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Neurological NCLEX Questions with Simplified
Solution
1. B. CN II and CN III: The nurse is caring for a patient who suttered 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
2. 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.
3. 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.
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B. Take a deep breath and exhale.
C. Describe the view from his window.
D. Touch his nose with his left index finger.
4. 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)
5. 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."
6. 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?
4 / 24 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.
10. 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
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E. Keeping serum cholesterol levels under control
11. 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
12. 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.
13. 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."
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C. Heterotopic ossification
D. Increased intracranial pressure (ICP)
17. 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
18. 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
19. 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.)
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A. Tinnitus
B. Diarrhea
C. Ottorhea
D. Battle sign
E. Chvostek sign
20. Al
ert 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
21. 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?
10 / 24 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.
23. 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."
24. 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
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D. 1 week before menstruation
25. 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.
26. 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
27. 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
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30. 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
31. 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
32. 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?
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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."
33. 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
34. 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
35. C. Inability to maintain own airway: Interventions to prevent which problem are the priority for
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B. Uncontrolled pain
C. Inability to maintain own airway
D. Decreased functional ability and mobility
36. 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 sutter from exaggerated and bizarre ettects from a variety of drugs.
D. Because the patient's MG medication, selegiline (Eldepryl), needs to be carefully monitored for patient reactions.
37. 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)
38. 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
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B. Promotion of rest
C. Reduction of fever
D. Prevention complications
39. 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. Diflculty swallowing
40. 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 ad- vances.: 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.
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C. "I should eat lightly for the remainder of the day."
D. " I should rest quietly for the remainder of the day."
43. D. increasing temperature, decreasing pulse, decreasing respirations, in-
creasing 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
44. 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
45. 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
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B. isometric exercises
C. coughing vigorously
D. exhaling during repositioning
46. 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
47. 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
48. 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
