Week 1

Question 1

What structures make up the CNS?

Answer 1

Brain, spinal cord, cranial nerves I & II, and the retina.

Question 2

How are the cerebral hemispheres connected?

Answer 2

By the corpus callosum.

Question 3

What connects the brain to the head and facial structures?

Answer 3

Cranial nerves.

Question 4

What does the ANS connect the CNS to?

Answer 4

Lungs, heart, stomach, intestines, bladder, and sex organs.

Question 5

What are the functions of the Frontal Lobes?

Answer 5

Judgement/ problem solving, speech/ articulation (broca), voluntary movement, emotional state.

Question 6

Main functions of the parietal lobe?

Answer 6

Spatial orientation, sensory integration and concept formation.

Question 7

Main functions of the temporal lobe?

Answer 7

Auditory processing and formation of spoken memories.

Wernicke’s area - language area for comprehension.

Question 8

Primary function of the occipital lobe?

Answer 8

Visual processing.

Question 9

1 priority in any neuro assessment?

Answer 9

Changes in level of consciousness (LOC).

Question 10

Correct order of LOC decline to monitor?

Answer 10

Conscious → confusion/agitation → lethargy → obtundation → stupor → deep coma.

Question 11

Hallmarks of confusion.

Answer 11

Progressive disorientation, forgetfulness, difficulty following commands, restlessness/agitation.

Question 12

Define lethargy.

Answer 12

A&Ox3 but very sluggish; sleeps often; awakens to voice or gentle touch.

Question 13

Define obtundation.

Answer 13

Extremely drowsy, minimal responsiveness; requires vigorous stimulation; briefly arousable.

Question 14

Define stupor.

Answer 14

Minimal movement; groans/moans; brief arousal only with repeated, forceful stimulation.

Question 15

Define coma.

Answer 15

No response to verbal stimuli; does not speak; may show decorticate/decerebrate or no response to pain.

Question 16

Three components of GCS.

Answer 16

Eye opening, best verbal response, best motor response.

Question 17

GCS eye opening scores.

Answer 17

4 spontaneous, 3 to speech, 2 to pain, 1 none.

Question 18

GCS verbal response scores.

Answer 18

5 oriented, 4 confused conversation, 3 inappropriate words, 2 incomprehensible sounds, 1 none.

Question 19

GCS motor response scores.

Answer 19

6 obeys, 5 localizes pain, 4 withdraws, 3 abnormal flexion, 2 abnormal extension, 1 none.

Question 20

Which cranial nerves are in the cerebrum?

Answer 20

CN I (olfactory) and CN II (optic).

Question 21

Where are cranial nerves III–XII located?

Answer 21

Brainstem.

Question 22

CN I and its bedside test.

Answer 22

Olfactory—smell identification.

Question 23

CN II and its bedside test.

Answer 23

Optic—visual acuity/fields.

Example: “How many fingers?” “Read out loud this sentence on a piece of paper/package”

Question 24

What are the primary roles of CN III?

Answer 24

Oculomotor—eyelid elevation and pupillary responses (accommodation, direct/consensual light).

Question 25

What does anisocoria mean?

Answer 25

Unequal pupils.

Question 26

What is nystagmus?

Answer 26

Rhythmic eye oscillation.

Question 27

What does hippus refer to?

Answer 27

Rapid pupillary constriction and dilation without stimuli

Question 28

What is ptosis?

Answer 28

Drooping eyelid.

Question 29

Which CNs are tested with the 6 cardinal fields of gaze?

Answer 29

CN III, IV (trochlear), VI (abducens).

Question 30

What are the functions of CN V?

Answer 30

Trigeminal—facial sensation (sensory) and muscles of mastication (motor).

Question 31

CN VIII bedside screen

Answer 31

Acoustic—whisper test; tuning fork (Rinne).

Question 32

CN IX main sensory function

Answer 32

Glossopharyngeal—posterior tongue taste; gag/swallow.

Question 33

CN X key bedside checks

Answer 33

Vagus—gag and cough reflex.

Question 34

What is CN XI and how is it assessed?

Answer 34

Accessory (Spinal accessory) Shoulder shrug against resistance; turn head against resistance at mandible.

Question 35

What is CN XII and how do we assess it?

Answer 35

Hypoglossal Ask pt to stick out tongue (midline?), move it side to side against resistance from tongue blade, checking for asymmetry, fasciculations,.

Question 36

Classic balance test for the cerebellum.

Answer 36

Romberg test.

Question 37

Rapid alternating movement testing evaluates what?

Answer 37

Cerebellar coordination (dysdiadochokinesia if impaired).

Question 38

Finger-to-nose testing evaluates what?

Answer 38

Upper extremity coordination.

Question 39

Hopping or heel-to-shin tests evaluate what?

Answer 39

Lower extremity coordination.

Question 40

Superficial tactile testing checks what pathway?

Answer 40

Light touch sensation.

Question 41

Position sense of a joint tests what?

Answer 41

Proprioception.

Question 42

Vibration sense uses what tool?

Answer 42

Tuning fork on bony prominences.

Question 43

Define stereognosis.

Answer 43

Identifying an object by touch alone.

Question 44

Define graphesthesia.

Answer 44

Recognizing numbers/letters traced on the skin.

Question 45

What are standard motor strength screens?

Answer 45

Bilateral 'push/pulls,' hand grasps, plantarflexion/dorsiflexion.

Question 46

List five common DTRs.

Answer 46

Biceps, triceps, brachioradialis, patellar, Achilles.

Question 47

What does a positive Babinski reflex suggest in adults?

Answer 47

It suggests CNS damage. ## Footnote Babinski response considered pathologic in adults.

Question 48

Define Cheyne-Stokes breathing.

Answer 48

Cycles of hyperventilation alternating with apnea.

Question 49

Conditions associated with Cheyne-Stokes.

Answer 49

Stroke, hyponatremia, TBI, brain tumors, heart failure, toxins/overdose, near death.

Question 50

Normal aging effects on sleep and reaction time.

Answer 50

Fragmented sleep; slowed reaction time.

Question 51

Normal aging effects on balance and movement.

Answer 51

Reduced balance and slower movements.

Question 52

Normal aging effects on memory and learning.

Answer 52

Mild memory loss and slower learning.

Question 53

Aging effect on temperature regulation and pain perception.

Answer 53

Impaired thermoregulation; altered pain sensation.

Question 54

What are the elements of a quick neuro check in hospitalized patients?

Answer 54

Vitals, LOC, GCS, key CNs (III, IV, VI, IX, X; VII for symmetry), bilateral strength, and light touch sensation.

Question 55

CT nursing considerations

Answer 55

Noninvasive; keep patient immobile; assess for claustrophobia/anxiety.

Question 56

MRI/MRA core advantage

Answer 56

Superior anatomic detail of soft tissues, bone, and vasculature.

Question 57

MRI safety priorities

Answer 57

Metal screening (patient/staff), pacemaker checks, tattoos with metallic ink, loud noise (ear protection), possible sedation for claustrophobia.

Question 58

What are the primary indications for EEG?

Answer 58

Detect seizure/electrical activity and evaluate brain death.

Question 59

What are the pre-test medication cautions for EEG?

Answer 59

Avoid stimulants, opioids, and sedatives; keep patient calm.

Question 60

Transcranial Doppler (TCD) measures what?

Answer 60

Cerebral blood flow velocity to identify vasospasm.

Question 61

TCD logistics.

Answer 61

Noninvasive ultrasound done by a tech; ~30–60 minutes.

Question 62

What does a PET scan show in neuro?

Answer 62

Metabolic function and changes in brain activity.

Question 63

What are the nursing considerations for a PET scan?

Answer 63

Consent, immobility, relaxation techniques; possible transient sensations (dizzy, HA, light-headed).

Question 64

What imaging test visualizes cerebral vessels using contrast and threading the cath up the femoral artery?

Answer 64

Cerebral angiogram

Question 65

What can a cerebral angiogram assess/detect?

Answer 65

Patency of cerebral blood vessels Narrowing or stenosis of cerebral blood vessels Occlusions Aneurysms Tumors Alterations in blood flow

Question 66

What are the pre-procedure nursing implications for cerebral angiograms?

Answer 66

Obtain consent/ allergies Check orders for NPO IV for hydration

Question 67

What are the post-procedure nursing implications for cerebral angiograms?

Answer 67

Assess puncture site for hematoma/ bleeding VS Distal pulses Neuro deficits

Question 68

Why are Lumbar punctures done?

Answer 68

To obtain CSF for culture Measure ICP Diagnostic for subarachnoid hemorrhage or epidural bleed (contraindicated if bleed already suspected - but if blood seen during another procedure it is used to diagnose)

Question 69

Nursing implications for Lumbar Puncture

Answer 69

Consent Bladder emptied Positioning (curled up on side) Specimens to the lab Check injection site

Question 70

What is a common side effect of a lumbar puncture?

Answer 70

"Spinal HA"

Question 71

Nursing implications for a Spinal HA?

Answer 71

Lie flat for 3-6 hours Hydration reassurance, quiet environment Analgesia