P22(A)

1. Which of the following characteristics indicates that the CSF is normal?

A. cloudy and pale yellow color

B. presence of erythrocytes

C. presence of numerous leukocytes

D. clear and colorless fluid

ANS: D

Explanation

ANS: D

2. 2. Which of the following is the usual location of language centers?

A. left hemisphere

B. right hemisphere

C. brainstem

D. hypothalamus

ANS: A

Explanation

ANS: A

3. What does a vegetative state refer to?

A. depression of the RAS and inability to initiate action

B. loss of awareness and intellectual function but continued brainstem function

C. continuing intellectual function but inability to communicate or move

D. disorientation and confusion with decreased responsiveness

ANS: B

Explanation

ANS: B

4. What is the rationale for vomiting with increased intracranial pressure?

A. chemoreceptors responding to changes in the blood

B. pressure extending to spinal nerves

C. pressure on the emetic center in the medulla

D. stimuli to the hypothalamic center for hunger and thirst

ANS: C

Explanation

ANS: C

5. Why are focal or generalized seizures an early indication of a brain tumor?

A. Surrounding inflammation stimulates neurons to discharge spontaneously.

B. Malignant tumors cause alkalosis, exciting the CNS.

C. Systemic effects of the brain tumor may cause seizures.

D. Metabolic effects of cancer change blood chemistry to trigger seizures.

ANS: A

Explanation

ANS: A

6. What is the probable source of an embolus causing a CVA?

A. right ventricle of the heart

B. femoral vein

C. common carotid artery

D. pulmonary artery

ANS: C

Explanation

ANS: C

7. What is an early indicator of increasing intracranial pressure?

A. papilledema

B. bilateral fixed dilated pupils

C. decreasing responsiveness

D. rapid heart rate

ANS: C

Explanation

ANS: C

8. In many types of encephalitis, such as St. Louis encephalitis, how are the viruses transmitted?

A. carriers

B. bites of mosquitoes and ticks

C. respiratory droplet

D. septic emboli in the circulation

ANS: B

Explanation

ANS: B

9. Which of the following conditions is NOT part of the criteria for a declaration of "brain death"?

A. no activity on EEG

B. absence of all reflexes

C. no spontaneous respirations

D. presence of any head injury

ANS: D

Explanation

ANS: D

10. What is the best definition of aphasia?

A. the inability to comprehend or express language appropriately

B. difficulty swallowing

C. loss of the visual field contralateral to the area of damage

D. the inability to articulate words clearly

ANS: A

Explanation

ANS: A

11. Through what area does the cerebrospinal fluid circulate around the brain and spinal cord?

A. between the double layers of the dura mater

B. in the subdural space

C. in the subarachnoid space

D. through the arachnoid villi

ANS: C

Explanation

ANS: C

12. What would be the effect of damage to the auditory association area in the left hemisphere?

A. loss of hearing in both ears

B. inability to understand what is heard

C. loss of hearing in the left ear

D. inability to determine the source of the sound

ANS: B

Explanation

ANS: B

13. Where are beta-1 adrenergic receptors located?

A. bronchiolar walls

B. arteriolar walls

C. cardiac muscle

D. glands of the intestinal tract

ANS: C

Explanation

ANS: C

14. In the weeks following CVA, why might some neurologic function return? 1. presence of collateral circulation 2. immediate therapy to dissolve thrombi and maintain perfusion 3. reduced inflammation in the area 4. development of alternative neuronal pathways

A. 1 only

B. 2 only

C. 1, 3

D. 2, 3, 4

E. 1, 2, 3, 4

ANS: E

Explanation

ANS: E

15. As intracranial pressure rises, the pupil of the eye, ipsilateral to the lesion, becomes dilated and unresponsive to light because of pressure on the:

A. optic nerve

B. PNS fibers in cranial nerve III

C. SNS nerve to the eye

D. occipital lobe

ANS: B

Explanation

ANS: B

16. Which of the following statements is TRUE about malignant brain tumors?

A. Most brain tumors arise from malignant neurons.

B. Primary brain tumors rarely metastasize outside the CNS.

C. The blood-brain barrier prevents secondary brain tumors.

D. Brainstem tumors do not manifest signs until they are quite large.

ANS: B

Explanation

ANS: B

17. What are significant signs of acute bacterial meningitis?

A. severe headache, nuchal rigidity, and photophobia

B. fatigue and lethargy, fever, and anorexia

C. focal signs, such as progressive paralysis in a limb

D. ascending paralysis beginning in the legs

ANS: A

Explanation

ANS: A

18. What is the typical change in blood pressure with increased intracranial pressure?

A. increasing diastolic pressure

B. decreasing systolic pressure

C. systolic and diastolic pressures decreasing proportionately

D. increasing pulse pressure

ANS: D

Explanation

ANS: D

19. All of the following apply to CVA EXCEPT:

A. the common cause is an atheroma with thrombus

B. maximum necrosis and infarction develop within several hours of onset

C. warning signs may appear with partial obstruction of the artery

D. increasing neurologic deficits usually develop during the first few days

ANS: B

Explanation

ANS: B

20. What would be the effect of infarction owing to obstruction in the right anterior cerebral artery?

A. some visual loss

B. sensory deficit involving the upper body

C. aphasia

D. contralateral weakness in the leg, impaired spatial relationships

ANS: D

Explanation

ANS: D

21. A brain tumor causes headache because the tumor:

A. causes ischemic pain in the brain

B. stretches the meninges and blood vessel walls

C. erodes the skull

D. compresses sensory fibers in cranial nerves

ANS: B

Explanation

ANS: B

22. What is a major function of the limbic system?

A. overall control of fluid balance

B. required for logical thinking, reason, and decision making

C. determines emotional responses

D. responsible for artistic and musical talents

ANS: C

Explanation

ANS: C

23. What would be the expected effect of a tumor developing in the inferior part of the left frontal lobe?

A. numbness in the right leg

B. weakness in the right side of the face

C. paralysis in the left leg

D. dizziness and loss of balance

ANS: B

Explanation

ANS: B

24. In a case of bacterial meningitis, where does swelling and purulent exudate form?

A. involving the pia, arachnoid, and surface of the entire brain

B. in the dura mater and epidural space

C. at the site of the injury or entry point of the microbes

D. primarily around the spinal cord

ANS: A

Explanation

ANS: A

25. Which of the following causes papilledema?

A. increased pressure of CSF at the optic disc

B. increased intraocular pressure

C. pressure on the oculomotor nerve

D. pressure on the optic chiasm

ANS: A

Explanation

ANS: A

26. Which of the following applies to the corticospinal tract?

A. It is an ascending tract.

B. The nerve fibers conduct sensory impulses.

C. It is an extrapyramidal tract.

D. It is a pyramidal tract for efferent impulses.

ANS: D

Explanation

ANS: D

27. Which of the following is a TRUE statement about transient ischemic attacks?

A. They usually cause necrosis and permanent brain damage.

B. Rupture of an aneurysm or damaged artery may cause a TIA.

C. They usually indicate systemic hypertension.

D. They often warn of potential cerebrovascular accidents.

ANS: D

Explanation

ANS: D

28. What is the effect of an enlarging brain abscess on cardiovascular activity?

A. increased heart rate and systemic vasodilation

B. low blood pressure and irregular heart and respiratory rates

C. systemic vasoconstriction and slower heart rate

D. immediate depression of the cardiac control centers

ANS: C

Explanation

ANS: C

29. Collateral circulation is most likely to be present when a CVA results from:

A. rupture of a cerebral artery

B. an embolus

C. development of an atheroma

D. vasospasm in the cerebral circulation

ANS: C

Explanation

ANS: C

30. Which of the following statements about berry aneurysms in the brain is NOT true?

A. They usually develop at points of bifurcation in the circle of Willis.

B. They are usually asymptomatic for many years.

C. Rupture causes signs of circulatory shock.

D. Following rupture, blood appears in the subarachnoid space.

ANS: C

Explanation

ANS: C

P22(A)

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