Assignment 2: Lab Assignment: Practice Assessment: Neurological Examination

Assignment 2: Lab Assignment: Practice Assessment: Neurological Examination

Assignment 2: Lab Assignment: Practice Assessment: Neurological Examination

Assignment 2: Lab Assignment: Practice
Assessment: Neurological Examination
Short of opening a patient's cranium or requesting a brain scan, what can an advanced practice
nurse do to determine the cause of neurological symptoms? A multitude of techniques can be
used to generate a neurological diagnosis.
In preparation for the Comprehensive (Head-to-Toe) Physical Assessment due this week, it is
recommended that you practice performing a neurological examination.
Note: This is a practice physical assessment.
To Prepare
 Arrange an appropriate time and setting with a volunteer "patient" to perform a
neurological examination.
 Download and review the Neurological Checklist provided in this week's Learning
Resources as well as review Seidel's Guide to Physical Examination online media.
The Lab Assignment
Complete the following in Shadow Health:
 Neurological (Practice)

Learning Resources

Required Readings (click to expand/reduce)

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019).
Seidel's guide to physical examination: An interprofessional approach (9th ed.).
St. Louis, MO: Elsevier Mosby.

 Chapter 7, “Mental Status”
This chapter revolves around the mental status evaluation of an

individual’s overall cognitive state. The chapter includes a list of mental
abnormalities and their symptoms.

 ·Chapter 23, “Neurologic System”
The authors of this chapter explore the anatomy and physiology of the
neurologic system. The authors also describe neurological examinations
and potential findings.
Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment
and clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby.
Credit Line: Advanced Health Assessment and Clinical Diagnosis in Primary
Care, 6th Edition by Dains, J.E., Baumann, L. C., & Scheibel, P. Copyright 2019
by Mosby. Reprinted by permission of Mosby via the Copyright Clearance
Center.

Chapter 4, “Affective Changes”
This chapter outlines how to identify the potential cause of affective changes in a
patient. The authors provide a suggested approach to the evaluation of this type of
change, and they include specific tools that can be used as part of the diagnosis.

Chapter 9, “Confusion in Older Adults”
This chapter focuses on causes of confusion in older adults, with an emphasis on
dementia. The authors include suggested questions for taking a focused history as
well as what to look for in a physical examination.

Chapter 13, “Dizziness”
Dizziness can be a symptom of many underlying conditions. This chapter outlines
the questions to ask a patient in taking a focused history and different tests to use
in a physical examination.

Chapter 19, “Headache”
The focus of this chapter is the identification of the causes of headaches. The first
step is to ensure that the headache is not a life-threatening condition. The authors
give suggestions for taking a thorough history and performing a physical exam.

Chapter 31, “Sleep Problems”
In this chapter, the authors highlight the main causes of sleep problems. They also
provide possible questions to use in taking the patient’s history, things to look for
when performing a physical exam, and possible laboratory and diagnostic studies
that might be useful in making the diagnosis.

Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.). Philadelphia,
PA: F. A. Davis.
 Chapter 2, "The Comprehensive History and Physical Exam" ("Cranial
Nerves and Their Function" and "Grading Reflexes") (Previously read in
Weeks 1, 2, 3, and 5)
Note: Download the Physical Examination Objective Data Checklist to use
as you complete the Comprehensive (Head-to-Toe) Physical Assessment
assignment.

Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R.
W. (2011). Physical examination objective data checklist. In Mosby’s guide to
physical examination (7th ed.). St. Louis, MO: Elsevier Mosby.
Credit Line: Mosby’s Guide to Physical Examination, 7th Edition by Seidel, H.
M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R.
W. Copyright 2011 by Elsevier. Reprinted by permission of Elsevier via the
Copyright Clearance Center.

Note: Download and review the Student Checklists and Key Points to use during
your practice neurological examination.

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019).
Neurologic system: Student checklist. In Seidel's guide to physical examination:
An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.
Credit Line: Seidel's Guide to Physical Examination, 9th Edition by Ball, J. W.,
Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. Copyright 2019 by
Elsevier Health Sciences. Reprinted by permission of Elsevier Health Sciences
via the Copyright Clearance Center.

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019).
Neurologic system: Key points. In Seidel's guide to physical examination: An
interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.
Credit Line: Seidel's Guide to Physical Examination, 9th Edition by Ball, J. W.,
Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. Copyright 2019 by
Elsevier Health Sciences. Reprinted by permission of Elsevier Health Sciences
via the Copyright Clearance Center.

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019).
Mental status: Student checklist. In Seidel's guide to physical examination: An
interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.
Credit Line: Seidel's Guide to Physical Examination, 9th Edition by Ball, J. W.,
Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. Copyright 2019 by
Elsevier Health Sciences. Reprinted by permission of Elsevier Health Sciences
via the Copyright Clearance Center.

Bearden , S. T., & Nay, L. B. (2011). Utility of EEG in differential diagnosis of
adults with unexplained acute alteration of mental status. American Journal of
Electroneurodiagnostic Technology, 51(2), 92–104.

This article reviews the use of electrocenographs (EEG) to assist in
differential diagnoses. The authors provide differential diagnostic
scenarios in which the EEG was useful.

Athilingam, P ., Visovsky, C., & Elliott, A. F. (2015). Cognitive screening in
persons with chronic diseases in primary care: Challenges and recommendations
for practice. American Journal of Alzheimer’s Disease & Other Dementias, 30(6),
547–558. doi:10.1177/1533317515577127

Sinclair , A. J., Gadsby, R., Hillson, R., Forbes, A., & Bayer, A. J. (2013). Brief
report: Use of the Mini-Cog as a screening tool for cognitive impairment in
diabetes in primary care. Diabetes Research and Clinical Practice, 100(1),
e23–e25. doi:10.1016/j.diabres.2013.01.001

Roalf, D. R., Moberg, P. J., Xei, S. X., Wolk, D. A., Moelter, S. T., & Arnold, S.
E. (2013). Comparative accuracies of two common screening instruments for
classification of Alzheimer’s disease, mild cognitive impairment, and healthy
aging. Alzheimer’s & Dementia, 9(5), 529–537. doi:10.1016/j.jalz.2012.10.001.
Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4036230/

Shadow Health Support and Orientation Resources
Use the following resources to guide you through your Shadow Health orientation as well
as other support resources:

Frey, C. [Chris Frey]. (2015, September 4). Student orientation [Video file].
Retrieved from https://www.youtube.com/watch?v=Rfd_8pTJBkY

Shadow Health. (n.d.). Shadow Health help desk. Retrieved
from https://support.shadowhealth.com/hc/en-us

Document: Shadow Health. (2014). Useful tips and tricks (Version 2) (PDF)

Document: Student Acknowledgement Form (Word document)
Note: You will sign and date this form each time you complete your DCE
Assignment in Shadow Health to acknowledge your commitment to Walden
University’s Code of Conduct.

Document: DCE (Shadow Health) Documentation Template for Comprehensive
(Head-to-Toe) Physical Assessment (Word document)
Use this template to complete your Assignment 3 for this week.

Optional Resources
LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2014). DeGowin’s diagnostic
examination (10th ed.). New York, NY: McGraw Hill Medical.

 Chapter 14, “The Neurologic Examination” (pp. 683–765)
This chapter provides an overview of the nervous system. The authors also
explain the basics of neurological exams.

 Chapter 15, “Mental Status, Psychiatric, and Social Evaluations” (pp.
766–786)
In this chapter, the authors provide a list of common psychiatric
syndromes. The authors also explain the mental, psychiatric, and social
evaluation process.
Mahlknecht, P., Hotter, A., Hussl, A., Esterhammer, R., Schockey, M., & Seppi,
K. (2010). Significance of MRI in diagnosis and differential diagnosis of
Parkinson’s disease. Neurodegenerative Diseases, 7(5), 300–318.

Required Media (click to expand/reduce)

Neurologic System – Week 9 (16m)

Online media for Seidel's Guide to Physical Examination
It is highly recommended that you access and view the resources included with the
course text, Seidel's Guide to Physical Examination. Focus on the videos and

animations in Chapters 7 and 23 that relate to the assessment of cognition and the
neurologic system. Refer to the Week 4 Learning Resources area for access instructions
on  https://evolve.elsevier.com/