In review of a nursing home patient's chart, the nurse practitioner discovers that the neurology ...

In review of a nursing home patient's chart, the nurse practitioner discovers that the neurology consult identified that the client has a homonymous hemianopsia. Which of the following statements accurately describes these findings?
 
  A. Partial loss of visual acuity in the ipsilateral peripheral fields
  B. Diplopia in the eye contralateral to the cerebral lesion
  C. Loss of vision in either the right or left halves of the visual fields
  D. Nystagmus in both eyes with asymmetrical movement

Question 2

The Mini-Cog is a short screening tool used to assess cognition. Which of the following statements pertaining to the test is a true statement?
 
  A. The patient will be asked to repeat five words immediately following the directions by the practitioner.
  B. The patient is asked to draw the hour and minute hands on a picture of an analog clock.
  C. A score of 0-2 is a positive screen for dementia.
  D. The patient is asked to recall five images from picture cards following the drawing of the clock hands.

Question 3

A 78-year-old man with Parkinson's disease is being cared for in a nursing home. The nurses observe that he coughs at mealtime; he has the ability to still feed himself with adaptive equipment. He has had no aspirations.
 
  Oral exam is normal, except during his swallowing assessment you note there is slight delayed elicitation. You assess that he has only mild dysphagia. You recommend which of the following as the next step in his care?
  A. Consult gastroenterologist for g-tube decision
  B. Consult speech pathologist for video fluoroscopy
  C. Provide a trial of foods of differing consistency
  D. Require that he is fed all his meals

Question 4

Which of the following assessment findings is commonly noted in a client with advanced Parkinson's disease?
 
  A. Macrographia
  B. Micrographia
  C. Ataxic gait
  D. Increased arm swing

Question 5

A middle-aged patient has been diagnosed with Parkinson's disease. What influences the nurse practitioner's decision to begin pharmacological treatment for this patient?
 
  A. Intentional tremors
  B. Gait instability requiring use of a cane
  C. Symptoms interfering with functional ability
  D. Medications initiated at first sign of unilateral involvement

Question 6

When assessing an elderly client who reports a tremor, which assessment findings would be most reliable in identifying Parkinson's disease?
 
  A. Any presence of tremor
  B. Symptoms of slowed movement, unstable angina, and tremor
  C. Resting tremor, slow unsteady gait, and cogwheel resistance
  D. Cogwheel rigidity, bradykinesia, and amnesia

Question 7

An older adult female patient had a stroke. What symptoms are not usually expressed by patients who have had a vertebrobasilar stroke?
 
  A. Vertigo
  B. Ataxia
  C. Dysarthria
  D. Monocular blindness

Question 8

An older male patient is experiencing acute onset of right-sided weakness, slurred speech, and confusion. What should the nurse practitioner do promptly?
 
  A. Administer an aspirin by mouth
  B. Evaluate for stroke and arrange transport to the hospital right away
  C. Do a thorough medication review and stat blood sugar
  D. Order an EKG and administer O2 by cannula immediately