Neuro NCLEX Questions and Answers Latest Update 2024 (with Rationale), Exams of Nursing

Download Neuro NCLEX Questions and Answers Latest Update 2024 (with Rationale) and more Exams Nursing in PDF only on Docsity! Neuro NCLEX Questions and Answers Latest Update 2024 (with Rationale) 1. A nurse obtains a focused health history for a client who is suspected of having bacterial meningitis. Which question would the nurse ask? A. “Do you live in a crowded residence?” B. “When was your last tetanus vaccination?” C. “Have you had any viral infections recently?” D. “Have you traveled out of the country in the last month?” 2. A nurse evaluates the results of diagnostic tests on a client’s cerebrospinal fluid (CSF). Which fluid results alert the nurse to possible viral meningitis? (Select all that apply.) A. Clear B. Cloudy C. Increased protein level D. Normal glucose level E. Bacterial organisms present F. Increased white blood cells 3. A nurse assesses a patient with a spinal cord injury at level T5. The patient’s blood pressure is 184/95 mm Hg, and the patient presents with a flushed face and blurred vision. What action would the nurse take first? A. Initiate oxygen via a nasal cannula. B. Place the patient in a supine position. C. Palpate the bladder for distention. D. Administer a prescribed beta-blocker. 4. An emergency room nurse initiates care for a patient with a cervical spinal cord injury who arrives via emergency medical services. What action would the nurse take first? A. Assess level of consciousness. B. Obtain vital signs. C. Administer oxygen therapy. D. Evaluate respiratory status. 5. After teaching a patient with a spinal cord injury, the nurse assesses the patient’s understanding. Which patient statement indicates a correct understanding of how to prevent respiratory problems at home? A. “I’ll use my incentive spirometer every 2 hours while I’m awake.” B. “I’ll drink thinned fluids to prevent choking.” C. “I’ll take cough medicine to prevent excessive coughing.” D. “I’ll position myself on my right side so I don’t aspirate.” 6. A nurse assesses a patient with a neurologic disorder. Which assessment finding would the nurse identify as a late manifestation of amyotrophic lateral sclerosis (ALS)? A. Dysarthria B. Dysphagia C. Muscle weakness D. Impairment of respiratory muscles B. Cognitive perception C. Respiratory system D. Sensory functions 13. The nurse learns that the pathophysiology of Guillain-Barré syndrome includes segmental demyelination. The nurse understands that this causes what? A. Delayed afferent nerve impulses B. Paralysis of affected muscles C. Paresthesia in upper extremities D. Slowed nerve impulse transmission 14. A patient with Guillain-Barré syndrome is admitted to the hospital. The nurse plans caregiving priority to interventions that address which priority patient problem? A. Anxiety B. Low fluid volume C. Inadequate airway D. Potential for skin breakdown 15. The nurse is preparing a patient for a Tensilon (edrophonium chloride) test. What action by the nurse is most important? A. Administering anxiolytics B. Having a ventilator nearby C. Obtaining atropine sulfate D. Sedating the patient 16. A patient is taking long-term corticosteroids for myasthenia gravis. What teaching is most important? A. Avoid large crowds and people who are ill. B. Check blood sugars four times a day. C. Use two forms of contraception. D. Wear properly fitting socks and shoes. 17. A patient with myasthenia gravis has the priority patient problem of inadequate nutrition. What assessment finding indicates that the priority goal for this patient problem has been met? A. Ability to chew and swallow without aspiration B. Eating 75% of meals and between-meal snacks C. Intake greater than output 3 days in a row D. Weight gain of 3 lbs (1.4 kg) in 1 month 18. A patient has undergone a percutaneous stereotactic rhizotomy. What instruction by the nurse is most important on discharge from the ambulatory surgical center? A. “Avoid having teeth pulled for 1 year.” B. “Brush your teeth with a soft toothbrush.” C. “Do not use harsh chemicals on your face.” D. “Inform your dentist of this procedure.” 19. A patient has trigeminal neuralgia and has begun skipping meals and not brushing his teeth, and his family believes that the patient has become depressed. What action by the nurse is best? A. Ask the patient to explain feelings related to this disorder. B. Explain how dental hygiene is related to overall health. C. Refer the patient to a medical social worker for assessment. D. Tell the patient that he or she will become malnourished in time. 20. A patient is receiving plasmapheresis. What assessment findings need to be reported to the provider as a priority? (Select all that apply.) A. Serum calcium level of 6.4 mg/dL (1.6 mmol/L) B. Urticarial rash C. Weight the following day D. Potassium level of 4.2 mEq/L (4.2 mmol/L) E. Photophobia 21. A patient is receiving plasmapheresis. What action by the nurse best prevents infection in this patient? A. Giving antibiotics prior to treatments B. Monitoring the patient’s vital signs C. Performing appropriate hand hygiene D. Placing the patient in protective isolation 22. An older patient is hospitalized with Guillain-Barré syndrome. A family member tells the nurse that the patient is restless and seems confused. What action by the nurse is best? A. Assess the patient’s oxygen saturation. B. Check the medication list for interactions. C. Place the patient on a bed alarm. D. Put the patient on safety precautions. 23. A patient with myasthenia gravis (MG) asks the nurse to explain the disease. What response by the nurse is best? A. “MG is an autoimmune problem in which nerves do not cause muscles to contract.” B. “MG is an inherited destruction of peripheral nerve endings and junctions.” C. “MG consists of trauma-induced paralysis of specific cranial nerves.” D. “MG is a viral infection of the dorsal root of sensory nerve fibers.” 24. A patient with myasthenia gravis is prescribed pyridostigmine (Mestinon). What teaching should the nurse plan regarding this medication? (Select all that apply.) A. “Do not eat a full meal for 45 minutes after taking the drug.” B. “Seek immediate care if you develop trouble swallowing.” C. “Take this drug on an empty stomach for best absorption.” D. “The dose may change frequently depending on symptoms.” E. “Your urine may turn a reddish-orange color while on this drug.” C. Refer the patient and spouse to a head injury support group. D. Tell the spouse that this is expected and he or she will have to learn to cope. 31. The nurse is caring for four patients with traumatic brain injuries. Which patient would the nurse assess first? A. Patient with amnesia for the incident B. Patient who has a Glasgow Coma Scale score of 12 C. Patient with a PaCO2 of 36 mm Hg who is on a ventilator D. Patient who has a temperature of 102° F (38.9° C) 32. A patient with a traumatic brain injury is agitated and fighting the ventilator. What drug does the nurse prepare to administer? A. Carbamazepine (Tegretol) B. Dexmedetomidine (Precedex) C. Diazepam (Valium) D. Mannitol (Osmitrol) 33. A patient who had a severe traumatic brain injury is being discharged home, where the spouse will be a full-time caregiver. What statement by the spouse would lead the nurse to provide further education on home care? A. “I know I can take care of all these needs by myself.” B. “I need to seek counseling because I am very angry.” C. “Hopefully things will improve gradually over time.” D. “With respite care and support, I think I can do this.” 34. A patient in the intensive care unit is scheduled for a lumbar puncture (LP) today. On assessment, the nurse finds the patient breathing irregularly with one pupil fixed and dilated. What action by the nurse is best? A. Ensure that informed consent is on the chart. B. Document these findings in the patient’s record. C. Give the prescribed preprocedure sedation. D. Notify the provider of the findings immediately. 35. After a craniotomy, the nurse assesses the patient and finds dry, sticky mucous membranes and restlessness. The patient has IV fluids running at 75 mL/hr. What action by the nurse is best? A. Assess the patient’s magnesium level. B. Assess the patient’s sodium level. C. Increase the rate of the IV infusion. D. Provide oral care every hour. 36. The nurse assesses a patient’s Glasgow Coma Scale (GCS) score and determines it to be 12 (a 4 in each category). What care does the nurse anticipate for this patient? A. Can ambulate independently B. May have trouble swallowing C. Needs frequent reorientation D. Will need near-total care 37. A patient has a traumatic brain injury and a positive halo sign. The patient is in the intensive care unit, sedated and on a ventilator, and is in critical but stable condition. What collaborative problem takes priority at this time? A. Inability to communicate B. Nutritional deficit C. Risk for acquiring an infection D. Risk for skin breakdown 38. A patient has meningitis following brain surgery. What comfort measures may the nurse delegate to the unlicensed assistive personnel (UAP)? (Select all that apply.) A. Applying a cool washcloth to the head B. Assisting the patient to a position of comfort C. Keeping voices soft and soothing D. Maintaining low lighting in the room E. Providing antipyretics for fever Answers with rationale 1. A- Meningococcal meningitis tends to occur in multiple outbreaks. It is most likely to occur in areas of high-density population, such as college dormitories, prisons, and military barracks. A tetanus vaccination would not place the client at increased risk for meningitis or protect the client from meningitis. A viral infection would not lead to bacterial meningitis but could lead to viral meningitis. extensive damage to the already fragile capillary system. Barrier cream will not protect the skin from pressure wounds. ROM exercises are used to prevent contractures. Sitting the patient in a chair once a day will decrease the patient’s risk of respiratory complications but will not decrease pressure on the patient’s hips and sacrum. 11. A, C, D- Neurogenic shock with acute spinal cord injury manifests with decreased oxygen saturation, symptomatic bradycardia, decreased level of consciousness, decreased urine output, and hypotension. 12. C- Patients with GBS have muscle weakness, possibly to the point of paralysis. If respiratory muscles are paralyzed, the patient may need mechanical ventilation, so the respiratory system is the priority. The nurse will complete urinary, cognitive, and sensory assessments as part of a thorough evaluation. 13. D- Demyelination leads to slowed nerve impulse transmission. The other options are not correct. 14. C- Airway takes priority. Anxiety is probably present, but a physical diagnosis takes priority over a psychosocial one. The patient has no reason to have low fluid volume unless he or she has been unable to drink for some time. If present, airway problems take priority over a circulation problem. An actual problem takes precedence over a risk for a problem. 15. C- Atropine is the antidote to edrophonium chloride and should be readily available when a patient is having a Tensilon test. The nurse would not give medications that might cause increased weakness or sedation. A ventilator is not necessary to have nearby, although emergency equipment should be available. 16. A- Corticosteroids reduce immune function, so patients taking these medications must avoid being exposed to illness. Long-term use can lead to secondary diabetes, but the patient would not need to start checking blood glucose unless diabetes had been detected. Corticosteroids do not affect the effectiveness of contraception. Wearing well-fitting shoes would be important to avoid injury, but not just because the patient takes corticosteroids. 17. D- Weight gain is the best indicator that the patient is receiving enough nutrition. Being able to chew and swallow is important for eating, but adequate nutrition can be accomplished through enteral means if needed. Swallowing without difficulty indicates an intact airway. Since the question does not indicate what the patient’s meals and snacks consist of, eating 75% may or may not be adequate. Intake and output refer to fluid balance. 18. C- The affected side is left without sensation after this procedure. The patient should avoid putting harsh chemicals on the face because he or she will not feel burning or stinging on that side. This will help avoid injury. The other instructions are not necessary. 19. A- Patients with trigeminal neuralgia are often afraid of causing pain, so they may limit eating, talking, dental hygiene, and socializing. The nurse first assesses the patient for feelings related to having the disorder to determine if a psychosocial link is involved. The other options may be needed depending on the outcome of the initial assessment. 20. Complications of plasmapheresis include hypocalcemia and urticarial rash. These need to be reported as a priority. Weight changes can occur due to fluid shifting or depletion, but this would not be a priority. The normal potassium level is not a concern and photophobia is not related. 21. C- Plasmapheresis is an invasive procedure, and the nurse uses good hand hygiene before and after patient contact to prevent infection. Antibiotics are not necessary. Monitoring vital signs does not prevent infection but could alert the nurse to its possibility. The patient does not need isolation. 22. A- In the older adult, an early sign of hypoxia is often confusion and restlessness. The nurse should first assess the patient’s oxygen saturation. The other actions are appropriate, but only after this assessment occurs. 23. A- MG is an autoimmune disorder in which nerve fibers are damaged and their impulses do not lead to muscle contraction. MG is not an inherited or a viral disorder and does not paralyze specific cranial nerves. 24. A, B, D- Pyridostigmine should be given with a small amount of food to prevent GI upset, but the patient should wait to eat a full meal due to the potential for aspiration. If difficulty with swallowing occurs, the patient should seek immediate attention. The dose can change on a day-to-day basis depending on the patient’s manifestations. Taking the drug on an empty stomach is not related although the patient needs to eat within 45 to 60 minutes afterwards. The patient’s urine will not turn reddish- orange while on this drug. 25. A, C, D, E- Possible pharmacologic treatment for Bell’s palsy includes acyclovir, famciclovir, prednisone, and valacyclovir. Carbamazepine is an anticonvulsant and mood-stabilizing drug and is not used for Bell’s palsy. 26. B, D, E- Cutting food up into smaller bites makes it easier for the patient to chew and swallow. Thickened liquids help prevent aspiration. The UAP can weigh the patient, but this does not help nutrition; however, it can demonstrate improvement. The nurse assesses the gag reflex and monitors laboratory values. 27. A, B, E- Improving mobility and strength involves the collaborative assistance of occupational therapy, physical therapy, and speech therapy. While support groups, social work, or chaplain referrals may be needed, they do not help with mobility. 28. A- These manifestations indicate Cushing’s syndrome, a potentially life-threatening increase in intracranial pressure (ICP), which is an emergency. Immediate medical attention is necessary, so the nurse notifies the provider or the Rapid Response Team. Increasing fluids would increase the ICP. The patient does not need a breathing treatment or pain medication. 29. A- A 2-point decrease in the Glasgow Coma Scale score is clinically significant and the nurse needs to see this patient first. An improvement in the score is a good sign. Amnesia is an expected finding with