NSG403100 NEURO NCLEX LATEST QUESTIONS & ANSWERS BEST GUARANTEED 2022\2023 RATED A+, Exams of Neurology

Download NSG403100 NEURO NCLEX LATEST QUESTIONS & ANSWERS BEST GUARANTEED 2022\2023 RATED A+ and more Exams Neurology in PDF only on Docsity! 1 [Date] NSG403100 NEURO NCLEX LATEST 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?  • 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. 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 NSG403 100 NEURO NCLEX LATEST EXAM Reposition the client to avoid neck flexion 2. Rapid Dilantin administration can cause cardiac 2 [Date] 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 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 swallowing • Guaiac-positive stools • Hematuria 6. After a hypophysectomy, vasopressin is given IM for which of the following reasons? 3. 2. Frequent 5 [Date] • Increasing temperature, increasing pulse, increasing respirations, decreasing blood pressure. • respirations, • Decreasing temperature, decreasing pulse, increasing respirations, decreasing blood pressure. • Decreasing temperature, increasing pulse, decreasing respirations, increasing blood pressure. 13. The nurse is evaluating the status of a client who had a craniotomy 3 days ago. The nurse would suspect the client is developing meningitis as a complication of surgery if the client exhibits:  • A negative Kernig’s sign • Absence of nuchal rigidity • A Glascow Coma Scale score of 15 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: • Tolerate the pain • Decrease the perception of pain  Increasing temperature, decreasing pulse, decreasing increasing blood pressure. A positive Brudzinski’s sign Escape the source of pain 6 [Date] • 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  • 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?  • 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  infection • Fractured clavicle Keeping extraneous noise to a minimum Hemorrhagic skin rash Middle ear 7 [Date] • Septic arthritis 1 0 [Date] 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  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? Put the client in the high-Fowler’s 1 1 [Date] • Absent corneal reflex • Decerebrate posturing • Movement of only the right or left half of the body  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  • 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.”  water.” The need for mechanica l ventilation Hypertension and bradycardia “Clean the meatus with soap and 1 2 [Date] 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? • 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 1 5 [Date] 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:  • 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  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: • A flattened abdomen  • Hyperactive bowel sounds Desmopressin (DDAVP, Stimate) Epidural Hematest positive nasogastric tube drainage 1 6 [Date] • 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  • 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  • 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 Limiting bladder catheterization to once every 12 hours Moving the client quickly as one unit 1 7 [Date] • Logrolling the client on a firm mattress  Logrolling the client on a soft mattress  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? • Positive reflexes  Hyperreflexia  • 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 Placing the client on a Stryker Inability to elicit a Babinski’s reflex 2 0 [Date] 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  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  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 Call the physician while another nurse checks the vital signs Elevating the head of the bed to 30 2 1 [Date] • 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 postictal behaviors for all seizures.  • 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. B.Balance and equilibrium. C.Visual acuity. D.Thinking and reasoning. Administer phenytoin (Dilantin) 200 mg PO daily. Body temperature control. 2 2 [Date] 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) 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. D.Elevate the head of his bed. 54. When obtaining the health history from a male client with retinal detachment, the nurse expects the client to report: A. C. Perform a lumbar puncture . Light flashes and floaters in front of the eye. 2 5 [Date] 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. 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. C.I nhibiting the action of carbonic anhydrase. Assessing the left leg Decreasing leukocyte infiltration at the site of ocular inflammation. 2 6 [Date] 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 D. Temperature of 99.2° F (37.3° C) 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. C.I nstilling 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? C. Urin e retention or incontinence Instilling one drop of pilocarpine 0.25% into both eyes four times daily. 2 7 [Date] A.The client leaves the side rails down. B. 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.Dystroph ic Helicopod D. Steppage 66. A client, age 22, is admitted with bacterial meningitis. Which hospital room would be the best choice for this client? A. A private room down the hall from the nurses’ station nurses’ station C. A semi private room with a 32-year-old client who has viral meningitis D. A two-bed room with a client who previously had bacterial meningitis 67. A physician diagnoses a client with myasthenia gravis, prescribing pyridostigmine (Mestinon), 60 mg P.O. every 3 hours. Before administering this The client uses a mirror to inspect the skin. C. B. An isolation room three doors from the 3 0 [Date] A. Impaired physica l mobility 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. 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. D.Shining a bright light into the pupil. B. Ineffective treatment of spasticity associated with spinal cord lesions. Turning the client’s head suddenly while holding the eyelids open. 3 1 [Date] 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. 76. A male client is color blind. The nurse understands that this client has a problem with: A.Rods. B. . C.Lens. D.Aqueous humor. 77. A female client who was trapped inside a car for hours after a headon 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 Pancuronium and succinylcholine both require cautious administration. Cones 3 2 [Date] 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. 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. 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: Vision changes Call the physician immediately. 3 5 [Date] 86. Which of the following signs and symptoms of increased ICP after head trauma would appear first? 1.Bradycardia 2.Large amounts of very dilute urine confusion 4. Widened pulse pressure 87. Problems with memory and learning would relate to which of the following lobes? 1.Frontal 2.Occipital 3.Parietal 4. Temporal 88. While cooking, your client couldn’t feel the temperature of a hot oven. Which lobe could be dysfunctional? 1.Frontal 2.Occipit al Parietal 4. Temporal 3. Restlessness and 3. 3 6 [Date] 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  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?  • 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)  Na i l bed pressure Evaluate urine specific gravity Methylprednisolone (Solu-Medrol) 3 7 [Date] • 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  93. A client with a cervical spine injury has Gardner-Wells tongs inserted for which of the following reasons? • To hasten wound healing  • To prevent autonomic dysreflexia • To hold bony fragments of the skul l 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 every 2 to 4 hours • Perform a straight catheterization every 8 hours while awake Raise the head of the bed immediately to 90 degrees To immobilize the cervical spine 2. Schedule intermittent catheterization