NSG403 100 NEURO NCLEX LATEST EXAM QUESTIONS & ANSWERS BEST GUARANTEED 2022-2023 RATED A+, Exams of Neurology

Download NSG403 100 NEURO NCLEX LATEST EXAM QUESTIONS & ANSWERS BEST GUARANTEED 2022-2023 RATED A+ and more Exams Neurology in PDF only on Docsity! CONFIDENTIAL NSG403 100 NEURO NCLEX LATEST EXAM QUESTIONS & ANSWERS BEST GUARANTEED 2022-2023 RATED A+ 1. An 18-year-old client is admitted with a closed head injury sustained in a MVA. His intracranial pressure (ICP) shows an upward trend. Which intervention should the nurse perform first?  Reposition the client to avoid neck flexion  Administer 1 g Mannitol IV as ordered  Increase the ventilator’s respiratory rate to 20 breaths/minute  Administer 100 mg of pentobarbital IV as ordered. 2. A client with a subarachnoid hemorrhage is prescribed a 1,000-mg loading dose of Dilantin IV. Which consideration is most important when administering this dose? 1. Therapeutic drug levels should be maintained between 20 to 30 mg/ml. 2. Rapid Dilantin administration can cause cardiac arrhythmias.  Dilantin should be mixed in dextrose in water before administration. • Dilantin should be administered through an IV catheter in the client’s hand. 3 While in the ER, a client with C8 tetraplegia develops a blood pressure of 80/40, pulse 48, and RR of 18. The nurse suspects which of the following conditions? 1. Autonomic dysreflexia 2.Hemorrhagic P a g e 1 | 32 shock 3. Neurogenic shock 4. Pulmonary embolism  When evaluating an ABG from a client with a subdural hematoma, the nurse notes the PaCO2 is 30 mm Hg. Which of the following responses best describes this result?  Appropriate; lowering carbon dioxide (CO2) reduces intracranial pressure (ICP).  Emergent; the client is poorly oxygenated.  Normal  Significant; the client has alveolar hypoventilation.  A client who had a transsphenoidal hypophysectomy should be watched carefully for hemorrhage, which may be shown by which of the following signs?  Bloody drainage from the ears 2. Frequent swallowing  Guaiac-positive stools  Hematuria 6. After a hypophysectomy, vasopressin is given IM for which of the following reasons?  To treat growth failure  To prevent syndrome of inappropriate antidiuretic hormone (SIADH)  To reduce cerebral edema and lower intracranial pressure  To replace antidiuretic hormone (ADH) normally secreted by the pituitary. 7. A client comes into the ER after hitting his head in an MVA. He’s alert and oriented. Which of the following nursing interventions should be done first? P a g e 2 | 32 14. A client is arousing from a coma and keeps saying, “Just stop the pain.” The nurse responds based on the knowledge that the human body typically and automatically responds to pain first with attempts to: P a g e 5 | 32  Tolerate the pain  Decrease the perception of pain  Escape the source of pain  Divert attention from the source of pain. 15. During the acute stage of meningitis, a 3-year-old child is restless and irritable. Which of the following would be most appropriate to institute?  Limiting conversation with the child  Keeping extraneous noise to a minimum  Allowing the child to play in the bathtub  Performing treatments quickly 16. Which of the following would lead the nurse to suspect that a child with meningitis has developed disseminated intravascular coagulation?  Hemorrhagic skin rash  Edema  Cyanosis  Dyspnea on exertion 17. When interviewing the parents of a 2-year-old child, a history of which of the following illnesses would lead the nurse to suspect pneumococcal meningitis?  Bladde r infection  Middle ear infection  Fractured clavicle P a g e 6 | 32  Septic arthritis P a g e 7 | 32 24. A client with C7 quadriplegia is flushed and anxious and complains of a pounding headache. Which of the following symptoms would also be anticipated?  Decreased urine output or oliguria  Hypertension and bradycardia  Respiratory depression  Symptoms of shock 25. A 40-year-old paraplegic must perform intermittent catheterization of the bladder. Which of the following instructions should be given?  “Clean the meatus from back to front.”  “Measure the quantity of urine.”  “Gently rotate the catheter during removal.”  “Clean the meatus with soap and water.” 26. An 18-year-old client was hit in the head with a baseball during practice. When discharging him to the care of his mother, the nurse gives which of the following instructions?  “Watch him for keyhole pupil the next 24 hours.”  “Expect profuse vomiting for 24 hours after the injury.”  “Wake him every hour and assess his orientation to person, time, and place.”  “Notify the physician immediately if he has a headache.” 27. Which neurotransmitter is responsible for may of the functions of the frontal lobe? P a g e 10 | 32  Dopamine  GABA  Histamine  Norepinephrine 28. The nurse is discussing the purpose of an electroencephalogram (EEG) with the family of a client with massive cerebral hemorrhage and loss of consciousness. It would be most accurate for the nurse to tell family members that the test measures which of the following conditions?  Extent of intracranial bleeding  Sites of brain injury  .Activity of the brain  Percent of functional brain tissue 29. A client arrives at the ER after slipping on a patch of ice and hitting her head. A CT scan of the head shows a collection of blood between the skull and dura mater. Which type of head injury does this finding suggest?  Subdural hematoma  Subarachnoid hemorrhage  Epidural hematoma  Contusion 30. After falling 20’, a 36-year-old man sustains a C6 fracture with spinal cord transaction. Which other findings should the nurse expect?  Quadriplegia with gross arm movement and diaphragmatic breathing P a g e 11 | 32  Quadriplegia and loss of respiratory function  Paraplegia with intercostal muscle loss  Loss of bowel and bladder control 31. A 20-year-old client who fell approximately 30’ is unresponsive and breathless. A cervical spine injury is suspected. How should the first- responder open the client’s airway for rescue breathing?  By inserting a nasopharyngeal airway  By inserting a oropharyngeal airway  By performing a jaw-thrust maneuver  By performing the head-tilt, chin-lift maneuver 32. The nurse is caring for a client with a T5 complete spinal cord injury. Upon assessment, the nurse notes flushed skin, diaphoresis above the T5, and a blood pressure of 162/96. The client reports a severe, pounding headache. Which of the following nursing interventions would be appropriate for this client? Select all that apply. 1.Elevate the HOB to 90 degrees 2.Loosen constrictive clothing 3.Use a fan to reduce diaphoresis 4.Assess for bladder distention and bowel impaction 5.Administer antihypertensive medication 6.Place the client in a supine position with legs elevated 1,2,4,5 33. The client with a head injury has been urinating copious amounts of dilute urine through the Foley catheter. The client’s urine output for the previous P a g e 12 | 32  Check for bladder distention  Raise the head of the bed  Contact the physician  Loosen tight clothing on the client  Administer an antihypertensive medication 2,4,1,3,5 41. A client is at risk for increased ICP. Which of the following would be a priority for the nurse to monitor?  Unequal pupil size  Decreasing systolic blood pressure  Tachycardia  Decreasing body temperature 42. Which of the following respiratory patterns indicate increasing ICP in the brain stem?  Slow, irregular respirations  Rapid, shallow respirations  Asymmetric chest expansion  Nasal flaring 43. Which of the following nursing interventions is appropriate for a client with an ICP of 20 mm Hg?  Give the client a warming blanket  Administer low-dose barbiturate  Encourage the client to hyperventilate  Restrict fluids P a g e 15 | 32 44. A client has signs of increased ICP. Which of the following is an early indicator of deterioration in the client’s condition?  Widening pulse pressure  Decrease in the pulse rate  Dilated, fixed pupil  Decrease in LOC 45. A client who is regaining consciousness after a craniotomy becomes restless and attempts to pull out her IV line. Which nursing intervention protects the client without increasing her ICP?  Place her in a jacket restraint  Wrap her hands in soft “mitten” restraints  Tuck her arms and hands under the draw sheet  Apply a wrist restraint to each arm 46. Which of the following describes decerebrate posturing?  Internal rotation and adduction of arms with flexion of elbows, wrists, and fingers  Back hunched over, rigid flexion of all four extremities with supination of arms and plantar flexion of the feet  Supination of arms, dorsiflexion of feet  Back arched; rigid extension of all four extremities. 47. A client receiving vent-assisted mode ventilation begins to experience cluster breathing after recent intracranial occipital bleeding. Which action would be most appropriate?  Count the rate to be sure the ventilations are deep enough to be sufficient P a g e 16 | 32  Call the physician while another nurse checks the vital signs and ascertains the patient’s Glasgow Coma score.  Call the physician to adjust the ventilator settings.  Check deep tendon reflexes to determine the best motor response 48. In planning the care for a client who has had a posterior fossa (infratentorial) craniotomy, which of the following is contraindicated when positioning the client?  Keeping the client flat on one side or the other  Elevating the head of the bed to 30 degrees  Log rolling or turning as a unit when turning  Keeping the head in neutral position 49. A client has been pronounced brain dead. Which findings would the nurse assess? Check all that apply.  Decerebrate posturing  Dilated nonreactive pupils  Deep tendon reflexes  Absent corneal reflex 2,3,4 50. A 23-year-old patient with a recent history of encephalitis is admitted to the medical unit with new onset generalized tonic-clonic seizures. Which nursing activities included in the patient’s care will be best to delegate to an LPN/LVN whom you are supervising?  Document the onset time, nature of seizure activity, and P a g e 17 | 32 function C. Cerebral function D. Sensory function 58. Shortly after admission to an acute care facility, a male client with a seizure disorder develops status epilepticus. The physician orders diazepam (Valium) 10 mg I.V. stat. How soon can the nurse administer the second dose of diazepam, if needed and prescribed? A. In 30 to 45 seconds B. In 10 to 15 minutes C. In 30 to 45 minutes D. In 1 to 2 hours 59. A female client complains of periorbital aching, tearing, blurred vision, and photophobia in her right eye. Ophthalmologic examination reveals a small, irregular, nonreactive pupil — a condition resulting from acute iris inflammation (iritis). As part of the client’s therapeutic regimen, the physician prescribes atropine sulfate (Atropisol), two drops of 0.5% solution in the right eye twice daily. Atropine sulfate belongs to which drug classification? A. Parasympathomimetic agent B. Sympatholytic agent C.Adrenergic blocker D. Cholinergic blocker 60. Emergency medical technicians transport a 27-year-old iron worker to the emergency department. They tell the nurse, “He fell from a two- story building. He has a large contusion on his left chest and a hematoma in the left parietal area. He has a compound fracture of his left P a g e 20 | 32 femur and he’s comatose. We intubated him and he’s maintaining an arterial oxygen saturation of 92% by pulse oximeter with a manual resuscitation bag.” Which intervention by the nurse has the highest priority? A. Assessing the left leg B. Assessing the pupils C. Placing the client in Trendelenburg’s position D. Assessing level of consciousness 61. An auto mechanic accidentally has battery acid splashed in his eyes. His coworkers irrigate his eyes with water for 20 minutes, and then take him to the emergency department of a nearby hospital, where he receives emergency care for the corneal injury. The physician prescribes dexamethasone (Maxidex Ophthalmic Suspension), two drops of 0.1% solution to be instilled initially into the conjunctival sacs of both eyes every hour; and polymyxin B sulfate (Neosporin Ophthalmic), 0.5% ointment to be placed in the conjunctival sacs of both eyes every 3 hours. Dexamethasone exerts its therapeutic effect by: A. Increasing the exudative reaction of ocular tissue. B. Decreasing leukocyte infiltration at the site of ocular inflammation. C. Inhibiting the action of carbonic anhydrase. D. Producing a miotic reaction by stimulating and contracting the sphincter muscles of the iris. 62. Nurse Amber is caring for a client who underwent a lumbar laminectomy two (2) days ago. Which of the following findings should the nurse consider abnormal? A. More back pain than the first postoperative day B. Paresthesia in the dermatomes near the wounds C. Urin e retention or incontinence D. Temperature of 99.2° F (37.3° C) P a g e 21 | 32 63. After an eye examination, a male client is diagnosed with open- angle glaucoma. The physician prescribes Pilocarpine ophthalmic solution (Pilocar), 0.25% gtt i, OU q.i.D. Based on this prescription, the nurse should teach the client or a family member to administer the drug by: A. Instilling one drop of pilocarpine 0.25% into both eyes daily. B. Instilling one drop of pilocarpine 0.25% into both eyes four times daily. C. Instilling one drop of pilocarpine 0.25% into the right eye daily. D. Instilling one drop of pilocarpine 0.25% into the left eye four times daily. 64. A female client who’s paralyzed on the left side has been receiving physical therapy and attending teaching sessions about safety. Which behavior indicates that the client accurately understands safety measures related to paralysis? A. The client leaves the side rails down. B. The client uses a mirror to inspect the skin. C. The client repositions only after being reminded to do so. D. The client hangs the left arm over the side of the wheelchair. 65. A male client in the emergency department has a suspected neurologic disorder. To assess gait, the nurse asks the client to take a few steps; with each step, the client’s feet make a half circle. To document the client’s gait, the nurse should use which term? A. Ataxic B. Dystrophi c C. Helicopod D. Steppage 66. A client, age 22, is admitted with bacterial meningitis. Which P a g e 22 | 32 C. Disturbed sensory perception (tactile) D. Self-care deficit : Dressing/grooming 73. A male client has a history of painful, continuous muscle spasms. He has taken several skeletal muscle relaxants without experiencing relief. His physician prescribes diazepam (Valium), two (2) mg P.O. twice daily. In addition to being used to relieve painful muscle spasms, Diazepam also is recommended for: A. long-term treatment of epilepsy. B. postoperative pain management of laminectomy clients. C. postoperative pain management of diskectomy clients D. treatment of spasticity associated with spinal cord lesions. 74. A female client who was found unconscious at home is brought to the hospital by a rescue squaD. In the intensive care unit, the nurse checks the client’s oculocephalic (doll’s eye) response by: A. Introducing ice water into the external auditory canal. B. Touching the cornea with a wisp of cotton. C. Turning the client’s head suddenly while holding the eyelids open. D. Shining a bright light into the pupil. 75. While reviewing a client’s chart, the nurse notices that the female client has myasthenia gravis. Which of the following statements about neuromuscular blocking agents is true for a client with this condition? A. The client may be less sensitive to the effects of a neuromuscular blocking agent. B. Succinylcholine shouldn’t be used; pancuronium may be used in a lower dosage. C. Pancuronium shouldn’t be used; succinylcholine may be used in a lower dosage. D. Pancuronium and succinylcholine both require cautious administration. P a g e 25 | 32 76. A male client is color blind. The nurse understands that this client has a problem with: A. Rods. B. Cones. C. Lens. D. Aqueous humor. 77. A female client who was trapped inside a car for hours after a head- on collision is rushed to the emergency department with multiple injuries. During the neurologic examination, the client responds to painful stimuli with decerebrate posturing. This finding indicates damage to which part of the brain? A. Diencephalon B. Medulla C. Midbrain D. Cortex 78. The nurse is assessing a 37-year-old client diagnosed with multiple sclerosis. Which of the following symptoms would the nurse expect to find? A. Vision changes B. Absent deep tendon reflexes C. Tremors at rest D. Flaccid muscles 79. The nurse is caring for a male client diagnosed with a cerebral aneurysm who reports a severe headache. Which action should the nurse perform? P a g e 26 | 32 A. Sit with the client for a few minutes. B. Administer an analgesic. C. Inform the nurse manager . D. Call the physician immediately. 80. During recovery from a cerebrovascular accident (CVA), a female client is given nothing by mouth, to help prevent aspiration. To determine when the client is ready for a liquid diet, the nurse assesses the client’s swallowing ability once each shift. This assessment evaluates: A. Cranial nerves I and II. B. Cranial nerves III and V. C. Cranial nerves VI and VIII. D. Cranial nerves IX and X. 81. A client admitted to the hospital with a subarachnoid hemorrhage has complaints of severe headache, nuchal rigidity, and projectile vomiting. The nurse knows lumbar puncture (LP) would be contraindicated in this client in which of the following circumstances? 1. Vomiting continues 2. Intracranial pressure (ICP) is increased 3. The client needs mechanical ventilation 4. Blood is anticipated in the cerebrospinal fluid (CSF) 82. A client with a subdural hematoma becomes restless and confused, with dilation of the ipsilateral pupil. The physician orders mannitol for which of the following reasons? 1. To reduce intraocular pressure 2. To prevent acute tubular necrosis P a g e 27 | 32  Evaluate urine specific gravity  Anticipate treatment for renal failure  Provide emollients to the skin to prevent breakdown  Slow down the IV fluids and notify the physician 91. A client is admitted with a spinal cord injury at the level of T12. He has limited movement of his upper extremities. Which of the following medications would be used to control edema of the spinal cord?  Acetazolamide (Diamox)  Furosemide (Lasix)  Methylprednisolone (Solu-Medrol)  Sodium bicarbonate 92. A 22-year-old client with quadriplegia is apprehensive and flushed, with a blood pressure of 210/100 and a heart rate of 50 bpm. Which of the following nursing interventions should be done first?  Place the client flat in bed  Assess patency of the indwelling urinary catheter  Give one SL nitroglycerin tablet  Raise the head of the bed immediately to 90 degrees 93. A client with a cervical spine injury has Gardner-Wells tongs inserted for which of the following reasons?  To hasten wound healing  To immobilize the cervical spine  To prevent autonomic dysreflexia  To hold bony fragments of the skull together 94. Which of the following interventions describes an appropriate bladder program for a client in rehabilitation for spinal cord injury? P a g e 30 | 32 1. Insert an indwelling urinary catheter to straight drainage 2. Schedule intermittent catheterization every 2 to 4 hours  Perform a straight catheterization every 8 hours while awake  Perform Crede’s maneuver to the lower abdomen before the client voids. 95. A client is admitted to the ER for head trauma is diagnosed with an epidural hematoma. The underlying cause of epidural hematoma is usually related to which of the following conditions?  Laceration of the middle meningeal artery  Rupture of the carotid artery  Thromboembolism from a carotid artery  Venous bleeding from the arachnoid space 96. A 23-year-old client has been hit on the head with a baseball bat. The nurse notes clear fluid draining from his ears and nose. Which of the following nursing interventions should be done first?  Position the client flat in bed  Check the fluid for dextrose with a dipstick  Suction the nose to maintain airway patency  Insert nasal and ear packing with sterile gauze 97 . When discharging a client from the ER after a head trauma, the nurse teaches the guardian to observe for a lucid interval. Which of the following statements best described a lucid interval?  An interval when the client’s speech is garbled P a g e 31 | 32  An interval when the client is alert but can’t recall recent events  An interval when the client is oriented but then becomes somnolent  An interval when the client has a “warning” symptom, such as an odor or visual disturbance. 98. Which of the following clients on the rehab unit is most likely to develop autonomic dysreflexia?  A client with a brain injury  A client with a herniated nucleus pulposus 3. A client with a high cervical spine injury 4. A client with a stroke 99. Which of the following conditions indicates that spinal shock is resolving in a client with C7 quadriplegia?  Absence of pain sensation in chest  Spasticity  Spontaneous respirations  Urinary continence 100. A nurse assesses a client who has episodes of autonomic dysreflexia. Which of the following conditions can cause autonomic dysreflexia?  Headache  Lumbar spinal cord injury  Neurogenic shock  Noxious stimuli P a g e 32 | 32