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NCLEX RN NEUROLOGICAL DISORDERS QUESTIONS AND
ANSWERS RATED A+ UPDATE 2025/
NB: EACH QUESTION HAS THE ANSWER PROVIDED ABOVE IT
a. A 60-year-old patient with right-sided weakness who has an infusion of tPA prescribed
After receiving a change-of-shift report on the following four patients, which patient should the nurse see first?
a. A 60-year-old patient with right-sided weakness who has an infusion of tPA prescribed
b. A 50-year-old patient who has atrial fibrillation and a new order for warfarin (Coumadin)
c. A 40-year-old patient who experienced a transient ischemic attack yesterday who has a dose of aspirin due
d. A 30-year-old patient with a subarachnoid hemorrhage 2 days ago who has nimodipine (Nimotop) scheduled
a. Administer IV 5% hypertonic saline.
A male patient who has possible cerebral edema has a serum sodium level of 116 mEq/L (116 mmol/L) and a decreasing level of consciousness (LOC). He is now complaining of a headache. Which prescribed interventions should the nurse implement first?
a. Administer IV 5% hypertonic saline.
b. Draw blood for arterial blood gases (ABGs).
c. Send patient for computed tomography (CT).
d. Administer acetaminophen (Tylenol) 650 mg orally.
a. Apply intermittent pneumatic compression stockings.
A 40-year-old patient has a ruptured cerebral aneurysm and subarachnoid hemorrhage. Which intervention will be included in the care plan?
a. Apply intermittent pneumatic compression stockings.
b.Assist to dangle on edge of bed and assess for dizziness.
c. Encourage patient to cough and deep breathe every 4 hours.
d. Insert an oropharyngeal airway to prevent airway obstruction.
A. Ask family members about the patient's health history.
When admitting an acutely confused 20-year-old patient with a head injury, which action should the nurse take?
a. Ask family members about the patient's health history.
b. Ask leading questions to assist in obtaining health data.
c. Wait until the patient is better oriented to ask questions.
d. Obtain only the physiologic neurologic assessment data.
a. ask questions that the patient can answer with "yes" or "no."
A female patient who had a stroke 24 hours ago has expressive aphasia. The nurse identifies the nursing diagnosis of impaired verbal communication. An appropriate nursing intervention to help the patient communicate is to
a. ask questions that the patient can answer with "yes" or "no."
b. develop a list of words that the patient can read and practice reciting.
c. have the patient practice her facial and tongue exercises with a mirror.
d. prevent embarrassing the patient by answering for her if she does not respond.
A) Assessing the patient's blood pressure
A patient who suffered a T6 lesion during a spinal cord injury (SCI) 10 days ago is progressing with treatment and rehabilitation following the immediate treatment of his injury. When preparing to help the physical therapist mobilize the patient for the first time since the injury, the nurse should prioritize which of the following assessments?
A) Assessing the patient's blood pressure
B) Monitoring the patient's cognition
C) Monitoring the patient's pain level
D) Assessing the patient's respiratory rate
a. assess the patient for a possible head injury.
The nurse observes a patient ambulating in the hospital hall when the patient's arms and legs suddenly jerk and the patient falls to the floor. The nurse will first
c. Blood pressure 148/78, pulse 112, respirations 28
d. Blood pressure 110/70, pulse 120, respirations 30
A) By assessing according to the Glasgow Coma Scale (GCS)
A neurological nurse is conducting a scheduled assessment of a patient who is receiving care on the unit. The nurse is aware of the need to conduct a vigilant assessment of the patient's level of consciousness (LOC). How should the nurse best gauge a patient's LOC?
A) By assessing according to the Glasgow Coma Scale (GCS)
B) By eliciting the patient's response to a question requiring judgment
C) By engaging the patient in a conversation, if possible
D) By observing the patient's interactions with caregivers
A) Cardiac and respiratory status
A patient who just suffered a hemorrhagic stroke is brought to the emergency department by ambulance. What should be the nurse's primary assessment focus?
A) Cardiac and respiratory status
B) Seizure activity
C) Urinary output
D) Fluid and electrolyte balance
a. Catheterize patient every 3 to 4 hours.
Following a cauda equina spinal cord injury, which action will the nurse include in the plan of care?
a. Catheterize patient every 3 to 4 hours.
b. Assist patient to ambulate several times daily.
c. Administer medications to reduce bladder spasm.
d. Stabilize the neck when repositioning the patient.
a. Check oxygen saturation.
A 68-year-old male patient is brought to the emergency department (ED) by ambulance after being found unconscious on the bathroom floor by his spouse. Which action will the nurse take first?
a. Check oxygen saturation.
b. Assess pupil reaction to light.
c. Verify Glasgow Coma Scale (GCS) score.
d. Palpate the head for hematoma or bony irregularities.
A) Computed tomography (CT)
D) Magnetic resonance imaging (MRI)
A middle-aged male has been brought to the emergency department by ambulance after being found unconscious by police with injuries consistent with an assault. Injuries on the man's face and skull necessitate prompt assessment for traumatic brain injury. What neuroimaging tests are best able to yield clinically meaningful data? Select all that apply.
A) Computed tomography (CT)
B) Radiographs (X-ray)
C) Positron emission tomography (PET)
D) Magnetic resonance imaging (MRI)
E) Doppler ultrasound
A) Difficulty speaking
A patient admitted with a stroke is coming to the unit from the emergency department. The nurse assigned to care for the new patient knows that what assessment finding is indicative of a stroke?
A) Difficulty speaking
B) Increase in heart rate
C) Facial edema
D) Electrolyte imbalance
A patient has been undergoing rehabilitation for the past 3 weeks following a hemorrhagic stroke. The nurse has observed that the patient is motivated to perform his activities of daily living independently, but rarely attempts tasks with his affected arm. How should the nurse address this observation with the patient?
A) "Even though it requires a huge effort, using your affected arm will help you build its strength."
B) "I've noticed that you're being very conscientious about protecting your affected arm, which is very important."
C) "If you don't push through the challenge of using your affected arm again it might never recover."
D) "You should be doing a lot more with your affected arm and a lot less with your strong arm."
A) Excess fluid volume
A patient is being treated in hospital for St. Louis encephalitis. When planning this patient's care, the nurse should be aware that this specific variant of encephalitis creates a potential for what nursing diagnosis?
A) Excess fluid volume
B) Risk for deficient fluid volume
C) Imbalanced nutrition: less than body requirements
D) Risk for unstable blood glucose
a. Focal
A patient reports feeling numbness and tingling of the left arm before experiencing a tonic-clonic seizure. The nurse determines that this history is consistent with what type of seizure?
a. Focal
b. Atonic
c. Absence
d. Myoclonic
A) Hyperthermia
The nurse is caring for a patient with increased intracranial pressure (ICP) caused by a traumatic brain injury. Which of the following clinical manifestations would indicate that the patient is experiencing increased brain compression causing brainstem damage?
A) Hyperthermia
B) Tachycardia
C) Hypertension
D) Bradypnea
A) Impaired gas exchange
A 55-year-old male patient has been admitted to the hospital with a gastrointestinal bleed, and the patient has just experienced a generalized seizure that may be attributable to alcohol withdrawal. When providing immediate care during the patient's seizure, what nursing diagnosis should be prioritized?
A) Impaired gas exchange
B) Acute pain
C) Acute confusion
D) Risk for impaired skin integrity
A) Inadequate action of acetylcholine
A middle-aged woman has just received word that her recent diagnostic testing has resulted in a diagnosis of myasthenia gravis. The nurse who is contributing to this woman's care should be aware that she is experiencing signs and symptoms that are the result of what pathophysiological process?
A) Inadequate action of acetylcholine
B) Nerve demyelination
C) Decreased levels of dopamine
D) Loss of upper and lower motor neurons
a. Inspect the oral mucosa.
A patient has been taking phenytoin (Dilantin) for 2 years. Which action will the nurse take when evaluating for adverse effects of the medication?
a. Inspect the oral mucosa.
A. Loosening restrictive clothing
B. Restraining the client's limbs
C. Removing the pillow and raising the side rails
D. Positioning the client to the side, if possible, with the head flexed forward
E. Keeping the curtain around the client and room door open so when helps arrives they can quickly enter to assist.
A) Maintain consistent, predictable routines whenever possible.
After suffering a fall, an 81-year-old woman with Alzheimer's disease (AD) is being treated in the hospital. Which of the following measures should be implemented in an effort to support the patient's cognitive function?
A) Maintain consistent, predictable routines whenever possible.
B) Provide an engaging, high-stimulation environment.
C) Establish clear consequences for aggressive behavior.
D) Ensure that the patient has a different care provider each day.
A) Males between ages 16 and 30
A public health nurse has formed a partnership with an advocacy group that acts on behalf of individuals who have experienced spinal cord injuries (SCIs). Health promotion efforts are being planned with a knowledge that the incidence of SCIs varies widely between demographic groups. What population has the highest incidence of spinal cord injuries?
A) Males between ages 16 and 30
B) Children between ages 3 and 12
C) Adults older than 70 years
D) Females in their 20s
a. "MS symptoms may be worse after the pregnancy."
A 31-year-old woman who has multiple sclerosis (MS) asks the nurse about risks associated with pregnancy. Which response by the nurse is accurate?
a. "MS symptoms may be worse after the pregnancy."
b. "Women with MS frequently have premature labor."
c. "MS is associated with an increased risk for congenital defects."
d. "Symptoms of MS are likely to become worse during pregnancy."
A) Older adults tend to have a blunted pain sensation, so complaints should be followed-up promptly.
A 77-year-old female patient who is recovering in the hospital from a total knee replacement has rung her call bell and told the nurse that she needs pain medication. When assessing the patient's pain, what principle should the nurse bear in mind?
A) Older adults tend to have a blunted pain sensation, so complaints should be followed-up promptly.
B) Older adults frequently confuse pain with other tactile sensations.
C) Pain in older adults is often unrelated to physical harm or pathophysiological processes.
D) The sensation of pain increases with age, so older adults typically feel more pain for a longer period than younger patients.
A. Padding the side rails of the bed
B. Placing an airway at the bedside
E. Placing oxygen and suction equipment at the bedside
F. Flushing the IV catheter to ensure that the site is patent
The nurse is instituting seizure precautions for a client who is being admitted from the emergency department. Which measures should the nurse include in planning for the client's safety? Select all that apply
A. Padding the side rails of the bed
B. Placing an airway at the bedside
C. Placing the bed in the high position
D. Putting a padded tongue blade at the head of the bed
E. Placing oxygen and suction equipment at the bedside
F. Flushing the IV catheter to ensure that the site is patent
a. Patient with myasthenia gravis who is reporting increased muscle weakness
B) Ensuring that he adheres to the prescribed treatment regimen before being discharged home
C) Helping him establish therapeutic relationships with people who have had similar injuries
D) Allowing him to receive care in a setting that is less institutional than a hospital
A) Respiratory function
A community health nurse is performing a home visit to a patient with amyotrophic lateral sclerosis (ALS). The nurse should prioritize assessments related to which of the following?
A) Respiratory function
B) Potential skin breakdown
C) Cardiac function
D) Cognition
a. risk for injury related to denial of deficits and impulsiveness.
For a patient who had a right hemisphere stroke the nurse establishes a nursing diagnosis of
a. risk for injury related to denial of deficits and impulsiveness.
b. impaired physical mobility related to right-sided hemiplegia.
c. impaired verbal communication related to speech-language deficits.
d. ineffective coping related to depression and distress about disability.
a. Short-term memory
A college athlete is seen in the clinic 6 weeks after a concussion. Which assessment information will the nurse collect to determine whether a patient is developing postconcussion syndrome?
a. Short-term memory
b. Muscle coordination
c. Glasgow Coma Scale
d. Pupil reaction to light
a. Side-rail pads
c. Oxygen mask
d. Suction tubing
A 27-year-old patient who has been treated for status epilepticus in the emergency department will be transferred to the medical nursing unit. Which equipment should the nurse have available in the patient's assigned room (select all that apply)?
a. Side-rail pads
b. Tongue blade
c. Oxygen mask
d. Suction tubing
e. Urinary catheter
f. Nasogastric tube
a. Start the ordered PRN oxygen at 6 L/min.
A hospitalized 31-year-old patient with a history of cluster headache awakens during the night with a severe stabbing headache. Which action should the nurse take first?
a. Start the ordered PRN oxygen at 6 L/min.
b. Put a moist hot pack on the patient's neck.
c. Give the ordered PRN acetaminophen (Tylenol).
d. Notify the patient's health care provider immediately.
A. Taking medications as scheduled
The nurse is teaching a client with myasthenia graves about the prevention of myasthenia and cholinergic crises. Which client activity suggests that teaching is most effective?
A. Taking medications as scheduled
B. Eating large, well-balanced meals
C. Doing muscle strengthening exercises
D. Doing all chores early in the day while less fatigued
d. The patient expresses anxiety about having surgery.
A) The patient should perform frequent physical activity but avoid becoming fatigued.
The nurse is liaising with the physical therapist and occupational therapist to create an activity management plan for a patient who has multiple sclerosis. What principle should be integrated into guidelines for exercise and activity that the team will provide to this patient in anticipation of discharge?
A) The patient should perform frequent physical activity but avoid becoming fatigued.
B) The patient should perform exercises that are brief but high-intensity.
C) The patient should prioritize energy conservation and remain on bed rest if possible.
D) The patient should attempt to maintain prediagnosis levels of activity and mobility.
a. The patient takes warfarin (Coumadin) daily.
When admitting a 42-year-old patient with a possible brain injury after a car accident to the emergency department (ED), the nurse obtains the following information. Which finding is most important to report to the health care provider?
a. The patient takes warfarin (Coumadin) daily.
b. The patient's blood pressure is 162/94 mm Hg.
c. The patient is unable to remember the accident.
d. The patient complains of a severe dull headache.
A) The sympathetic nervous system is a component of the peripheral nervous system (PNS).
A nurse who works in a neurological rehabilitation facility is aware of the complex structure and function of the nervous system. Which of the following statements most accurately describes an aspect of the structure of the neurological system?
A) The sympathetic nervous system is a component of the peripheral nervous system (PNS).
B) The cranial nerves and spinal nerves are components of the central nervous system (CNS).
C) The somatic nervous system consists of sympathetic and parasympathetic branches.
D) The PNS is a component of the CNS.
A) The woman's stroke has a hemorrhagic etiology.
A woman has been brought to the emergency department (ED) by her distraught husband who believes that she has had a stroke. A rapid assessment by the care team confirms that the husband's suspicions are likely accurate, and the woman is being screened for the possible administration of recombinant tissue plasminogen activator (r tPA). Which of the following factors would contraindicate the use of tPA?
A) The woman's stroke has a hemorrhagic etiology.
B) The woman is older than 80 years of age.
C) The woman has previously had a stroke.
D) The woman has hypertension and type 1 diabetes.
A. Tinnitus
The client arrives at the emergency department complaining of back spasms. The client states, "I have been taking 2 to 3 aspirin every 4 hours for the last week, and it hasn't helped my back." Since acetylsalicylic acid intoxication is suspected, the nurse should assess the client for which manifestation?
A. Tinnitus
B. Diarrhea
C. Constipation
D. Photosensitivity
a. Urinary catheter care
c. Continuous cardiac monitoring
d. Maintain a warm room temperature
e. Administration of H2 receptor blockers
When caring for a patient who experienced a T2 spinal cord transection 24 hours ago, which collaborative and nursing actions will the nurse include in the plan of care (select all that apply)?
a. Urinary catheter care
b. Nasogastric (NG) tube feeding
B) 1+
C) 2+
D) 3+
b. 11.
A 46-year-old patient with a head injury opens the eyes to verbal stimulation, curses when stimulated, and does not respond to a verbal command to move but attempts to push away a painful stimulus. The nurse records the patient's Glasgow Coma Scale score as
a. 9.
b. 11.
c. 13.
d. 15.
b. Acetaminophen (Tylenol)
A hospitalized patient complains of a bilateral headache, 4/10 on the pain scale, that radiates from the base of the skull. Which prescribed PRN medications should the nurse administer initially?
a. Lorazepam (Ativan)
b. Acetaminophen (Tylenol)
c. Morphine sulfate (Roxanol)
d. Butalbital and aspirin (Fiorinal)
B) Acyclovir (Zovirax)
A patient with herpes simplex virus (HSV) encephalitis has been admitted to the ICU. What medication would the nurse expect the health care provider to order for the treatment of this disease process?
A)Cyclosporine (Neoral)
B) Acyclovir (Zovirax)
C) Cyclobenzaprine (Flexeril)
D) Ampicillin (Principen)
B. Affect is flat, with periods of emotional lability
A client has a neurological deficit involving the limbic system. On assessment, which finding is specific to this type of deficit?
A. Is disoriented to person, place, and time
B. Affect is flat, with periods of emotional lability
C. Cannot recall what was eaten for breakfast today
D. Demonstrates inability to add and subtract; does not know who is the president of the US
b. Allow the family to stay with the patient and briefly explain all procedures to them.
An unconscious 39-year-old male patient is admitted to the emergency department (ED) with a head injury. The patient's spouse and teenage children stay at the patient's side and ask many questions about the treatment being given. What action is best for the nurse to take?
a. Ask the family to stay in the waiting room until the initial assessment is completed.
b. Allow the family to stay with the patient and briefly explain all procedures to them.
c. Refer the family members to the hospital counseling service to deal with their anxiety.
d. Call the family's pastor or spiritual advisor to take them to the chapel while care is given.
B) Alteration in level of consciousness (LOC)
When caring for a patient who has had a hemorrhagic stroke, close monitoring of vital signs and neurological status is imperative. What is the earliest sign of deterioration in a patient with a hemorrhagic stroke?
A) Headache
B) Alteration in level of consciousness (LOC)
C) Tonic-clonic seizures
D) Shortness of breath
b. antiparkinsonian drugs.
