NEURO
The gums appear enlarged and
The nurse is caring for patient Park Hee-
Su Cute with increased intracranial
pressure. The nurse would note which of
the following trends in vital signs if the
intracranial pressure is rising?
a. Increasing temperature, increasing
pulse, increasing respiration, decreasing
blood pressure
b. increasing temperature, decreasing
pulse, decreasing respiration, increasing
blood pressure
c. Decreasing temperature, decreasing
pulse, increasing respiration, decreasing
blood pressure
d. Decreasing temperature, increasing
pulse, decreasing respiration, increasing
You are providing nursing care for a
patient with GBS. What observation
would you report immediately?
A. Complaints of numbness and tingling
B. Facial weakness and difficulty
speaking
C. Rapid heart rate of 102 beats per
minute
D. Shallow respirations and decreased
breath sounds
A patient recently started on phenytoin
(Dilantin) to control simple complex
seizures is seen in the outpatient clinic.
Which information obtained during his
chart review and assessment will be of
greatest concern?
a.
inflamed.
b. The white blood cell count is
2300/mm3.
c. Patient occasionally forgets to take
the
phenytoin until after lunch.
d. Patient wants to renew his driver’s
license in the next month.
A 40-year-old paraplegic must perform
intermittent catheterization of the
bladder. Which of the following
instructions should be given?
a. “Clean the meatus from back to front.”
b. “Measure the quantity of urine.”
c. “Gently rotate the catheter during
removal.”
d. “Clean the meatus with soap and
water.”
The client with a head injury has been
urinating copious amounts of dilute urine
through the Foley catheter. The client‟s
urine output for the previous shift was
3000 ml. The nurse implements a new
physician order to administer:
a. Desmopressin (DDAVP, stimate)
b. Dexamethasone (Decadron)
c. Ethacrynic acid (Edecrin)
d. Mannitol (Osmitrol)
After a hypophysectomy, vasopressin
(decrease urine output) is given IM for
which of the following reasons?
a. To treat growth failure
b. To prevent syndrome of inappropriate
antidiuretic hormone (SIADH)
c. To reduce cerebral edema and lower
intracranial pressure
d. To replace antidiuretic hormone
(ADH) normally secreted by the pituitary.
In planning the care for a client who has
had a posterior fossa (infratentorial)
craniotomy, which of the following is
contraindicated when positioning the
client?
a. Keeping the client flat on one side or
the
other
b. Elevating the head of the bed to 30
degrees
c. Log rolling or turning as a unit when
turning
d. Keeping the head in neutral position
The 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
tests positive for glucose – Halo Sign
The nurse is planning to institute seizure
precautions for a client who is being
admitted from the emergency
department. Which of the following
measures would the nurse avoid in
planning for the client’s safety?
a. Padding the side rails of the bed
b. Putting a padded tongue blade at the
head of the bed
c. Placing an airway, oxygen, and
suction
equipment at the bedside
d. Having intravenous equipment ready
for
insertion of an intravenous catheter
The nurse is caring for the client who
begins to experience seizure activity
while in bed. Which of the following
actions by the nurse would be
contraindicted?
a. Loosening restrictive clothing
b. Restraining the client’s limbs
c. Removing the pillow and raising
padded
side rails
d. Positioning the client to the side, if
possible, with the head flexed forward
The client with Parkinson’s disease has
a nursing diagnosis of Falls, Risk for
related to an abnormal gait documented
in the nursing care plan. The nurse
assesses the client, expecting to
observe which type of gait?
a. Unsteady and staggering
b. Shuffling and propulsive
c. Broad-based and waddling
d. Accelerating with walking on the toes
The nurse develops a teaching plan for
a client newly diagnosed with
Parkinson’s disease. Which of the
following topics that the nurse plans to
discuss is the most important?
a. Maintaining a balanced nutrition
b. Enhancing the immune system
c. Maintaining a safe environment
d. Engaging in diversional activities
A client with multiple sclerosis is
receiving baclofen (Lioseral). The nurse
determines that the drug is effective
when it achieves which of the following?
a. Induces sleep
b. Stimulates the client’s appetite
c. Relieves muscular spasticity
d. Reduces urine bacterial count
Which of the following is not a
typical manifestation of Multiple
sclerosis?
a. Double vision
b. Sudden bursts of energy
c. Weakness in the extremities
d. Muscle tremors
A client with multiple sclerosis is
receiving baclofen (Lioseral). The nurse
determines that the drug is effective
when it achieves which of the
following?
a. Induces sleep
b. Stimulates the client’s appetite
c. Relieves muscular spasticity
d. Reduces urine bacterial count
A client has had multiple sclerosis for 15
years and has received various drug
therapies. What is the primary reason
why the nurse has found it difficult to
evaluate the effectiveness of the drugs
that the client used? The client exhibits
intolerance to many drugs
b. The client experiences spontaneous
remissions from time to time
c. The client requires multiple drugs
simultaneously
d. The client endures long periods of
exacerbation before the illness
responds to a particular drug
When a nurse talks to a client with
multiple sclerosis who has slurred
speech, which nursing intervention is
contraindicated?
a. Encouraging the client to speak
slowly
b. Encouraging the client to speak
distinctly
c. Asking the client to repeat
indistinguishable words
d. Asking the client to speak louder
when tired
The right hand of a client with multiple
sclerosis trembles severely whenever
she attempts a voluntary movement.
She spills her coffee twice at lunch and
cannot get her dress fastened securely.
Which is the best legal
documentation in nurse’s notes of the
chart for this client assessment?
a. “Has an intention tremor of the
right hand”
b. “Right hand tremor worsens
on purposeful acts”
c. “Needs assistance in dressing and
eating due to severe trembling and
clumsiness”
d. “Slight shaking of right hand
that increases to severe tremor when
client tries to button her clothes and
drink rom a cup”
A client with multiple sclerosis is
experiencing bowel incontinence and is
starting a bowel retraining program.
Which strategy is inappropriate?
a. Eating a diet high in fiber
b. Setting a regular time for elimination
c. Using an elevated toilet seat
d. Limiting fluid intake to 1000mL/day
Which of the following is an
inappropriate outcome to establish with
a client who has multiple sclerosis?
a. The client will develop joint mobility
b. The client will develop muscle
strength
c. The client will develop cognition
d. The client will develop mood elevation
Which intervention should the nurse
suggest to help a client with multiple
sclerosis avoid episodes of urinary
incontinence?
a. Limit fluid intake to 1000mL/day
b. Insert an indwelling urinary catheter
c. Establish a regular voiding schedule
d. Administer prophylactic antibiotics,
as ordered
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 brings which of
the following items into the client’s
room?
a. Nebulizer and pulse oximeter
b. Blood pressure cuff and flashlight
c. Flashlight and incentive spirometer
d. Electrocardiographic
monitoring electrodes and
intubation tray
The client is admitted in the
hospital with a diagnosis of
Guillain-Barré syndrome. The
nurse inquires during the nursing
admission interview if the client
has a history of :
a. Seizures or trauma to the brain
b. Meningitis during the last 5 years
c. Back injury or trauma to the
spinal chord
d. Respiratory or gastrointestinal
infection during the previous
month
Which conditions or factors in a middle-
aged woman diagnosed with Guillain-
Barré syndrome are most likely to have
contributed to this problem?
a. Her neighbor also had Guillain-Barré
syndrome.
b. She had a viral infection about 2
weeks ago
c. She works with oil paints and paint
thinner as an artist.
d. She has a cardiac dysrhythmia.
The client has been diagnosed to have
Guillain-Barre Syndrome (GBS). Which
of the following should the nurse include
in the nursing care plan of the client?
a) check ability to hear
b) check bladder distention
c) check blood pressure every 2 hours
d) check deep tendon reflexes every
shift
Which of the following problems in a
client with Guillain-Barre
Syndrome (GBS) should be given
highest priority by the nurse?
a) renal problems
b) neurologic problems
c) respiratory problems
d) cardiovascular problems
Which of the following nursing
interventions would be included in the
care plan for a patient with Guillain-
Barre Syndrome (GBS)?
a. Encourage the patient to void 1 hour
after drinking
b. Order a low-residue diet
c. Provide total assistance as needed
with all activities of daily living
d. Instruct the patient on daily muscle
stretching
The 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
The nurse is teaching the 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 exercise
c. Doing all chores early in the day
while less fatigued
d. Taking medications on time to
maintain therapeutic blood level
The nurse 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
A client with myasthenia gravis asks the
nurse why the disease has occurred.
What pathology underlies the nurse’s
reply?
a. A genetic defect in the production of
acetylcholine
b. An inefficient use of the
neurotransmitter acetylcholine
c. A decreased number of functioning
acetylcholine receptor sites
d. An inhibition of the enzyme AChE,
leaving the end-plates folded
A client with myasthenia gravis has
been receiving neostigmine (Prostigmin)
and asks about its action. What
information about its action should the
nurse consider when formulating a
response?
a. Stimulates the cerebral cortex
b. Blocks the action of cholinesterase
c. Replaces deficient neurotransmitters
d. Accelerates transmission along neural
sheaths
The client had been diagnosed to
have Parkinson's disease. He is
receiving levodopa. Which of the
following health teachings should be
included by the nurse?
a. avoid over exposure to sunlight
b. avoid taking pyridoxine and fortified
cereals
c. increase fluid intake
d. discontinue the drug if it causes
reddish brown discoloration of urine
The nurse identifies the nursing
diagnosis of impaired physical mobility
related to bradykinesia for a patient with
Parkinson’s disease. To assist the
patient to ambulate safely, the nurse
should:
a. Allow the patient to ambulate only
with assistance.
b. Instruct the patient to rock from side
to side to initiate leg movement.
c. Have the patient take small steps in a
straight line directly in front of the feet.
d. Teach the patient to keep the feet in
contact with the floor and slide them
forward.
What is the primary responsibility of a
nurse during a client’s generalized motor
seizure?
a. Inserting a plastic airway between the
teeth
b. Determining whether an aura was
experienced
c. Administering the prescribed prn
anticonvulsant
d. Clearing the immediate environment
for client safety
When entering a room on a medical unit,
the nurse identifies that a client is having
a seizure. What should the nurse do in
addition to protecting the client from self-
injury?
a. Insert an oral airway.
b. Monitor the seizure activity.
c. restraint the patient’s extremities
d. Begin oxygen by mask at 8 L/min.
A client is diagnosed with Parkinson
disease and asks the nurse what causes
the disease. On which underlying
pathology does the nurse base a
response?
a. Disintegration of the myelin sheath
b. Breakdown of the corpora
quadrigemina
c. Reduced acetylcholine receptors at
synapses
d. Degeneration of the neurons of the
basal ganglia
What does the nurse understand that
clients with myasthenia gravis, Guillain-
Barré syndrome, and amyotrophic
lateral sclerosis (ALS) share in
common?
1. Progressive deterioration until death
2. Deficiencies of essential
neurotransmitters
3. Increased risk for respiratory
complications
4. Involuntary twitching of small muscle
groups
Which teaching intervention is most
appropriate for the client with
Parkinson’s disease?
a. Universal precautions
b. Seizure precautions
c. Fall precautions
d. Isometric exercises
The client had been diagnosed to
have Parkinson's disease. He is
receiving levodopa. Which of the
following health teachings should be
included by the nurse?
a) avoid over exposure to sunlight
b) avoid taking pyridoxine and fortified
cereals
c) increase fluid intake
d) discontinue the drug if it causes
reddish brown discoloration of urine
The nurse identifies the nursing
diagnosis of impaired physical mobility
related to bradykinesia for a patient with
Parkinson’s disease. To assist the
patient to ambulate safely, the nurse
should:
a. Allow the patient to ambulate only
with assistance.
b. Instruct the patient to rock from side
to side to initiate leg movement.
c. Have the patient take small steps in a
straight line directly in front of the feet.
d. Teach the patient to keep the feet in
contact with the floor and slide them
forward.
What is the primary responsibility of a
nurse during a client’s generalized motor
seizure?
1. Inserting a plastic airway between the
teeth
2. Determining whether an aura was
experienced
3. Administering the prescribed prn
anticonvulsant
4. Clearing the immediate environment
for client safety
When entering a room on a medical unit,
the nurse identifies that a client is having
a seizure. What should the nurse do in
addition to protecting the client from self-
injury?
1. Insert an oral airway.
2. Monitor the seizure activity.
3. restraint the patient’s extremities
4. Begin oxygen by mask at 8 L/min.
What nursing action is essential when a
client experiences hemianopsia as the
result of a left ischemic stroke?
1. Place objects within the visual field.
2. Teach passive range of motion
exercises.
3. Instill artificial tear drops into the
affected eye.
4. Reduce time client is positioned on
the left side.
Which health problem does the nurse
identify from an older client’s history that
increases the client’s risk factors for a
brain attack?
1. Glaucoma
2. Hypothyroidism
3. Continuous nervousness
4. Transient ischemic attacks
A client is diagnosed with Parkinson
disease and asks the nurse what causes
the disease. On which underlying
pathology does the nurse base a
response?
1. Disintegration of the myelin sheath
2. Breakdown of the corpora
quadrigemina
3. Reduced acetylcholine receptors at
synapses
4. Degeneration of the neurons of the
basal ganglia
The nurse identifies the nursing
diagnosis of impaired physical mobility
related to bradykinesia for a patient with
Parkinson’s disease. To assist the
patient to ambulate safely, the nurse
should:
a. Allow the patient to ambulate only
with assistance.
b. Instruct the patient to rock from side
to side to initiate leg movement.
c. Have the patient take small steps in a
straight line directly in front of the feet.
d. Teach the patient to keep the feet in
contact with the floor and slide them
forward.
Which statement indicates that the
family has a good understanding of the
changes in motor movement associated
with Parkinson’s disease?
a. “I can never tell what he’s thinking. He
hides behind a frozen face.”
b. “She drools all the time just so I can’t
take her out anywhere.”
c. “I think this disease makes him
nervous. He perspires all the time.”
d. “I can offer smaller meals with bite- c. Fall precautions
size portions and a liquid supplement.”
d. Isometric exercises

While assessing airway and breathing,

Mrs. Perlita presenting with increased
ICP would most likely exhibit which of
the following vital signs?
a. BP 190/84, HR 150 and an
irregular respiratory pattern
b. BP 80/50, HR 50 and Kussmaul
respirations
c. BP 80/50, HR 150 and Cheyne-
Stokes respiration
d. BP 190/84, HR 50 and an
irregular respiratory pattern
Which statement made by Mr. Delima
who is going home after a trans-
sphenoidal hypophysectomy indicates
an adequate understanding of actions to
prevent complications from this
treatment?
a. “I will wear dark glasses whenever I
am outdoors.”
b. “I will keep food on upper shelves in
the refrigerator so that I do not have to
bend over.”
c. “I will wash the incision line every day
with peroxide and redress it
immediately.”
d. “I will remember to cough and deep
breathe at least every 2 hours while I am
awake.”
Which teaching intervention is most
appropriate for the client with
Parkinson’s disease?
a. Universal precautions
b. Seizure precautions