A neuron in a haystack: advanced neurologic assessment.

An advanced practice nurse (APN) often encounters patients with alterations in neurologic functioning, regardless of the practice setting. In many situations, the APN will be asked to perform the initial evaluation and determine if additional testing and consultation are indicated. For the APN who does not routinely encounter these patients, the experience may be challenging. This article presents an organized approach to the examination of patients with alterations in mentation and level of consciousness and considerations for differential diagnosis.