1.

A white female client is admitted

to an acute care facility with a
diagnosis of cerebrovascular
accident (CVA). Her history reveals
bronchial asthma, exogenous
obesity, and iron deficiency anemia.
Which history finding is a risk
factor for CVA?
A. Caucasian race
B. Female sex
C. Obesity
D. Bronchial asthma
2. The nurse is teaching a female
client with multiple sclerosis. When
teaching the client how to reduce
fatigue, the nurse should tell the
client to:
A. take a hot bath.
B. rest in an air-conditioned room.
C. increase the dose of muscle
relaxants.
D. avoid naps during the day.
3. A male client is having a tonicclonic seizures. What should the
nurse do first?
A. Elevate the head of the bed.
B. Restrain the clients arms and legs.
C. Place a tongue blade in the clients
mouth.
D. Take measures to prevent injury.
4. A female client with GuillainBarr syndrome has paralysis
affecting the respiratory muscles
and requires mechanical

ventilation. When the client asks the

nurse about the paralysis, how
should the nurse respond?
A. You may have difficulty
believing this, but the paralysis
caused by this disease is
temporary.
B. Youll have to accept the fact that
youre permanently paralyzeD.
However, you wont have any sensory
loss.
C. It must be hard to accept the
permanency of your paralysis.
D. Youll first regain use of your legs
and then your arms.
5. The nurse is working on a
surgical floor. The nurse must
logroll a male client following a:
A. laminectomy.
B. thoracotomy.
C. hemorrhoidectomy.
D. cystectomy.
6. A female client with a suspected
brain tumor is scheduled for
computed tomography (CT). What
should the nurse do when preparing
the client for this test?
A. Immobilize the neck before the
client is moved onto a stretcher.
B. Determine whether the client is
allergic to iodine, contrast dyes, or
shellfish.
C. Place a cap over the clients head.
D. Administer a sedative as ordered.

7. During a routine physical

examination to assess a male
clients deep tendon reflexes, the
nurse should make sure to:
A. use the pointed end of the reflex
hammer when striking the Achilles
tendon.
B. support the joint where the
tendon is being tested.
C. tap the tendon slowly and softly
D. hold the reflex hammer tightly.
8. A female client is admitted in a
disoriented and restless state after
sustaining a concussion during a
car accident. Which nursing
diagnosis takes highest priority in
this clients plan of care?
A. Disturbed sensory perception
(visual)
B. Self-care deficient:
Dressing/grooming
C. Impaired verbal communication
D. Risk for injury
9. A female client with amyotrophic
lateral sclerosis (ALS) tells the
nurse, Sometimes I feel so
frustrateD. I cant do anything
without help! This comment best
supports which nursing diagnosis?
A. Anxiety
B. Powerlessness
C. Ineffective denial
D. Risk for disuse syndrome
10. For a male client with suspected
increased intracranial pressure

(ICP), a most appropriate

respiratory goal is to:
A. prevent respiratory alkalosis.
B. lower arterial pH.
C. promote carbon dioxide
elimination.
D. maintain partial pressure of arterial
oxygen (PaO2) above 80 mm Hg
11. Nurse Mary witnesses a
neighbors husband sustain a fall
from the roof of his house. The
nurse rushes to the victim and
determines the need to opens the
airway in this victim by using which
method?
A. Flexed position
B. Head tilt-chin lift
C. Jaw thrust maneuver
D. Modified head tilt-chin lift
12. The nurse is assessing the motor
function of an unconscious male
client. The nurse would plan to use
which plan to use which of the
following to test the clients
peripheral response to pain?
A. Sternal rub
B. Nail bed pressure
C. Pressure on the orbital rim
D. Squeezing of the
sternocleidomastoid muscle
13. A female client admitted to the
hospital with a neurological
problem asks the nurse whether
magnetic resonance imaging may be
done. The nurse interprets that the

client may be ineligible for this

diagnostic procedure based on the
clients history of:
A. Hypertension
B. Heart failure
C. Prosthetic valve replacement
D. Chronic obstructive pulmonary
disorder
14. A male client is having a lumbar
puncture performeD. The nurse
would plan to place the client in
which position?
A. Side-lying, with a pillow under the
hip
B. Prone, with a pillow under the
abdomen
C. Prone, in slight-Trendelenburgs
position
D. Side-lying, with the legs pulled
up and head bent down onto chest.
15. The nurse is positioning the
female client with increased
intracranial pressure. Which of the
following positions would the nurse
avoid?
A. Head mildline
B. Head turned to the side
C. Neck in neutral position
D. Head of bed elevated 30 to 45
degrees
16. A female client has clear fluid
leaking from the nose following a
basilar skull fracture. The nurse
assesses that this is cerebrospinal
fluid if the fluid:

A. Is clear and tests negative for

glucose
B. Is grossly bloody in appearance
and has a pH of 6
C. Clumps together on the dressing
and has a pH of 7
D. Separates into concentric rings
and test positive of glucose
17. A male client with a spinal cord
injury is prone to experiencing
automatic dysreflexiA. The nurse
would avoid which of the following
measures to minimize the risk of
recurrence?
A. Strict adherence to a bowel
retraining program
B. Keeping the linen wrinkle-free
under the client
C. Preventing unnecessary pressure
on the lower limbs
D. Limiting bladder catheterization
to once every 12 hours
18. The nurse is caring for the male
client who begins to experience
seizure activity while in beD. Which
of the following actions by the nurse
would be contraindicated?
A. Loosening restrictive clothing
B. Restraining the clients limbs
C. Removing the pillow and raising
padded side rails
D. Positioning the client to side, if
possible, with the head flexed forward
19. The nurse is assigned to care for
a female client with complete right-

sided hemiparesis. The nurse plans

care knowing that this condition:
A. The client has complete bilateral
paralysis of the arms and legs.
B. The client has weakness on the
right side of the body, including the
face and tongue.
C. The client has lost the ability to
move the right arm but is able to walk
independently.
D. The client has lost the ability to
move the right arm but is able to walk
independently.
20. The client with a brain attack
(stroke) has residual dysphagiA.
When a diet order is initiated, the
nurse avoids doing which of the
following?
A. Giving the client thin liquids
B. Thickening liquids to the
consistency of oatmeal
C. Placing food on the unaffected side
of the mouth
D. Allowing plenty of time for
chewing and swallowing
21. The nurse is assessing the
adaptation of the female client to
changes in functional status after a
brain attack (stroke). The nurse
assesses that the client is adapting
most successfully if the client:
A. Gets angry with family if they
interrupt a task
B. Experiences bouts of depression
and irritability

C. Has difficulty with using modified

feeding utensils
D. Consistently uses adaptive
equipment in dressing self
22. Nurse Kristine is trying to
communicate with a client with
brain attack (stroke) and aphasiA.
Which of the following actions by
the nurse would be least helpful to
the client?
A. Speaking to the client at a slower
rate
B. Allowing plenty of time for the
client to respond
C. Completing the sentences that
the client cannot finish
D. Looking directly at the client
during attempts at speech
23. A female client has experienced
an episode of myasthenic crisis. The
nurse would assess whether the
client has precipitating factors such
as:
A. Getting too little exercise
B. Taking excess medication
C. Omitting doses of medication
D. Increasing intake of fatty foods
24. The nurse is teaching the female
client with myasthenia gravis about
the prevention of myasthenic and
cholinergic crises. The nurse tells
the client that this is most
effectively done by:
A. Eating large, well-balanced meals
B. Doing muscle-strengthening

exercises
C. Doing all chores early in the day
while less fatigued
D. Taking medications on time to
maintain therapeutic blood levels
25. A male client with Bells palsy
asks the nurse what has caused this
problem. The nurses response is
based on an understanding that the
cause is:
A. Unknown, but possibly includes
ischemia, viral infection, or an
autoimmune problem
B. Unknown, but possibly includes
long-term tissue malnutrition and
cellular hypoxia
C. Primary genetic in origin, triggered
by exposure to meningitis
D. Primarily genetic in origin,
triggered by exposure to neurotoxins
26. The nurse has given the male
client with Bells palsy instructions
on preserving muscle tone in the
face and preventing denervation.
The nurse determines that the client
needs additional information if the
client states that he or she will:
A. Exposure to cold and drafts
B. Massage the face with a gentle
upward motion
C. Perform facial exercises
D. Wrinkle the forehead, blow out the
cheeks, and whistle
27. Female client is admitted to the
hospital with a diagnosis of

Guillain-Barre syndrome. The

nurse inquires during the nursing
admission interview if the client has
history of:
A. Seizures or trauma to the brain
B. Meningitis during the last 5 years
C. Back injury or trauma to the spinal
cord
D. Respiratory or gastrointestinal
infection during the previous
month.
28. A female client with GuillainBarre syndrome has ascending
paralysis and is intubated and
receiving mechanical ventilation.
Which of the following strategies
would the nurse incorporate in the
plan of care to help the client cope
with this illness?
A. Giving client full control over care
decisions and restricting visitors
B. Providing positive feedback and
encouraging active range of motion
C. Providing information, giving
positive feedback, and encouraging
relaxation
D. Providing intravenously
administered sedatives, reducing
distractions and limiting visitors
29. A male client has an impairment
of cranial nerve II. Specific to this
impairment, the nurse would plan
to do which of the following to
ensure client to ensure client safety?

A. Speak loudly to the client

B. Test the temperature of the shower
water
C. Check the temperature of the food
on the delivery tray.
D. Provide a clear path for
ambulation without obstacles
30. A female client has a
neurological deficit involving the
limbic system. Specific to this type
of deficit, the nurse would
document which of the following
information related to the clients
behavior.
A. Is disoriented to person, place, and
time
B. Affect is flat, with periods of
emotional lability
C. Cannot recall what was eaten for
breakfast today
D. Demonstrate inability to add and
subtract; does not know who is
president
NCLEX exam questionnaire about
Degenerative Diseases and some
questions about CVA
1. 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.
2. 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. lidocaine (Xylocaine)
D. furosemide (Lasix)
3. After striking his head on a tree
while falling from a ladder, a young
man age 18 is admitted to the
emergency department. Hes
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.

4. When obtaining the health

history from a male client with
retinal 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.
5. Which nursing diagnosis takes
highest priority for a client with
Parkinsons crisis?
A. Imbalanced nutrition: Less than
body requirements
B. Ineffective airway clearance
C. Impaired urinary elimination
D. Risk for injury
6. To encourage adequate
nutritional intake for a female
client with Alzheimers 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.
7. The nurse is performing a mental
status examination on a male client

diagnosed with subdural

hematoma. This test assesses which
of the following?
A. Cerebellar function
B. Intellectual function
C. Cerebral function
D. Sensory function
8. 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 a 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
9. 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
clients 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
10. Emergency medical technicians
transport a 27-year-old iron worker
to the emergency department. They
tell the nurse, He fell from a twostory 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 hes comatose. We
intubated him and hes maintaining
an arterial oxygen saturation of
92% by pulse oximeter with a
manual-resuscitation bag. Which
intervention by the nurse has the
highest priority?

where he receives emergency care

for 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.

A. Assessing the left leg

B. Assessing the pupils
C. Placing the client in
Trendelenburgs position
D. Assessing level of consciousness

12. Nurse Amber is caring for a

client who underwent a lumbar
laminectomy 2 days ago. Which of
the following findings should the
nurse consider abnormal?

11. 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,

A. More back pain than the first

postoperative day
B. Paresthesia in the dermatomes near
the wounds

C. Urine retention or incontinence

D. Temperature of 99.2 F (37.3 C)
13. After an eye examination, a
male client is diagnosed with openangle 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.

C. The client repositions only after

being reminded to do so.
D. The client hangs the left arm over
the side of the wheelchair.
15. 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
clients feet make a half circle. To
document the clients gait, the nurse
should use which term?
A. Ataxic
B. Dystrophic
C. Helicopod
D. Steppage
16. A client, age 22, is admitted with
bacterial meningitis. Which hospital
room would be the best choice for
this client?

14. A female client whos 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. A private room down the hall from

the nurses station
B. An isolation room three doors
from the nurses station
C. A semiprivate room with a 32-yearold client who has viral meningitis
D. A two-bed room with a client who
previously had bacterial meningitis

A. The client leaves the side rails

down.
B. The client uses a mirror to
inspect the skin.

17. A physician diagnoses a client

with myasthenia gravis, prescribing
pyridostigmine (Mestinon), 60 mg

P.O. every 3 hours. Before

administering this
anticholinesterase agent, the nurse
reviews the clients history. Which
preexisting condition would
contraindicate the use of
pyridostigmine?
A. Ulcerative colitis
B. Blood dyscrasia
C. Intestinal obstruction
D. Spinal cord injury
18. A female client is admitted to
the facility for investigation of
balance and coordination problems,
including possible Mnires
disease. When assessing this client,
the nurse expects to note:
A. vertigo, tinnitus, and hearing
loss.
B. vertigo, vomiting, and nystagmus
C. vertigo, pain, and hearing
impairment.
D. vertigo, blurred vision, and fever.
19. 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
10 days to help prevent ear infection.
D. Dont fly in an airplane, climb
to high altitudes, make sudden
movements, or expose yourself to
loud sounds for 30 days.
20. 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. Muscle weakness
D. Slurred speech
21. 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

22. A male client is admitted with a

cervical spine injury sustained
during a diving accident. When
planning this clients care, the nurse
should assign 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
23. 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), 2 mg
P.O. twice daily. In addition to
being used to relieve painful muscle
spasms, diazepam also is
recommended for:

the intensive care unit, the nurse

checks the clients oculocephalic
(dolls eye) response by:
A. introducing ice water into the
external auditory canal.
B. touching the cornea with a wisp of
cotton.
C. turning the clients head
suddenly while holding the eyelids
open.
D. shining a bright light into the pupil.
25. While reviewing a clients 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. 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.

A. The client may be less sensitive to

the effects of a neuromuscular
blocking agent.
B. Succinylcholine shouldnt be used;
pancuronium may be used in a lower
dosage.
C. Pancuronium shouldnt be used;
succinylcholine may be used in a
lower dosage.
D. Pancuronium and
succinylcholine both require
cautious administration.

24. A female client who was found

unconscious at home is brought to
the hospital by a rescue squaD. In

26. 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.
27. 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
C. Midbrain
D. Cortex
28. The nurse is assessing a 37-yearold 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

29. 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.
30. 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 clients 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.
NCLEX-style examination about
Neurological Disorders that covers
topics like: Meningitis, Level of
Consciousness, Seizures
1. 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)
2. 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
3. To promote osmotic diuresis to
decrease ICP
4. To draw water into the vascular
system to increase blood pressure
3. A client with subdural hematoma
was given mannitol to decrease
intracranial pressure (ICP). Which
of the following results would best
show the mannitol was effective?
1. Urine output increases
2. Pupils are 8 mm and nonreactive

3. Systolic blood pressure remains at

150 mm Hg
4. BUN and creatinine levels return to
normal
4. Which of the following values is
considered normal for ICP?
1. 0 to 15 mm Hg
2. 25 mm Hg
3. 35 to 45 mm Hg
4. 120/80 mm Hg
5. Which of the following symptoms
may occur with a phenytoin level of
32 mg/dl?
1. Ataxia and confusion
2. Sodium depletion
3. Tonic-clonic seizure
4. Urinary incontinence
6. 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
3. Restlessness and confusion
4. Widened pulse pressure
7. Problems with memory and
learning would relate to which of
the following lobes?
1. Frontal
2. Occipital

3. Parietal
4. Temporal

4. Prone, with a pillow under the

abdomen.

8. While cooking, your client

couldnt feel the temperature of a
hot oven. Which lobe could be
dysfunctional?

11. A nurse is assisting with caloric

testing of the oculovestibular reflex
of an unconscious client. Cold water
is injected into the left auditory
canal. The client exhibits eye
conjugate movements toward the
left followed by a rapid nystagmus
toward the right. The nurse
understands that this indicates the
client has:

1. Frontal
2. Occipital
3. Parietal
4. Temporal
9. The nurse is assessing the motor
function of an unconscious client.
The nurse would plan to use which
of the following to test the clients
peripheral response to pain?

1. A cerebral lesion
2. A temporal lesion
3. An intact brainstem
4. Brain death

1. Sternal rub
2. Pressure on the orbital rim
3. Squeezing the sternocleidomastoid
muscle
4. Nail bed pressure

12. The nurse is caring for the client

with increased intracranial
pressure. The nurse would note
which of the following trends in
vital signs if the ICP is rising?

10. The client is having a lumbar

puncture performed. The nurse
would plan to place the client in
which position for the procedure?

1. Increasing temperature, increasing

pulse, increasing respirations,
decreasing blood pressure.
2. Increasing temperature,
decreasing pulse, decreasing
respirations, increasing blood
pressure.
3. Decreasing temperature, decreasing
pulse, increasing respirations,
decreasing blood pressure.
4. Decreasing temperature, increasing

1. Side-lying, with legs pulled up

and head bent down onto the chest
2. Side-lying, with a pillow under the
hip
3. Prone, in a slight Trendelenburgs
position

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:
1. A positive Brudzinskis sign
2. A negative Kernigs sign
3. Absence of nuchal rigidity
4. 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:
1. Tolerate the pain
2. Decrease the perception of pain
3. Escape the source of pain
4. 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?

1. Limiting conversation with the

child
2. Keeping extraneous noise to a
minimum
3. Allowing the child to play in the
bathtub
4. Performing treatments quickly
16. Which of the following would
lead the nurse to suspect that a
child with meningitis has developed
disseminated intravascular
coagulation?
1. Hemorrhagic skin rash
2. Edema
3. Cyanosis
4. 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?
1. Bladder infection
2. Middle ear infection
3. Fractured clavicle
4. Septic arthritis
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
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 initiation of antibiotics
4. Maintain neutropenic precautions
21. A nurse is reviewing the record
of a child with increased ICP and
notes that the child has exhibited
signs of decerebrate posturing. On
assessment of the child, the nurse
would expect to note which of the
following if this type of posturing
was present?
1. Abnormal flexion of the upper
extremities and extension of the lower
extremities
2. Rigid extension and pronation of
the arms and legs
3. Rigid pronation of all extremities
4. Flaccid paralysis of all extremities
22. Which of the following
assessment data indicated nuchal
rigidity?
1. Positive Kernigs sign
2. Negative Brudzinskis sign
3. Positive homans sign
4. Negative Kernigs sign
23. Meningitis occurs as an
extension of a variety of bacterial
infections due to which of the
following conditions?

1. Congenital anatomic abnormality

of the meninges
2. Lack of acquired resistance to the
various etiologic organisms
3. Occlusion or narrowing of the CSF
pathway
4. Natural affinity of the CNS to
certain pathogens
24. Which of the following
pathologic processes is often
associated with aseptic meningitis?
1. Ischemic infarction of cerebral
tissue
2. Childhood diseases of viral
causation such as mumps
3. Brain abscesses caused by a variety
of pyogenic organisms
4. Cerebral ventricular irritation from
a traumatic brain injury
25. You are preparing to admit a
patient with a seizure disorder.
Which of the following actions can
you delegate to LPN/LVN?
1. Complete admission assessment.
2. Set up oxygen and suction
equipment.
3. Place a padded tongue blade at
bedside.
4. Pad the side rails before patient
arrives.

10-item examination about

Neurological Disorders
1. Regular oral hygiene is an
essential intervention for the client
who has had a stroke. Which of the
following nursing measures is
inappropriate when providing oral
hygiene?
1. Placing the client on the back
with a small pillow under the head.
2. Keeping portable suctioning
equipment at the bedside.
3. Opening the clients mouth with a
padded tongue blade.
4. Cleaning the clients mouth and
teeth with a toothbrush.
2. A 78 year old client is admitted to
the emergency department with
numbness and weakness of the left
arm and slurred speech. Which
nursing intervention is priority?
1. Prepare to administer recombinant
tissue plasminogen activator (rt-PA).
2. Discuss the precipitating factors
that caused the symptoms.
3. Schedule for A STAT computer
tomography (CT) scan of the head.
4. Notify the speech pathologist for an
emergency consult.
3. A client arrives in the emergency
department with an ischemic stroke

and receives tissue plasminogen

activator (t-PA) administration.
Which is the priority nursing
assessment?

1. Increased vascular permeability.

2. Vasoconstriction.
3. Dissolved emboli.
4. Prevention of hemorrhage

1. Current medications.
2. Complete physical and history.
3. Time of onset of current stroke.
4. Upcoming surgical procedures.

7. The client diagnosed with atrial

fibrillation has experienced a
transient ischemic attack (TIA).
Which medication would the nurse
anticipate being ordered for the
client on discharge?

4. During the first 24 hours after

thrombolytic therapy for ischemic
stroke, the primary goal is to
control the clients:
1. Pulse
2. Respirations
3. Blood pressure
4. Temperature
5. What is a priority nursing
assessment in the first 24 hours
after admission of the client with a
thrombotic stroke?
1. Cholesterol level
2. Pupil size and pupillary response
3. Vowel sounds
4. Echocardiogram
6. What is the expected outcome of
thrombolytic drug therapy?

1. An oral anticoagulant
medication.
2. A beta-blocker medication.
3. An anti-hyperuricemic medication.
4. A thrombolytic medication.
8. Which client would the nurse
identify as being most at risk for
experiencing a CVA?
1. A 55-year-old African American
male.
2. An 84-year-old Japanese female.
3. A 67-year-old Caucasian male.
4. A 39-year-old pregnant female.
9. Which assessment data would
indicate to the nurse that the client
would be at risk for a hemorrhagic
stroke?
1. A blood glucose level of 480 mg/dl.
2. A right-sided carotid bruit.
3. A blood pressure of 220/120

mmHg.
4. The presence of bronchogenic
carcinoma.
10. The nurse and unlicensed
assistive personnel (UAP) are
caring for a client with right-sided
paralysis. Which action by the UAP
requires the nurse to intervene?
1. The assistant places a gait belt
around the clients waist prior to

ambulating.
2. The assistant places the client on
the back with the clients head to the
side.
3. The assistant places her hand
under the clients right axilla to
help him/her move up in bed.
4. The assistant praises the client for
attempting to perform ADLs
independently.