A.	Having a master’s or doctoral degree	
B.	Patient is a physician	
C.	Patient has Down’s syndrome	
D.	History of neurological disease	

ANS:	C	PTS:	1

	12.	Which drug for Alzheimer’s disease should be administered beginning at the time of diagnosis?
A.	Cholinesterase inhibitors	
B.	Anxiolytics	
C.	Antidepressants	
D.	Atypical antipsychotics	

ANS:	A	PTS:	1

	13.	The health-care provider is treating a patient who was hit in the head with a frying pan. Which of the following should the provider suspect?
A.	Intraparenchymal hemorrhage	
B.	Subdural hematoma	
C.	Epidural hematoma	
D.	Subarachnoid hematoma	

ANS:	B	PTS:	1

	14.	Which hematoma occurs along the temporal cranial wall and results from tears in the middle meningeal artery?
A.	Epidural hematoma	
B.	Subdural hematoma	
C.	Subarachnoid hematoma	
D.	Intraparenchymal hemorrhage	

ANS:	A	PTS:	1

	15.	Which of the following must be completed prior to administering TPA (tissue plasminogen activator)?
A.	Full-body MRI	
B.	Head x-ray	
C.	Head CT	
D.	Head MRI	

ANS:	C	PTS:	1

	16.	Which cranial nerve is affected in a patient with a cerebrovascular accident who has difficulty chewing?
A.	CN V	
B.	CN VII	
C.	CN IX	
D.	CN X	

ANS:	A	PTS:	1

	17.	Which of the following has been linked to a delay in treatment for stroke?
A.	Patient has stroke symptoms at work.	
B.	Patient experiences stroke during the day.	
C.	Patient lives with a family member.	
D.	Patient calls their primary-care provider (PCP) instead of 911 at sign of stroke.	

ANS:	D	PTS:	1

	18.	When a patient has a carotid bruit, which of the following should the PCP gather from the patient history?
A.	History of hemophilia	
B.	History of peripheral vascular occlusive disease	
C.	History of seizure disorder	
D.	History of sickle cell disease	

ANS:	B	PTS:	1

	19.	Which patient is more likely to have a cluster headache?
A.	A female in her reproductive years	
B.	A 40-year-old African American male	
C.	A 55-year-old female who drinks 10 cups of coffee daily	
D.	A 45-year-old male awakened at night	

ANS:	D	PTS:	1

	20.	Which patient is most likely to have myasthenia gravis (MG)?
A.	A 75-year-old Caucasian woman	
B.	A 31-year-old Hispanic woman	
C.	A 55-year-old African American male	
D.	A 10-year-old Middle Eastern male	

ANS:	B	PTS:	1

	21.	Inattention and a sleep–wake cycle disturbance are the hallmark symptoms of:
A.	Dementia	
B.	Alzheimer’s disease	
C.	Parkinson’s disease	
D.	Delirium	

ANS:	D	PTS:	1

	22.	Which type of meningitis is more benign, self-limiting, and caused primarily by a virus?
A.	Purulent meningitis	
B.	Chronic meningitis	
C.	Aseptic meningitis	
D.	Herpes meningitis	

ANS:	C	PTS:	1

	23.	A patient has been diagnosed with meningitis caused by a Streptococcus pneumoniae infection. Which of the following treatments would be appropriate?
A.	Cefotaxime	
B.	Isoniazid	
C.	Acyclovir	
D.	Amphotericin	

ANS:	A	PTS:	1

	24.	Which of the following should be started promptly if viral encephalitis is suspected?
A.	Oral amoxicillin	
B.	IV acyclovir	
C.	IV ampicillin	
D.	Oral acyclovir	

ANS:	B	PTS:	1

	25.	What is usually the first sign or symptom that a patient would present with that would make you suspect herpes zoster?
A.	A stabbing pain on one small area of the body	
B.	A vesicular skin lesion on one side of the body	
C.	A pain that is worse upon awakening	
D.	A lesion on the exterior ear canal	

ANS:	B	PTS:	1

	26.	Which patient is most likely to be diagnosed with Guillain-Barré syndrome?
A.	A 6-month-old infant	
B.	A 30-year-old man	
C.	A 72-year-old woman	
D.	A 50-year-old man	

ANS:	C	PTS:	1

	27.	Gabby, aged 22, has Bell’s palsy on the right side of her face. Her mouth is distorted, and she is concerned about permanent paralysis and pain. What do you tell her?
A.	“Most patients have complete recovery in 3 to 6 months.”	
B.	“Unfortunately, you’ll probably have a small amount of residual damage.”	
C.	“Don’t worry, I’ll take care of everything.”	
D.	“You may have a few more episodes over the course of your lifetime but no permanent damage.”	

ANS:	A	PTS:	1

	28.	A patient is presenting with chorea (dance-like movements). Which of the following diseases might the patient have?
A.	Dementia	
B.	Parkinson’s disease	
C.	Wilson’s disease	
D.	Huntington’s disease	

ANS:	D	PTS:	1

	29.	Which of the following signs would a health-care provider expect to see in a patient with Parkinson-plus disorder?
A.	Resting tremor	
B.	Bradykinesia	
C.	Rigidity	
D.	Postural instability	

ANS:	D	PTS:	1

	30.	Which of the following is a sign or symptom of a migraine?
A.	Light sensitivity	
B.	Nonpulsatile pain	
C.	Nasal stuffiness	
D.	Bandlike pain	

ANS:	A	PTS:	1

	31.	Carotid endarterectomy should be considered only for symptomatic patients with greater than what percentage of stenosis?
A.	Greater than 25%	
B.	Greater than 50%	
C.	Greater than 75%	
D.	Only for 100% occlusion	

ANS:	B	PTS:	1

	32.	Which of the following activities is part of the functional activities questionnaire?
A.	Asking the patient to unravel a Rubik’s cube	
B.	Determining if the patient can drive on the highway	
C.	Asking the patient about a news event from the current week	
D.	Seeing if the patient can keep his or her home clean	

ANS:	C	PTS:	1

	33.	About 90% of all headaches are:
A.	Tension	
B.	Migraine	
C.	Cluster	
D.	Without pathological cause	

ANS:	D	PTS:	1

	34.	Which statement is true regarding driving and patients with a seizure disorder?
A.	Once diagnosed with a seizure disorder, patients must never drive again.	
B.	After being seizure free for 6 months, patients may drive.	
C.	Each state has different laws governing driving for individuals with a seizure disorder.	
D.	These persons may drive but never alone.	

ANS:	C	PTS:	1

	35.	Julie has relapsing-remitting muscular sclerosis. She has not had a good response to interferon. Which medication might help given IV once a month?
A.	Glatiramer acetate	
B.	Natalizumab	
C.	Fingolimod	
D.	Glucocorticoids	

ANS:	B	PTS:	1

	36.	The “freezing phenomenon” is a cardinal feature of:
A.	Parkinson’s disease	
B.	Alzheimer’s disease	
C.	A cerebrovascular accident (CVA)	
D.	Bell’s palsy	

ANS:	A	PTS:	1

	37.	A ratchet-like rhythmic contraction, especially in the hand, during passive stretching is known as:
A.	Spinothalamic dysfunction	
B.	Ratcheting	
C.	Cogwheeling	
D.	Hand tremors	

ANS:	C	PTS:	1

	38.	Which condition is characterized by the impaired ability to learn new information along with a cognitive disturbance in either language, function, or perception?
A.	Guillain-Barré syndrome	
B.	Parkinson’s disease	
C.	Alzheimer’s disease	
D.	Delirium	

ANS:	C	PTS:	1

	39.	A score of 12 to 24 on this test indicates intermediate Alzheimer’s disease:
A.	SLUMS	
B.	MoCA	
C.	FAST	
D.	MMSE	

ANS:	D	PTS:	1

	40.	IV thrombolytic therapy following an ischemic CVA should be given within how many hours of symptom onset?
A.	1 hour	
B.	3 hours	
C.	6 hours	
D.	12 hours	

ANS:	B	PTS:	1

	41.	When administered at the beginning of an attack, oxygen therapy may help this kind of headache?
A.	Tension	
B.	Migraine	
C.	Cluster	
D.	Stress	

ANS:	C	PTS:	1