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 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? P a g e 1 | 28  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?  Assess full ROM to determine extent of injuries  Call for an immediate chest x-ray  Immobilize the client’s head and neck  Open the airway with the head-tilt-chin-lift maneuver 8. A client with a C6 spinal injury would most likely have which of the following symptoms?  Aphasia  Hemiparesis P a g e 2 | 28  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  Septic arthritis P a g e 5 | 28 18. The nurse is assessing a child diagnosed with a brain tumor . Which of the following signs and symptoms would the nurse expect the child to demonstrate? Select all that apply. 1.Head tilt 2.Vomiting 3. Polydipsia 4. Lethargy 5. Increased appetite 6. Increased pulse 1,2,4 19. A lumbar puncture is performed on a child suspected of having bacterial meningitis. CSF is obtained for analysis. A nurse reviews the results of the CSF analysis and determines that which of the following results would verify the diagnosis? 1. Cloudy CSF, decreased protein, and decreased glucose 2. Cloudy CSF, elevated protein, and decreased glucose 3. Clear CSF, elevated protein, and decreased glucose 4. Clear CSF, decreased pressure, and elevated protein 20. A nurse is planning care for a child with acute bacterial meningitis. Based on the mode of transmission of this infection, which of the following would be included in the plan of care? 1. No precautions are required as long as antibiotics have been started 2. Maintain enteric precautions 3. Maintain respiratory isolation precautions for at least 24 hours after the P a g e 6 | 28 initiation of antibiotics 4. Maintain neutropenic precautions 21. During an episode of autonomic dysreflexia in which the client becomes hypertensive, the nurse should perform which of the following interventions?  Elevate the client’s legs  Put the client flat in bed Put the client in the Trendelenburg’s position  Put the client in the high-Fowler’s position 22 A 30-year-old was admitted to the progressive care unit with a C5 fracture from a motorcycle accident. Which of the following assessments would take priority?  Bladder distension  Neurological deficit  Pulse ox readings  The client’s feelings about the injury 23. A client has a cervical spine injury at the level of C5. Which of the following conditions would the nurse anticipate during the acute phase?  Absent corneal reflex  Decerebrate posturing  Movement of only the right or left half of the body  The need for mechanical ventilation 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? P a g e 7 | 28 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 shift was 3000 ml. The nurse implements a new physician order to administer:  Desmopressin (DDAVP, Stimate)  Dexamethasone (Decadron)  Ethacrynic acid (Edecrin)  Mannitol (Osmitrol) 34. The nurse is caring for the client in the ER following a head injury. The client momentarily lost consciousness at the time of the injury and then regained it. The client now has lost consciousness again. The nurse takes quick action, knowing this is compatible with:  Skull fracture  Concussion  Subdural hematoma  Epidural hematoma 35. The nurse is caring for a client who suffered a spinal cord injury 48 hours ago. The nurse monitors for GI complications by assessing for: P a g e 10 | 28  A flattened abdomen  Hematest positive nasogastric tube drainage  Hyperactive bowel sounds  A history of diarrhea 36. A client with a spinal cord injury is prone to experiencing autonomic dysreflexia. The nurse would avoid which of the following measures to minimize the risk of recurrence?  Strict adherence to a bowel retraining program  Limiting bladder catheterization to once every 12 hours  Keeping the linen wrinkle-free under the client  Preventing unnecessary pressure on the lower limbs 37. The nurse is planning care for the client in spinal shock. Which of the following actions would be least helpful in minimizing the effects of vasodilation below the level of the injury?  Monitoring vital signs before and during position changes  Using vasopressor medications as prescribed  Moving the client quickly as one unit  Applying Teds or compression stockings. 38. The nurse is caring for a client admitted with spinal cord injury. The nurse minimizes the risk of compounding the injury most effectively by:  Keeping the client on a stretcher  Logrolling the client on a firm mattress  Logrolling the client on a soft mattress  Placing the client on a Stryker frame 39. The nurse is evaluating neurological signs of the male client in spinal shock following spinal cord injury. Which of the following observations by the nurse indicates that spinal shock persists? P a g e 11 | 28  Positive reflexes  Hyperreflexia  Inability to elicit a Babinski’s reflex  Reflex emptying of the bladder 40. A client with a spinal cord injury suddenly experiences an episode of autonomic dysreflexia. After checking the client’s vital signs, list in order of priority, the nurse’s actions (Number 1 being the first priority and number 5 being the last priority).  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 P a g e 12 | 28 behaviors for all seizures.  Administer phenytoin (Dilantin) 200 mg PO daily.  Teach patient about the need for good oral hygiene.  Develop a discharge plan, including physician visits and referral to the Epilepsy Foundation. 51. If a male client experienced a cerebrovascular accident (CVA) that damaged the hypothalamus, the nurse would anticipate that the client has problems with: A. Body temperature control. B. Balance and equilibrium. C. Visual acuity. D. Thinking and reasoning. 52. A female client admitted to an acute care facility after a car accident develops signs and symptoms of increased intracranial pressure (ICP). The client is intubated and placed on mechanical ventilation to help reduce ICP. To prevent a further rise in ICP caused by suctioning, the nurse anticipates administering which drug endotracheally before suctioning? A. Phenytoin (Dilantin) B. Mannitol (Osmitrol) C. Lidocain e (Xylocaine) D. Furosemide (Lasix) 53. After striking his head on a tree while falling from a ladder, a young man age 18 is admitted to the emergency department. He’s unconscious and his pupils are nonreactive. Which intervention would be the most dangerous for the client? A. Give him a barbiturate. B. Place him on mechanical ventilation. C. Perform a lumbar puncture . D. Elevate the head of his bed. 54. When obtaining the health history from a male client with retinal P a g e 15 | 28 detachment, the nurse expects the client to report: A. Light flashes and floaters in front of the eye. B. A recent driving accident while changing lanes. C. Headaches, nausea, and redness of the eyes. D. Frequent episodes of double vision. 55. Which nursing diagnosis takes highest priority for a client with Parkinson’s crisis? A. Imbalanced nutrition : Less than body requirements B. Ineffective airway clearance C. Impaired urinary elimination D. Risk for injury 56. To encourage adequate nutritional intake for a female client with Alzheimer’s disease, the nurse should: A. Stay with the client and encourage him to eat. B. Help the client fill out his menu. C. Give the client privacy during meals. D. Fill out the menu for the client. 57. The nurse is performing a mental status examination on a male client diagnosed with a subdural hematoma. This test assesses which of the following? A. Cerebellar function B. Intellectual 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? P a g e 16 | 28 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 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 P a g e 17 | 28 C. Vertigo, pain, and hearing impairment. D. Vertigo, blurred vision, and fever. 69. A male client with a conductive hearing disorder caused by ankylosis of the stapes in the oval window undergoes a stapedectomy to remove the stapes and replace the impaired bone with a prosthesis. After the stapedectomy, the nurse should provide which client instruction? A. “Lie in bed with your head elevated, and refrain from blowing your nose for 24 hours.” B. “Try to ambulate independently after about 24 hours.” C. “Shampoo your hair every day for ten (10) days to help prevent ear infection.” D. “Don’t fly in an airplane, climb to high altitudes, make sudden movements, or expose yourself to loud sounds for 30 days.” 70. Nurse Marty is monitoring a client for adverse reactions to dantrolene (Dantrium). Which adverse reaction is most common? A. Excessive tearing B. Urine retention C. Muscl e weakness D. Slurred speech 71. The nurse is monitoring a male client for adverse reactions to atropine sulfate (Atropine Care) eyedrops. Systemic absorption of atropine sulfate through the conjunctiva can cause which adverse reaction? A. Tachycardia B. Increased salivation C. Hypotension D. Apnea 72. A male client is admitted with a cervical spine injury sustained during a diving accident. When planning this client’s care, the nurse should assign the P a g e 20 | 28 highest priority to which nursing diagnosis? A. Impaired physical mobility B. Ineffective breathing pattern 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 21 | 28 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? A. Sit with the client for a few minutes. B. Administer an analgesic. C. Inform the nurse manager . D. Call the physician immediately. P a g e 22 | 28 2. Occipital 3. Parietal 4. Temporal 89. The nurse is assessing the motor function of an unconscious client. The nurse would plan to use which of the following to test the client’s peripheral response to pain?  Sternal rub  Pressure on the orbital rim  Squeezing the sternocleidomastoid muscle  Nai l bed pressure 90. . A client with head trauma develops a urine output of 300 ml/hr, dry skin, and dry mucous membranes. Which of the following nursing interventions is the most appropriate to perform initially?  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 P a g e 25 | 28  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? 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 P a g e 26 | 28 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  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 P a g e 27 | 28