Chapter 12: Structure and Function of the Neurologic System My Nursing Test Banks

Huether and McCance: Understanding Pathophysiology, 5th Edition

Chapter 12: Structure and Function of the Neurologic System

Test Bank

MULTIPLE CHOICE

1. When a patient asks what the somatic nervous system controls, how should the nurse respond? It controls:

a.

The heart

b.

The spinal cord

c.

Skeletal muscle

d.

Smooth muscle organs

ANS: C

The somatic nervous system consists of pathways that regulate voluntary motor control, the skeletal muscle system.

The somatic nervous system does not control the heart; the autonomic nervous system controls the heart.

The somatic nervous system does not control the spinal cord; the central nervous system (CNS) does.

The somatic nervous system does not control the smooth muscle organs; the autonomic system does.

REF: p. 293

2. A nurse is preparing to teach about nerves. Which information should the nurse include? The axon leaves the cell body at the:

a.

Axon hillock

b.

Nissl body

c.

Node of Ranvier

d.

Myelin sheath

ANS: A

The axon hillock is the cone-shaped process where the axon leaves the cell body.

The Nissl body is involved in protein synthesis.

Axons branch at the node of Ranvier.

The myelin sheath covers the entire membrane.

REF: p. 295

3. When a student asks in which region of the neuron do nerve impulses travel the fastest, how should the nurse respond? The:

a.

Large axon

b.

Axon hillock

c.

Cell body

d.

Dendrites

ANS: A

Large axons transmit impulses at a faster rate.

The axon hillock has a low threshold level.

The cell body is not the fastest.

The dendrites carry impulses toward the cell body, but not as quickly as large axons.

REF: p. 295

4. A neurologist is teaching the staff about motor neurons. Which information should be included? Motor neurons are structurally classified as _____ neurons.

a.

Unipolar

b.

Pseudounipolar

c.

Bipolar

d.

Multipolar

ANS: D

A motor neuron is typically multipolar.

Unipolar neurons are found in the retina.

Pseudounipolar neurons have one process; the dendritic portion of each of these neurons extends away from the CNS, and the axon portion projects into the CNS.

Bipolar neurons are found in the eye.

REF: p. 295

5. An experiment looking at an isolated neuron revealed a sensory nerve with one process containing a dendritic portion extending away from the CNS and an axon extending toward the CNS. Which of the following classifications would this neuron fall into?

a.

Bipolar

b.

Multipolar

c.

Pseudounipolar

d.

Interpolar

ANS: C

Pseudounipolar neurons have one process; the dendritic portion of each of these neurons extends away from the CNS, and the axon portion projects into the CNS.

Bipolar neurons have two distinct processes arising from the cell body.

Multipolar neurons are the most common and have multiple processes capable of extensive branching. A motor neuron is typically multipolar.

Interpolar is not a type of neuron.

REF: p. 295

6. A cell was isolated from the CNS. A researcher revealed that its main function was to clear cellular debris. What type of cell is the researcher studying?

a.

Astrocyte

b.

Ependymal cell

c.

Microglia

d.

Schwann cell

ANS: C

Microglia remove debris (phagocytosis) in the CNS.

Astrocytes are neuroglial cells and do not have phagocytic properties.

Ependymal cells are neuroglial cells and do not have phagocytic properties.

Schwann cells help form the myelin sheath in the peripheral nervous system (PNS).

REF: p. 296

7. Which answer indicates a nurse understands regeneration of neurons? Neurons that have the capacity for regeneration include:

a.

Unmyelinated neurons in the brain

b.

Myelinated neurons in the spinal cord

c.

Myelinated peripheral neurons

d.

Postganglionic motor neurons

ANS: C

Regeneration is limited to myelinated fibers and generally occurs only in the PNS.

Regeneration does not occur in unmyelinated neurons.

Regeneration does not occur in myelinated neurons in the spinal cord.

Regeneration does not occur in postganglionic motor neurons.

REF: p. 297

8. When a presynaptic neuron is stimulated in a patients body by an electrical current, neurotransmitters are released from the:

a.

Synapse

b.

Synaptic bouton

c.

Synaptic cleft

d.

Receptor

ANS: B

When an impulse originates in a presynaptic neuron, the impulse reaches the vesicles, where chemicals (neurotransmitters) are stored in the synaptic bouton.

Neurons are not physically continuous with one another. The region between adjacent neurons is called a synapse.

The synaptic cleft is the space between the neurons.

Neurotransmitters attach to the receptor.

REF: p. 297

9. An aide asks a nurse what neurotransmitters interact with. Which response is the nurses best answer? Neurotransmitters interact with the postsynaptic membrane by binding to a:

a.

Receptor

b.

Nissl body

c.

Glial cell

d.

Neurofibril

ANS: A

Neurotransmitters bind to a receptor.

The Nissl body is involved in protein synthesis.

Neurotransmitters bind to receptors, not glial cells.

Neurofibrils provide support for the neuron.

REF: pp. 297-298

10. If a neurons membrane potential is held as close to the threshold potential by excitatory postsynaptic potentials (EPSPs), the neuron is said to be:

a.

Hyperpolarized

b.

Facilitated

c.

Integrated

d.

Inhibited

ANS: B

Facilitation refers to the effect of EPSP on the plasma membrane potential.

The postsynaptic neurons plasma membrane may be inhibited, which is called hyperpolarized.

When the neurons membrane potential is held close to the threshold potential the neuron is facilitated, not integrated.

When the neurons membrane potential is held close to the threshold potential, the neuron is facilitated, not inhibited.

REF: p. 298

11. A 20-year-old male was brought to the emergency room (ER) for severe burns. He requested something for the excruciating pain he was experiencing. Blocking which of the following neurotransmitters would reduce his pain?

a.

Enkephalin

b.

Dopamine

c.

Acetylcholine

d.

Substance P

ANS: D

Substance P is a neurotransmitter in pain transmission pathways. Blocking the release of substance P by morphine reduces pain.

The opiates morphine and heroin bind to endorphin and enkephalin receptors on presynaptic neurons and reduce pain by blocking the release of neurotransmitters.

Dopamine is a neurotransmitter involved in activity.

Acetylcholine plays a role in nerve conduction presynaptically.

REF: p. 298

12. A 19-year-old male college student reports to his primary care provider that he cannot stay awake in class regardless of how much sleep he gets. A drug that stimulates which of the following areas would best treat his problem?

a.

Corpora quadrigemina

b.

Reticular activating system

c.

Cerebellum

d.

Hypothalamus

ANS: B

The reticular activating system is responsible for wakefulness.

The reticular activating system is responsible for wakefulness, not the corpora quadrigemina.

The reticular activating system is responsible for wakefulness, not the cerebellum.

The reticular activating system is responsible for wakefulness, not the hypothalamus.

REF: p. 299

13. A 32-year-old female suffers from severe brain damage following a motor vehicle accident. After rehabilitation she notices that her thought processes and goal-oriented behavior are impaired. Which area does the nurse suspect is damaged?

a.

Thalamus

b.

Limbic

c.

Prefrontal

d.

Occipital

ANS: C

The prefrontal area is responsible for goal-oriented behavior (e.g., ability to concentrate), short-term or recall memory, the elaboration of thought, and inhibition on the limbic areas of the CNS.

The prefrontal area is responsible for goal-oriented behavior, not the thalamus.

The prefrontal area is responsible for goal-oriented behavior, not the limbic system.

The prefrontal area is responsible for goal-oriented behavior, not the occipital area.

REF: p. 301

14. A neurologist is teaching about the region responsible for motor aspects of speech. Which area is the neurologist discussing?

a.

Wernicke area

b.

Broca area

c.

Primary speech area

d.

Insula

ANS: B

The Broca area is responsible for the motor aspects of speech.

The Broca area is responsible for the motor aspects of speech, not the Wernicke area.

The Broca area is responsible for the motor aspects of speech, not the primary speech area.

The Broca area is responsible for the motor aspects of speech, not the insula.

REF: p. 301

15. A patient is looking at a picture of the brain and points to the convolutions on the surface of the cerebrum. The nurse should tell the patient these are called:

a.

Sulci

b.

Fissures

c.

Reticular formations

d.

Gyri

ANS: D

The surface of the cerebrum (cerebral cortex) is covered with convolutions called gyri, which greatly increase the cortical surface area and the number of neurons.

The surface of the cerebrum (cerebral cortex) is covered with convolutions called gyri, not sulci, which greatly increase the cortical surface area and the number of neurons.

The surface of the cerebrum (cerebral cortex) is covered with convolutions called gyri, not fissures, which greatly increase the cortical surface area and the number of neurons.

The surface of the cerebrum (cerebral cortex) is covered with convolutions called gyri, not the reticular formation, which greatly increase the cortical surface area and the number of neurons.

REF: p. 299

16. A 45-year-old male was previously diagnosed with Parkinson disease. He has impaired fine repetitive motor movements. Which of the following areas does the nurse suspect is most likely damaged?

a.

Basal ganglia

b.

Prefrontal area

c.

Hippocampus

d.

Temporal lobe

ANS: A

The basal ganglia system is believed to exert a stabilizing effect on motor movements. Parkinson disease and Huntington disease are conditions associated with defects of the basal ganglia. They are characterized by various involuntary or exaggerated motor movements.

It is the basal ganglia system, not the prefrontal area, that is affected in Parkinson disease.

It is the basal ganglia system, not the hippocampus, that is affected in Parkinson disease.

It is the basal ganglia system, not the temporal lobe, that is affected in Parkinson disease.

REF: p. 303

17. A neurologist is teaching about the location of the primary visual cortex in the brain. Which area is the neurologist discussing?

a.

Frontal lobe

b.

Temporal lobe

c.

Occipital lobe

d.

Parietal lobe

ANS: C

The visual cortex is located in the occipital lobe.

The visual cortex is located in the occipital lobe, not the frontal lobe.

The visual cortex is located in the occipital lobe, not the temporal lobe.

The visual cortex is located in the occipital lobe, not the parietal lobe.

REF: p. 301

18. A nurse is preparing to teach about functions to maintain homeostasis and instinctive behavioral patterns. Which area of the brain is the nurse discussing?

a.

Thalamus

b.

Medulla

c.

Cerebellum

d.

Hypothalamus

ANS: D

The hypothalamus functions to maintain a constant internal environment and instinctive behavioral patterns.

It is the hypothalamus, not the thalamus, that maintains homeostasis. The thalamus serves also as a relay center for information from the basal ganglia and cerebellum to the appropriate motor area.

The medulla controls reflex activities, such as heart rate, respiration, blood pressure, coughing, sneezing, swallowing, and vomiting.

It is the hypothalamus that maintains homeostasis. The cerebellum is responsible for reflexive, involuntary fine-tuning of motor control, for maintaining balance and posture through extensive neural connections.

REF: p. 304

19. When a nurse is teaching about the transverse fiber tract that connects the two cerebral hemispheres, what term should the nurse use?

a.

Peduncle

b.

Corpus callosum

c.

Basal ganglia

d.

Pons

ANS: B

The corpus callosum connects the two cerebral hemispheres and is essential in coordinating activities between hemispheres.

The corpus callosum, not the peduncle, connects the two cerebral hemispheres and is essential in coordinating activities between hemispheres. The peduncle is made up of efferent fibers of the corticospinal, corticobulbar, and corticopontocerebellar tracts.

The corpus callosum connects the two cerebral hemispheres and is essential in coordinating activities between hemispheres. The basal ganglia is a portion of the pyramidal system.

The corpus callosum, not the pons, connects the two cerebral hemispheres and is essential in coordinating activities between hemispheres. The pons (bridge) is easily recognized by its bulging appearance below the midbrain and above the medulla.

REF: p. 303

20. A student nurse asks the nurse what controls reflex activities concerned with heart rate and blood pressure. What is the nurses best response? These reflex activities are controlled by the:

a.

Medulla oblongata

b.

Pons

c.

Midbrain

d.

Cerebrum

ANS: A

The medulla oblongata controls reflex activities, such as heart rate, respiration, blood pressure, coughing, sneezing, swallowing, and vomiting.

The medulla oblongata, not the pons, controls heart rate and blood pressure.

The medulla oblongata, not the midbrain, controls heart rate and blood pressure. The midbrain is primarily a relay center for motor and sensory tracts, as well as a center for auditory and visual reflexes.

The medulla oblongata controls reflex activities, such as heart rate and blood pressure. The cerebrum plays a role in the transfer of information.

REF: p. 304

21. A 12-year-old presents with hydrocephalus. Blockage of which of the following would cause this condition?

a.

Cerebral aqueduct

b.

Inferior colliculi

c.

Red nucleus

d.

Tegmentum

ANS: A

Blockage of the cerebral aqueduct leads to hydrocephalus.

Blockage of the cerebral aqueduct, not the inferior colliculi, leads to hydrocephalus.

Blockage of the cerebral aqueduct, not the red nucleus, leads to hydrocephalus.

Blockage of the cerebral aqueduct, not the tegmentum, leads to hydrocephalus.

REF: p. 304

22. A patient presents with altered respiratory patterns following head trauma. Based upon the symptoms, which of the following areas does the nurse suspect is injured?

a.

Cerebrum

b.

Cerebellum

c.

Midbrain

d.

Reticular formation

ANS: D

The reticular formation is a large network of diffuse nuclei that control vital reflexes, such as those controlling cardiovascular function and respiration.

The reticular formation, not the cerebrum, controls respiration.

The reticular formation, not the cerebellum, controls respiration.

The reticular formation, not the midbrain, controls respiration.

REF: p. 299

23. A nurse recalls characteristics of upper motor neurons include:

a.

Directly innervating muscles

b.

Influencing and modifying spinal reflex arcs

c.

Cell bodies located in the gray matter of the spinal cord

d.

Dendritic processes extending out of the CNS

ANS: B

Upper motor neurons are completely contained within the CNS. Their primary roles are controlling fine motor movement and influencing/modifying spinal reflex arcs and circuits.

Upper motor neurons are completely contained within the CNS. Their primary roles are controlling fine motor movement and influencing/modifying spinal reflex arcs and circuits. They do not innervate muscles.

Upper motor neurons are completely contained within the CNS. Their primary roles are controlling fine motor movement and influencing/modifying spinal reflex arcs and circuits. Lower motor neurons interact with gray matter.

Dendrites are part of neurons.

REF: p. 306

24. A nurse is teaching about the area of the spinal cord that contains cell bodies involved in the autonomic nervous system. Which of the following area is the nurse discussing?

a.

Anterior horn

b.

Ventral horn

c.

Lateral horn

d.

Dorsal horn

ANS: C

The lateral horn contains cell bodies within the autonomic nervous system.

The anterior horn contains the nerve cell bodies for efferent pathways that leave the spinal cord by way of spinal nerves.

The ventral horn contains the nerve cell bodies for efferent pathways that leave the spinal cord by way of spinal nerves.

The dorsal horn contains sensory neurons.

REF: p. 305

25. A neurologist is teaching about sensory pathways. Which information should the neurologist include? Sensory pathways in the spinal cord include the:

a.

Corticospinal tract

b.

Pyramids

c.

Spinothalamic tract

d.

Anterior column

ANS: C

The spinothalamic tract carries nerve impulses from the spinal cord to the thalamus in the diencephalon.

The spinothalamic tract carries impulses; the corticospinal tract carries motor impulses.

The pyramids assist with motor movements.

The anterior column carries nerve impulses.

REF: p. 305

26. A nurse is discussing the membrane that separates the cerebellum from the cerebrum. What term should the nurse use to describe this membrane?

a.

Tentorium cerebelli

b.

Falx cerebri

c.

Arachnoid membrane

d.

Temporal lobe

ANS: A

The tentorium cerebelli, a common landmark, is a membrane that separates the cerebellum below from the cerebral structures above.

The tentorium cerebelli separates the cerebellum, not the falx cerebri.

The tentorium cerebelli separates the cerebellum, not the arachnoid membrane.

The tentorium cerebelli separates the cerebellum, not the temporal lobe.

REF: p. 308

27. What term should the nurse use when talking about the outermost membrane surrounding the brain?

a.

Dura mater

b.

Arachnoid mater

c.

Pia mater

d.

Falx cerebri

ANS: A

The dura mater is the outer layer of the brain.

The arachnoid is a spongy, weblike structure that loosely follows the contours of the cerebral structures.

The pia mater adheres to the contours of the brain.

The falx cerebri dips between the two cerebral hemispheres along the longitudinal fissure.

REF: p. 307

28. Cerebrospinal fluid (CSF) can accumulate around the brain when there is injury to the sites of CSF reabsorption, which are called the:

a.

Arachnoid villi

b.

Epidural foramina

c.

Lateral apertures

d.

Choroid plexuses

ANS: A

CSF is reabsorbed through a pressure gradient between the arachnoid villi and the cerebral venous sinuses.

The site of CSF absorption is the arachnoid villi, not the epidural foramina.

The site of CSF absorption is the arachnoid villi, not the lateral apertures.

The site of CSF absorption is the arachnoid villi, not the choroid plexuses.

REF: p. 309

29. A nurse remembers the brain receives approximately ____% of the cardiac output.

a.

80

b.

40

c.

20

d.

10

ANS: C

The brain receives approximately 20% of the cardiac output.

The brain receives 20%, not 80%, of the cardiac output.

The brain receives 20%, not 40%, of the cardiac output.

The brain receives 20%, not 10%, of the cardiac output.

REF: p. 310

30. The _____ ensures collateral blood flow from blood vessels supplying the brain.

a.

Carotid arteries

b.

Basal artery

c.

Circle of Willis

d.

Vertebral arteries

ANS: C

The circle of Willis ensures collateral blood circulation in the brain.

The circle of Willis ensures collateral blood circulation. The carotid arteries supply the brain.

The circle of Willis, not the basal artery, ensures collateral blood circulation in the brain.

The circle of Willis, not the vertebral arteries, ensures collateral blood circulation in the brain.

REF: p. 310

31. Which cell type is the nurse discussing? A cell that is involved in forming the blood-brain barrier is the:

a.

Microglia

b.

Schwann cell

c.

Oligodendrocyte

d.

Astrocyte

ANS: D

Astrocytes are involved in forming the blood-brain barrier.

The microglia remove debris (phagocytosis) in the CNS.

Schwann cells provide structural support and nutrition for the neurons.

Oligodendrocytes form the myelin sheaths.

REF: p. 311

32. When a patients vagus nerve is stimulated, what does the nurse expect to observe?

a.

Increased gastrointestinal activity

b.

Increased heart rate

c.

Pupil constriction

d.

Vasoconstriction

ANS: A

Stimulation of the vagus nerve increases gastrointestinal activity.

Stimulation of the vagus nerve increases gastrointestinal activity and it decreases heart rate.

Stimulation of the vagus nerve increases gastrointestinal activity and causes pupil dilation.

Stimulation of the vagus nerve increases gastrointestinal activity and leads to vasodilation.

REF: p. 321

33. A 40-year-old male suffers from head trauma that affects cranial nerve I. Which of the following symptoms would the nurse expect?

a.

Visual disturbances

b.

Loss of sense of smell

c.

Loss of ability to taste

d.

Hearing disturbances

ANS: B

Cranial nerve I controls the sense of smell.

Visual disturbances are associated with cranial nerve II.

Cranial nerve VII is related to tasting.

Cranial nerve VIII is related to hearing.

REF: p. 315

34. Which neurotransmitter is released when a patients parasympathetic motor neurons are stimulated?

a.

Epinephrine

b.

Serotonin

c.

Acetylcholine

d.

Substance P

ANS: C

Parasympathetic motor neurons release acetylcholine.

Adrenergic motor neurons release epinephrine.

Serotonin is associated with the brain.

Substance P is a neurotransmitter in pain transmission pathways. Blocking the release of substance P by morphine reduces pain.

REF: p. 317

35. Which action will occur when a patients -1 receptors are stimulated?

a.

Dilation of the coronary arteries

b.

Vasoconstriction of arteries

c.

Increase in the strength of myocardial contraction

d.

Decrease in the rate of myocardial contraction

ANS: C

Stimulation of -1 receptors results in increased strength of myocardial contraction.

-1 receptor stimulation does not affect the coronary arteries.

-1 receptor simulation leads to dilation.

-1 receptor stimulation leads to increased rate of contraction.

REF: p. 319

36. A patient begins taking a new drug that causes pupil dilation, vasoconstriction, decreased gastrointestinal motility, and goose bumps. Which of the following receptors are activated?

a.

Alpha 1

b.

Alpha 2

c.

Beta 1

d.

Beta 2

ANS: A

Alpha 1 stimulation leads to pupil dilation.

Alpha 2 stimulation leads to inhibition of intestinal secretions.

Beta 1 stimulation leads to miosis or pupillary constriction.

Beta 2 stimulation leads to pupillary constriction.

REF: p. 319

37. When a student asks which type of nerves transmit nerve impulses at the fastest rate, what is the best response by the nurse?

a.

Large, non-myelinated

b.

Small, myelinated

c.

Large, myelinated

d.

Small, non-myelinated

ANS: C

Large and myelinated nerves transmit impulses at the fastest rate.

Myelinated nerves transmit the fastest, not non-myelinated.

Large nerves transmit the fastest, not small.

Large, myelinated impulses transmit the fastest, not small non-myelinated nerves.

REF: p. 295

38. Which of the following patients has the best chance of recovery from nerve injury? A patient with a(n):

a.

Torn nerve

b.

Crushed nerve

c.

Injury located closer to the cell body of the nerve

d.

Injury located closer to the synapse

ANS: B

Crush injuries to the nerve provide the greatest opportunity for recovery.

Torn or cut injuries may never recover.

A location closer to the cell body of the nerve may lead to cell death.

A location closer to the synapse may not recover and may scar.

REF: p. 297

39. The nurse is assessing the patient with a pen light. The integrity of which cranial nerve is being evaluated?

a.

Olfactory

b.

Vagus

c.

Oculomotor

d.

Trigeminal

ANS: C

In evaluating the oculomotor nerve, the pupils are examined for size, shape, and equality; pupillary reflex tested with a pen light (pupils should constrict when illuminated); and ability to follow moving objects.

Olfactory is assessed using smells.

Vagus is assessed using the ophthalmoscope.

The trigeminal is assessed with a safety pin and hot and cold objects for sensations of pain, touch, and temperature.

REF: p. 315

MULTIPLE RESPONSE

1. Which of the following is a neuroglial cell? (Select all that apply.)

a.

Astrocyte

b.

Oligodendrocyte

c.

Neuron

d.

Ependymal cell

e.

Melanocyte

ANS: A, B, D

Neuroglial cells include astrocytes, oligodendrocytes, and ependymal cells. Neurons and melanocytes are not neuroglial cells.

REF: p. 296

COMPLETION

1. A nurse is monitoring intracranial pressure. A nurse recalls the normal upper limit of intracranial pressure is _______ mm Hg.

ANS: 14

REF: p. 309

2. When a patient wants to know how many vertebrae make up the vertebral column, the nurse responds with _____.

ANS:

33

thirty-three

REF: p. 33

Mosby items and derived items 2012 Mosby, Inc., an imprint of Elsevier Inc.

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