1.

Derek Ramsey suffered a severe head injury when sailing his yacht on the ocean and haven’t
recovered and was unconscious when brought to the hospital. His eyes open when pain is
elicited, he doesn’t respond to any stimulus while his hands withdraw from pain. Give the total
Glasgow Coma Scale score for him.
a. 9
b. 5
c. 3
d. 6
2. Billy Crawford fell from a building and suffered from multiple injuries. He was brought to the
hospital and endotracheal tube was inserted. He won’t even move when sternal rub was done
and she won’t respond also to pain. Give his total score using the Glasgow Coma Scale.
a. 3
b. 5
c. 8
d. 11
3. Vhong crashed his head during a basketball game and was brought to the ER. When the nurse
assesses his level of consciousness she notes the following: his hand withdraws to pain when the
nailbeds are pinched, his eyes open continuously and he converses with the nurse. Give the
total Glasgow Coma Scale of the patient
a. 14
b. 11
c. 12
d. 15
4. A type of aphasia wherein the patient cannot understand and express language.
a. Receptive aphasia
b. Expressive aphasia
c. Global aphasia
d. None of the above
5. An abnormal posture associated with severe brain injury, characterized by abnormal flexion of
the upper and lower extremities.
a. Decortication
b. Decerebration
c. Hyperextension
d. Hyperflexion
6. This is the blindness of half of the field of vision in one or both eyes
a. Hemiplegia
b. Hemiparesis
c. Hemianopsia
 d. Quadriplegia

7. Vice Ganda suffered a stroke. Afterwards when he is going to resume his job as a writer in a
newspaper he has already forgotten how to write. This is an example of
a. Ataxia
b. Apraxia
c. Aphasia
d. Agnosia
8. A growing lesion of the hypoglossal nerve of the patient will cause which of the following
symptoms
a. Loss of sensation on the tongue
b. Loss of gustatory sense on the tongue
c. Loss of movement of the tongue
d. Loss of sensation of the pharynx
9. Destruction of the acetylcholine receptors in a cell membrane will cause which of the following?
a. Paralysis of the skeletal muscles
b. Loss of tactile sensation
c. Bradycardia
d. Hypotension
10. This part of the autonomic nervous system prepares the body for physical activity by stimulating
the adrenal cortex to produce cortisol, increasing vascular permeability of the brain, stimulate
the liver to produce glucose.
a. Sympathetic nervous system
b. Sensory nervous system
c. Somatic nervous system
d. Parasympathetic nervous system

31. This is the action of Sumatriptan (Sumitrex) which is a drug for migraine headaches:

A. Vasoconstriction and reduces inflammation

B. Vasoconstriction then vasodilation
C. Vasodilation and reduces inflammation
D. Vasodilation then vasoconstriction

32. Acetaminophen (Tylenol) can help relieve any type of headache, which of the following food
should accompany this:

A. Milk
B. Cheese
C. Coffee
D. Apple
33. Which of the following nursing diagnoses is the most appropriate for a person who is in the
aura phase of migraine headache:

A. Fear
B. Acute pain
C. Ineffective tissue perfusion
D. Impaired physical mobility

34. The most common type of headache experienced after the person drinks alcohol is

A. Trigeminal autonomic cephalgias

B. Migraine headache
C. Organic headache
D. Metabolic headache

35. The cerebral blood flow drops below normal pressure of 50 mm Hg due to increased
intracranial pressure:

A. Cushing’s Response
B. Cushing’s Syndrome
C. Monro-Kellie Hypothesis
D. Cushing’s Triad

36. Which of the following composes of the Cushing’s Triad?

A. Hypertension, tachycardia and bradypnea

B. Hypotension, tachycardia and tachypnea
C. Widened pulse pressure, bradycardia and bradypnea
D. Hypotension, bradycardia and tachypnea

37. Increased intracranial pressure can compress any structure in the brain-causing malfunction
of a certain part of the body. The following are the complications of increased intracranial
pressure except:

A. Cerebral palsy
B. Syndrome of inappropriate anti-diuretic hormone
C. Diabetes insipidus
D. Brain stem herniation

38. What would be the primary reason why the temperature of a person with cerebral edema be
lowered?

A. Increased body temperature can cause febrile seizures to the patient

B. So that there would be fluid shifting from intracellular to extracellular
 C. To decrease the discomfort of the patient
D. To reduce the oxygen and metabolic requirements of the brain

39. This is the normal intracranial pressure of a person:

A. 15-30 mm Hg
B. 5-10 mm Hg
C. 10-20 mm Hg
D. 30-40 mm Hg

40. Anne Curtis is for discharge after having a subdural hemorrhage. The following will be your patient
teaching for increased intracranial pressure except:

A. Avoid flexing the hips

B. Avoid straining during defecation
C. Avoid eating protein-rich diet
D. Avoid any doing strenuous activities

41. While administering mannitol to a patient which of the following are you going to take note?

A. Temperature
B. Respiratory rate
C. Intake and output
D. Cardiac rate

42. This would be the best nursing diagnosis for a person who has a ventriculostomy on his head:

A. Risk for injury

B. Fluid volume deficit
C. Pain
D. Risk for infection

43. Which of the following would be the cause of primary epilepsy?

A. Encephalitis
B. Tumor
C. Unknown
D. Meningitis

44. What would be the complication of a seizure?

A. Anoxia
 B. Tumor
C. Parkinson’s Disease
D. Reye’s Syndrome

45. They usually consist of a staring spell that lasts for several seconds:
A. Absence seizures
B. Grand Mal Seizures
C. Myoclonic Seizure
D. Atonic Seizures

46. Shows a tonic-clonic seizure that lasts for 15-20 seconds associated with high fever:

A. Complex partial seizures

B. Febrile seizures
C. Partial seizures
D. Absence seizures

47. This type of seizure originate from a specific brain area, begins in the fingers and spreads to
the wrist arm and face in a clonic contraction, there is no loss of consciousness”

A. Tonic-clonic seizures
B. Absence seizures
C. Febrile seizures
D. Partial seizures

48. Which of the following lobes of the brain is affected when the aura for tonic-clonic seizures is
where the patient smells a foul-smelling odor?

A. Frontal lobe
B. Parietal lobe
C. Occipital lobe
D. Temporal lobe

49. Which of the following lobes of the brain is affected when the aura for tonic-clonic seizures
causes the patient to see flashing of lights?

A. Parietal lobe
B. Occipital lobe
C. Temporal lobe
D. Frontal lobe

50. When the patient is suffering from epilepsy, in what position are you going to place him in
while seizure is ongoing?
 A. High Fowler’s position
B. Side lying position
C. Semi Fowler’s position
D. Tredelenburg’s position

51. What type of beverage will a patient avoid when the patient is having seizure disorders?

A. Caffeine
B. Sodas
C. Alcohol
D. Carbonated drinks

52. Status epilepticus is the resultant of the following disorder except:

A. Abrupt withdrawal of anticonvulsant medications

B. Hypoxic encephalopathy
C. Acute head injury
D. High fever

53. The stage of tonic-clonic seizure where the entire patient’s muscles contract, the extremities
stiffen, face distorts, and then all the muscles contract and relax producing quick jerky
movements:

A. Aura phase
B. Prodromal phase
C. Posticteric phase
D. Tonic-clonic phase

54. This is a regular, rhythmic, slower flexion-extension contraction; involves principally the
metacarpophalangeal and wrist joints; alternating movements between thumb and index finger
described as “pill-rolling”; disappears during voluntary movement.

A. Tremor at rest
B. Parkinsonian tremor
C. Asterixis
D. Athetosis

55. The most common cause of cerebrovascular disease is

a. Arteriosclerosis
b. Embolism
c. Hypertensive changes
d. Vasospasm
56. The etiology of an ischemic stroke would include
a. Cardiogenic embolus
b. Cerebral aneurysm
 c. Arteriovenous malformation
d. Intracerebral hemorrhage
57. The majority of ischemic strokes have what type of origin?
a. Cardiogenic embolic
b. Cryptogenic
c. Large artery thrombotic
d. Small artery thrombotic
58. The nurse knows that symptoms associated with a transient ischemic attack (TIA), which is a
precursor of stroke usually subsides in
a. 1 hour
b. 3 to 6 hours
c. 12 hours
d. 24 to 36 hours
59. The degree of neurologic damage that occurs with an ischemic stroke depends on the
a. Location of the lesion
b. Size of the area of inadequate perfusion
c. Amount of collateral blood flow
d. Combination of the above factors
60. A stroke victim is experiencing memory loss and impaired learning capacity. The nurse knows
that brain damage has occurred in which lobe?
a. Frontal
b. Occipital
c. Parietal
d. Temporal
61. The most common motor dysfunction of a stroke is
a. Ataxia
b. Diplopia
c. Dysphagia
d. Hemiplegia
62. When giving t-PA to a stroke patient, the nurse must make sure to monitor for which of the
following on the patient?
a. Vomiting
b. Bleeding
c. Hypotension
d. Low urine output
63. The most common side-effect of t-PA is
a. An allergic reaction
b. Bleeding
c. Severe vomiting
d. A second stroke in 6 to 12 hours
64. A classic diagnostic symptom of hemorrhagic stroke is the patient’s complaint of
a. Numbness of an arm or leg
 b. Double vision
c. Severe headache
d. Dizziness and tinnitus
65. When approaching a patient who has homonymous hemianopsia, the nurse must make sure to
approach the patient on
a. The affected side
b. The unaffected side
c. The front
d. The right side
66. Which of the following nursing diagnosis would be appropriate to a stroke patient who has lost
his sensation on the right side of the body after a stroke incident?
a. Activity intolerance
b. Disturbed sensory perception
c. Risk for impaired skin integrity
d. Deficient self-care
67. In order to manage the patient’s dysphagia after a stroke the nurse must make sure to do which
of the following?
a. Offer small frequent meals to the patient
b. Give small amount of food when feeding the patient
c. Liquefy all of the food of the patient
d. Place the patient on NGT
68. Which of the following is a risk factor for stroke?
a. Alcoholism
b. Sedentary lifestyle
c. Cigarette smoker
d. All of the above
69. Most patient’s with hemorrhagic stroke are placed in bed in what position?
a. High Fowler’s
b. Prone
c. Supine
d. Semi-Fowler’s
70. All of the following statements about the occurrence of head injuries are correct EXCEPT
a. The majority of all victims are younger than 25 years of age
b. An estimated 50,000 persons die annually from these injuries
c. Motor vehicle crashes are the primary cause
d. The majority of injuries occur in females
71. A cerebral hemorrhage located within the brain is classified as
a. An epidural hematoma
b. An extradural hematoma
c. An intracerebral hematoma
d. A subdural hematoma
72. The Glasgow Coma Scale is used to determine the level of consciousness. A score considered
indicative of a coma is
a. 1
b. 3
c. 5
d. 8
73. Assessing the level of consciousness in an important nursing measure after surgery. Signs of
increasing intracranial pressure (ICP) include
a. Bradycardia
b. Increased systolic blood pressure
c. Widening pulse pressure
d. All of the above
74. Comatose patients are mechanically ventilated to control ICP. Hypocapnia is a goal that can be
achieved with a PaCO2 in the range of
a. 10 to 25 mm Hg
b. 25 to 30 mm Hg
c. 30 to 35 mm Hg
d. 35 to 40 mm Hg
75. A cause of elevated body temperature in a head injured patient is
a. Cerebral irritation from hemorrhage
b. Damage to the hypothalamus
c. Infection
d. All of the above
76. More than 50% of patients with new spinal cord injury are
a. 30 years of age or younger
b. 30 to 40 years of age
c. 40 to 50 years of age
d. 50 years of age and older
77. The primary cause of spinal cord injury is
a. Gunshot wounds
b. Industrial accidents
c. Sports activities
d. Motor vehicle accidents
78. Respiratory difficulty and paralysis of all four extremities occur with spinal cord injury located
a. Cervical region
b. Sacral region
c. Lumbar region
d. Thoracic region
79. High doses of which drug have been found to reduce swelling and disability if given within 8
hours after injury?
a. Mannitol
b. Methylprednisolone
 c. Naloxone
d. Neomycin
80. Loss of autonomic nervous system function below the level of the lesion causes what kind of
shock?
a. Cardiac
b. Hypovolemic
c. Septic
d. Neurogenic
81. Orthostatic hypertension is a common problem for spinal cord injuries at the level of
a. C4
b. T7
c. L4
d. S1
82. A common complication of immobility in a spinal cord injury is
a. Pressure ulcers
b. Deep vein thrombosis
c. Urinary tract infection
d. Pneumonia
83. If head trauma occurs in the temporal lobe of the patient, what would be the probable signs and
symptoms presented by this patient?
a. Memory loss
b. Speech difficulties
c. Visual disturbances
d. Numbness of an extremities
84. If stroke occurs in the occipital lobe of the patient, the nurse would expect the patient to
present these signs and symptoms
a. Memory loss and sensory deprivation
b. Visual disturbances
c. Speech difficulties
d. Paralysis of an extremity
85. What can be a risk factor for cerebrovascular accident in a patient
a. A history of transient ischemic attacks
b. Chronic cigarette smoking
c. Diet of high in fats
d. All of the above
86. If a patient has an atherosclerotic carotid artery. You also would expect the patient to have
these plaques in which arteries?
a. Cephalic arteries
b. Hepatic artery
c. Renal arteries
d. Coronary arteries
87. One of the common diseases associated with embolic type of stroke is
 a. Myocardial infarction
b. Deep vein thrombosis
c. Arteriosclerosis
d. Aortic aneurysm
88. What would be the antidote to heparin?
a. Naloxone
b. Vitamin K
c. Protamine sulfate
d. Digitalis
89. What would be the antidote to coumadin (Warfarin)?
a. Digitalis
b. Naloxone
c. Protamine sulfate
d. Vitamin K
90. What would be the best position of the patient who has spinal cord injury?
a. Prone
b. Semi-Fowler’s
c. Supine
d. Side-lying

SITUATION: Mr. Freddy Roach an 54 year old male was recently diagnosed with Parkinson’s
Disease because of evident symptoms of muscle rigidity, bradykinesia and resting hand
tremors.

1. Parkinson’s disease is a progressive, chronic neurological disorder that is usually:

A. associated with severe head injury
B. associated with chronic diseases
C. associated with old age
D. known to affect people of all ages with no known cause

2. Parkinson’s disease reflects an imbalance between inhibitory and stimulating activity of

nerves in the:

A. reticular activating system

B. cerebellum
C. basal ganglia
D. limbic system

3. The main, underlying problem with Parkinson’s disease seems to be a decrease in the
neurotransmitter:

A. acetylcholine
 B. norepinephrine
C. dopamine
D. serotonin

4. No therapy is available that will stop the loss of neurons and the eventual decline of function
in Parkinsonism patients. As a result, nursing care should involve all of the following except:

A. regular exercises to slow loss of function

B. support and education as drugs fail and new therapy is needed
C. community and family support networking
D. discontinuation of drug therapy to test for a cure

5. Anticholinergic drugs are effective in early Parkinson’s disease. The act:

A. to block the stimulating effects of acetylcholine in the brain to bring

activity back to balance.
B. To block the signs and symptoms of the disease, making it more acceptable.
C. To inhibit dopamine effects in the brain
D. To increase the effectiveness of GABA.

SITUATION: Mrs. Garampingat diagnosed of Multiple Sclerosis was brought to the hospital due
to complication of her disease. She was brought to the medical-surgical unit to assess her
conditions.

6. Which equipment should be at the bed side when the patient with Multiple Sclerosis is
experiencing respiratory complications?

A. Sphygmomanometer
B. Padded tongue blade
C. Nasal cannula and oxygen
D. Suction machine with catheters

7. The client is scheduled to have CT scan, what should the nurse do when preparing the client
for this test?

A. Immobilize the neck when the client is moved onto the gurney
B. Determine whether the client is allergic to iodine, contrast dies or
shellfish
C. Place a cap over the client’s head
D. Administer a sedative as ordered

8. In assessing the woman for Multiple Sclerosis, which of the following symptoms would the
nurse expect?
 A. Vision changes
B. Absent deep tendon reflex
C. Tremors at rest
D. Flaccid muscles

9. When providing discharge teaching to the client, the nurse should include which teaching?

A. “Avoid taking daytime naps.”

B. “Avoid taking hot baths and showers.”
C. “Limit your fruit and vegetable intake.”
D. “Restrict fluid intake to 1500 ml/day.”

10. The client has ongoing medication of beta-1a (Avonex) and beta-1b (Betaseron) which are
interferons that reduce the frequency of relapse by 30%. What is the action of these drugs?

A. They remyelinate the CNS

B. They produce more oligodendrocytes that produce myelin sheath of the CNS
C. They reduce T-cell proliferation
D. They prevent respiratory complications

SITUATION: Sakuragi has symptoms of impaired speech, difficulty chewing and swallowing and
excessive drooling.

11. The physician suspects for Amyotrophic Lateral Sclerosis. To help confirm this disorder, the
nurse prepares the client for various diagnostic tests. The nurse expects the physician to order:

A. electromyography (EMG)
B. Doppler scanning
C. Doppler ultrasonography
D. Quantitative special phonoangiography

12. In a client with Amyotrophic Lateral Sclerosis and respiratory distress, which finding is the
earliest indication of reduced oxygenation?

A. Decreased heart rate

B. Increased restlessness
C. Increased blood pressure
D. Decreased Level of Consciousness (LOC)

13. This drug will help decrease muscular spasms in a patient:

A. Baclofen
B. Diazepam
C. Quinidine
D. Phenytoin
14. When the patient was informed that the prognosis for this disease is very poor because it
eventually leads to death. What would be the initial action of the patient?

A. Acceptance
B. Anger
C. Depression
D. Denial

15. The following are true about Amyotrophic Lateral Sclerosis except:

A. Exact cause is unknown

B. Its symptoms include crying spells or inappropriate laughter
C. Recovery will occur from 6 to 12 months
D. Muscle biopsy shows atrophic fibers between normal fibers

SITUATION: Jack Amam-Mo suddenly woke up in shock to discover his left face was sagging
and was having difficulty in closing his left eye. Upon admission to the hospital the diagnosis
was Bell’s Palsy.

16. Which of the following health history of Jack will you take into importance in his current
situation?

A. Recent infection of varicella

B. Fungal infections
C. Having migraines
D. Allergy to cephalosphorins

17. The nurse encourages the patient to massage his affected face upwards; the reason for
doing this is to:

A. To prevent pain from occurring

B. To prevent atrophy of the facial muscles
C. To help the client chew his food
D. All of the above

18. The following would help improve the muscle tonicity of the affected face except:

A. Blowing exercises
B. Whistling
C. Coughing exercises
D. Wrinkling the forehead

19. A client with Bell’s Palsy should wear which of the following to decrease normal evaporation
from the eye?
 A. Sunglasses
B. Concave lens eyeglasses
C. Convex lens eyeglasses
D. Wrap-around sunglasses or goggles

20. The patient is depressed about his current condition and often complains that his
face is distorted. What would be the appropriate nursing diagnosis for this?
A. Activity intolerance
B. Ineffective breathing pattern
C. Risk for suicide
D. Body image disturbance

21. When caring for a client with a nursing diagnosis Impaired Swallowing related to
neuromuscular impairment, the nurse should:

A. position the client to supine position

B. elevate the head of the bed 90 degrees during meals
C. encourage the client to remove dentures
D. encourage thin liquids for dietary intake

22. The nurse is teaching a client and his family about Baclofen (Lioresal) therapy. Baclofen is
an analogue of which neurotransmitter?

A. Acetylcholine
B. Gamma Amino Butyric Acid
C. Norepinephrine
D. Dopamine

23.The nurse is teaching a client with Multiple Sclerosis. When teaching the client 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

24. Which nursing diagnosis takes highest priority with Parkinson’s Crisis?

A. Imbalanced nutrition: less than body requirements

B. Ineffective airway clearance
C. Impaired urinary elimination
D. Risk for injury

25. The patient with Mutiple Sclerosis is experiencing diplopia and is having a difficulty focusing
on reading books and other materials. What would be the best intervention for this problem?
 A. Cover one eye with an eye patch
B. Tell the patient to do other activities such as listening to music
C. Encourage the patient to wear correctional glasses
D. None of the above

26. During assessment the nurse knows that the most frequently reported disabling
symptom found in multiple sclerosis is
a. Depression
b. Double vision
c. Fatigue
d. Pain
27. A positive diagnosis of myasthenia gravis can be reached by using the following test
a. Tensilon test
b. MRI
c. CT scan
d. Electromyography
28. A surgical intervention that can cause substantial remission of myasthenia gravis is
a. Esophagostomy
b. Myomectomy
c. Thymectomy
d. Splenectomy
29. Bell’s palsy is characterized by weakness or paralysis of the facial muscles. It is a
disorder of what cranial nerve?
a. Third
b. Fourth
c. Fifth
d. Seventh
30. Tinnitus and vertigo are clinical manifestations of damage to which cranial nerve?
a. Fourth
b. Sixth
c. Eighth
d. Tenth
31. This is the drug administered to patient’s who will undergo Tensilon test
a. Edrophonium
b. Valium
c. Parlodel
d. Levodopa
32. Which of the following would be the priority nursing diagnosis for patients suffering from
myasthenia gravis?
a. Ineffective breathing pattern
b. Risk for injury
c. Activity intolerance
d. Altered nutrition: less than body requirements
33. Which of the following would indicate the patient to experience levodopa toxicity?
a. Orthostatic hypotension
b. Urinary retention
c. Hallucination
d. Dry mouth
34. The following are positive signs for Parkinson’s disease EXCEPT
a. Resting hand tremors
 b. Akinesia
c. Postural disturbance
d. Hypertension
35. Which nerves are typically affected for the patient suffering from myasthenia gravis?
a. Cranial nerves
b. Spinal nerves
c. Somatic nerves
d. All of the above

36. Which statement is true for a patient who has pathology in Wernicke's area of the
cerebrum?
A. Receptive speech is affected.
B. The parietal lobe is involved.
C. Sight processing is abnormal.
D. An abnormal Romberg test is present

37. After a major head trauma, the patient's respiratory and cardiac functions are affected.
Which area of the brain is damaged?
A. Temporal lobe of the cerebrum
B. Brainstem
C. Cerebellum
D. Spinal nerves

38. A patient's sudden onset of hemiplegia has necessitated a computed tomography (CT) of
her head. Which assessment should you complete before this diagnostic study?
A. Assess the patient's immunization history.
B. Screen the patient for any metal parts or a pacemaker.
C. Assess the patient for allergies to shellfish, iodine, or dyes.
D. Assess the patient's need for tranquilizers or antiseizure medications.

39. Which option indicates a sign of Cushing's triad, an indication of increased intracranial
pressure (ICP)?
A. Heart rate increases from 90 to 110 beats/minute
B. Kussmaul respirations
C. Temperature over 100.4° F (38° C)
D. Heart rate decreases from 75 to 55 beats/minute
40. Which option is the most sensitive indication of increased ICP?
A. Papilledema
B. Cushing's triad
C. Projectile vomiting
D. Change in the level of consciousness (LOC)
41. What is the standard to evaluate the degree of impaired consciousness for a patient with
an acute head trauma?
A. Glasgow Coma Scale
B. National Institutes of Health (NIH) Stroke Scale
C. Romberg test
D. Widening pulse pressure, bradycardia, and respirations

42. You plan care for the patient with increased ICP with the knowledge that the best way to
position the patient is to
A. keep the head of the bed flat.
B. elevate the head of the bed to 30 degrees.
C. maintain patient on the left side with the head supported on a pillow.
D. use a continuous-rotation bed to continuously change patient position.

43. An elderly patient fell at home. Which information from the patient's history makes this
patient at high risk for an intracerebral bleed?
A. History of a heart condition
B. Taking warfarin (Coumadin)
C. Has lost consciousness for 5 seconds
D. History of migraine headaches

44. During admission of a patient with a severe head injury to the emergency department,
you place the highest priority on assessment of
A. patency of airway.
B. presence of a neck injury.
C. neurologic status with the Glasgow Coma Scale.
D. cerebrospinal fluid leakage from the ears or nose.

45. A patient with a suspected closed head injury has bloody nasal drainage. You suspect
that this patient has a cerebrospinal fluid (CSF) leak when observing which of the
following?
A. A halo sign on the nasal drip pad
B. Decreased blood pressure and urinary output
 C. A positive reading for glucose on a Test-tape strip
D. Clear nasal drainage along with the bloody discharge

46. You are caring for a patient admitted with a subdural hematoma after a motor vehicle
accident. Which change in vital signs would you interpret as a manifestation of increased
intracranial pressure?
A. Tachypnea
B. Bradycardia
C. Hypotension
D. Narrowing pulse pressure

47. You assess a patient for signs of meningeal irritation and observe her for nuchal
rigidity. Which option indicates the presence of this sign of meningeal irritation?
A. Tonic spasms of the legs
B. Curling in a fetal position
C. Arching of the neck and back
D. Resistance to flexion of the neck

48. The patient had an ischemic stroke and is undergoing rehabilitation. He is diagnosed
with homonymous hemianopsia. What should you do?
A. Better arrange the environment to suit the patient's needs.
B. Teach the patient to turn his head to scan the environment.
C. Obtain prescriptive glasses for the patient.
D. Have the patient wear an eye patch.

49. Which nursing intervention is most appropriate when communicating with a patient
suffering from aphasia after a stroke?
A. Present several thoughts at once so that the patient can connect the ideas.
B. Ask open-ended questions to provide the patient the opportunity to speak.
C. Use simple, short sentences accompanied by visual cues to enhance comprehension.
D. Finish the patient's sentences to minimize the frustration associated with slow
speech.

50. During the postictal period of a seizure, you would expect the patient to
A. demonstrate minor jerking and eye fluttering.
B. sleep for several hours.
C. be incontinent of urine and feces.
D. require ventilator assistance.
51. A classic sign of an absence (petit mal) seizure is
A. blank stare.
B. frequent smacking of lips.
C. urinary incontinence.
D. asking the same question over and over.

52. The pathophysiology of multiple sclerosis (MS) is related to an attack on the

A. myelin sheaths on various neurons.
B. goblet cells of the muscles.
C. lining of the blood vessels.
D. lack of acetylcholine at the synaptic junction.

53. Which gastrointestinal complication would you expect in the patient with multiple
sclerosis?
A. Diarrhea
B. Bowel obstruction
C. Constipation
D. Rectal prolapse

54. What is the cause of the clinical manifestations of Parkinson's disease?

A. Decreased levels of dopamine
B. Decreased levels of acetylcholine
C. Increased levels of angiotensinogen
D. Increased levels of relaxin

55. The patient asks you, "How can I be certain I have Parkinson's disease?" Your response is
based on the knowledge that the absolute confirmation of the diagnosis is
A. decreased serum dopamine level.
B. positive response to medication administration.
C. nerve biopsy.
D. electromyography (EMG).

56. Which nursing diagnosis is more appropriate for a patient with advanced Parkinson's
disease?
A. Urinary urge incontinence related to effects of drug therapy
B. Ineffective breathing pattern related to diaphragm fatigue
 C. Risk for aspiration related to impaired swallowing
D. Risk for injury related to limited vision

57. You would correctly identify the pathophysiologic etiology of myasthenia gravis as a
deficit of
A. dopamine.
B. acetylcholine.
C. myelin.
D. albumin.

58. Which nursing diagnosis is likely to be a priority in the care of a patient with myasthenia
gravis?
A. Acute confusion
B. Bowel incontinence
C. Activity intolerance
D. Disturbed sleep pattern

59. You would correctly identify that the most common early symptom(s) of myasthenia
gravis are
A. weakness, fatigue, and ptosis.
B. significant unilateral weakness.
C. nausea, dizziness, and dysphagia.
D. numbness and tingling of the extremities.

60. When administering a Tensilon test to a patient with a possible diagnosis of myasthenia
gravis, you would realize the test is positive if the patient
A. reports improved muscle strength.
B. demonstrates improved cognition.
C. experiences a surge of energy.
D. exhibits enhanced vision.

61. A patient has ptosis secondary to myasthenia gravis. Which assessment finding would
you expect to see in this patient?
A. Redness and swelling of the conjunctiva
B. Drooping of the upper lid margin in one or both eyes
C. Redness, swelling, and crusting along the lid margins
D. Small, superficial white nodules along the lid margin
 62. Which statement is true regarding the prevalence of amyotrophic lateral sclerosis (ALS)?
A. Death occurs in less than one year
B. Survival rate is less than two years
C. Rates are higher in males than females
D. Rates are highest in the age group of 20 to 30 year olds

63. An important nursing diagnosis for the patient with amyotrophic lateral (ALS) is
A. impaired gas exchange related to paralysis of respiratory muscles.
B. hypothermia related to impaired regulation by the hypothalamus.
C. impaired memory related to cognitive changes.
D. dysreflexia related to loss of sympathetic nervous tone
Situation: Markova a 67 year old patient complains of halo vision, blurred vision, difficulty seeing in low
light. She has been diagnosed to have Primary Glaucoma.

1. Which of the following reasons why Markova has developed a primary type of glaucoma?
a. Because she may have a pre-existing condition like diabetes mellitus
b. Unknown cause
c. Probably brought about by her chronic hypertension
d. She may be eating foods high in sodium
2. When formulating the nursing diagnosis of this patient the nurse must prioritize which of the
following?
a. Acute pain
b. Risk for infection
c. Risk for injury
d. Activity intolerance
3. The goal of pharmacologic therapy in glaucoma is to
a. Reduce the redness of the eye
b. Avoid blindness
c. Increase optic blood flow
d. Decrease the intraocular pressure
4. Which of the following persons would be high-risk in the development of glaucoma?
a. Persons 20-40
b. Caucasians
c. Patients with diabetes mellitus
d. None of the above
5. When teaching the patient to instill eyedrops to the patient suffering from glaucoma it is
important for the nurse to teach it by
a. Pulling the lower eyelid downward and instill the medication
b. Allow the medication to settle by closing the eyes at least 5 minutes
c. Pulling the upper eyelid upward and instill the medication
d. Placing the medication by using sterile cotton balls from the inner to outer canthus
Situation: Mang Kanor a 65 year old male has had cataract for almost 5 years now. He also has diabetes
mellitus type II.

6. Which of the following reasons would be best why Mang Kanor has developed cataract?
a. Because of his age
b. His diabetes mellitus type II
c. He perhaps had a previous head injury
d. He may have use corticosteroids for a long time
7. When teaching Mang Kanor with regards to diet in relation to his condition the nurse must
emphasize on
a. High sodium intake
b. High protein and high caloric diet
c. Sodium restriction
d. Low potassium diet
8. Mang Kanor is also taking aspirin for the maintenance of his hypertension. What should the
nurse do before the patient will undergo extracapsular cataract extraction?
a. Withhold the medication
b. Just allow Mang Kanor to take the maintenance drug
c. Decrease the dosage of aspirin
d. Assess the complete blood count results of the patient
9. After Mang Kanor has undergone extracapsular cataract extraction. The nurse will let Mang Jose
wear which of the following for the first 24 hours?
a. Eyeglasses
b. Contact lenses
c. Eye shield
d. None
10. What type of medication will be prescribed to Mang Kanor prior to his operation?
a. Miotics
b. NSAIDs
c. Corticosteroids
d. Mydriatics

11. A tumor growing on the hypothalamus would indicate an alteration in which of the following?
a. Fluid and electrolyte balance, sexual drive, emotions, hormone secretions, etc.
b. Heart rate, respiratory rate, swallowing, and coughing.
c. Abstract thinking, hearing and smelling.
d. Vision and eye movement.
12. Destruction of neurons in the temporal lobe would present problems like
a. Visual alterations
b. Difficulty in understanding speech
c. Memory loss
 d. Ability to express oneself
13. A person has suffered a stroke; he now has paralysis of the left side of the body. The site of
stroke would possibly be found in the
a. Right frontal lobe
b. Left occipital lobe
c. Left frontal lobe
d. Right temporal lobe
14. A person is having difficulty in moving his right facial muscles. The incongruence of his face is
very evident because his right face appears to have sagged down. He can neither smile nor
frown in his right face. There may be a lesion found in
a. Trigeminal nerve
b. Facial nerve
c. Olfactory nerve
d. Accessory nerve
15. Death of neurons found in the occipital lobe will manifest symptoms like
a. Difficulty initiating movement
b. Memory loss
c. Visual alterations
d. Ability to initiate speech
16. A severe blow to the nape of the person can render the person unconscious because the
that controls the person’s consciousness is found in the brainstem.
a. Pons
b. Medulla oblongata
c. Reticular activating system
d. Cerebellum
17. When assessing for the functioning of the parietal lobe of the patient which of the following
would tell you that the parietal lobe is intact?
a. The patient’s pupils constrict when light is shone upon the eyes
b. The patient can recall memories that happened during childhood
c. The patient can easily lift his upper limbs when requested
d. The patient can distinguish the basic tastes and responds to pain

18. The patient’s sense of hearing and balance is transmitted into the cerebrum by the
a. Olfactory nerve
b. Trigeminal nerve
c. Vestibulocochlear nerve
d. Glossopharyngeal nerve
19. A physician should be very careful in performing digital rectal examination, because of the
parasympathetic nervous system is stimulated through the it can cause
bradycardia to a patient.
 a. Accessory nerve
b. Vagus nerve
c. Hypoglossal nerve
d. Trochlear nerve
20. A person who had an accident tells you that he cannot recall the incident and can neither recall
his memories. The person may have injury to what lobe of the brain?
a. Frontal lobe
b. Temporal lobe
c. Occipital lobe
d. Parietal lobe
21. A patient is experiencing constant pain on his decaying tooth whenever the patient eats sweets.
The nerve that transmits pain to the parietal lobe of the brain is
a. Trochlear nerve
b. Glossopharyngeal nerve
c. Abducent nerve
d. Trigeminal nerve
22. The patient cannot name objects around him and has inability to express his feelings. Which
area of the brain is damaged?
a. Broca’s area
b. Primary sensory cortex
c. Wernicke’s area
d. Primary motor cortex
23. The patient cannot understand the meaning of simple words after the patient has suffered from
a stroke. There may be a problem arising from the patient’s
a. Primary sensory cortex
b. Corpus callosum
c. Wernicke’s area
d. Broca’s area
24. If the patient cannot move both his upper and lower extremities because of spinal cord injury.
There may be damage at what region of the spinal cord?
a. Sacrum
b. Lumbar
c. Cervical
d. Coccygeal
25. If the patient has paralysis of the lower half of the body and cannot control his bowel and
bladder movement. There may be lesion growing on what region of the spinal cord?
a. Cervical
b. Thoracic
c. Ischiadic
d. Lumbosacral
26. If there is increased secretion of serotonin in the body of a patient. What will be the clinical
manifestations presented by the patient?
 a. The patient may appear depressed and sometimes immobile
b. The patient is going to exhibit symptoms of dementia
c. The patient is going to show signs of delirium
d. The patient will show signs of involuntary muscle movements.
27. If the dopamine secreting neurons are destroyed in the substantia nigra of the brain of a person.
The following signs and symptoms will be shown are
a. Hallucinations, illusions and delusions
b. Hyperalgesia
c. Difficulty initiating purposeful movements and resting hand tremors
d. Convulsions
28. If the dopamine is increased in the central nervous system of a person. The patient may present
which of the following signs and symptoms?
a. Hyperactivity and impulsiveness
b. Hallucination, illusions or delusions
c. Seizures
d. Increased energy brought about by increase uptake of glucose
29. If the person appears aggressive and is extremely moody. But before he was a very loving and
understanding person. He was diagnosed to have a growing tumor in the brain. Where the
tumor would be found?
a. Temporal lobe
b. Occipital lobe
c. Parietal lobe
d. Frontal lobe
30. This is the branch of the autonomic nervous system that is activated when a person is resting.
There is an increase perfusion of blood in the digestive system and urinary system.
a. Sympathetic nervous system
b. Parasympathetic nervous system
c. Somatic nervous system
d. Peripheral nervous system