Symptoms and Tests for Neural Conditions - NCLEX-PN

Decerebrate positioning is an involuntary response of abduction, extension, and hyperpronation of the upper extremities due to noxious stimuli. There also is hyperextension of the lower extremities and the feet are plantarflexed. Decorticate positioning involves "mummy baby" posture - elbows, wrists, and fingers flexed, and legs extended and rotated medially. The Babinski reflex involves the extension of the big toe following stimulation of the sole of the foot. The crossed extensor reflex is also known as the withdrawal reflex, which involves the differential flexion and relaxation of muscles in the withdrawal of a limb. Vestibulospinal reflexes involve the use of vestibular organs and skeletal muscle to maintain balance, posture, and coordination.

The score of this client includes: eye open response is a , best verbal response is and best motor response is .

Romberg's test is an evaluation of both proprioception and vestibular function. The patient is asked to stand with eyes open, then to close their eyes and remain still. Any tilting or loss of balance is considered to be a sign of either proprioceptive or vestibular impairment, and should be evaluated further.

Gait test assesses for gait abnormalities. Rapidly alternating movement test is done with the patient seated with their hands on their thighs. They are asked to rapidly turn their hands over, then return them palms down to their thighs 10 times. This test is evaluating for dysdiadochokinesis, or inability to perform rapidly alternating movements. Ataxia, or the loss of control of bodily movements, is not a specific test, but rather a clinical finding.

In adults, the most common cause of dysdiadochokinesia is multiple sclerosis.

Cerebellar lesion is the most common cause of this finding in children. This symptom is not a normal finding in Parkinson's disease, or in pontine gliomas (tumors of the pons), though neurological impairment or ataxia itself may make rapidly alternating movements difficult.

Increased intracranial pressure can be chronic or acute. The nurse must assess for pupilary response, level of consciousness, and quality of headache if present, in addition to motor response.

Migraine aura that persists after headache has resolved should be evaluated for stroke, transient ischemic attack, or arteriovenous malformation.

Aphasia is the term for neurological impairment of a person's ability to speak or understand language.

The other terms listed all denote various deficiencies:

• Ataxia is a loss or lack of coordinated motor function.
• Apraxia describes a lack of motor planning or inability to execute a specific intentional movement.
• Dysmetria is an inability to judge distance when attempting movements such as grasping at a nearby object

The therapeutic serum phenytoin level is between .

would be below the therapeutic level and may be due to non-compliance by the client or increased metabolism of the drug. The other options are within the listed therapeutic range.

A seizure is defined as an abnormal surge or excess of electrical activity in the brain. This can result in partial or total loss of consciousness, and may cause muscular spasms, twitches, or other types of dyskinesia (disorders of movement). Spasms, twitches, and dyskinesias are not always caused by seizure disorders, however - they may be caused by a wide range of neuromuscular dysfunctions.

Positive symptoms in schizophrenia are any symptoms of cognitive excess or disordered thinking. These include delusions, such as delusions of grandeur or persecution, hallucinations, and disorganized speech or behavior.

The belief that general or innocuous events exist specifically for or relate specifically to an individual is called a delusion of reference. Examples include belief that a billboard or television commercial is attempting to communicate directly to an individual, the ascribing of significance to random coincidences, or the observation of coded signals or signs in the general environment.

The belief that other people can hear one's thoughts is described by the term thought broadcasting. This is a common symptom in schizophrenia. It is differentiated from telepathy in that thought broadcasting, there is a delusion that thoughts can be heard by anyone, while telepathy is generally non-verbal communication between specific individuals, and may be receptive as well as projective. Auditory hallucinations are false perceptions of sounds (or internal thought perceived at emanating from another source), while delusions of persecution can take many forms but generally include a degree of paranoia or feeling of being targeted for harm or attack.

Depression has been linked with alterations in taste sensation, including decreased sensitivity to sweetness. This may contribute in some part to the high consumption of sweet foods in certain individuals experiencing a depressive episode. None of the other conditions listed have been correlated with alterations in taste receptor function.

The correct answer is "Anorexia nervosa." This is the correct answer because in this patient, who is a young female, which is the most commonly encountered demographic for eating disorders, she notes that she has been drastically restricting her intake of food, that she has body dysmorphic thoughts (e.g. thinking that she is "too fat" despite that her BMI is 14), and we learn that her BMI is 14. A diagnosis of anorexia can be made if a patient is restricting their eating or drinking intentionally, and/or is participating in purge behavior, and has a BMI less than 17.5, as in this patient.

Should this patient have presented in an identical manner, but her BMI been greater than 17.5, by definition, the correct answer would be bulimia nervosa. Given her BMI though, bulimia nervosa is not correct. There is no evidence of binge-eating behavior in this patient either, making that answer incorrect.

While generalized anxiety disorder and/or major depressive disorder are often co-morbid in patients with eating disorders, there is not enough evidence in the example to suggest either diagnosis for this patient.

Decerebrate positioning is an involuntary response of abduction, extension, and hyperpronation of the upper extremities due to noxious stimuli. There also is hyperextension of the lower extremities and the feet are plantarflexed. Decorticate positioning involves "mummy baby" posture - elbows, wrists, and fingers flexed, and legs extended and rotated medially. The Babinski reflex involves the extension of the big toe following stimulation of the sole of the foot. The crossed extensor reflex is also known as the withdrawal reflex, which involves the differential flexion and relaxation of muscles in the withdrawal of a limb. Vestibulospinal reflexes involve the use of vestibular organs and skeletal muscle to maintain balance, posture, and coordination.

The score of this client includes: eye open response is a , best verbal response is and best motor response is .

Romberg's test is an evaluation of both proprioception and vestibular function. The patient is asked to stand with eyes open, then to close their eyes and remain still. Any tilting or loss of balance is considered to be a sign of either proprioceptive or vestibular impairment, and should be evaluated further.

Gait test assesses for gait abnormalities. Rapidly alternating movement test is done with the patient seated with their hands on their thighs. They are asked to rapidly turn their hands over, then return them palms down to their thighs 10 times. This test is evaluating for dysdiadochokinesis, or inability to perform rapidly alternating movements. Ataxia, or the loss of control of bodily movements, is not a specific test, but rather a clinical finding.

In adults, the most common cause of dysdiadochokinesia is multiple sclerosis.

Cerebellar lesion is the most common cause of this finding in children. This symptom is not a normal finding in Parkinson's disease, or in pontine gliomas (tumors of the pons), though neurological impairment or ataxia itself may make rapidly alternating movements difficult.

Increased intracranial pressure can be chronic or acute. The nurse must assess for pupilary response, level of consciousness, and quality of headache if present, in addition to motor response.

Migraine aura that persists after headache has resolved should be evaluated for stroke, transient ischemic attack, or arteriovenous malformation.

Aphasia is the term for neurological impairment of a person's ability to speak or understand language.

The other terms listed all denote various deficiencies:

• Ataxia is a loss or lack of coordinated motor function.
• Apraxia describes a lack of motor planning or inability to execute a specific intentional movement.
• Dysmetria is an inability to judge distance when attempting movements such as grasping at a nearby object