REVISED PERCEPTION & COORDINATION EXAM
1. A 75-year old woman is admitted to a nursing home with a diagnosis of primary dementia of the
Alzheimer's type. In the nursing home, which of these behaviors of the client is of greatest
danger to her?
a. she wanders into other patient's room
b. she climbs over the side rails of her bed
c. she eats the food off other resident's plates
d. she refuses to change her clothes
2. An elderly client is diagnosed with Alzheimer's disease. When planning care, the nurse should
include which of these vital considerations?
a. allowing him to plan his own day
b. encouraging outside diversional activities
c. limiting his caloric intake
d. providing a calm, predictable environment
3. A 40n year old male patient is complaining of chronic progressive and mental deterioration is
admitted to the unit. The nurse recognizes that these characteristics indicate a disease that
results in degeneration of the basal ganglia and cerebral cortex. The disease is called:
A. Parkinson’s Disease
B. Multiple sclerosis
C. Huntington’s Disease
D. Alzheimer’s disease
Answer : C
Huntington’s disease is a hereditary disease in which degeneration of the basal ganglia and
cerebral cortex causes chronic progressive chorea (muscle twitching) and mental deterioration,
ending in dementia. Huntington’s disease usually strikes people ages 25 to 55.
4. Elsa Santos is a 18 year old student admitted to the ward with a diagnosis of epilepsy. She tells
the nurse that she is experiencing a generalized tingling sensation and is “smelling roses”. The
nurse understands that Esla is probably experiencing:
a. an acute alcohol withdrawal
b. an acute CVA
c. an aura
d. an olfactory hallucination
Answer: C
5. Betty Lee is a 58 year old woman who is being admitted to the medical ward with trigeminal
neuralgia. The nurse anticipates that Mr. Lee will demonstrate which of the following major
complaints?
a. excruciating, intermittent, paroxysmal facial pain
b. unilateral facial droop
c. painless eye spasm
d. mildly painful unilateral eye twitching
6. If a male client experienced a cerebrovascular accident (CVA) that damaged the hypothalamus,
the nurse would anticipate that the client has problems with:
a. body temperature control.
b. balance and equilibrium.
c. visual acuity.
d. thinking and reasoning
Answer A. The body’s thermostat is located in the hypothalamus; therefore, injury to that area
can cause problems of body temperature control. Balance and equilibrium problems are related
to cerebellar damage. Visual acuity problems would occur following occipital or optic nerve
injury. Thinking and reasoning problems are the result of injury to the cerebrum
7. When obtaining the health history from a male client with retinal detachment, the nurse
expects the client to report:
a. light flashes and floaters in front of the eye.
b. a recent driving accident while changing lanes.
c. headaches, nausea, and redness of the eyes.
d. frequent episodes of double vision.
8. Which nursing diagnosis takes highest priority for a client with Parkinson’s crisis?
a. Imbalanced nutrition: Less than body requirements
b. Ineffective airway clearance
c. Impaired urinary elimination
d. Risk for injury
9. A male client is admitted with a cervical spine injury sustained during a diving accident. When
planning this client’s care, the nurse should assign highest priority to which nursing diagnosis?
a. Impaired physical mobility
b. Ineffective breathing pattern
c. Disturbed sensory perception (tactile)
d. Self-care deficient: Dressing/grooming
Answer B. Because a cervical spine injury can cause respiratory distress, the nurse should take
immediate action to maintain a patent airway and provide adequate oxygenation. The other
options may be appropriate for a client with a spinal cord injury — particularly during the course
of recovery — but don’t take precedence over a diagnosis of Ineffective breathing pattern.
10. A female client who was trapped inside a car for hours after a head-on collision is rushed to the
emergency department with multiple injuries. During the neurologic examination, the client
responds to painful stimuli with decerebrate posturing. This finding indicates damage to which
part of the brain?
a. Diencephalon
b. Medulla
c. Midbrain
d. Cortex
11. The nurse is assessing a 37-year-old client diagnosed with multiple sclerosis. Which of the
following symptoms would the nurse expect to find?
a. Vision changes
b. Absent deep tendon reflexes
c. Tremors at rest
d. Flaccid muscles
Answer A. Vision changes, such as diplopia, nystagmus, and blurred vision, are symptoms of
multiple sclerosis. Deep tendon reflexes may be increased or hyperactive — not absent.
Babinski’s sign may be positive. Tremors at rest aren’t characteristic of multiple sclerosis;
however, intentional tremors, or those occurring with purposeful voluntary movement, are
common in clients with multiple sclerosis. Affected muscles are spastic, rather than flaccid.
12. The nurse is caring for a male client diagnosed with a cerebral aneurysm who reports a severe
headache. Which action should the nurse perform?
a. Sit with the client for a few minutes.
b. Administer an analgesic.
c. Inform the nurse manager.
d. Call the physician immediately
13. During recovery from a cerebrovascular accident (CVA), a female client is given nothing by
mouth, to help prevent aspiration. To determine when the client is ready for a liquid diet, the
nurse assesses the client’s swallowing ability once each shift. This assessment evaluates:
a. cranial nerves I and II.
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b. cranial nerves III and V.
c. cranial nerves VI and VIII.
d. cranial nerves IX and X.
After striking his head on a tree while falling from a ladder, a young man age 18 is admitted to
the emergency department. He’s unconscious and his pupils are nonreactive. Which
intervention would be the most dangerous for the client?
a. Give him a barbiturate.
b. Place him on mechanical ventilation.
c. Perform a lumbar puncture.
d. Elevate the head of his bed.
A white female client is admitted to an acute care facility with a diagnosis of cerebrovascular
accident (CVA). Her history reveals bronchial asthma, exogenous obesity, and iron deficiency
anemia. Which history finding is a risk factor for CVA?
a. Caucasian race
b. Female sex
c. Obesity
d. Bronchial asthma
The nurse is teaching a female client with multiple sclerosis. When teaching the client how to
reduce fatigue, the nurse should tell the client to:
a. take a hot bath.
b. rest in an air-conditioned room
c. increase the dose of muscle relaxants.
d. avoid naps during the day
A male client is having a tonic-clonic seizures. What should the nurse do first?
a. Elevate the head of the bed.
b. Restrain the client’s arms and legs.
c. Place a tongue blade in the client’s mouth.
d. Take measures to prevent injury.
A female client with Guillain-Barré syndrome has paralysis affecting the respiratory muscles and
requires mechanical ventilation. When the client asks the nurse about the paralysis, how should
the nurse respond?
a. “You may have difficulty believing this, but the paralysis caused by this disease is
temporary.”
b. “You’ll have to accept the fact that you’re permanently paralyzed. However, you won’t have
any sensory loss.”
c. “It must be hard to accept the permanency of your paralysis.”
d. “You’ll first regain use of your legs and then your arms.”
The nurse is working on a surgical floor. The nurse must logroll a male client following a:
a. laminectomy.
b. thoracotomy.
c. hemorrhoidectomy.
d. cystectomy.
A female client with a suspected brain tumor is scheduled for computed tomography (CT). What
should the nurse do when preparing the client for this test?
a. Immobilize the neck before the client is moved onto a stretcher.
b. Determine whether the client is allergic to iodine, contrast dyes, or shellfish.
c. Place a cap over the client’s head.
d. Administer a sedative as ordered.
21. During a routine physical examination to assess a male client’s deep tendon reflexes, the nurse
should make sure to:
a. use the pointed end of the reflex hammer when striking the Achilles tendon.
b. support the joint where the tendon is being tested.
c. tap the tendon slowly and softly
d. hold the reflex hammer tightly.
22. The nurse is assessing the motor function of an unconscious male client. The nurse would plan
to use which plan to use which of the following to test the client’s peripheral response to pain?
a. Sternal rub
b. Nail bed pressure
c. Pressure on the orbital rim
d. Squeezing of the sternocleidomastoid muscle
23. A female client admitted to the hospital with a neurological problem asks the nurse whether
magnetic resonance imaging may be done. The nurse interprets that the client may be ineligible
for this diagnostic procedure based on the client’s history of:
a. Hypertension
b. Heart failure
c. Prosthetic valve replacement
d. Chronic obstructive pulmonary disorder
24. A male client is having a lumbar puncture performed. The nurse would plan to place the client in
which position?
a. Side-lying, with a pillow under the hip
b. Prone, with a pillow under the abdomen
c. Prone, in slight-Trendelenburg’s position
d. Side-lying, with the legs pulled up and head bent down onto chest.
25. The nurse is positioning the female client with increased intracranial pressure. Which of the
following positions would the nurse avoid?
a. Head mildline
b. Head turned to the side
c. Neck in neutral position
d. Head of bed elevated 30 to 45 degrees
Answer D. The client undergoing lumbar puncture is positioned lying on the side, with the legs
pulled up to the abdomen and the head bent down onto the chest. This position helps open the
spaces between the vertebrae.
26. The client with a brain attack (stroke) has residual dysphagia. When a diet order is initiated, the
nurse avoids doing which of the following?
a. Giving the client thin liquids
b. Thickening liquids to the consistency of oatmeal
c. Placing food on the unaffected side of the mouth
d. Allowing plenty of time for chewing and swallowing
27. The nurse is assessing the adaptation of the female client to changes in functional status after a
brain attack (stroke). The nurse assesses that the client is adapting most successfully if the
client:
a. Gets angry with family if they interrupt a task
b. Experiences bouts of depression and irritability
c. Has difficulty with using modified feeding utensils
d. Consistently uses adaptive equipment in dressing self
28. Nurse Kristine is trying to communicate with a client with brain attack (stroke) and aphasia.
Which of the following actions by the nurse would be least helpful to the client?
a. Speaking to the client at a slower rate
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b. Allowing plenty of time for the client to respond
c. Completing the sentences that the client cannot finish
d. Looking directly at the client during attempts at speech
A female client has experienced an episode of myasthenic crisis. The nurse would assess
whether the client has precipitating factors such as:
a. Getting too little exercise
b. Taking excess medication
c. Omitting doses of medication
d. Increasing intake of fatty foods
The nurse is teaching the female client with myasthenia gravis about the prevention of
myasthenic and cholinergic crises. The nurse tells the client that this is most effectively done by:
a. Eating large, well-balanced meals
b. Doing muscle-strengthening exercises
c. Doing all chores early in the day while less fatigued
d. Taking medications on time to maintain therapeutic blood levels
A male client with Bell’s palsy asks the nurse what has caused this problem. The nurse’s
response is based on an understanding that the cause is:
a. Unknown, but possibly includes ischemia, viral infection, or an autoimmune problem
b. Unknown, but possibly includes long-term tissue malnutrition and cellular hypoxia
c. Primary genetic in origin, triggered by exposure to meningitis
d. Primarily genetic in origin, triggered by exposure to neurotoxins
The nurse has given the male client with Bell’s palsy instructions on preserving muscle tone in
the face and preventing denervation. The nurse determines that the client needs additional
information if the client states that he or she will:
a. Exposure to cold and drafts
b. Massage the face with a gentle upward motion
c. Perform facial exercises
d. Wrinkle the forehead, blow out the cheeks, and whistle
Which of the following symptoms is associated with exacerbation of multiple sclerosis?
A. Anorexia
B. Seizures
C. Diplopia
D. Insomnia
The licensed practical nurse is assisting the charge nurse in planning care for a client with a
detached retina. Which of the following nursing diagnoses should receive priority?
A. Alteration in comfort
B. Alteration in mobility
C. Alteration in skin integrity
D. Alteration in O2 perfusion
The physician has prescribed Cyclogel preoperatively to:
a) prevent dryness of the cornea and conjunctiva
b) reduce the inflammation of the iris and choroids
c) paralyze the ciliary muscle
d) promote drainage of aqueous humor from the chamber of the eye
After discharge,Mr. Calvo attends the eye clinic for follow-up visits. When he receives his
cataract glasses, it is important that the nurse advise him that:
a) his peripheral vision will be increased
b) objects will appear closer than they really are
c) magnification by the lens is only about 10%
d) daily eye drops are required with these lenses
37. The nurse should instruct a client preparing for eye surgery that which of these activities will be
restricted post-operatively?
a) bending with the knees flexed
b) bending from the waist
c) keeping the head in a neutral position
d) lying flat
38. Nursing care for Mr. Calvo during the first 48 hours after surgery will include:
a) maintain bed rest
b) changing the dressing daily
c) encouraging coughing and deep breathing
d) lie on the unoperated side
Situation: Mr.Shotz Tugahan Frasco is diagnosed with glaucoma and is scheduled for surgery.
39. Which symptoms are associated with acute closed-angle glaucoma?
a) diplopia and photophobia
b) episodic blindness and no pain
c) blurred vision and colored rings around lights
d) sensation of curtain drawn across the visual field
40. A nurse is providing instructions to a client and the family regarding home care after right eye
cataract removal. Which statement by the client would indicate an understanding of the
instructions?
a) I will not sleep on my left side
b) I will not sleep on my right side
c) I will not sleep with my head elevated
d) I will not wear my glasses until my physician says it is okay