Neurological NCLEX Questions

C. Inability to maintain own airway

Interventions to prevent which problem are the priority for a patient with myasthenia gravis (MG)? A. Accidental injury B. Uncontrolled pain C. Inability to maintain own airway D. Decreased functional ability and mobility

B. What the patient was doing prior to the seizure. C. What time the seizure began and how long it lasted. D. Whether body movements are unilateral and symmetrical. E. Which direction the patient's eyes turned during the seizure.

The LPN/LVN is talking with a patient, who has epilepsy, when he begins having a tonic-clonic (grand mal) seizure. Which assessment(s) should the LPN/LVN make? (Select all that apply.) A. What the patient had eaten prior to the seizure. B. What the patient was doing prior to the seizure. C. What time the seizure began and how long it lasted. D. Whether body movements are unilateral and symmetrical. E. Which direction the patient's eyes turned during the seizure.

D. The health care provider reviews the x-rays

The client is admitted to the hospital for observation with a probable minor head injury after an automobile crash. The nurse expects the cervical collar will remain in place until which time? A. The client is taken for spinal x-rays B. The family comes to visit after surgery C. The nurse needs to provide physical care D. The health care provider reviews the x-rays

D. Side- laying with legs pulled up and chin to the chest

The client is having a lumbar puncture preformed. The nurse should place the client in which position for the procedure? A. Supine, in semi-fowlers B. Prone, in slight Trendelenburg C. Prone, with a pillow under the abdomen D. Side- laying with legs pulled up and chin to the chest

D. exhaling during respostioning

The client recovering from a head injury is arousable and participating in care. The nurse determines that the client understands measures to prevent elevations in intracranial pressure if the nurse observes the client doing which of the following? A. Blowing the nose B. isometric exercises C. coughing vigorously D. exhaling during repositioning

B. Minor headache

The client was seen and treated in the ER for a concussion. Before discharge, the nurse explains the signs and symptoms of worsening condition. The nurse determines that the family needs further teaching if they state they will return to the ED if the client experiences which sign and symptom? A. Vomiting B. Minor headache C. Difficulty speaking D. Difficulty awakening

D. Comparing the amount of prescribed weights with the amount in use

The client with a cervical spine injury has Crutchfield tongs applied in the ER. The nurse should preform which essential action when caring for this client? A. Providing a standard bed frame B. Removing a standard bed frame C. Removing the weights if the client is uncomfortable D. Comparing the amount of prescribed weights with the amount in use

D. Limiting bladder catherization to once every 12 hours

The client with a spinal cord injury is prone to experiencing autonomic dysreflexia. The least appropriate measure to minimize the risk of autonomic dysreflexia is which action? A. Strictly adhering to a bowel retraining program B. Keeping the linen wrinkle-free under the client C. Avoiding unnecessary pressure on the lower limbs D. Limiting bladder catherization to once every 12 hours

A. raise the head of bed and removed the noxious stimulus

The client with spinal cord injury suddenly experiences an episode of autonomic dysreflexia. After checking the vital signs, which immediate action should the nurse take? A. raise the head of bed and removed the noxious stimulus B. lower the head of bed and remove the noxious stimulus C. lower the head of bed and administer an antihypertensive agent D. remove the noxious stimulus and administer an antihypertensive agent

A. Decreasing level of consciousness (LOC)

The nurse is assessing a patient who has a brain tumor. What assessment finding is most indicative of increased ICP in this patient? A. Decreasing level of consciousness (LOC) B. Elevated temperature C. Agitation and hostility D. Increasing blood pressure (BP)

C. "Checking this reflex assesses involuntary muscular contractions."

The nurse is assessing the patient's patellar reflex. The patient asks what the purpose of this exam is. Which response by the nurse is correct? A. "I am checking the conscious nerve response in your leg." B. "This assessment determines your hand-eye coordination." C. "Checking this reflex assesses involuntary muscular contractions." D. "The patellar reflex demonstrates large voluntary muscle coordination."

C. Head of bed elevated 30 to 45 degrees head and neck midline

The nurse is caring for a client who has undergone craniotomy with a supratentoral incision. The nurse should plan to place the client in which position post-op? A. Head of bed flat, head and neck midline B. Head of bed flat, head turned to the nonoperative side C. Head of bed elevated 30 to 45 degrees head and neck midline D. Head of bed elevated 30 to 45 degrees, head turned to the operative side

D. increasing temperature, decreasing pulse, decreasing respirations, increasing BP

The nurse is caring for a client with an increased intracranial pressure. ( ICP) Which change in vital signs would occur is ICP is rising? A. increasing temperature, increasing pulse, increasing respirations, and decreasing BP B. decreasing temperature, decreasing pulse, increasing respirations, decreasing BP C. decreasing temperature, increasing pulse, decreasing respirations, increasing BP D. increasing temperature, decreasing pulse, decreasing respirations, increasing BP

C. White blood cells (WBCs) 100/mm3

The nurse is caring for a patient who has undergone a lumbar puncture in order to run tests on the cerebrospinal fluid (CSF). The nurse knows which laboratory value is abnormal? A. Glucose 60 mg/100 mL B. Clear, colorless appearance C. White blood cells (WBCs) 100/mm3 D. Total protein 40 mg/100 mL

B. CN II and CN III

The nurse is caring for a patient who suffered massive head trauma, and suspected increased intracranial pressure (ICP) from an automobile accident. Which cranial nerves are most appropriate to check at this time? A. CN I and CN II B. CN II and CN III C. CN III and CN IV D .CN IV and CN V

C. Severe, throbbing headache

The nurse is caring for the client who has suffered a spinal cord injury. The nurse further monitors the client for signs and symptoms of autonomic dysreflexia and suspects this complication if which sign and symptoms is noted? A. sudden tachycardia B. Pallor of face and neck C. Severe, throbbing headache D. Severe and sudden hypotension

A. CSF circulates within the subarachnoid space. B. CSF cushions and protects the brain and spinal cord. D. CSF is reabsorbed by the arachnoid villi at the same rate at which it is formed. E. CSF is formed continuously within the ventricles of the brain as a filtrate from the blood.

The nurse is measuring the pressure of the CSF. Which statement accurately describes CSF? (Select all that apply.) A. CSF circulates within the subarachnoid space. B. CSF cushions and protects the brain and spinal cord. C. CSF normal pressure is 90 to 150 cm water pressure (cm H2O). D. CSF is reabsorbed by the arachnoid villi at the same rate at which it is formed. E. CSF is formed continuously within the ventricles of the brain as a filtrate from the blood.

D. Determine whether the patient is able to move his legs and arms

The nurse is performing a "neuro check" on a patient who has demonstrated a decreased LOC. What is the best way to assess the patient's neuromuscular status? A. Measure the patient's vital signs. B. Test the reaction of the patient's pupils to light. C. Check the patient's response to the stimulus of pinching. D. Determine whether the patient is able to move his legs and arms

C. At the time of menstruation

The nurse is providing patient teaching to a 23-year-old female who has recently been diagnosed with epilepsy. The nurse should educate the patient that seizures are most likely to occur at which time in the patient's menstrual cycle? A. At the time of ovulation B. 1 week after menstruation C. At the time of menstruation D. 1 week before menstruation

A. Cerebral thrombosis C. Cerebral hemorrhage E. Atherosclerosis of the arteries in the head and neck

The nurse is providing teaching to a group of patients regarding CVA (stroke). The patients demonstrate an understanding of the teaching when listing which factors as being the possible cause of a stroke? (Select all that apply.) A. Cerebral thrombosis B. Cerebral encephalitis C. Cerebral hemorrhage D. Meningococcal meningitis E. Atherosclerosis of the arteries in the head and neck

B. Head turned to the side

The nurse observes the unlicensed assistive personnel positioning the client with increased intracranial pressure. Which position would require intervention by the nurse? A. Head midline B. Head turned to the side C. neck in neutral position D. head of bed elevated to 30 to 45 degrees

A. Polyuria

The nurse suspects that a 36-year-old patient recovering from a hypophysectomy (removal of the pituitary gland) has developed diabetes insipidus (DI). What sign or symptom is most indicative of DI? A. Polyuria B. Polyphagia C. Hypertension D. Hyperkalemia

D. "This helps to strengthen and retrain muscles "

The nurse who is caring for a patient following a stroke performs passive range-of-motion exercises on the patient. The patient asks why these exercises are so important. Which response by the nurse is accurate? A. "This helps the patient believe she is making some progress." B. "This helps overcome mood swings and crying spells." C. "This helps prevent fatigue from worsening." D. "This helps to strengthen and retrain muscles."

D. "I can take a four hour car ride, as long as I stay perfectly still.

The patient who had a laminectomy following a herniated lumbar disk is preparing to be discharged. Which statement by the patient indicates a need for additional discharge instructions? A. "I should try to maintain a normal weight." B. "It is best for me to do my back exercises twice a day." C. "I need to be sure not to twist or bend at the waist when lifting things." D. "I can take a four hour car ride, as long as I stay perfectly still.

B. The cranial nerves are involved in the disease process. C. Muscle weakness is the major characteristic of the disorder. E.Progressive degeneration of the spinal cord occurs as the disease advances.

The student nurse is caring for a patient with MG. The student demonstrates adequate learning when identifying which pathophysiologic factors regarding the disease? (Select all that apply.) A. The disease is an acute disorder. B. The cranial nerves are involved in the disease process. C. Muscle weakness is the major characteristic of the disorder. D. The etiology of the majority of cases of the disease is autoimmune. E.Progressive degeneration of the spinal cord occurs as the disease advances.

D. Touch his nose with his left index finger.

When rating a patient using the Glasgow Coma Scale, what would be appropriate for the LPN/LVN to ask the patient to do in order to test the patient's motor response? A. Roll his eyes in a circle. B. Take a deep breath and exhale. C. Describe the view from his window. D. Touch his nose with his left index finger.

B. " I will drive only during the daytime"

The nurse has provided discharge instructions to a client with an application of a halo device. The nurse determines that the client needs further teaching if which statement is made? A. " I will use a straw for drinking" B. " I will drive only during the daytime" C. " I will use caution because the device alters balance" D. " I will wash the skin daily under the lambs wool liner of the vest"

A. Muscle pain B. Slurred speech C. Muscle spasticity E. Difficulty swallowing

The nurse is assessing a patient admitted for a work-up to rule out ALS. Which symptoms are typically exhibited in a patient with ALS? (Select all that apply.) A. Muscle pain B. Slurred speech C. Muscle spasticity D. Decreased sensation E. Difficulty swallowing

B. "I need to apply ice to the bump on her head for 20 minutes every hour for 72 hours."

A 13-year-old female patient has been seen in a walk-in clinic following a blow to the head from a fall during basketball practice. Which statement by the parent indicates the need for further discharge teaching? A. "I need to wake her up every 2 or 3 hours for the first 24 hours." B. "I need to apply ice to the bump on her head for 20 minutes every hour for 72 hours." C. "I need to check her pupils frequently with a flashlight to be sure her pupils constrict." D. "I need to watch for any changes in the level of consciousness or vomiting for 48 hours."

A. Pad the bed's side rails B. place an airway by the bedside C. Place oxygen equipment at the bedside D. place suction equipment at the bedside

A client with a seizure disorder is being admitted to the hospital. Which should the nurse plan to implement for this client? Select all that apply A. Pad the bed's side rails B. place an airway by the bedside C. Place oxygen equipment at the bedside D. place suction equipment at the bedside E. Take a padded tongue blade to the wall at the head of the bed

D. Quadriplegia

A patient experienced injury to the spinal cord in the cervical region, with paralysis and loss of sensory perception in both legs and both arms. What term is used to describe this condition? A. Paraplegia B. Hemiplegia C. Homoplegia D. Quadriplegia

A. Halo Test

After a head injury, the patient begins to have drainage from the nose. The nurse assesses the drainage by which method? A. Halo test B. Tinel sign C. Battle sign D. Babinski sign

Alert Confused Lethargy Obtunded Stuporous Comatose

All the following are LOCs. Starting with the optimal LOC, place these in order of a decreasing LOC. Alert Lethargic Confused Obtunded Comatose Stuporous

C. MG

For which condition would a patient most need to have medical alert identification? A. Poliomyelitis B. MS C. MG D. Cerebrovascular accident (CVA)

A. Proper treatment for hypertension B. Adequate treatment of atherosclerosis C. Avoiding the use of recreational drugs E. Keeping serum cholesterol levels under control

The LPN/LVN discusses ways to prevent a stroke with a patient. Which measures should the nurse include in her teaching? (Select all that apply.) A. Proper treatment for hypertension B. Adequate treatment of atherosclerosis C. Avoiding the use of recreational drugs D. Encouraging the use of seat belts in vehicles E. Keeping serum cholesterol levels under control

D. separates into concentric rings and tests positive for glucose

The client has clear fluid leaking from the nose after a basilar skull fracture. The nurse determines that is is cerebrospinal fluid ( CSF) if the fluid meets which criteria? A. Is grossly bloody in appearance and has a pH of 6 B. Clumps together on the dressing and has a pH of 7 C. Is clear in appearance and tests negative for glucose D. separates into concentric rings and tests positive for glucose

A. " I should drink extra fluids for the remainder of the day."

The client has just undergone computed tomography ( CT) scanning with a contrast medium. Which statement by the client demonstrates an understanding of the post procedure care? A. " I should drink extra fluids for the remainder of the day." B. " I should not take any medications for atleast 4 hours." C. "I should eat lightly for the remainder of the day." D. " I should rest quietly for the remainder of the day."

B. Epistaxis

The nurse obtaining an admission history for a patient recovering from a CVA finds a medication history including aspirin (Ecotrin). What should alert the nurse to a possible adverse effect of this drug? A. Nausea B. Epistaxis C. Hyperactivity D. Abdominal distention

C. "Drinking very cold or hot liquids is frequently a trigger, so you should avoid both."

The patient with trigeminal neuralgia asks the nurse if there is anything she can do to prevent future episodes of the disorder. Which response by the nurse is correct? A. "It is best if you speak with your physician about this condition." B. "Unfortunately, there is little you can do to prevent future episodes of pain." C. "Drinking very cold or hot liquids is frequently a trigger, so you should avoid both." D. "Surgery is the only form of treatment that will prevent this condition from recurring."

C. Turn the patient slowly and as one unit to avoid twisting the spine.

The student nurse is assisting the nurse in turning a patient who is in cervical traction. What is most important for the LPN/LVN to instruct the student to do when assisting in turning the patient? A. Flex the knees and hips before turning the patient. B. Support the patient's head with a pillow so that his neck is flexed. C. Turn the patient slowly and as one unit to avoid twisting the spine. D. Place the patient's back in traction so that the spine will be kept slightly flexed.

D. Pupil changes can be caused by pressure on the ocular nerve.

When increased ICP is suspected, the nurse performs a complete neurologic assessment. What does the pupillary response indicate? A. High pressure can cause blurred vision. B. Hemorrhage can cause visual impairment. C. Pupil dilation is the first sign of increased ICP. D. Pupil changes can be caused by pressure on the ocular nerve.

D. Severe headache that wakes patient and visual problems

A patient has been diagnosed with a cerebral neoplasm. What are the symptoms of a cerebral neoplasm? A. Long-term memory loss and paralysis B. Loss of muscle strength and paresthesia C. Grand mal seizure activity and facial paralysis D. Severe headache that wakes patient and visual problems

B. Aphasia

A patient has had a left-sided cerebrovascular accident (CVA). Which condition does the nurse expect the patient to have as a result of the CVA? A. Ataxia B. Aphasia C. Dyslexia D. Quadriplegia

B. Weakness of the limbs

A patient has recently been diagnosed with MS. The family asks the nurse about the common manifestations of the disease. The nurse is correct by identifying which as the most common clinical manifestation of the disease? A. Urinary incontinence B. Weakness of the limbs C. A loss of the sense of smell D. Decreased intellectual function

C. The patient tilts his head back when trying to swallow solid foods.

A patient is admitted to a rehabilitation facility following a brain injury that has resulted in dysphagia. While observing the patient and his wife, the nurse determines further instruction is necessary if which activity is performed? A. The patient sips from a cup rather than using a straw. B. The patient sits in his chair for 45 minutes after each meal. C. The patient tilts his head back when trying to swallow solid foods. D. The patient's wife places a teaspoon of food in the patient's mouth at a time.

A. Tinnitus C. Ottorhea D. Battle sign

A patient is bought in by ambulance with a suspected brain injury. What are the outward symptoms of head injury? (Select all that apply.) A. Tinnitus B. Diarrhea C. Ottorhea D. Battle sign E. Chvostek sign

A. The patient should have periodic drug levels drawn.

A patient who has epilepsy is to take phenytoin (Dilantin). What is an important teaching point that the LPN/LVN should include regarding this medication? A. The patient should have periodic drug levels drawn. B. The patient should regulate the dosage according to need. C. The patient should take the medication with juice containing vitamin C. D. The patient should take an extra dose of the medication before exercising.

B. "The procedure is safe and painless; you will hear a clicking noise as the CT machine rotates."

A patient who is to have computed tomography (CT scan) of the brain voices concern about the procedure. The LPN/LVN can best allay the patient's fears by making which statement? A. "CT scans use only a small amount of radioactive material injected into your brain." B. "The procedure is safe and painless; you will hear a clicking noise as the CT machine rotates." C. "You will probably be given something to make you drowsy and deaden the pain during the CT scan." C. "CT scanning is a new procedure, and since it involves the brain, I think the doctor can answer your questions better than I can."

A. Sustenance of life

During the acute stage of Guillain-Barré syndrome, what is the priority goal of nursing and medical treatment? A. Sustenance of life B. Promotion of rest C. Reduction of fever D. Prevention complications

A. Hospice Services

During the advanced stages of amyotrophic lateral sclerosis (ALS), which service would be most beneficial to the family and patient? A. Hospice services B. In-home physical therapy C. Pulmonary rehabilitation program D. Nursing visits from a home health care agency

D. Paresthesia and weakness of the lower extremities

Following a viral respiratory infection, a patient develops symptoms of Guillain-Barré syndrome. What is most closely associated with this disorder? A. Emotional lability B. Hyperactive deep tendon reflexes C. Flapping tremors of the hands and feet D. Paresthesia and weakness of the lower extremities

C. "It is a good idea for me to take a hot shower in the morning to relax my muscles."

When teaching the patient with multiple sclerosis (MS) about how to best manage his disease, the nurse determines the patient requires further instruction when making which statement? A. "It is important that I attend all of my physical therapy sessions." B. "I should eat adequate fiber to prevent constipation." C. "It is a good idea for me to take a hot shower in the morning to relax my muscles." D. "The injections of interferon beta-1b (Betaseron) will help manage my symptoms."

A. Brain atrophy

Which of the following conditions can increase the risk for torn vessels and contusion on the brain if an accident that involves brain injury occurs? A. Brain atrophy B. Hydrocephalus C. Heterotopic ossification D. Increased intracranial pressure (ICP)

A. The 76-year-old patient who is taking an anticoagulant

Which patient is the nurse most concerned with developing a subdural hematoma following an injury that resulted with a blow to the head? A. The 76-year-old patient who is taking an anticoagulant B. The 16-year-old football player who suffered a concussion C. The 36-year-old patient who has a history of migraine headaches D. The 56-year-old patient who is taking an antihypertensive medication

C. Because the myasthenic patient can suffer from exaggerated and bizarre effects from a variety of drugs.

Why should the nurse check with the physician to be sure that she knows a patient has MG when prescribing medications? A. Because the patient needs sublingual medications due to excessive salivation. B. Because when the patient is in remission, certain drugs should not be prescribed. C. Because the myasthenic patient can suffer from exaggerated and bizarre effects from a variety of drugs. D. Because the patient's MG medication, selegiline (Eldepryl), needs to be carefully monitored for patient reactions.