Nurselabs Neurological Practice Exam with Answers (169 Solved Questions)

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Nurselabs Neurological Practice Exam with Answers (169 Solved Questions) - Page 1 preview image

1. An 18-year-old client is admitted with a closed headinjury sustained in a MVA. His intracranial pressure(ICP)showsanupwardtrend.Whichinterventionshould the nurse perform first?A. Reposition the client to avoid neck flexion.B. Administer 1 g Mannitol IV as ordered.C. Increase the ventilator’s respiratory rate to 20breaths/minute.D. Administer 100 mg of pentobarbital IV as ordered.2.Aclientwithasubarachnoidhemorrhageisprescribed a 1,000-mg loading dose of Dilantin IV.Whichconsiderationismostimportantwhenadministering this dose?A.Therapeuticdruglevelsshouldbemaintainedbetween 20 to 30 mg/ml.B.RapidDilantinadministrationcancausecardiac arrhythmias.C. Dilantin should be mixed in dextrose in waterbefore administration.D. Dilantin should be administered through an IVcatheter in the client’s hand.3. A client with head trauma develops a urine output of300ml/hr,dryskin,anddrymucousmembranes.Which of the following nursing interventions is themost appropriate to perform initially?A. Evaluate urine specific gravity.B. Anticipate treatment for renal failure.C.Provideemollientstotheskintopreventbreakdown.D. Slow down the IV fluids and notify the physician.4.Whenevaluatingan ABGfromaclientwithasubdural hematoma, the nurse notes the PaCO2 is 30mmHg.Whichofthefollowingresponsesbestdescribes this result?A. Appropriate; lowering carbon dioxide (CO2)reduces intracranial pressure (ICP).B. Emergent; the client is poorly oxygenated.C. NormalD. Significant; the client has alveolar hypoventilation.5.Aclientwhohadatranssphenoidalhypophysectomyshouldbewatchedcarefullyforhemorrhage, which may be shown by which of thefollowing signs?A. Bloody drainage from the earsB. Frequent swallowingC. Guaiac-positive stoolsD. Hematuria6. After a hypophysectomy, vasopressin is given IMfor which of the following reasons?A. To treat growth failure.B. To prevent syndrome of inappropriate antidiuretichormone (SIADH).C. To reduce cerebral edema and lower intracranialpressure.D.Toreplaceantidiuretichormone(ADH)normally secreted by the pituitary.7. A client comes into the ER after hitting his head inanMVA.He’salertandoriented.Whichofthefollowing nursing interventions should be done first?A. Assess full ROM to determine extent of injuries.B. Call for an immediate chest x-ray.C. Immobilize the client’s head and neck.D.Opentheairwaywiththehead-tilt-chin-liftmaneuver.8. A client with a C6 spinal injury would most likelyhave which of the following symptoms?A. AphasiaB. HemiparesisC. ParaplegiaD. Tetraplegia9. A 30-year-old was admitted to the progressive careunit with a C5 fracture from a motorcycle accident.Whichofthefollowingassessmentswouldtakepriority?A. Bladder distensionB. Neurological deficitC. Pulse ox readingsD. The client’s feelings about the injury10.WhileintheER,aclientwithC8tetraplegiadevelops a blood pressure of 80/40, pulse 48, and RRof18.Thenursesuspectswhichofthefollowingconditions?A. Autonomic dysreflexiaB. Hemorrhagic shockC. Neurogenic shockD. Pulmonary embolism11. A client is admitted with a spinal cord injury at thelevel of T12. He has limited movement of his upperextremities. Which of the following medications wouldbe used to control edema of the spinal cord?A. acetazolamide (Diamox)B. furosemide (Lasix)C. methylprednisolone (Solu-Medrol)D. sodium bicarbonate12.A22-year-oldclientwithquadriplegiaisapprehensive and flushed, with a blood pressure of210/100 and a heart rate of 50 bpm. Which of thefollowing nursing interventions should be done first?A. Place the client flat in bed.B. Assess patency of the indwelling urinary catheter.C. Give one SL nitroglycerin tablet.D. Raise the head of the bed immediately to 90degrees.13. A client with a cervical spine injury has Gardner-Wellstongsinsertedforwhichofthefollowingreasons?A. To hasten wound healing.B. To immobilize the cervical spine.C. To prevent autonomic dysreflexia.D. To hold bony fragments of the skull together.14. Which of the following interventions describes anappropriatebladderprogramforaclientinrehabilitation for spinal cord injury?lOMoARcPSD|13778330

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Nurselabs Neurological Practice Exam with Answers (169 Solved Questions) - Page 2 preview image

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A. Insert an indwelling urinary catheter to straightdrainage.B. Schedule intermittent catheterization every 2to 4 hours.C. Perform a straight catheterization every 8 hourswhile awake.D. Perform Crede’s maneuver to the lower abdomenbefore the client voids.15. A client who is admitted to the ER for head traumaisdiagnosedwithanepiduralhematoma.Theunderlyingcauseofepiduralhematomaisusuallyrelated to which of the following conditions?A. Laceration of the middle meningeal artery.B. Rupture of the carotid artery.C. Thromboembolism from a carotid artery.D. Venous bleeding from the arachnoid space.16. A 23-year-old client has been hit on the head witha baseball bat. The nurse notes clear fluid drainingfrom his ears and nose. Which of the following nursinginterventions should be done first?A. Position the client flat in bed.B. Check the fluid for dextrose with a dipstick.C. Suction the nose to maintain airway patency.D. Insert nasal and ear packing with sterile gauze.17. When discharging a client from the ER after Anintervalwhenthe client’s speechis garbled.headtrauma, the nurse teaches the guardian to observe fora lucid interval. Which of the following statements bestdescribes a lucid interval?A. An interval when the client’s speech is garbled.B. An interval when the client is alert but can’t recallrecent events.C. An interval when the client is oriented but thenbecomes somnolent.D.Anintervalwhentheclienthasa“warning”symptom, such as an odor or visual disturbance.18. Which of the following clients on the rehab unit ismost likely to develop autonomic dysreflexia?A. A client with a brain injury.B. A client with a herniated nucleus pulposus.C. A client with a high cervical spine injury.D. A client with a stroke.19. Which of the following conditions indicates thatspinalshockisresolvinginaclientwithC7quadriplegia?A. Absence of pain sensation in chestB. SpasticityC. Spontaneous respirationsD. Urinary continence20. A nurse assesses a client who has episodes ofautonomicdysreflexia.Whichofthefollowingconditions can cause autonomic dysreflexia?A. HeadacheB. Lumbar spinal cord injuryC. Neurogenic shockD. Noxious stimuli21. During an episode of autonomic dysreflexia inwhichtheclientbecomeshypertensive,thenurseshould perform which of the following interventions?A. Elevate the client’s legs.B. Put the client flat in bed.C. Put the client in Trendelenburg's position.D. Put the client in the high-Fowler’s position.22. A client with a T1 spinal cord injury arrives at theemergency department with a BP of 82/40, pulse 34,dry skin, and flaccid paralysis of the lower extremities.Which of the following conditions would most likely besuspected?A. Autonomic dysreflexiaB. HypervolemiaC. Neurogenic shockD. Sepsis23. A client has a cervical spine injury at the level ofC5. Which of the following conditions would the nurseanticipate during the acute phase?A. Absent cornealreflex.A. Absent corneal reflex.B. Decerebrate posturing.C. Movement of only the right or left half of the body.D. The need for mechanical ventilation.24.AclientwithC7quadriplegiaisflushedandanxiousandcomplainsofapoundingheadache.Whichofthefollowingsymptomswouldalsobeanticipated?A. Decreased urine output or oliguriaB. Hypertension and bradycardiaC. Respiratory depressionD. Symptoms of shock25. A 40-year-old paraplegic must perform intermittentcatheterization of the bladder. Which of the followinginstructions should be given?A. “Clean the meatus from back to front.”B. “Measure the quantity of urine.”C. “Gently rotate the catheter during removal.”D. “Clean the meatus with soap and water.”26. An 18-year-old client was hit in the head with abaseball during practice. When discharging him to thecareofhismother,thenursegiveswhichofthefollowing instructions?A. “Watch him for a keyhole pupil the next 24 hours.”B. “Expect profuse vomiting for 24 hours after theinjury.”C.“Wakehimeveryhourandassesshisorientation to person, time, and place.”D.“Notifythe physicianimmediatelyifhehasaheadache.”27. Which neurotransmitter is responsible for many ofthe functions of the frontal lobe?A. DopamineB. GABAC. HistamineD. NorepinephrinelOMoARcPSD|13778330

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Nurselabs Neurological Practice Exam with Answers (169 Solved Questions) - Page 4 preview image

28.Thenurseisdiscussingthepurposeofanelectroencephalogram(EEG)withthefamilyofaclient with massive cerebral hemorrhage and loss ofconsciousness.Itwouldbemostaccurateforthenurse to tell family members that the test measureswhich of the following conditions?A. Extent of intracranial bleeding.B. Sites of brain injury.C. Activity of the brain.D. Percent of functional brain tissue.29. A client arrives at the ER after slipping on a patchof ice and hitting her head. A CT scan of the headshows a collection of blood between the skull andduramater.Whichtypeofheadinjurydoesthisfinding suggest?A. Subdural hematomaB. Subarachnoid hemorrhageC. Epidural hematomaD. Contusion30. After falling 20’, a 36-year-old man sustains a C6fracturewithspinalcordtransaction.Whichotherfindings should the nurse expect?A. Quadriplegia with gross arm movement anddiaphragmatic breathing.B. Quadriplegia and loss of respiratory function.C. Paraplegia with intercostal muscle loss.D. Loss of bowel and bladder control.31. A 20-year-old client who fell approximately 30’ isunresponsive and breathless. A cervical spine injury issuspected. How should the first-responder open theclient’s airway for rescue breathing?A. By inserting a nasopharyngeal airway.B. By inserting an oropharyngeal airway.C. By performing a jaw thrust maneuver.D. By performing the head-tilt, chin-lift maneuver.32. The nurse is caring for a client with a T5 completespinal cord injury. Upon assessment, the nurse notesflushed skin, diaphoresis above the T5, and a bloodpressureof162/96.Theclientreportsasevere,pounding headache. Which of the following nursinginterventionswouldbeappropriateforthisclient?Select all that apply.A. Elevate the HOB to 90 degrees.B. Loosen constrictive clothing.C. Use a fan to reduce diaphoresis.D.Assessforbladderdistentionandbowelimpaction.E. Administer antihypertensive medication.F. Place the client in a supine position with legselevated.33. The client with a head injury has been urinatingcopious amounts of dilute urine through the Foleycatheter. The client’s urine output for the previous shiftwas 3000 ml. The nurse implements a new physicianorder to administer:A. desmopressin (DDAVP, Stimate)B. Dexamethasone (Decadron)B. Dexamethasone (Decadron) C. ethacrynic acid(Edecrin)D. mannitol (Osmitrol)34.ThenurseiscaringfortheclientintheERfollowing a head injury. The client momentarily lostconsciousnessatthetimeoftheinjuryandthenregained it. The client now has lost consciousnessagain. The nurse takes quick action, knowing this iscompatible with:A. Skull fractureB. ConcussionC. Subdural hematomaD. Epidural hematoma35. The nurse is caring for a client who suffered aspinal cord injury 48 hours ago. The nurse monitorsfor GI complications by assessing for:A. A flattened abdomen.B. Hematest positive nasogastric tube drainage.C. Hyperactive bowel sounds.D. A history of diarrhea.36. A clientwithaspinalcordinjuryispronetoexperiencing autonomic dysreflexia. The nurse wouldavoid which of the following measures to minimize therisk of recurrence?A. Strict adherence to a bowel retraining program.B. Limiting bladder catheterization to once every12 hours.C. Keeping the linen wrinkle-free under the client.D. Preventing unnecessary pressure on the lowerlimbs.37. The nurse is planning care for the client in spinalshock. Which of the following actions would be leasthelpful in minimizing the effects of vasodilation belowthe level of the injury?A. Monitoring vital signs before and during positionchanges.B. Using vasopressor medications as prescribed.C. Moving the client quickly as one unit.D. Applying Teds or compression stockings.38. The nurse is caring for a client admitted withspinal cord injury. The nurse minimizes the risk ofcompounding the injury most effectively by:A. Keeping the client on a stretcher.B. Logrolling the client on a firm mattress.C. Logrolling the client on a soft mattress.D. Placing the client on a Stryker frame.39. The nurse is evaluating neurological signs of themale client in spinal shock following spinal cord injury.Whichofthefollowingobservationsbythenurseindicates that spinal shock persists?A. Positive reflexesB. HyperreflexiaC. Inability to elicit a Babinski’s reflex.D. Reflex emptying of the bladder.40. A client is at risk for increased ICP. Which of thefollowing would be a priority for the nurse to monitor?lOMoARcPSD|13778330

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A. Unequal pupil sizeB. Decreasing systolic blood pressureC. TachycardiaD. Decreasing body temperature41. Which of the following respiratory patterns indicateincreasing ICP in the brain stem?A. Slow, irregular respirationsB. Rapid, shallow respirationsC. Asymmetric chest expansionD. Nasal flaring42. Which of the following nursing interventions isappropriate for a client with an ICP of 20 mm Hg?A. Give the client a warming blanket.B. Administer low-dose barbiturate.C. Encourage the client to hyperventilate.D. Restrict fluids.43. A client has signs of increased ICP. Which of thefollowing is an early indicator of deterioration in theclient’s condition?A. Widening pulse pressureB. Decrease in the pulse rateC. Dilated, fixed pupilD. Decrease in LOC44. A client who is regaining consciousness after acraniotomy becomes restless and attempts to pull outher IV line. Which nursing intervention protects theclient without increasing her ICP?A. Place her in a jacket restraint.B. Wrap her hands in soft “mitten” restraints.C. Tuck her arms and hands under the draw sheet.D. Apply a wrist restraint to each arm.45.Whichofthefollowingdescribesdecerebrateposturing?A. Internal rotation and adduction of arms with flexionof elbows, wrists, and fingers.B.Backhunchedover,rigidflexionofallfourextremities with supination of arms and plantar flexionof the feet.C. Supination of arms, dorsiflexion of feet.D.Backarched;rigidextensionofallfourextremities.46. A client receiving vent-assisted mode ventilationbegins to experience cluster breathing after recentintracranial occipital bleeding. Which action would bemost appropriate?A. Count the rate to be sure the ventilations are deepenough to be sufficient.B. Call the physician while another nurse checksthevitalsignsandascertainsthepatient’sGlasgow Coma score.C. Call the physician to adjust the ventilator settings.D. Check deep tendon reflexes to determine the bestmotor response.47. In planning the care for a client who has had aposterior fossa (infratentorial) craniotomy, which of thefollowingiscontraindicatedwhenpositioningtheclient?A. Keeping the client flat on one side or the other.B. Elevating the head of the bed to 30 degrees.C. Logrolling or turning as a unit when turning.D. Keeping the head in a neutral position.48. A client has been pronounced brain dead. Whichfindings would the nurse assess? Select all that apply.A. Decerebrate posturingB. Dilated nonreactive pupilsC. Deep tendon reflexesD. Absent corneal reflex49. A 23-year-oldpatientwitharecenthistoryofencephalitis is admitted to the medical unit with newonsetgeneralizedtonic-clonicseizures.Whichnursing activities included in the patient’s care will bebesttodelegatetoanLPN/LVNwhomyouaresupervising?A.Documenttheonsettime,natureofseizureactivity, and postictal behaviors for all seizures.B. Administer phenytoin (Dilantin) 200 mg POdaily.C. Teach the patient about the need for good oralhygiene.D. Developa discharge plan,includingphysicianvisits and referral to the Epilepsy Foundation.1.ToencourageadequatenutritionalintakeforafemaleclientwithAlzheimer’sdisease,thenurseshould: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.2.Thenurseisperformingamentalstatusexaminationonamaleclientdiagnosedwithasubdural hematoma. This test assesses which of thefollowing?A. Cerebellar functionB. Intellectual functionC. Cerebral functionD. Sensory function3. Shortly after admission to an acute care facility, amale client with a seizure disorder develops statusepilepticus. The physician orders diazepam (Valium)10 mg I.V. stat. How soon can the nurse administertheseconddoseofdiazepam,ifneededandprescribed?A. In 30 to 45 secondsB. In 10 to 15 minutesC. In 30 to 45 minutesD. In 1 to 2 hours4. A femaleclientcomplainsofperiorbitalaching,tearing, blurred vision, and photophobia in her righteye.Ophthalmologicexaminationrevealsasmall,lOMoARcPSD|13778330

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