A patient is diagnosed with Meningitis. During the physical examination in the supine position, the nurse flexed the patient's neck and the patient flexed his knees and hip while complaining of neck pain. This is known as:

Obturator sign

Brudzinski sign

Phalen sign

Tinel sign

Answer and Explanation

The Correct Answer is B

A.   The obturator sign is used to assess for appendicitis, not meningitis. To perform this test, the patient’s right knee is flexed to 90 degrees, and the nurse rotates the hip internally and externally. Pain during this maneuver can indicate irritation of the obturator muscle, which is associated with inflammation of the appendix.

B.   The Brudzinski sign is a clinical test used to assess meningeal irritation. When the patient’s neck is passively flexed while lying supine, a positive Brudzinski sign is indicated if the patient involuntarily flexes their knees and hips in response to neck pain. This sign is often seen in meningitis as a result of irritation of the meninges.
C.   The Phalen sign is used to diagnose carpal tunnel syndrome. The patient flexes their wrists and holds the position for a period of time to see if symptoms of numbness or tingling appear in the fingers, which would indicate median nerve compression at the wrist. This sign is unrelated to meningitis.
D.   The Tinel sign is also used to diagnose carpal tunnel syndrome and other peripheral nerve issues. It involves tapping on the nerve (such as the median nerve at the wrist) to see if it causes tingling or a “pins and needles” sensation along the nerve’s distribution. Like the Phalen sign, it is not related to meningitis.

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Correct Answer is C

Explanation

A. The trigeminal nerve (CN V) is primarily responsible for sensory information from the face and motor control of the muscles of mastication (chewing). It does not carry taste sensations. Instead, it is involved in sensation (e.g., touch, pain, temperature) of the face and mouth, but not taste.
B. The vagus nerve (CN X) has various functions, including parasympathetic control of the heart, lungs, and digestive tract, and sensory and motor functions in the throat and voice box. It does contribute to taste sensation in the region of the pharynx and the epiglottis, but it is not primarily responsible for the taste sensation on the posterior third of the tongue.
C. The glossopharyngeal nerve (CN IX) is responsible for taste sensation on the posterior one-third of the tongue. It also contributes to the sensory innervation of the pharynx and helps in the regulation of saliva production. This nerve is specifically involved in the taste perception in the back third of the tongue.
D. The facial nerve (CN VII) provides taste sensation to the anterior two-thirds of the tongue. It also controls the muscles of facial expression and contributes to the production of saliva and tears. The facial nerve does not provide taste sensation to the posterior third of the tongue.

A. Coma B. Stupor C. Lethargy D. Obtunded

Correct Answer is D

Explanation

A. Coma is a state of profound unconsciousness where the patient cannot be awakened and does not respond to any external stimuli. The patient is completely unresponsive, with no eye opening or verbal responses.
B. Stupor is a state where the patient is almost completely unresponsive and can only be awakened by vigorous or painful stimuli. When aroused, they may only give brief, non-purposeful responses.
C. Lethargy is characterized by drowsiness and decreased alertness. The patient may fall asleep easily but can be awakened and will respond appropriately to stimuli. They might appear sluggish or tired.
D. Obtunded refers to a state where the patient has a reduced level of consciousness and responsiveness. They may be difficult to arouse, respond slowly to stimuli, and have a dulled sense of awareness. They need increased stimulation to achieve a response.

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A patient is diagnosed with Meningitis. During the physical examination in the supine position, the nurse flexed the patient's neck and the patient flexed his knees and hip while complaining of neck pain. This is known as:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Taste in the 1/3 posterior of your tongue is given by:

Correct Answer is C

Explanation

In the Neuro ICU (intensive care unit) while performing a neurological assessment of the patient the nurse noticed the patient: patient opens eyes, looks at you, responds slowly, and is somewhat confused. What level of consciousness (LOC) is this patient presenting?

Correct Answer is D

Explanation

A client opens the eyes and answers questions however falls back asleep within seconds. How should the nurse document this assessment finding?

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When preparing to test a client for meningeal irritation, what would the nurse do first?