Neuro Practice Questions

Question 1

A nurse is teaching a client with seizures to recognize an aura .what should the nurse instruct the client to notice as an onset of an aura ?

a . a postictal state of amnesia

b. a hallucination that occurs during a seizure activity
c. a symptom that occurs just before a seizure
d. A feeling of relaxation as a seizure begins to subside

Answer 1

c. a symptom that occurs just before a seizure

Question 2

the nurse is planning care for a client with multiple sclerosis .which problems should the nurse expect the client to experience ? select all that apply

a. visual disturbances
b. coagulations abnormalities
c. Balance problems
d. immunity compromise
e. resting tremors

Answer 2

a. visual disturbances
c. Balance problems

Question 3

Which of the following diagnostic test is contraindicated in a patient exhibiting clinical manifestations of Cushing triad ?

a. CT scan
b. MRI
c. lumbar puncture
d. cerebral angiogram

Answer 3

c. lumbar puncture

Question 4

When caring for a patient with altered level of consciousness, the nurse is preparing to test cranial nerve V. What assessment technique with the nurse used to elicit a response from cranial nerve V?

1. Palpate trapezius muscle while patient shrugs shoulders against resistance
2. administer the whisper or watch tick test
3. check for facial sensation
4. observe for symmetry of facial movements

Answer 4

check for facial sensation

Question 5

Which term refers to the inability to coordinate muscle movements, resulting in difficulty walking ?

a. agnosia
b. ataxia
c. spasticity
d. rigidity

Answer 5

b. ataxia

Question 6

A patient diagnosed with TIAS is scheduled for a carotid endarterectomy. The nurse explains that this procedure will be done to what ?

a. decreased cerebral edema
b. prevent seizure activity that is common following a TIA
c. prevent a stroke by removing arthrosclerotic plaques blocking cerebral flow

d. find out what type of stroke and the cause of the TIA

Answer 6

c. prevent a stroke by removing arthrosclerotic plaques blocking cerebral flow

Question 7

TPA ( tissue plasminogen activator ) therapy should be initiated within what time frame of an ischemic stroke to achieve the best functional outcome ?

a. 3 hours
b. 6 hours
c. 9 hours
d. 12 hours

Answer 7

a. 3 hours

Question 8

Which refers to blindness in the right or left half in the same side of the visual field in both eyes?

1. Hemianopsia
2. diplopia
3. nystagmus
4. homonymous Hemianopsia

Answer 8

homonymous Hemianopsia

Question 9

A preceptor is discussing stroke with the new nurse on the unit, what cardiac dysrhythmias with the preceptor tell the new nurse is associated with cardiogenic embolic strokes ?

1. Ventricular tachycardia
2. atrial fibrillation
3. supraventricular tachycardia
4. bundle branch block

Answer 9

atrial fibrillation

Question 10

What is indicative of a right hemisphere stroke ?

1. aphasia
2. spatial perceptional deficits
3. retrograde amnesia
4. altered intellectual ability and memory loss

Answer 10

spatial perceptional deficits

Question 11

A nurse is caring for a client with multiple sclerosis, you are performing your initial shift assessment. You know muscle spasticity. What medication would you expect to be ordered to control this manifestation ?

a. Avonex (Interferon beta -1a)
b. Baclofen (lioresal)
c. Decadron (dexamethasone )
d. luminal (phenobarbital )

Answer 11

b. Baclofen (lioresal)

Question 12

The nurse is performing an admission history of a client recovering from a stroke. Medication history reveals he has been taking the drug Clopidogrel (Plavix )

a. Epistaxis
b. abdominal distention
c. chest pain
d. orthostatic hypertension

Answer 12

a. Epistaxis

Question 13

A client with trigeminal neuralgia is brought to the emergency Department in the midst of persistent pain diazepam (valium ) is administered intravenously . the nurse anticipates that the effects of diazepam will be to decrease central neuronal activity and ?

a. block calcium channel blocker in the muscles
b. relax peripheral muscles
c. dilate the tracheobronchial structures
d. provide amnesia of the seizure episode

Answer 13

b. relax peripheral muscles

Question 14

Sinemet( carbidopa /levodopa) Is prescribed for a client with Parkinson’s disease. Which of the following would the nurse include in the teaching plan for the client about Sinemet ?

a. It is poorly absorbed if given with high fat diets
b. it must be monitored by weekly laboratory tests
c. it causes an initial euphoria followed by depression
d. it may cause a side effect of orthostatic hypertension

Answer 14

d. it may cause a side effect of orthostatic hypertension

Question 15

When administering cogentin (benztropine ) for Parkinson’s disease ,the nurse would be concerned with assessing the client for which of the following ?

1. dry mouth
2. Constipation
3. fever
4. urinary retention
5. blurred vision from constricted pupils

Answer 15

dry mouth

Constipation

urinary retention

Question 16

The client recently diagnosed with guilian Barre syndrome is drooling and having difficulty swallowing secretions .when the family asks why this occurs the nurse indicates that the cause

is ?

1. obstructed blood flow to the midbrain
2. demyelination of some cranial nerves
3. deficiency in Thiamine and Pyridoxine In the CNS
4. demyelination in a part of the central nervous systems

Answer 16

demyelination of some cranial nerves

Question 17

The nurse is admitting a client with a diagnosis of meningitis which of the nurses assessment findings support this diagnosis ? select all that apply

a. nuchal rigidity
b. severe headache
c. pill rolling tremor
d. photophobia
e. fever

Answer 17

a. nuchal rigidity
b. severe headache
d. photophobia
e. fever

Question 18

A client with a history of epilepsy has consecutive seizures lasting more than five minutes and is in regular epilepticus . which intervention should be included in the client’s immediate treatment? select all that apply

a. Administer dexamethasone intravenously
b. administer oxygen
c. prepare for immediate Defibrillation
d. continue to protect the patient from injury
e. keep the client in side-lying position

Answer 18

b. administer oxygen
d. continue to protect the patient from injury
e. keep the client in side-lying position

Question 19

A client who had a craniotomy two days earlier is receiving mannitol intravenously to decrease intracranial pressure .which diagnostic laboratory values should be monitored while the client is receiving this medication ?

1. Serum osmolarity
2. white blood cell counts
3. C reactive protein level
4. erythrocyte sedimentation rate

Answer 19

Serum osmolarity

Question 20

a client is admitted to the hospital with an activation of myasthenia’s gravis .what are appropriate nursing actions? select all that apply

1. administer an anticholinesterase drug
2. anticipate need for anticholinergic drug
3. develop a bowel training for constant diarrhea
4. encourage well balanced solid food consumption
5. teach the necessity for annual flu vaccine

Answer 20

administer an anticholinesterase drug

teach the necessity for annual flu vaccine

Question 21

The nurse is assessing a client with advanced amyotrophic lateral sclerosis . which of the following assessment findings does the nurse expect ? select all that apply

a. double vision
b. difficulty breathing
c. difficulty swallowing
d. muscle weakness
e. resting tremor

Answer 21

b. difficulty breathing
c. difficulty swallowing
d. muscle weakness

Question 22

The nurse is caring for clients diagnosed with multiple sclerosis for over 2 years which medication should the nurse question administering

a. tegretol
b. betaseron
c. Tensilon
d. gamunex

Answer 22

c. Tensilon

Question 23

The nurse is positioning the female patient with increased intracranial pressure which of the following positions with the nurse avoid ?

a. head midline
b. head turned to side
c. head of bed elevated 30 degrees
d. neck in neutral position

Answer 23

b. head turned to side

Question 24

home care nurse is performing a health screening at a local mall the nurse knows that which of the following clients is at highest risk for developing cerebral vascular accident ?

1. a 32 year old Caucasian female with history of type one diabetes mellitus and oral contraceptive use for eight years
2. a 49 year old Caucasian male who works as an accountant executive at an ad agency and has a cholesterol level of 250 mg/dl
3. a 50 year old African American female with a history of mitral valve prolapse and smoked cigarettes for 30 years
4. a 60 year old African American male with a history of hypertension and is 20 pounds overweight

Answer 24

a 50 year old African American female with a history of mitral valve prolapse and smoked cigarettes for 30 years

Question 25

a 76 year old woman is given a diagnosis of Parkinson’s disease the nurse notices the patient is ambulating with short accelerating steps the nurse should ?

1. offer the client a wheelchair
2. provide a Walker for the client to use
3. suggested the client were comfortable fitting shoes
4. teach client to walk with a broad based gait

Answer 25

teach client to walk with a broad based gait

Question 26

Which actions would the nurse perform as a part of wound care during the emergent phase of treatment for patient with partial thickness burns on the hands and legs ? select all that apply

1. administer a tetanus antitoxin
2. assess the extent in depth of the burns
3. perform blood culture two times
4. start fluid replacement with normal Saline or lactated ringer solution
5. prepare for intubation

Answer 26

administer a tetanus antitoxin

assess the extent in depth of the burns

start fluid replacement with normal Saline or lactated ringer solution

Question 27

as a home health care nurse , you plan to visit a patient with myasthenia’s gravis to help bathing and exercising. When would be the best time to visit the patient to help these tasks?

1. mid afternoon
2. mid morning
3. evening
4. before bedtime

Answer 27

mid morning

Question 28

during assessing (dolls eye movement ) in a comatose patient ,the examiner observed that the patient’s eyes turned to the left side when his head turned to the right side this finding indicates ?

1. the client is deep coma state
2. his brainstem is intact
3. cranial nerves III,IV, and VI are damaged
4. his brainstem has been affected

Answer 28

his brainstem is intact

Question 29

which components are able to change Intercranial pressure ?

select all that apply

1. cerebral blood
2. skull bone
3. brain tissue
4. scalp tissue
5. cerebrospinal fluid

Answer 29

cerebral blood

brain tissue

cerebrospinal fluid

Question 30

the client is experiencing parasympathetic response to pain. What responses should the nurse assess for ? select all that apply

a. increase blood pressure
b. Bradycardia
c. constricted pupils
d. diaphoresis
e. elevated blood glucose

Answer 30

b. Bradycardia
c. constricted pupils

Question 31

A client returns to the surgical neuro unit after an anterior cervical diskectomy and Fusion . what is the nurses first action ?

a. assess pain status
b. assess vital signs
c. check the client’s level of consciousness
d. check pupils for any dilation

Answer 31

b. assess vital signs

Question 32

a nurse is performing hourly neurological assessment checks on a client who has a craniotomy which option correctly describes the outcome if increased intracranial pressure is untreated and progresses ?

1. Displacement of the brain tissue
2. increase in cerebral circulation and perfusion
3. increase in serum pH
4. improved brain tissue oxygenation

Answer 32

1. Displacement of the brain tissue

Question 33

following an industrial accident in which the client sustained a severe craniocerebral trauma , the client develops the complication of diabetes insipidus , a nurse suspects this complication is occurring when observing which symptom

1. hyperglycemia
2. high osmolarity level in urine
3. decreased in level of consciousness
4. large amount of urine output

Answer 33

large amount of urine output

Question 34

the client who had a craniotomy two days earlier is receiving mannitol intravenously which of the following clinical manifestations indicate one of the positive outcomes of this therapy ?

1. high serum osmolarity
2. improved urine output
3. the Glasgow coma’s score is from 13 to 11
4. elevated erythrocyte sedimentation rate

Answer 34

improved urine output

Question 35

A nurse plans care for a client and notice that all the following must be completed for a client being prepared for brain injury which intervention should the nurse complete first ?

1. complete the preoperative checklist
2. perform entire neurological assessment
3. remove the clients rings ,gold chain and wrist watch
4. administer 10 mEq KCL IV for a serum potassium level of 3.0 mEq/L

Answer 35

administer 10 mEq KCL IV for a serum potassium level of 3.0 mEq/L

Question 36

A client undergoes supratentorial craniotomy with bare holes after sustaining a head injury in automobile accident. Because of the presence of Burr holes, the client is at risk for developing an infection. An early clinical manifestation of meningeal irritation is ?

1. battle sign
2. home inside
3. brundzinski’s sign
4. the plantar reflex

Answer 36

brundzinski’s sign

Question 37

a 30 year old admitted with subarachnoid hemorrhage exhibits aphasia and hemiparesis . these neurologic deficits , which may be present immediately after the sub arachnoid hemorrhage are primarily caused by :

1. blood loss
2. tissue death
3. electrolyte imbalance
4. vascular spasm

Answer 37

vascular spasm

Question 38

a construction worker falls off the roof of a two Story building and is taken to the hospital unconscious the nurse would be most concerned if the initial assessment reveals :

1. reactive pupil
2. a depressed fontanelle
3. bleeding from the ears
4. an elevated temperature

Answer 38

bleeding from the ears

Question 39

A client with basilar skull fracture was admitted to the ER . during assessment the nurse should expect the client to have ?

1. negative dolls eye movement
2. raccoon eyes
3. contralateral pupil dilation
4. instant changed level of consciousness

Answer 39

raccoon eyes