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NCLEX RN Exam – Neurological Disorders

1. The nurse is assisting with caring for a client after a craniotomy. Which is the best position for the client to be placed?
2. The nurse is caring for a client following a supratentorial craniotomy, in which a large tumor was removed from the left side. In which position can the nurse safely place the client? Refer to Figures.
3. A client with a seizure disorder is being admitted to the hospital. Which should the nurse plan to implement for this client? Select all that apply
4. The nurse is caring for a client with increased intracranial pressure (ICP). Which change in vital signs would occur if ICP is rising?
5. The nurse observes the unlicensed assistive personnel (UAP) positioning the client with increased intracranial pressure (ICP). Which position would require intervention by the nurse?
6. The client recovering from a head injury is arousable and participating in care. The nurse determines that the client understands measures to prevent elevations in intracranial pressure (ICP) if the nurse observes the client doing which activity?
7. The client has clear fluid leaking from the nose after a basilar skull fracture. The nurse determines that this is cerebrospinal fluid (CSF) if the fluid meets which criteria?
8. The client is admitted to the hospital for observation with a probable minor head injury after an automobile crash. The nurse expects the cervical collar will remain in place until which time?
9. The client was seen and treated in the emergency department (ED) for a concussion. Before discharge, the nurse explains the signs/symptoms of a worsening condition. The nurse determines that the family needs further teaching if they state they will return to the ED if the client experiences which sign/symptom?
10. The nurse is caring for a client who has undergone craniotomy with a supratentorial incision. The nurse should plan to place the client in which position postoperatively?
11. The client with a cervical spine injury has Crutchfield tongs applied in the emergency department. The nurse should perform which essential action when caring for this client?
12. The nurse has provided discharge instructions to a client with an application of a halo device. The nurse determines that the client needs further teaching if which statement is made?
13. The nurse is caring for the client who has suffered spinal cord injury. The nurse further monitors the client for signs of autonomic dysreflexia and suspects this complication if which sign/symptom is noted?
14. The client with spinal cord injury is prone to experiencing autonomic dysreflexia. The least appropriate measure to minimize the risk of autonomic dysreflexia is which action?
15. The client with spinal cord injury suddenly experiences an episode of autonomic dysreflexia. After checking vital signs, which immediate action should the nurse take?
16. The nurse is assigned to care for an adult client who had a stroke and is aphasic. Which interventions should the nurse use for communicating with the client? Select all that apply.
17. The nurse is admitting a client with Guillain-Barré syndrome to the nursing unit. The client has an ascending paralysis to the level of the waist. Knowing the complications of the disorder, the nurse should bring which items into the client’s room?
18. The nurse is caring for a client with an intracranial aneurysm who was previously alert. Which finding should be an early indication that the level of consciousness (LOC) is deteriorating?
19. The nurse is planning to put aneurysm precautions in place for the client with a cerebral aneurysm. Which item should be included as part of the precautions?
20. The nurse is caring for a client who begins to experience seizure activity while in bed. Which action by the nurse would be contraindicated?
21. The nurse is planning care for the client with hemiparesis of the right arm and leg. Where should the nurse plan to place objects needed by the client?
22. The nurse is reinforcing instructions to the family of a stroke client who has homonymous hemianopsia about measures to help the client overcome the deficit. The nurse determines that the family understands the measures to use if they state that they will do which?
23. A client has experienced an episode of myasthenic crisis. The nurse collects data to determine whether the client has experienced which precipitating factor?
24. A client with Parkinson’s disease is embarrassed about the symptoms of the disorder and is bored and lonely. The nurse should plan which approach as therapeutic in assisting the client to cope with the disease?
25. The nurse has given suggestions to the client with trigeminal neuralgia about strategies to minimize episodes of pain. The nurse determines that the client needs further teaching if the client made which statement?
26. A client has an impairment of cranial nerve II. Specific to this impairment, the nurse plans to do which to ensure client safety?
27. The nurse is monitoring a client with a blunt head injury sustained from a motor vehicle crash. Which would indicate a basal skull fracture as a result of the injury?
28. A client has a cerebellar lesion. The nurse determines that the client is adapting successfully to this problem if the client demonstrates proper use of which item?
29. The nurse is planning care for a client who displays confusion secondary to a neurological problem. Which approach by the nurse would be least helpful in assisting this client?
30. A client with a neurological impairment experiences urinary incontinence. Which nursing action should help the client adapt to this alteration?
31. The nurse has obtained a personal and family history from a client with a neurological disorder. Which finding in the client’s history is least likely associated with a risk for neurological problems?
32. A client with right leg hemiplegia is experiencing difficulty with mobility. The nurse determines that the family needs reinforcement of teaching if the nurse observes which action by the family?
33. The nurse is preparing a client who is scheduled to have cerebral angiography performed. Which should the nurse check before the procedure?
34. A client admitted to the hospital with a neurological problem indicates to the nurse that magnetic resonance imaging (MRI) may be done. Which finding noted in the client history indicates that the client may be ineligible for this diagnostic procedure?
35. A client is somewhat nervous about having magnetic resonance imaging (MRI). Which statement by the nurse should provide reassurance to the client about the procedure?
36. The nurse is trying to help the family of an unconscious client cope with the situation. Which intervention should the nurse plan to incorporate into the care routine for the client?
37. The nurse is suctioning an unconscious client who has a tracheostomy. The nurse should avoid which action during this procedure?
38. The nurse has applied a hypothermia blanket to a client with a fever. The nurse should inspect the skin frequently to detect which complication of hypothermia blanket use?
39. The nurse is caring for an unconscious client who is experiencing persistent hyperthermia with no signs and symptoms of infection. The nurse understands that there may be damage to the client’s thermoregulatory center which is located in which part of the brain?
40. A client seeking treatment for an episode of hyperthermia is being discharged to home. The nurse determines that the client needs clarification of discharge instructions if the client makes which statement?
41. The family of an unconscious client with increased intracranial pressure is talking at the client’s bedside. They are discussing the gravity of the client’s condition and wondering if the client will ever recover. How should the nurse interpret the client’s situation?
42. The nurse is providing care to a client with increased intracranial pressure (ICP). Which approaches would be beneficial in controlling the client’s ICP from an environmental viewpoint? Select all that apply.
43. The nurse is preparing to give the postcraniotomy client medication for incisional pain. The family asks the nurse why the client is receiving codeine sulfate and not “something stronger.” The nurse should formulate a response based on which understanding of codeine?
44. The nurse reinforces home care instructions to the postcraniotomy client. Which statement by the client indicates the need for further teaching?
45. The nurse notes documentation that a postcraniotomy client is having difficulty with body image. The nurse determines that the client is still working on the postoperative outcome criteria when the client indicates which altered personal appearance?
46. A client with spinal cord injury becomes angry and belligerent whenever the nurse tries to administer care. Which is the best response by the nurse?
47. A client with a spinal cord injury expresses little interest in food and is very particular about the choice of meals that are actually eaten. How should the nurse interpret this?
48. A client who is paraplegic after spinal cord injury has been taught muscle-strengthening exercises for the upper body. The nurse determines that the client will derive the least muscle-strengthening benefit from which activity?
49. A client with diplopia has been taught to use an eye patch to promote better vision and prevent injury. The nurse determines that the client understands how to use the patch if the client states that he or she will do which?
50. The nurse is planning care for a client in spinal shock. Which action would be least helpful in minimizing the effects of vasodilation below the level of the injury?
51. The nursing instructor asks a nursing student about the points to document if the client has had a seizure. The instructor determines that the student needs to research seizures and related documentation points if the student states which assessment is important?
52. The nurse is planning to institute seizure precautions for a client who is being admitted from the emergency department. Which measure should the nurse avoid in planning for the client’s safety?
53. The nurse has given medication instructions to the client receiving phenytoin (Dilantin). The nurse determines that the client understands the instructions if the client makes which comment?
54. A client with a stroke (brain attack) has residual dysphagia. When a diet prescription is initiated, the should nurse avoid which action?
55. The nurse is trying to communicate with a stroke (brain attack) client with aphasia. Which action by the nurse would be least helpful to the client?
56. A client receives a dose of edrophonium (Enlon). The client shows improvement in muscle strength for a period of time following the injection. The nurse should interpret this finding as indicative of which disease process?
57. A client with myasthenia gravis is having difficulty speaking. The client’s speech is dysarthric and has a nasal tone. The nurse should use which communication strategies when working with this client? Select all that apply.
58. The nurse is teaching the client with myasthenia gravis about prevention of myasthenic and cholinergic crises. The nurse tells the client that this is most effectively done by which activity?
59. The nurse has instructed the client with myasthenia gravis about ways to manage his or her own health at home. The nurse determines that the client needs further teaching if the client makes which statements?
60. A client with Parkinson’s disease is experiencing a parkinsonian crisis. The nurse should immediately place the client where?
61. The nurse has given instructions to the client with Parkinson’s disease about maintaining mobility. The nurse determines that the client understands the directions if the client states that he or she will perform which activity?
62. An adult client had a cerebrospinal fluid (CSF) analysis after lumbar puncture. The nurse interprets that a negative value of which is consistent with normal findings?
63. The nurse is collecting data on a client with a diagnosis of meningitis and notes that the client is assuming this posture. (Refer to figure.) The nurse contacts the health care provider and reports that the client is exhibiting which?
64. An older gentleman is brought to the emergency department by a neighbor who heard him talking and wandering in the street at 3 am. The nurse should first determine which about the client?
65. An 84-year-old client in an acute state of disorientation was brought to the emergency department by the client’s daughter. The daughter states that this is the first time that the client experienced confusion. The nurse determines from this piece of information that which is unlikely to be the cause of the client’s disorientation?
66. A resident in a long-term care facility prepares to walk out into a rainstorm after saying, “My father is waiting to take me for a ride.” An appropriate response by the nurse is which?
67. The nurse observes that a client with Parkinson’s disease has very little facial expression. The nurse attributes this piece of data to which information?
68. The nurse overhears the term sundowning used to describe the behavior of a client newly admitted to the nursing unit during the previous evening shift. Of which diagnosis is sundowning a symptom?
69. A client in the emergency department is diagnosed with Bell’s palsy. The nurse collecting data on this client expects to note which observation?
70. An adult client with suspected meningitis has undergone lumbar puncture to obtain cerebrospinal fluid (CSF) for analysis of a bacterial infection. The nurse checks for which value indicating a bacterial infection of the CSF?
71. The nurse is monitoring a client with a head injury and notes that the client is assuming the posture shown in the figure. What is the client exhibiting that would require the nurse to notify the registered nurse immediately? Refer to the figure.
72. The nurse is assisting in caring for a client who sustained a traumatic head injury following a motor vehicle crash. The nurse documents that the client is exhibiting decerebrate posturing. The nurse bases this documentation on which observation?
73. The nurse is caring for a client diagnosed with Bell’s palsy 1 week ago. Which data would indicate a potential complication associated with Bell’s palsy?
74. The nurse is collecting data on a client suspected of having Alzheimer’s disease. The priority data should focus on which characteristic of this disease?
75. The nurse is monitoring a client with a C5 spinal cord injury for spinal shock. Which findings would be associated with spinal shock in this client? Select all that apply.
76. The nurse is ambulating a client with a known seizure disorder. The client says, “I’m seeing those flashing lights again,” then loses consciousness and develops a clonic-tonic seizure. Which would be the nurse’s initial action?
77. The nurse is collecting data on a client with myasthenia gravis. The nurse determines that the client may be developing myasthenic crisis if the client makes which statement?
78. Which information will the nurse reinforce to the client scheduled for a lumbar puncture?
79. The nurse is reinforcing instructions to a client taking divalproex sodium (Depakote). The nurse tells the client to return to the clinic for follow-up laboratory studies related to which test?
80. Which data collection finding supports the possible diagnosis of Bell’s palsy?
81. The nurse reviews the health care provider’s treatment plan for a client with Guillain-Barré syndrome. Which prescription noted in the client’s record should the nurse question?
82. A client has a halo vest that was applied following a C6 spinal cord injury. The nurse performs which action to determine whether the client is ready to begin sitting up?
83. A client is admitted to the emergency department with a C4 spinal cord injury. The nurse performs which intervention first when collecting data on the client?
84. A client with myasthenia gravis is experiencing prolonged periods of weakness. The health care provider prescribes a test dose of edrophonium (Enlon) and the client becomes weaker. The nurse interprets this outcome as indicative of which result?
85. The nurse is assisting in gathering data on cranial nerve XII of a client who sustained a brain attack (stroke). The nurse understands that the client should be asked to perform which action?
86. The nurse is reviewing the medical record of a client diagnosed with amyotrophic lateral sclerosis (ALS). Which initial sign/symptom of this disorder supports this diagnosis?
87. The nurse is assisting in caring for a client with a supratentorial lesion. The nurse monitors which criterion as the critical index of central nervous system (CNS) dysfunction?
88. The nurse caring for a client following a craniotomy monitors for signs of increased intracranial pressure (ICP). Which indicates an early sign of increased ICP?
89. Acetazolamide is prescribed for a client with a diagnosis of a supratentorial lesion. The nurse monitors the client for effectiveness of this medication, knowing which is its primary action?
90. Which sign/symptom is observed in the clonic phase of a seizure?
91. The nurse is preparing for the admission of a client with a prescription for seizure precautions. Which supplies will the nurse make available to this client? Select all that apply.
92. The nurse is preparing for the admission of a client with a diagnosis of early stage Alzheimer’s disease. The nurse assists in developing a plan of care, knowing that which is a characteristic of early Alzheimer’s disease?
93. The clinic nurse is reviewing the medical record of a client scheduled to be seen in the clinic. The nurse notes that the client is prescribed selegiline hydrochloride (Eldepryl). The nurse understands that this medication is prescribed for which diagnosis?
94. The nurse is reviewing the record of a client with a suspected diagnosis of Huntington’s disease. Which documented early symptom supports this diagnosis?
95. The nurse is assisting in caring for a client with a suspected diagnosis of meningitis. The nurse reinforces to the client information regarding which diagnostic test that is commonly used to confirm this diagnosis?
96. The nurse is preparing for the admission of a client with a suspected diagnosis of herpes simplex encephalitis. Which diagnostic test should be prescribed to confirm this diagnosis?
97. The nurse is caring for a client with a diagnosis of multiple sclerosis who has been prescribed oxybutynin (Ditropan). The nurse evaluates the effectiveness of the medication by asking the client which question?
98. The nurse is preparing for the admission of a client with a suspected diagnosis of Guillain-Barré syndrome. Which sign/symptom is considered a primary symptom of this syndrome?
99. A thymectomy via a median sternotomy approach is performed on a client with a diagnosis of myasthenia gravis. The nurse has assisted in developing a plan of care for the client and includes which nursing action in the plan?
100. The nurse is caring for a client with a diagnosis of right (nondominant) hemispheric brain attack (stroke). The nurse notes that the client is alert and oriented to time and place. Based on these findings, the nurse makes which determination?
101. The nurse is preparing to care for a client with a diagnosis of brain attack (stroke). The nurse notes in the client’s record that the client has anosognosia. The nurse plans care, knowing which is a characteristic of anosognosia?
102. The nurse is preparing a plan of care for a client with a brain attack (stroke) who has global aphasia. The nurse incorporates communication strategies in the plan of care, knowing that the client’s speech should fit which characterization?
103. The nurse is caring for a client with a diagnosis of brain attack (stroke) with anosognosia. To meet the needs of the client with this deficit, which action does the nurse plan?
104. 104 The nurse is caring for a client who sustained a spinal cord injury. While administering morning care, the client developed signs and symptoms of autonomic dysreflexia. Which is the initial nursing action?
105. A female client with myasthenia gravis comes to the health care provider’s office for a scheduled office visit. The client is very concerned and tells the nurse that her husband seems to be avoiding her because she is very unattractive. Which is the appropriate nursing response?
106. A client is recovering at home after suffering a brain attack (stroke) 2 weeks ago. A home caregiver tells the home health nurse that the client has some difficulty swallowing food and fluids. Which nursing action would be appropriate?
107. The nurse is collecting neurological data on a poststroke adult client. Which technique should the nurse perform to adequately check proprioception?
108. The nurse develops a plan of care for a client following a lumbar puncture. Which interventions should be included in the plan? Select all that apply.
109. A client with Parkinson’s disease “freezes” while ambulating, increasing the risk for falls. Which suggestion should the nurse include in the client’s plan of care to alleviate this problem?
110. The nurse is assisting in checking for Tinel’s sign in a client suspected of having carpal tunnel syndrome (CTS). Which technique should the nurse expect to be used to elicit this sign?
111. The nurse is monitoring a client with a spinal cord injury who is experiencing spinal shock. Which assessment will provide the nurse with the best information about recovery from the spinal shock?
112. The nurse is caring for a client with a cerebral aneurysm who is on aneurysm precautions and is monitoring the client for signs of aneurysm rupture. The nurse understands that an early sign of rupture is which?
113. The nurse is caring for a client with a head injury and is monitoring the client for signs of increased intracranial pressure (ICP). Which sign if noted in the client should the nurse report immediately?
114. The nurse is caring for a client with a spinal cord injury. High-top sneakers on the client’s feet will prevent the occurrence of which?
115. A halo vest is applied to a client following a cervical spine fracture. The nurse reinforces instructions to the client regarding safety measures related to the vest. Which statement by the client indicates a need for further teaching?
116. The nurse is preparing a plan of care to monitor for complications in a client who will be returning from the operating room following transsphenoidal resection of a pituitary adenoma. Which intervention does the nurse document in the plan as the priority nursing intervention for this client?
117. The nurse is reinforcing discharge instructions to a client who has undergone transsphenoidal surgery for a pituitary adenoma. Which statement by the client indicates the client understands the discharge instructions?
118. The nurse is collecting admission data on a client with Parkinson’s disease. The nurse asks the client to stand with the feet together and the arms at the side and then to close the eyes. The nurse notes that the client begins to fall when the eyes are closed. Based on this finding, the nurse documents which in the client’s record?
119. A nursing student is collecting data on a client recently diagnosed with meningitis. The student expects to note which signs and symptoms? Select all that apply.
120. A client is suspected of having a diagnosis of Guillain-Barré syndrome (GBS). Which findings would support a diagnosis of Guillain-Barré syndrome? Select all that apply.
121. The nurse is collecting data on a client diagnosed with Parkinson’s disease. Which finding indicates a serious complication of this disorder?
122. The nurse notices that a client with trigeminal neuralgia has been withdrawn, is having frequent episodes of crying, and is sleeping excessively. Which method is the best way for the nurse to explore issues with the client regarding these behaviors?
123. A client with suspected Guillain-Barré syndrome has a lumbar puncture performed. The cerebrospinal fluid (CSF) protein is 750 mg/dL. The nurse analyzes these results as which?
124. A client with a T4 spinal cord injury is to be monitored for autonomic dysreflexia (hyperreflexia). Which finding is indicative of this complication?
125. The nurse is monitoring a client with a spinal cord injury for signs of spinal shock. Which sign is indicative of this complication of a spinal cord injury?
126. A client with tetraplegia complains bitterly about the nurse’s slow response to the call light and the rigidity of the therapy schedule. Which interpretation of this behavior should serve as a basis for planning nursing care?
127. A client with Parkinson’s disease is developing dementia. Which action should the nurse plan to assist the client in maintaining self-care abilities?
128. The nurse is caring for a client that is comatose and notes in the client’s chart that the client is exhibiting decerebrate posturing. The nurse understands that which definition describes decerebrate posturing?
129. A client recovering from a craniotomy complains of a “runny nose.” Based on the interpretation of the client’s complaint, which action should the nurse take?
130. The nurse is planning care for a client with Bell’s palsy. Which measure should be included in the plan?
131. A client with Guillain-Barré syndrome has been asking many questions about the condition, and the nursing staff feels that the client is very discouraged about her condition. It is important for the nurse to include which information in discussions with the client?
132. The nurse is monitoring a client who sustained a head injury and suspects that the client has a skull fracture. This conclusion is based on which findings? Select all that apply.
133. A client experiences an episode of Bell’s palsy and complains about increasing clumsiness. The nurse should prepare the client for which diagnostic study (studies) to determine the cause of the complaints? Select all that apply.
134. When the nurse taps at the level of the client’s facial nerve, the following response is noted. How should the nurse document this finding on the client record? Refer to figure.
135. The nurse is collecting neurological data on an unconscious client. On the application of a central noxious stimulus, the nurse observes this response. How should the nurse document this response on the client’s record? Refer to figure.
136. The nurse suspects neurogenic shock in a client with complete transection of the spinal cord at the T3 (thoracic 3) level if which clinical symptoms are observed?
137. The nurse is told in the report that a client has a positive Chvostek’s sign. Which other data should the nurse expect to find on data collection? Select all that apply.
138. The nurse determines that motor function of which cranial nerve is intact if the client can perform this action? Refer to figure.
139. A client complains of pain in the lower back and pain and spasms in the hamstrings when the nurse attempts to extend the client’s leg. How should the nurse record this finding on the client’s medical record? Refer to figure.
140. A client with a stroke (brain attack) is experiencing residual dysphagia. The nurse should remove which food items that arrived on the client’s meal tray from the dietary department?
141. The nurse is caring for a client following craniotomy who has a supratentorial incision. The nurse reviews the client’s plan of care, expecting to note that the client should be maintained in which position?
142. A client is about to undergo a lumbar puncture (LP). The nurse tells the client that which position will be used during the procedure?