MABINI COLLEGES

College of Nursing & Midwifery

Daet, Camarines Norte

ASSESSING NEUROLOGIC SYSTEM

_____________________________
Name

_____________________________
Section

Assessing Neurologic Syatem Prepared by: Nomelita S. Lo Page 1

 PRETEST

ASSESSING THE NEUROLOGIC SYSTEM

Multiple Choice

1) The term central nervous system refers to the:

A) autonomic and peripheral nervous systems
B) brain, spinal cord, and cranial nerves
C) brain and cranial nerves
D) spinal cord and spinal nerves
E) brain and spinal cord

2) Fibers that carry information from the skin, joints, and skeletal muscles to the central nervous
system are:
A) motor
B) visceral sensory
C) somatic sensory
D) interneurons
E) parasympathetic
3) Which of these neuroglial cells forms the myelin sheath in the central nervous system:
A) astrocytes
B) oligodendrocytes
C) Schwann cells
D) ependymal cells
E) Schwann cells

4) The Schwann cell forms a myelin sheath around the:

A) dendrites
B) cell body
C) nucleus
D) axon
E) nodes of Ranvier

5) The neuron processes that normally receive incoming stimuli are called:
A) axons
B) dendrites
C) neurolemmas
D) Schwann cells
E) satellite cells

6) Collections of nerve cell bodies inside the CNS are called:

A) ganglia
B) tracts
C) nerves
D) nuclei
E) tracts or ganglia

7) The major role of the interneuron is to:

A) carry information from the central nervous system to muscles and/or the viscera
B) form a lipid-protein (lipoprotein) cell membrane on the outside of axons
C) transmit nerve impulses from the skin and organs to the central nervous system
D) connect motor and sensory neurons in their pathways
E) detect the amount of stretch in skeletal muscles or tendons and their joints
8) Neurons with several processes branching off the cell body, such as motor neurons and
Assessing Neurologic Syatem Prepared by: Nomelita S. Lo Page 2
interneurons, are structurally classified as:
A) efferent
B) multipolar
C) afferent
D) bipolar
E) unipolar

9) The two major functional properties of neurons are:

A) cover and line body surfaces
B) contraction and movements
C) irritability and conductivity
D) connect and protect
E) lubricate and secrete

10) White matters refers to myelinated fibers in the:

A) CNS
B) PNS
C) ANS
D) SNS
E) both ANS and SNS

11) Impulse conduction is fastest in neurons that are:

A) myelinated
B) unmyelinated
C) sensory
D) motor
E) cerebral

12) Bipolar neurons are commonly:

A) motor neurons
B) called neuroglia
C) found in ganglia
D) found in the eye and nose
E) more abundant in adults than in children

13) During the resting state, a neuron is:

A) polarized with sodium ions outside the cell and potassium ions inside the cell
B) propagating the action potential
C) depolarizing and generating an action potential
D) restoring the ionic conditions utilizing the sodium-potassium pump
E) repolarizing as potassium ions diffuse out of the cell

14) Immediately after an action potential is propagated, which one of the following ions rapidly
diffuses out of the cell into the tissue fluid:
A) sodium
B) chloride
C) calcium
D) potassium
E) magnesium

15) An action potential is caused by an influx of these ions into the cell:
A) potassium
B) sodium
C) calcium
D) magnesium
E) both potassium and sodium

16) Nerve impulse transmissions occurring along myelinated neurons are called:
A) saltatory conduction
B) threshold
Assessing Neurologic Syatem Prepared by: Nomelita S. Lo Page 3
C) graded potential
D) sodium-potassium pump
E) all-or-none response

17) The diffusion of potassium ions out of a neuron causes it to experience:

A) an action potential
B) depolarization
C) repolarization
D) a graded potential

18) Which one of the following is the correct sequence of events that correlates to the sequence
of events of a nerve impulse:
1. the membrane becomes depolarized
2. sodium channels open and sodium ions diffuse inward
3. the membrane becomes repolarized
4. potassium channels open and potassium ions diffuse outward while sodium is actively
transported out of the cell
A) 3, 2, 4, 1
B) 2, 1, 4, 3
C) 2, 1, 3, 4
D) 1, 2, 4, 3
E) 4, 1, 3, 2

19) Which ion causes neurotransmitter vesicles to fuse with the axon's membrane during the
conduction of a nerve impulse from one neuron to the next:
A) chlorine
B) sodium
C) potassium
D) calcium
E) magnesium

20) The gap between two communicating neurons is termed:

A) synaptic cleft
B) cell body
C) effector
D) Schwann cell
E) node of Ranvier

21) The substance that is released at axonal endings to propagate a nervous impulse is called:
A) an ion
B) nerve glue
C) a neurotransmitter
D) the sodium-potassium pump
E) an action potential

22) Which of the following is the correct sequence in a typical reflex arc:
A) effector, afferent neuron, integration center, efferent neuron, receptor
B) receptor, afferent neuron, integration center, efferent neuron, effector
C) effector, efferent neuron, integration center, afferent neuron, receptor
D) receptor, efferent neuron, integration center, afferent neuron, effector
E) receptor, afferent neuron, efferent neuron, integration center, effector

23) Muscles and glands are:

A) receptors
B) effectors
C) myelinated
D) part of the peripheral nervous system
E) part of the central nervous system

24) Which type of reflex involves skeletal muscles:

Assessing Neurologic Syatem Prepared by: Nomelita S. Lo Page 4
A) parasympathetic
B) sympathetic
C) autonomic
D) somatic
E) visceral

25) The elevated ridges of tissue on the surface of the cerebral hemispheres are known as
__________ while the shallow grooves are termed __________.
A) sulci; gyri
B) gyri; sulci
C) ganglia; gyri
D) tracts; ganglia
E) receptors; effectors

26) A stroke in the primary motor area has caused Don to lose control over his skeletal muscles
on the right side of his body. What lobe of his brain was damaged:
A) occipital lobe
B) temporal lobe
C) frontal lobe
D) parietal lobe
E) pyramidal tract

27) Sally has a brain injury; she knows what she wants to say but can't vocalize the words. The
part of her brain that deals with the ability to speak is the:
A) longitudinal fissure
B) gyrus
C) central sulcus
D) Broca's area
E) primary motor area
28) The midbrain, pons, and medulla oblongata are housed in the:
A) diencephalon
B) hypothalamus
C) brain stem
D) pineal gland
E) cerebellum

29) Which lobe contains the primary motor area and enables voluntary control of skeletal muscle
movements:
A) parietal lobe
B) temporal lobe
C) occipital lobe
D) frontal lobe
E) diencephalon

30) The pituitary gland is most closely associated with the:

A) hypothalamus
B) thalamus
C) pineal gland
D) midbrain
E) medulla oblongata

31) Cerebrospinal fluid circulates through all of the following except:

A) subarachnoid space
B) corpus callosum
C) cerebral aqueduct
D) fourth ventricle
E) lateral ventricles
32) The area of the brain stem that plays a role in consciousness and the awake/sleep cycles is
the:
Assessing Neurologic Syatem Prepared by: Nomelita S. Lo Page 5
A) thalamus
B) reticular activating system (RAS)
C) pineal gland
D) limbic system
E) cerebellum
33) Control of temperature, endocrine activity, metabolism, and thirst are functions associated
with the:
A) medulla oblongata
B) cerebellum
C) hypothalamus
D) thalamus
E) cerebrum

34) The vital centers for the control of visceral activities such as heart rate, breathing, blood
pressure, swallowing, and vomiting are located in the:
A) pons
B) medulla oblongata
C) midbrain
D) cerebrum
E) hypothalamus

35) Loss of muscle coordination results from damage to the:

A) cerebrum
B) hypothalamus
C) cerebellum
D) thalamus
E) midbrain

36) Which one of the following represents the correct sequence from outermost to innermost
layers of the meninges:
A) pia mater, dura mater, arachnoid mater
B) pia mater, arachnoid mater, dura mater
C) arachnoid mater, dura mater, pia mater
D) dura mater, pia mater, arachnoid mater
E) dura mater, arachnoid mater, pia mater

37) The dura mater located in the fissure that separates the cerebrum from the cerebellum is:
A) falx cerebri
B) tentorium cerebelli
C) falx cerebelli
D) longitudinal fissure
E) corpus callosum

38) The cerebrospinal fluid:

A) is secreted by the arachnoid villi
B) enters the four ventricles after filling and circulating through the subarachnoid space
C) is secreted mostly by the ependymal cells lining the brain ventricles
D) is continually formed mostly by the choroid plexuses
E) is identical in composition to whole blood
39) The blood-brain barrier is effective against the passage of:
A) water
B) nutrients such as glucose
C) alcohol
D) anesthetics
E) metabolic waste such as urea

40) Which of the following brain dysfunctions is also known as a stroke:

A) cerebrovascular accident (CVA)
B) Alzheimer's disease
C) aphasia
Assessing Neurologic Syatem Prepared by: Nomelita S. Lo Page 6
D) cerebral edema
E) Parkinson's disease

41) The gray matter of the spinal cord:

A) surrounds the central canal
B) contains myelinated fiber tracts
C) is made up of the dorsal, lateral, and ventral columns
D) surrounds the white matter of the spinal cord
E) always carries sensory information to the brain

42) Cell bodies of the sensory neurons of the spinal nerves are located in:
A) the dorsal root ganglia of the spinal cord
B) the ventral root ganglia of the spinal cord
C) the thalamus
D) the hypothalamus
E) sympathetic ganglia

43) Which one of the following is the correct sequence of nerves that exit the spinal cord, going
from superior to inferior:
A) thoracic spinal nerves, cervical spinal nerves, lumbar spinal nerves, sacral spinal nerves
B) cervical spinal nerves, lumbar spinal nerves, thoracic spinal nerves, sacral spinal nerves
C) thoracic spinal nerves, cervical spinal nerves, sacral spinal nerves, lumbar spinal nerves
D) cervical spinal nerves, thoracic spinal nerves, sacral spinal nerves, lumbar spinal nerves
E) cervical spinal nerves, thoracic spinal nerves, lumbar spinal nerves, sacral spinal nerves

44) Which one of the following is the correct sequence in connective tissue sheaths, going from
outermost to innermost layer:
A) epineurium, endoneurium, perineurium
B) epineurium, perineurium, endoneurium
C) perineurium, epineurium, endoneurium
D) perineurium, endoneurium, epineurium
E) endoneurium, epineurium, perineurium

45) Each spinal nerve branches into a ventral and dorsal:

A) root
B) ganglion
C) plexus
D) ramus
E) tract

46) The function of the olfactory nerve concerns:

A) hearing
B) vision
C) chewing
D) smell
E) eye movement

47) The nerve that contains sensory fibers that are involved in hearing is:
A) cranial nerve II
B) cranial nerve III
C) cranial nerve V
D) cranial nerve VIII
E) cranial nerve IX

48) Spinal nerves exiting the cord from the level of L4 to S4 form the:
A) lumbar plexus
B) femoral plexus
C) sacral plexus
D) thoracic plexus
E) obturator plexus
Assessing Neurologic Syatem Prepared by: Nomelita S. Lo Page 7
49) Damage to this nerve results in "wristdrop," the inability to extend the hand at the wrist:
A) phrenic
B) axillary
C) obturator
D) radial
E) femoral

50) Which nervous system subdivision is a chain of two motor neurons consisting of a
preganglion and a postganglionic neuron:
A) somatic
B) central
C) autonomic
D) visceral
E) sensory

51) Which of the nerve plexuses serves the shoulder and arm:
A) sacral
B) phrenic
C) lumbar
D) brachial
E) cervical

52) The sciatic nerve is the largest nerve in the body resulting from a combination of which two
nerves:
A) pudendal and femoral nerves
B) femoral and tibial nerves
C) pudendal and common peroneal nerves
D) common fibular and tibial nerves
E) pudendal and tibial nerves

53) The sympathetic and parasympathetic nervous systems are subdivisions of the:
A) central nervous system
B) voluntary nervous system
C) autonomic nervous system
D) somatic nervous system
E) peripheral nervous system

54) In contrast to the somatic nervous system, the autonomic nervous system:
A) has two motor neurons
B) has two afferent neurons
C) stimulates its effector cells
D) has both afferent and efferent fibers
E) has centers in the brain and spinal cord

55) Which one of these effectors is NOT directly controlled by the autonomic nervous system:
A) smooth muscle
B) cardiac muscle
C) skeletal muscle
D) most glands
E) abdominal organs

56) Preparing the body for the "fight-or-flight" response during threatening situations is the role
of the:
A) sympathetic nervous system
B) cerebrum
C) parasympathetic nervous system
D) somatic nervous system
E) afferent nervous system

Assessing Neurologic Syatem Prepared by: Nomelita S. Lo Page 8

57) Which of the following effects is characteristic of the parasympathetic nervous system:
A) decreases activity of the digestive system
B) stimulates sweat glands to produce perspiration
C) decreases urine output
D) increases metabolic rate
E) decreases heart rate

58) The effects of the sympathetic nervous system are essentially opposite of the:
A) central nervous system
B) parasympathetic nervous system
C) autonomic nervous system
D) motor division
E) sensory division

59) Sympathetic division fibers leave the spinal cord in the:

A) craniosacral regions, and the postganglionic fibers secrete norepinephrine
B) thoracolumbar region, and the postganglionic fibers secrete acetylcholine
C) craniosacral region, and the postganglionic fibers secrete acetylcholine
D) thoracolumbar region, and the postganglionic fibers secrete norepinephrine
E) craniosacral region, and the preganglionic fibers secrete norepinephrine

60) Which subdivision of the autonomic nervous system operates using the neurotransmitters
norepinephrine and epinephrine:
A) parasympathetic
B) somatic
C) sympathetic
D) peripheral
E) central

61) Which one of the following statements about aging is most accurate:
A) the brain reaches its maximum weight around the seventh decade of life
B) synaptic connections are too fixed to permit a great deal of learning after the age of 35
C) despite some neuronal loss, an unlimited number of neural pathways are available and ready
to be developed; therefore, additional learning can occur throughout life
D) learning throughout the adult and aging years is supported primarily by glial proliferation
E) increased efficiency of the sympathetic nervous system enhances the ability to learn

Assessing Neurologic Syatem Prepared by: Nomelita S. Lo Page 9

 MABINI COLLEGES, INC.
College of Nursing and Midwifery
Governor Panotes Avenue,
Daet, Camarines Norte

NEUROLOGIC ASSESSMENT
Nursing Interview Guide to Collect Subjective Data

Name: _____________________________ Year & Section:___________________ Date:

_____________

QUESTIONS FINDINGS

Current Symptoms

1. Headaches, numbness, or tingling?

2. Seizure activity?

3 .Dizziness, light-headedness, or problem with balance?

4. Decrease in ability to smell or taste?

5. Ringing in ears

6. Change in vision?

7. Difficulty understanding when people are talking to you

when you talk to others?

8. Difficulty in swallowing?

9. Loss of bowel and bladder control

10 . Memory Loss?

11. Tremors?

Past History

1. Head injury?

2. Meningitis?

3. Encephalitis?

4. Spinal cord injury?

5. Stroke?

6. Treatment received?

Family History

1. High blood pressure?

2. Stroke?

3. Alzheimer disease?

Assessing Neurologic Syatem Prepared by: Nomelita S. Lo Page 10

 4. Epilepsy?

5. Brain cancer?

6. Huntington chorea

Lifestyle and Health Practices

1. Any prescription or non-prescription medications?

2. Smoking?

3. Wearing of seatbelts/protective headgear?

4. Daily diet?

5. Exposure to lead, insecticides, pollutants,

chemicals?
6. Lifting of heavy objects?

Questions

7. Frequent repetitive movements?

8. Functioning daily activities?

Analysis of data

1. Formulates nursing diagnosis, (wellness,

risk,actual)
2. Formulate collaborative problems.

3. Make necessary referrals.

Nursing Interview Guide to Collect Objective Data

QUESTIONS FINDINGS

Clinical Symptoms Findings

1. Gather equipment, such as:

 examination gloves, -Substances to smell and taste
 pencil and paper, -tongue blade - test tube
 cotton-tipped applicators, - tuning fork with hot &
 newsprint to read, - tape measure cold water
 opthalmoscope, - cotton balls
 paper clip, penlight, - objects to feel -reflex
 Snellen chart, - sterile ball hammer
2. Explain the procedure to client.

3. Ask the client to put on gown.

Mental Status

1. Assess level of consciousness.

2. Observe appearance and behaviour.

3. Observe mood, feelings, and expressions.

4. Observe thought processes and perceptions.

Assessing Neurologic Syatem Prepared by: Nomelita S. Lo Page 11

 5. Observe cognitive abilities.

Cranial Nerves

1. Test cranial nerve I- Olfactory

2. Test cranial nerve II-Optic

3. Test cranial nerve III- Oculomotor

4. Test cranial nerve IV- Throchlear

5. Test cranial nerve V- Trigeminal

6. Test cranial nerve VI-Abducens

7. Test cranial nerve VII- Facial

8. Test cranial nerve VIII- Acoustic (Vestibulochlear)

9. Test cranial nerve IX- Glossopharyngeal

10. Test cranial nerve X-Vagus

11. Test cranial nerve XI-Spinal Accessory

12. Test cranial nerve XII-Hypoglosal

Motor & Cerebelar System

1. Test condition and movement of muscles

2. Test Balance.

3. Test position sensations

4. Test tactile discrimination (fine touch)

Reflexes

1. Test deep tendon reflexes (biceps, brachioradialis, triceps, patellar,

Achilles and ankle clonus)
2. Test superficial reflexes (plantar, abdominal, cremasteric)

3. Test for meningeal irritation/inflammation (Brudzinski and Kernig signs if

indicated)
Analysis of Data

1. Formulate nursing diagnosis (wellness, risk, actual

2. Formulate collaborative problems

3. Make necessary referrals.

Assessing Neurologic Syatem Prepared by: Nomelita S. Lo Page 12

 ASSESSING THE NEUROLOGIC SYSTEM

Rating

Procedure 5 4 3 2 1

1. Assemble equipment and supplies:

 Percussion hammer
 Tongue depressors (one broken diagonally, for testing pain
sensation)
 Wisps of cotton, to assess light touch sensation
 Test tubes of hot and cold water, for skin temperature
assessment (optional)
1. Explain to the client what you are going to do, why it is necessary,
and how he can cooperate.
2. Wash hands and observe other appropriate infection control
procedures.
3. Provide for client privacy.
4. Determine client’s history of the following:
 Presence of pain in the head, back, or extremities, as well
as onset and aggravating and alleviating factors.
 Disorientation to time, place or person
 Speech disorders
 Any history of loss of consciousness, fainting, convulsions,
trauma, tingling or numbness, tremors or tics, limping,
paralysis, uncontrolled muscle movements, loss of
memory, or mood swings
 Alterations in smell, vision, taste, touch, or hearing.
5. I f the client display difficulty speaking:

6. Point to common objects, and ask the client to name them.

7. Ask the client to read some words and to match the printed and
written words with pictures.
8. Ask the client to respond to simple verbal and written commands,
e.g., “point to your toes” or “raise your left arm”.
9. Determine the clients’ orientation to time, place, and person by
tactful questioning.
10. Listen for lapses memory.

11. Test the ability to concentrate or attention span by asking the client
to recite the alphabet or to count backward from 100.
12. Apply the Glasgow coma scale

13. Test cranial Nerves.

Cranial Nerve I-Olfactory

Assessing Neurologic Syatem Prepared by: Nomelita S. Lo Page 13

 Ask client to close eyes and identify different mild aromas, such as
coffee, vanilla.

Cranial Nerve II-Optic

Ask client to read Snellen’s chart, check visual fields by
confrontation, and conduct an opthalmoscopic examination.

Cranial Nerve III-Oculomotor

Assess six ocular movements and pupil reaction

Cranial Nerve IV-Trochlear

Assess six ocular movements.

Cranial Nerve V-Trigeminal

While clients looks upward, lightly touch lateral sclera of eye to elicit
blink reflex. To test light sensation, have client close eyes and wipe
a wisp of cotton over client’s forehead and paranasal sinuses. To
test deep sensation, use alternating blunt and sharp ends of a
safety pin over same area.

Cranial Nerve VI-Abducens

Assess directions of gaze.

Cranial Nerve VII-Facial

Ask client to smile, raise the eyebrows, frown, puff out his cheeks,
close his eyes tightly. Ask client to identify various tastes place on
tip and sides of tongue-sugar, salt-and identify areas of taste.

Cranial Nerve VIII-Auditory

Assess client’s ability to hear spoken word and vibrations of tuning
fork.

Cranial Nerve IX-Glossopharyngeal

Apply tastes on posterior tongue for identification. Ask the client to
move tongue from side to side and up and down.

Cranial Nerve X-Vagus

Assessed with CN IX; assess client’s speech for hoarseness.

Cranial Nerve XI-Accessory

Ask client to shrug shoulders against resistance from your hands
and to turn his head to side against resistance from your hand.
Repeat for other side.

Cranial Nerve XII-Hypoglossal

Ask client to protrude his tongue at midline, then move it to side to
side.
14. Test reflexes using a percussion hammer, comparing one side of
the body with other to evaluate the symmetry of response.
15. Gross motor and Balance Tests
Walking Gait
Ask the client to walk across the room and back, and assess the client’s
gait.

Romberg’s Test
Ask the client to stand with feet together and arms resting at the sides,
first with eyes open, then closed.

Standing On One Foot With Eyes Closed

Ask the client to close his eyes and stand on one foot, the other. Stand
close to the client during this test.

Heel-Toe Walking
Ask the client to walk straight line, placing the heel of one foot directly in
front of the toes of the other foot.

Assessing Neurologic Syatem Prepared by: Nomelita S. Lo Page 14

 Toe or Heel Walking
Ask the client to walk several steps on the toes and then on the heels.
16. Fine motor Tests for the upper Extremities

Finger to Nose Test

Ask the client to abduct and extends the arms at shoulder height and
rapidly touch the nose alternately with one index finger and then the
other. Have the client repeat the test with the eyes closed if the test is
performed easily.

Alternating Supination and Pronation of Hands on Knees

Ask the client to pat both knees with the palms of both hands and then
with the backs of the hands alternately at an ever-increasing rate.

Finger to Nose and the Nurse’s Finger

Ask the client to touch the nose and then your index finger, held at a
distance at about 45 cm (18 in), at a rapid and increasing rate.

Fingers to Fingers

Ask the client to spread the arms broadly at shoulder height and then
bring the fingers together at the midline, First with eyes open and then
closed, first slowly and then rapidly.

Fingers to Thumb (Same Hand)

Ask the client to touch each finger of one hand to the thumb of the same
hand as rapidly as possible.

17. Fine motor Tests for the Lower Extremities

Ask the client to lie supine and to perform these tests:

Heel Down Opposite Shin

Ask the client to place the heel of one foot just below the opposite knee
and run the heel down the shin to the foot. The client may also use a
sitting position for this test.

Toe or Ball of Foot to the Nurse’s Finger

Ask the client to touch your finger with the large toe of each floor.

17. Light-Touch Sensation.

Compare the light-touch sensation of symmetric areas of the body.

Ask the client to close the eyes and to respond by saying “yes or now”
whenever the client feels the cotton wisp touching the skin.

With a wisp of cotton, lightly touch one specific spot and then the same
spot on the other side of the body.

Test areas on the forehead, cheek, hand, lower arm, abdomen, foot, and
lower leg. Check a specific area of the limb first.

Ask the client to point to the spot where the touch was left.

If areas of sensory dysfunction are found, determine the boundaries of

sensation by testing responses about every 2.5 cm (1 in) in the area.
Make a sketch of the sensory loss area for recording purposes.

Assessing Neurologic Syatem Prepared by: Nomelita S. Lo Page 15

 18. Pain Sensation
Assess pain sensation as follows:
Ask the client to close his eyes and to say “sharp,” “dull,” “don’t know”
when the sharp or dull of end of the broken tongue depressor is felt.

Alternately, use the sharp and dull end of the sterile pin or needle to
lightly prick designated anatomic areas at random. The face is not tested
in this manner.

Allow at least 2 seconds between each test

19. Temperature Sensation

Touch skin areas with test tubes filled with hot or cold water.

Have the client respond say saying “hot,” or “cold,” “don’t know”.

20. Position or Kinesthetic Sensation

Commonly, the middle fingers and the large toes are tested for the
kinesthetic sensation.

To test fingers, support the client’s arm with one hand and hold the client’s
palm in the other. To test the toes, place the client’s heels on the examining
table.

Ask the clients to close his eyes

Grasp a middle finger or a big toe firmly between your thumb and index
finger, and exert the same pressure on both sides of the finger or toe while
moving it

Move the finger or toe until it is up, down or straight out, and ask the client to
identify the positions.

21. Tactile Discrimination

For all tests, the clients eyes need to be closed:

One and Two Point Discrimination

Alternately stimulate the skin with two pins simultaneously and then with
one pin. Ask whether the client feels one or two pinpricks.

Stereognosis

Place familiar objects-such as a key, paper clip, or coin-in the client’s

hand, and ask the client to identify them.

If the client has a motor impairment of the hand and is unable to

manipulate an object, write a number or letter on the client’s palm, using
a blunt instrument, and ask the client to identify it.

Extinction Phenomenon

Simultaneously stimulate two symmetric areas of the body, such as the

thighs, the cheeks or the hands.

22. Documents findings in the client record.

Assessing Neurologic Syatem Prepared by: Nomelita S. Lo Page 16

STUDENT SIGNATURE OVER PRINTED NAME CLINICAL INSTRUCTOR

MABINI COLLEGES, INC.

College of Nursing and Midwifery
Governor Panotes Avenue,
Daet, Camarines Norte

NEUROLOGIC ASSESSMENT
POSTTEST

Name: __________________________ Year & Section: _________________ Date: __________ Score:

Test I. Multiple Choice.

Direction: Choose the one best answer for each of the following multiple choice questions.

___ 1. Sensations of temperature, pain, and crude and light touch are carried by way of the

a. extrapyramidal tract.
b. corticospinal tract.
c. spinothalamic.
d. posterior tract.

___ 2. The cranial nerve that has sensory fibers for taste and fibers that result in the
“gag reflex” is the
a. vagus.
b. trigeminal.
c. hypoglossal.
d. Glossopharyngeal
___ 3. The nurse is assessning an older adult client when the client tells the nurse that she has
experienced transient blind spots for the last few days
a. Vagus nerve damage.
b. stroke
c. spinal cord compression
d. Parkinson’s disease.
___ 4. The nurse is planning a presentation to a group of adults on the topic of strokes. Which of the
following should the nurse plan to include in the teaching plan.
a. Stroke is the number one cause of death in the United States.
b. Smoking and high cholesterol levels are at risk factors for stroke.
c. Clients who stroke while taking oral contraceptive pills are not at a higher risk.
d. Postmenopausal women taking estrogen are at greater risk for STROKE.
___ 5. The nurse is caring for a client during the immediate postoperative period after abdominal
surgery. While performing a “neuro check” the nurse should assess the client’s
a. Sensation
b. Deep tendon reflexes
c. Ability to speak
d. Recent memory
___ 6. The nurse is preparing to percuss a clients reflexes in his arms. To use the reinforcement
technique, the nurse should ask the client to
a. Clench the jaw
b. Stretch the opposite arm
c. Hold his neck toward the floor
d. Straighten his legs forward.

Assessing Neurologic Syatem Prepared by: Nomelita S. Lo Page 17

___ 7. Which cranial nerve is the nurse testing when the client is asked to identify a scented object?
a. Occulomotor
b. Facial
c. Optic
d. Olfactory
___ 8. Reduced ability to sense vibrations of a tuning fork may be present with
a. Peripheral neuropathy.
b. Nystagmus.
c. Graftesthesia
d. Stereognosis
___ 9. While assessing the neurologic system of a confused older adult, the nurse observes that the
client is unable to recall past events. The nurse suspects that the client may be exhibiting signs of
a. Depression
b. Anxiety
c. Attention deficit disorder
d. Cerebral cortex disorder
___ 10. The nurse is assessing the neurologic system of an adult client’s recent memory, the nurse
should ask the client
a.”What you have for breakfast/”
b. “How old were you began working?”
president of the United States?”
c. “Who is the 44th
d. “Can you recall the name of your first grade teacher?”
___ 11. While assessing the pupils of a hospitalized adult client, the nurse observes that the client’s
pupils are dilated to 6 cm. The nurse suspects that the client is exhibiting signs of
a. Oculomotor nerve paralysis
b. Damage to the pons
c. Alcohol abuse
d. Cocaine abuse
___ 12. The nurse is assessing the neurologic system of an adult client.To test the client’s motor function
of the facial nerve, the nurse should
a. Ask the client to purse the lips.
b. Ask the client to open mouth and say “Ah”
c. Note the presence of gag reflex
d. Observe the client swallow a sip of water
___ 13. The nurse is assessing the neurologic system of a client who has spastic muscle tone. The nurse
should explain to the client that spastic muscle tone is associated with impairment to the
a. extrapyramidal tract
b. spinothalamic tract
c. posterior columns
d. corticospinal tract
___ 14. The nurse is preparing to perform the Romberg test on an adult male client. The nurse should
instruct the client to
a. squat down as far as he is able to do so.
b. Keep his eyes open while he bends at the knees.
c. Stand erect with arms at the sides and feet together.
d. Touch the tip of his nose with his finger.
___ 15. The nurse is planning to test position sensation in an adult female client. To perform this
procedure, the nurse should ask the client to close her eyes while the nurse moves the client’s
a. Arm away from the body.
b. Toes up to down.
c. Hand forward and then backward.
d. Leg away from the body.

Assessing Neurologic Syatem Prepared by: Nomelita S. Lo Page 18

 MABINI COLLEGES, INC.
College of Nursing and Midwifery
Governor Panotes Avenue,
Daet, Camarines Norte

Reflection: What I have learned from the Activity

___________________________________________
Area-RLE Skills Laboratory
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Date: _____________________
____ _______________________
Signature Over Printed Name of Student

Assessing Neurologic Syatem Prepared by: Nomelita S. Lo Page 19

 _____________________________
Signature over printed Name of C. I

MABINI COLLEGES, INC.

College of Nursing and Midwifery
Governor Panotes Avenue,
Daet, Camarines Norte

Reflection: What I have learned from the Activity

___________________________________________
Area-RLE Skills Laboratory
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Date: _____________________
____ _______________________
Signature Over Printed Name of Student

_____________________________

Assessing Neurologic Syatem Prepared by: Nomelita S. Lo Page 20

 Signature over printed Name of C. I

MABINI COLLEGES, INC.

College of Nursing and Midwifery
Governor Panotes Avenue,
Daet, Camarines Norte

Reflection: What I have learned from the Activity

___________________________________________
Area-RLE Skills Laboratory
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Date: _____________________
____ _______________________
Signature Over Printed Name of Student

Assessing Neurologic Syatem Prepared by: Nomelita S. Lo Page 21

 _____________________________
Signature over printed Name of C. I

MABINI COLLEGES, INC.

College of Nursing and Midwifery
Governor Panotes Avenue,
Daet, Camarines Norte

Reflection: What I have learned from the Activity

___________________________________________
Area-RLE Skills Laboratory
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Date: _____________________
____ _______________________
Signature Over Printed Name of Student

Assessing Neurologic Syatem Prepared by: Nomelita S. Lo Page 22

 _____________________________
Signature over printed Name of C. I

MABINI COLLEGES, INC.

College of Nursing and Midwifery
Governor Panotes Avenue,
Daet, Camarines Norte

Reflection: What I have learned from the Activity

___________________________________________
Area-RLE Skills Laboratory
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Date: _____________________
____ _______________________
Signature Over Printed Name of Student

Assessing Neurologic Syatem Prepared by: Nomelita S. Lo Page 23

 _____________________________
Signature over printed Name of C. I

MABINI COLLEGES, INC.

College of Nursing and Midwifery
Governor Panotes Avenue,
Daet, Camarines Norte

Reflection: What I have learned from the Activity

___________________________________________
Area-RLE Skills Laboratory
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Date: _____________________
____ _______________________
Signature Over Printed Name of Student

Assessing Neurologic Syatem Prepared by: Nomelita S. Lo Page 24

 _____________________________
Signature over printed Name of C. I

Assessing Neurologic Syatem Prepared by: Nomelita S. Lo Page 25