Past Pointing Test Of Vestibular Function

Past-Pointing Test of Vestibular Function: A Comprehensive Guide

Introduction:

Are you a healthcare professional seeking a deeper understanding of vestibular function assessment? Or perhaps you're a patient curious about the diagnostic tools used to evaluate balance disorders? Whatever your reason, this comprehensive guide delves into the past-pointing test, a crucial component of vestibular examination. We'll unravel the mechanics of this test, its clinical significance, the variations involved, interpreting results, and potential limitations. By the end, you'll have a solid grasp of the past-pointing test's role in diagnosing and managing vestibular pathologies.


What is the Past-Pointing Test?

The past-pointing test is a simple yet insightful clinical maneuver used to assess the presence of unilateral vestibular lesions. It exploits the vestibulo-ocular reflex (VOR), a crucial mechanism responsible for stabilizing gaze during head movements. The VOR normally keeps your eyes fixed on a target even when your head moves, preventing visual blurring. However, damage to the vestibular system can disrupt the VOR, leading to inaccurate pointing towards a target after head movements.

How the Past-Pointing Test is Performed:

The test is typically performed with the patient seated comfortably, eyes closed, and arm extended. The examiner instructs the patient to touch their index finger to the examiner's finger (the target), which is held about arm's length away. The patient's head is then rotated a specific number of times (typically 3-5) to the right or left. After the head movement is stopped, the patient is instructed to point again towards the examiner's finger with their eyes still closed. The deviation of their finger from the target indicates the presence and direction of a vestibular lesion.


Interpreting the Results:

A consistent deviation of the finger towards the side of the lesion indicates a positive past-pointing test. For instance, a consistent deviation to the right after a series of left head turns suggests a right-sided vestibular lesion. The magnitude of the deviation can also provide valuable information regarding the severity of the lesion. It's crucial to remember that this test is rarely used in isolation. Results are best interpreted in conjunction with other vestibular tests like the head impulse test (HIT) and the caloric test.


Variations and Modifications of the Past-Pointing Test:

While the standard procedure described above is common, variations exist:

Number of Head Turns: The number of rotations can be adjusted based on the patient's tolerance and the examiner's assessment.
Speed of Rotation: The speed of the head rotation can influence the results, with faster rotations potentially revealing more subtle deficits.
Use of Visual Cues: Some variations involve momentarily allowing the patient to open their eyes to re-orient themselves before attempting to point with their eyes closed. This helps to differentiate between peripheral and central vestibular pathologies.
Different Body Positions: Although typically seated, the test can be adapted to other positions depending on the patient's condition and clinical needs.


Clinical Significance and Applications:

The past-pointing test is invaluable in the evaluation of various vestibular disorders, including:

Vestibular Neuritis: Inflammation of the vestibular nerve.
Labyrinthitis: Inflammation of the inner ear, including the vestibule.
Benign Paroxysmal Positional Vertigo (BPPV): A common inner ear disorder causing brief episodes of vertigo. While not always a primary indicator for BPPV, it can contribute to the overall assessment.
Meniere's Disease: An inner ear disorder characterized by vertigo, tinnitus, and hearing loss.
Central Vestibular Lesions: Although less sensitive to central lesions, a positive past-pointing test can contribute to the overall diagnostic picture when combined with other tests.

Limitations of the Past-Pointing Test:

It is crucial to acknowledge the limitations of this test:

Subjectivity: The interpretation of the test's results can be somewhat subjective, relying on the examiner's judgment of the finger's deviation.
Patient Compliance: The test requires patient cooperation and understanding of instructions, which can be challenging in certain populations (e.g., young children, individuals with cognitive impairments).
Non-Specific Findings: A positive test isn't always indicative of a specific vestibular disorder. Other neurological conditions can produce similar results.
Influence of other Factors: Factors like fatigue, medication side effects, and pre-existing neurological conditions can influence test results.


Conclusion:

The past-pointing test remains a valuable tool in the neuro-otological examination, offering a straightforward and informative assessment of vestibular function. While it should not be the sole criterion for diagnosis, its integration with other vestibular tests significantly contributes to a comprehensive understanding of a patient's vestibular condition. The careful interpretation of results, considering patient history and other clinical findings, is crucial for accurate diagnosis and effective management of vestibular disorders.


Article Outline:

Title: Past-Pointing Test of Vestibular Function: A Comprehensive Guide

Introduction: Hook, overview of the article's content.
Chapter 1: Understanding the Past-Pointing Test: Definition, mechanism, and purpose.
Chapter 2: Performing the Past-Pointing Test: Step-by-step procedure, variations, and modifications.
Chapter 3: Interpreting Test Results: Analyzing deviations, clinical significance, and limitations.
Chapter 4: Clinical Applications and Limitations: Vestibular disorders, confounding factors, and test limitations.
Conclusion: Summary and emphasis on the test's clinical value.


(Detailed explanation of each chapter is provided above in the main article body.)


FAQs:

1. Is the past-pointing test painful? No, the past-pointing test is generally a painless procedure.
2. How long does the past-pointing test take? The test typically takes only a few minutes to administer.
3. Can the past-pointing test be used to diagnose all vestibular disorders? No, the test is most useful for detecting unilateral vestibular lesions but isn't specific to a single disorder.
4. What if the patient has difficulty understanding instructions? Modifications may be needed, potentially involving visual cues or simpler instructions. The examiner's judgment is crucial.
5. How accurate is the past-pointing test? Accuracy depends on several factors, including examiner experience and patient cooperation. It's most effective when used in conjunction with other tests.
6. Are there any risks associated with the past-pointing test? The test poses minimal risk, but patients with severe neck pain or other physical limitations should be assessed carefully.
7. What other tests are often performed alongside the past-pointing test? Head impulse test (HIT), caloric test, and videonystagmography (VNG) are frequently used.
8. Can the past-pointing test be used in children? Yes, but modifications might be necessary depending on the child's age and developmental level.
9. What should I do if I experience dizziness or vertigo after the past-pointing test? Report your symptoms to your doctor, who can investigate the underlying cause.


Related Articles:

1. Head Impulse Test (HIT): A detailed explanation of the HIT, another crucial vestibular test.
2. Caloric Testing: A comprehensive guide to caloric testing, a method for assessing vestibular function using warm and cool water irrigation.
3. Videonystagmography (VNG): An in-depth look at VNG, a sophisticated technique for evaluating eye movements and vestibular function.
4. Vestibular Neuritis: Diagnosis and Treatment: A review of vestibular neuritis, its causes, symptoms, and treatment options.
5. Benign Paroxysmal Positional Vertigo (BPPV): An explanation of BPPV, including its causes, diagnosis, and management.
6. Meniere's Disease: Understanding the Symptoms and Treatment Options: A comprehensive overview of Meniere's disease.
7. Vestibular Rehabilitation Therapy: An exploration of vestibular rehabilitation, a non-surgical treatment for balance disorders.
8. Dizziness and Vertigo: Causes and Treatments: A broader overview of dizziness and vertigo, covering various potential causes.
9. Central Vestibular Disorders: Diagnosis and Management: A detailed discussion of central vestibular disorders and their management.


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  past pointing test of vestibular function: Baloh and Honrubia's Clinical Neurophysiology of the Vestibular System Robert William Baloh, Kevin A. Kerber, 2011 Continued Praise for Clinical Neurophysiology of the Vestibular System.
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  past pointing test of vestibular function: Pocket Guide and Toolkit to Dejong's Neurologic Examination William W. Campbell, 2007-11-01 Designed as a diagnostic tool for non-neurologists or first-year neurology residents, this pocket guide contains the most essential information from the best-selling DeJong's The Neurologic Examination, Sixth Edition. Included are step-by-step instructions for each stage of the neurologic examination, numerous illustrations depicting examination techniques, and frequently used tests and scales such as the Boston Naming Test, Glasgow Coma Scale, and Denver Scale of Communication Function. A toolkit at the back of the book contains lightweight adaptations of implements used in performing the examination, such as visual acuity charts, a red lens, a multi-pinhole, an optokinetic nystagmus tape, and other devices.
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  past pointing test of vestibular function: Clinical Adult Neurology Jody Corey-Bloom, MD, PhD, Ronald B. David, MD, 2008-12-19 Extensively illustrated and liberally laced with clinically helpful tools, Clinical Adult Neurology is an affordable reference for all clinicians and residents. With emphasis on diagnostic tools and strategies as well as management pearls and perils, Clinical Adult Neurology will meet the needs of all health care practitioners caring for patients with neurologic disorders. The book is organized into three sections, with Section 1 covering all aspects of neurologic evaluation, Section 2 describing common clinical problems in neurology, and Section 3 discussing all aspects of neurologic diseases. All sections and chapters emphasize the clinical approach to the patient with consistently useful pedagogical tools, including Features tables for diagnostic help with all neurologic diseases, Pearls and Perils boxes that represent pithy distillations of clinical wisdom from leading experts, Key Clinical Questions boxes that help clinicians frame patient diagnosis and management; and annotated bibliographies that highlight the most important references for further study. The book's organization, format, and features all stress the efficient and well-rationed use of medical care for patients with neurologic disease. Succinct content presentations make all information easy to locate and digest. The format will also be a helpful tool for those preparing for examinations. Highlights include: An emphasis on diagnosis, management, and all pertinent clinical issues Heavily illustrated Contributions by the foremost experts on all aspects of neurologic diseases Extensive use of clinically helpful tables, charts, and boxes with practical advice on all aspects of diagnosis and management
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  past pointing test of vestibular function: DeJong's the Neurologic Examination William Wesley Campbell, Russell N. DeJong, 2005 This classic text is a comprehensive, detailed guide to the neurologic examination. The book provides a thorough understanding of both the techniques of the examination and the anatomic and physiologic bases of the results. The brand new edition offers you a complete, concise reference you'll use everyday to quickly interpret the signs and symptoms of neurologic dysfunction, compare and contrast abnormalities, confirm findings, and make accurate differential diagnoses confidently to assess responses to treatment. This heavily revised new edition provides complete coverage of the nervous system including anatomic and physiologic presentation of disorders, recommended examination procedures, neurodiagnostic and laboratory testing, diagnostic reasoning, and neurologic differential diagnosis guidelines. You'll confidently identify the signs and symptoms of disease, know when additional diagnostic testing is indicated, accurately interpret diagnostic data, and recommend effective treatment options.
  past pointing test of vestibular function: The Stroke Book Michel T. Torbey, Magdy H. Selim, 2013-07-18 An essential companion for busy professionals seeking to navigate stroke-related clinical situations successfully and make quick informed treatment decisions.
  past pointing test of vestibular function: The Paroxysmal Disorders Bettina Schmitz, Barbara Tettenborn, Donald L. Schomer, 2010-09-09 The paroxysmal disorders present neurologists and other medical professionals with diagnostic problems across a range of disorders, including multiple sclerosis, migraine and epilepsy. This new English language edition of a compendium of the paroxysmal disorders, originally published in German as Paroxysmale Störugen in der Neurologie, is an informative and practical resource for clinicians, which provides invaluable help with differential diagnosis and management. Fully updated throughout, this new edition comprehensively covers the entire spectrum of the paroxysmal disorders, including sudden falls, headache, vertigo attacks, memory loss, visual disturbances, seizures and anxiety. Each chapter is practice oriented, covering definitions, etiology, epidemiology, diagnosis, examination techniques and therapy. Detailed guidelines for gathering case-histories, essential for accurate diagnosis, are also provided. Important reading for clinicians, professionals and academic researchers working in neurology, psychiatry, epilepsy, internal medicine and ENT.
  past pointing test of vestibular function: Orthopedic Physical Assessment - E-Book Robert C. Manske, David J. Magee, 2020-12-11 **Selected for Doody's Core Titles® 2024 with Essential Purchase designation in Sports Medicine** Build your skills in the assessment of musculoskeletal pathology! Orthopedic Physical Assessment, 7th Edition covers the principles of assessment for all of the body's structures and joints, including topics such as gait, posture, the head and face, amputees, primary care, and sports emergencies. The 7th edition offers additional functional assessment forms (e-tools), updated evidence-based reliability and validity tables, and hundreds of video clips (included with print purchase) demonstrating special tests on how to perform musculoskeletal assessment. Written by noted PT educators David J. Magee and Robert C. Manske, this reference uses a systematic, evidence-based approach to prepare you for success in clinicals, board exams, and in rehabilitation practice. - Over 2,500 full-color illustrations and photographs depict key concepts, along with assessment techniques and special tests. - At-a-glance icons show the clinical utility of special tests, supplemented by updated, evidence-based reliability and validity tables for tests and techniques - Quick-reference data includes hundreds of summary boxes, red-flag and yellow-flag boxes, differential diagnosis tables, muscle and nerve tables, and classification, normal values, and grading tables. - A Summary (Précis) of Assessment in each chapter serves as a review of assessment steps. - Combined with other books in the Musculoskeletal Rehabilitation series — Scientific Foundations and Principles of Practice, Pathology and Intervention, and Athletic and Sports Issues — this book provides you with the knowledge and background necessary to assess and treat musculoskeletal conditions. - NEW! Updated information in all chapters includes new special tests, as well as photos, line drawings, boxes, tables, and references. - NEW! Head and Face chapter features updated information on concussion management. - NEW! Enhanced Diagnostic Ultrasound Imaging section added to applicable chapters, along with new photos and diagnostic images. - NEW! Updated psychometric tables for special tests list reliability, sensitivity, specificity, and + and – likelihood ratios when available. - NEW! More case studies present real-life scenarios to help you develop assessment and diagnostic skills using information from the chapter. - NEW! Additional functional assessment forms (e-tools) have been incorporated. - NEW! Video clips, included with print purchase, demonstrate special tests to give you a clearer understanding of how to perform musculoskeletal assessment. - NEW! Enhanced ebook version, included with print purchase, provides access to all of the text, figures, and references from the book on a variety of devices.
  past pointing test of vestibular function: Saunders Comprehensive Review for the NCLEX-RN Examination Linda Anne Silvestri, 2011 Accompanying CD-ROM includes more than 4500 NCLEX examination-style review questions in quiz, study, or exam mode, a diagnostic pre-test, audio and video questions, and audio review summaries.
  past pointing test of vestibular function: Saunders Comprehensive Review for the NCLEX-RN® Examination - E-Book Linda Anne Silvestri, 2010-10-12 This title includes additional digital media when purchased in print format. For this digital book edition, media content is not included.
  past pointing test of vestibular function: Advances in Translational Neuroscience of Eye Movement Disorders Aasef Shaikh, Fatema Ghasia, 2020-01-03 A comprehensive book that reviews advances in ocular motor research on topics of general interest, rare, specialized or unique conditions, and pertinent basic neuroscience. A rare collection with contributions from basic neuroscientists, neurologists, and ophthalmologists. Includes dedicated chapters on mathematical models, pharmacotherapy, neuromodulation, motion perception, visual influence on eye movement, physiology of strabismus, and microsaccades. This book is dedicated to David Robinson - one of the pioneers of contemporary ocular motor and vestibular neuroscience.
  past pointing test of vestibular function: Neurology Charles Clarke, Robin Howard, Martin Rossor, Simon Shorvon, 2016-09-06 Neurology: A Queen Square Textbook, second edition, is a fully revised and updated companion that demonstrates the rapid pace of advancement within clinical neurology and applied neuroscience A comprehensive and practical overview of current developments within clinical neurology, synthesising clinical neurology with translational research Expertly edited and written by neurologists, neuroscientists and neurosurgeons working at Queen Square, advised by an distinguished International Editor team to present a global perspective Introductory chapters summarise the basic sciences underpinning the practice of clinical neurology, including genetics, channelopathies, immunology, neurophysiology and neuropathology All chapters fully revised and updated to reflect the increasing role of neurologists in acute care Includes new contributions concerning major developments in the care of; stroke, epilepsy, dementia, Parkinson's disease, multiple sclerosis, neuromuscular disease, headache, infections, spinal disease, cranial nerve disease, neuropsychiatry, neurogenetics, neuro-oncology, uroneurology, neuro-otology, neuro-ophthalmology, pain medicine, sleep medicine, metabolic disease, drugs and toxins, autonomic disease, systemic disease, and neurorehabilitationfor dementia, epilepsy, headaches, neuro-genetics and many more
  past pointing test of vestibular function: Saunders Comprehensive Review for the NCLEX-PN® Examination - E-Book Linda Anne Silvestri, Angela Silvestri, 2020-12-23 Get the best review for the NCLEX-PN® exam from the leading NCLEX® experts! Written by Linda Anne Silvestri and Angela E. Silvestri, Saunders Comprehensive Review for the NCLEX-PN® Examination, 8th Edition provides everything you need to prepare for success on the NCLEX-PN. The book includes a review of all nursing content areas, more than 4,500 NCLEX exam-style questions, detailed rationales, test-taking tips and strategies, and new Next-Generation NCLEX (NGN)-style questions. An Evolve website simulates the exam-taking experience with a choice of practice questions along with realistic practice tests. Based on Silvestri's proven Pyramid to Success, this complete review is a perennial favorite of students preparing for the NCLEX. - More than 4,500 practice questions are included in the book and on Evolve. - Detailed rationales are provided for both correct and incorrect answer options. - Alternate item format questions include multiple response, prioritizing, fill-in-the-blank, figure/chart, and video clips. - Test-taking strategies provide useful hints for analyzing and uncovering correct answer options. - Pyramid Points and Pyramid Alerts identify content that typically appears on the NCLEX-PN exam - Pyramid to Success sections at the beginning of each unit provide an overview of content, guidance for your review, and the subject's relative importance in the NCLEX-PN text plan. - What Should You Do? boxes in each chapter help you develop critical thinking skills, with answers at the end of the chapter. - UNIQUE! A 75-question pre-test on Evolve provides feedback on your strengths and weaknesses, and the results generate an individualized study calendar. - NEW! Next-Generation NCLEX® (NGN)-style questions ensure that you are ready for the biggest change to the NCLEX-PN test plan in many years. - New! The current NCLEX-PN® test plan is incorporated throughout the book and the Evolve companion website.
  past pointing test of vestibular function: Vertigo Shabih H. Zaidi, Arun Sinha, 2013-06-24 ​This monograph on vertigo is based on the personal, hands-on, practical and clinical experience of managing vertigo in a large university-affiliated hospital. It covers all aspects of the subject, offering the latest information on epidemiology, aetiopathogenesis, diagnostics, the battery of vestibular and allied tests, treatment, rehabilitative management and ethical considerations. The neglected but substantial problem of paediatric vertigo is addressed, as are the many pathologies in the elderly population that can lead to disequilibrium and repeated falls. This book will prove of value to a range of practitioners, including family physicians, otologists, audiologists, vestibular scientists, neurologists, paediatricians, geriatricians, physiotherapists, rehabilitation therapists and general doctors, as well as medical and nursing students.
  past pointing test of vestibular function: Elsevier's Canadian Comprehensive Review for the NCLEX-RN Examination - E-Book Linda Anne Silvestri, Angela Silvestri, 2021-06-14 Prepare for success on the NCLEX-RN® exam with the review book written for Canadian nursing students! Elsevier's Canadian Comprehensive Review for the NCLEX-RN® Examination, 2nd Edition provides everything you need to prepare for the NCLEX® exam — complete content review and more than 5,000 NCLEX examination-style questions in the book and online. Proving that not all NCLEX exam review books are the same, only this book includes the kinds of questions that consistently test the critical thinking skills needed to pass today's NCLEX exam. In addition, all answers include detailed rationales and test-taking strategies with tips on how to best approach each question. From Canadian editors Patricia Bradley and Karin Page-Cutrara, and NCLEX review experts Linda Anne Silvestri and Angela Silvestri, this edition integrates Canadian approaches to nursing, making this the only comprehensive review text written from a fully Canadian perspective. It's THE book of choice for NCLEX preparation! - More than 5,000 practice questions in the text and online offer ample testing practice. - UNIQUE! Detailed test-taking strategy and rationale is included for each question, offering clues for analyzing and uncovering the correct answer option. - UNIQUE! Priority Nursing Action boxes provide information about the steps you will take in clinical situations requiring clinical judgement and prioritization. - UNIQUE! Pyramid Points icons indicate important information, identifying content that typically appears on the NCLEX-RN® examination. - UNIQUE! Pyramid Alerts appear in red text and highlight important nursing concepts. - UNIQUE! Priority Concepts — two in each chapter — discuss important content and nursing interventions. - New graduate's perspective is offered on how to prepare for the NCLEX-RN, in addition to nonacademic preparation, the CAT format, and test-taking strategies. - Mnemonics are included to help you remember important information. - 75-question comprehensive exam covers all content areas in the book in the same percentages that they are covered on the actual NCLEX-RN test plan. - Practice questions on delegation, prioritization, and triage/disaster management emphasize these areas on the NCLEX exam. - Companion Evolve website provides 25 new Next Generation NCLEX® (NGN)-style questions plus all alternate item format questions including multiple response, prioritizing (ordered response), fill-in-the-blank, figure/illustration (hot spot), chart/exhibit, video, and audio questions. - Question categories on Evolve are organized by cognitive level, client needs area, integrated process, and content area, allowing completely customizable exams or study sessions. - UNIQUE! Audio review summaries on Evolve cover pharmacology, acid-base balance, and fluids and electrolytes.
  past pointing test of vestibular function: Advanced Health Assessment & Clinical Diagnosis in Primary Care - E-Book Joyce E. Dains, Linda Ciofu Baumann, Pamela Scheibel, 2015-04-24 Take the ‘next step’ in health assessment! Advanced Health Assessment and Clinical Diagnosis in Primary Care, 5th Edition goes beyond basic history and physical examination to help you master the diagnostic reasoning process. You’ll develop this key skill by following assessment guidelines that focus on a specific complaint rather than beginning with a previously established diagnosis or disease entity. Written by advanced practice nursing experts Joyce Dains, Linda Baumann, and Pamela Scheibel, this edition includes new chapters on evidence-based preventive health screening and on heartburn and indigestion, along with a new full-color design. Master the differential diagnosis process outlined in this book, and you’ll be able to accurately diagnose the majority of patients seen in today’s primary care settings. A clear, consistent diagnostic reasoning process takes you to the next step of health assessment — beyond basic history and physical examination to diagnostic reasoning. Diagnostic Reasoning: Focused History sections use ‘self-questions’ to walk you through the thinking process involved in obtaining a pertinent, relevant, problem-specific history that will assist in differential diagnosis. Diagnostic Reasoning: Focused Physical Examination sections explain how to perform more advanced diagnostic techniques and interpret the findings. Key Questions guide you through assessment and toward an accurate diagnosis by listing questions to ask the patient, followed by explanations of what the patient's responses might signify. Laboratory and Diagnostic Studies sections outline the types of studies that might be appropriate based on the focused history and focused physical examination. Differential Diagnosis sections offer the most common diagnoses for each patient problem and summarize the history and physical examination findings, along with recommended laboratory and diagnostic studies. Differential Diagnosis tables provide a quick-reference summary of possible diagnoses for each patient problem. Evidence-Based Practice boxes — more than 30 are NEW — summarize the scientific evidence related to the diagnosis of patient problems. Alphabetical Table of Contents provides a convenient listing of common health problems.
  past pointing test of vestibular function: Elsevier's Canadian Comprehensive Review for the NCLEX-RN® Examination - E-Book Patricia A. Bradley, Karin L. Page-Cutrara, Linda Anne Silvestri, Angela Silvestri, 2023-03-28 A truly Canadian edition of Elsevier's best-selling NCLEX® exam review book! Elsevier's Canadian Comprehensive Review for the NCLEX-RN® Examination, 3rd Edition provides everything you need to prepare for the NCLEX® exam — complete content review, more than 5,000 NCLEX practice questions in the book and online, and preparation for the Next-Generation NCLEX®. In addition, all answers include detailed rationales and test-taking strategies with tips on how to best approach each question. Integrating Canadian approaches to nursing throughout the text, this book is the only comprehensive NCLEX review written from a Canadian perspective. It's THE book of choice for NCLEX preparation! - Completely up-to-date coverage from a Canadian perspective reflects Canadian approaches to nursing and health care, including the addition of the latest Canadian statistics, research, legislation, regulations, references, clinical practice guidelines, and more. - More than 5,000 practice questions in the text and online offer ample testing practice. - UNIQUE! Detailed test-taking strategy and rationale is included for each question, offering clues for analyzing and uncovering the correct answer option. - UNIQUE! Priority Nursing Action boxes provide information about the steps to be taken in clinical situations requiring clinical judgement and prioritization. - UNIQUE! Pyramid Points icons indicate important information, identifying content that typically appears on the NCLEX-RN® examination. - UNIQUE! Pyramid Alerts appear in red text and highlight important nursing concepts. - New graduate's perspective is offered on how to prepare for the NCLEX-RN, in addition to nonacademic preparation, the CAT format, and test-taking strategies. - Mnemonics are included to help you remember important information. - 79-question comprehensive exam covers all content areas in the book in the same percentages that they are covered on the actual NCLEX-RN test plan and includes four case–study-format questions for the NGN. - Practice questions on delegation, prioritization, and triage/disaster management emphasize these areas on the NCLEX exam. - Companion Evolve website provides 30 new questions for the Next Generation NCLEX® plus all alternate item format questions including multiple response, prioritizing (ordered response), fill-in-the-blank, figure/illustration (hot spot), and chart/exhibit. - Question categories on Evolve are organized by cognitive level, client needs area, integrated process, and content area, allowing you to choose completely customizable exams or study sessions. - UNIQUE! Audio review summaries on the Evolve companion website cover pharmacology, acid-base balance, and fluids and electrolytes.
  past pointing test of vestibular function: Saunders Canadian Comprehensive Review for the NCLEX-RN Linda Anne Silvestri, 2016-09 Now there's a Canadian edition of the book that is often called the 'the best NCLEX(R) exam review book ever! Saunders Canadian Comprehensive Review for the NCLEX-RN(R) Examination provides everything your students need to prepare for the NCLEX exam -- complete content review and over 5,100 NCLEX examination-style questions in the book and online. This is the first edition to put the NCLEX-RN(R) exam in a Canadian context. An Evolve companion website includes instructor resources that make it easy to integrate this book into any course, along with detailed feedback and assessment for your students' work. Don't make the mistake of assuming the quality of the questions is the same in all NCLEX exam review books, because only this book includes the kind of questions that consistently test the critical thinking skills necessary to pass today's NCLEX exam. Even better, all answers include detailed rationales to help students learn from their answer choices, as well as test-taking strategies with tips on how to best approach each question. Written by the most trusted name in NCLEX review, Linda Anne Silvestri, and featuring special resources to help Canadian students succeed, this is THE book of choice for NCLEX preparation. Read any customer review or ask your colleagues to see why there's nothing else like it!
  past pointing test of vestibular function: An Introduction to Clinical Emergency Medicine S. V. Mahadevan, Gus M. Garmel, 2012-04-10 Fully-updated edition of this award-winning textbook, arranged by presenting complaints with full-color images throughout. For students, residents, and emergency physicians.