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NCLEX Neuro

Subjects : nclex, health-sciences, nursing

Instructions:

Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can study here.
Match each statement with the correct term.
Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.

This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.

1. acceleration injury
Blunt trauma
Short loss of consciousness (just a few seconds) with few or no symptoms. The patient - most often a child - typically interrupts an activity and stares blankly. These seizures begin and end abruptly and may occur several times a day. Patients are us
A client with a spinal cord injury is prone to experiencing autonomic dysreflexia. The nurse would avoid which of the following measures to minimize the risk of recurrence?
Head is suddenly forced to stop or start moving - or to turn rapidly.

2. Dopamine
Caused by a blow to the back of the head - characteristic signs: blood in the sinuses; a clear fluid called cerebrospinal fluid (CSF) leaking from the nose or ears; raccoon eyes
Which neurotransmitter is responsible for may of the functions of the frontal lobe?
Meningies - csf - blood - brain barrier - skull
A client who is regaining consciousness after a craniotomy becomes restless and attempts to pull out her IV line. Which nursing intervention protects the client without increasing her ICP?

3. Unequal pupil size
Gap between the dura and the cortical surface of the brain.
A client is at risk for increased ICP. Which of the following would be a priority for the nurse to monitor?
A client who is regaining consciousness after a craniotomy becomes restless and attempts to pull out her IV line. Which nursing intervention protects the client without increasing her ICP?
Collision between a rapidly moving body part and a stationary object

4. Parkinson's disease
A patient with glaucoma has medication prescribed to decrease intraocular pressure. Which of the following medication should be questioned by the nurse?
A client with head trauma develops a urine output of 300 ml/hr - dry skin - and dry mucous membranes. Which of the following nursing interventions is the most appropriate to perform initially?
A gentleman from Peru is brought by his wife to the clinic. He does not speak English and she is translating for him. You learn that he was a manganese miner for over twenty years. This gentleman is at particular risk of developing symptoms of which
A client has noticed a decrease in taste sensation. Which of the following cranial nerves are most likely involved

5. Intracranial hemorrhages
Sudden and general loss of muscle tone - particularly in the arms and legs - which often results in a fall.
Dural and arachnoid membranes and their associated blood vessels are readily torn by the impact and fractured bone fragments
Muscle stiffness - rigidity
Blunt trauma

6. Hyperflexion injuries
An 18-year - old client is admitted with a closed head injury sustained in a MVA. His intracranial pressure (ICP) shows an upward trend. Which intervention should the nurse perform first?
Dural and arachnoid membranes and their associated blood vessels are readily torn by the impact and fractured bone fragments
Whiplash - shaken baby
A patient in the hospital for observation after a presumed seizure is found thrashing about in his room. Which of the following would be an improper intervention?

7. Clonic Seizure
Repetitive - rhythmic jerks that involve both sides of the body at the same time.
You are working in the emergency department when a college freshman is brought in by his roommate. The freshman has a severe headache - stiff neck - subjective fever and his roommate had to pull over en route to the hospital to let the patient vomit.
Which of the following physiologic changes would be expected in a patient with presbyopia?
Muscle stiffness - rigidity

8. 'Wake him every hour and assess his orientation to person - time - and place
Vitals/turn freq/call light close/ ROM
After falling 20' - a 36-year - old man sustains a C6 fracture with spinal cord transaction. Which other findings should the nurse expect
An 18-year - old client was hit in the head with a baseball during practice. When discharging him to the care of his mother - the nurse gives which of the following instructions?
Gap between the dura and the cortical surface of the brain.

9. Evaluate urine specific gravity
Repetitive - rhythmic jerks that involve both sides of the body at the same time.
A patient has a normal sensory change that results in diminished sense of taste. How would this be documented
A client comes into the ER after hitting his head in an MVA. He's alert and oriented. Which of the following nursing interventions should be done first?
A client with head trauma develops a urine output of 300 ml/hr - dry skin - and dry mucous membranes. Which of the following nursing interventions is the most appropriate to perform initially?

10. Decrease in LOC

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11. Place a tongue - blade in the patient's mouth to prevent blockage of the airway.
A patient has a normal sensory change that results in diminished sense of taste. How would this be documented
Dural and arachnoid membranes and their associated blood vessels are readily torn by the impact and fractured bone fragments
A patient in the hospital for observation after a presumed seizure is found thrashing about in his room. Which of the following would be an improper intervention?
A client has been pronounced brain dead. Which findings would the nurse assess?

12. Rapid dilantin administration can cause cardiac arrhythmias
An 18-year - old client is admitted with a closed head injury sustained in a MVA. His intracranial pressure (ICP) shows an upward trend. Which intervention should the nurse perform first?
Collision between a rapidly moving body part and a stationary object
A 23-year - old client has been hit on the head with a baseball bat. The nurse notes clear fluid draining from his ears and nose. Which of the following nursing interventions should be done first?
A client with a subarachnoid hemorrhage is prescribed a 1 -000- mg loading dose of Dilantin IV. Which consideration is most important when administering this dose?

13. nsg intervention for spinal injury
Vitals/turn freq/call light close/ ROM
Sporadic jerks - usually on both sides of the body. Patients sometimes describe the jerks as brief electrical shocks. When violent - these seizures may result in dropping or involuntarily throwing objects.
After falling 20' - a 36-year - old man sustains a C6 fracture with spinal cord transaction. Which other findings should the nurse expect
A client is admitted to the ER for head trauma is diagnosed with an epidural hematoma. The underlying cause of epidural hematoma is usually related to which of the following conditions?

14. Immobilize the client's head and neck

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15. Put the client in the high - Fowler's position
Which neurotransmitter is responsible for may of the functions of the frontal lobe?
A client arrives at the ER after slipping on a patch of ice and hitting her head. A CT scan of the head shows a collection of blood between the skull and dura mater. Which type of head injury does this finding suggest?
During an episode of autonomic dysreflexia in which the client becomes hypertensive - the nurse should perform which of the following interventions?
Gap between the dura and the cortical surface of the brain.

16. Basilar skull fractures
A client is admitted to the ER for head trauma is diagnosed with an epidural hematoma. The underlying cause of epidural hematoma is usually related to which of the following conditions?
Caused by a blow to the back of the head - characteristic signs: blood in the sinuses; a clear fluid called cerebrospinal fluid (CSF) leaking from the nose or ears; raccoon eyes
Sporadic jerks - usually on both sides of the body. Patients sometimes describe the jerks as brief electrical shocks. When violent - these seizures may result in dropping or involuntarily throwing objects.
Blunt trauma

17. Decorticate
Abnormal posturing that involves rigidity - flexion of the arms - clenched fists - and extended legs.
Which of the following nursing interventions is appropriate for a client with an ICP of 20 mm Hg?
The nurse is evaluating neurological signs of the male client in spinal shock following spinal cord injury. Which of the following observations by the nurse indicates that spinal shock persists?
A client with head trauma develops a urine output of 300 ml/hr - dry skin - and dry mucous membranes. Which of the following nursing interventions is the most appropriate to perform initially?

18. Laceration of the middle meningeal artery
A client who is regaining consciousness after a craniotomy becomes restless and attempts to pull out her IV line. Which nursing intervention protects the client without increasing her ICP?
The nurse is discussing the purpose of an electroencephalogram (EEG) with the family of a client with massive cerebral hemorrhage and loss of consciousness. It would be most accurate for the nurse to tell family members that the test measures which o
A client with head trauma develops a urine output of 300 ml/hr - dry skin - and dry mucous membranes. Which of the following nursing interventions is the most appropriate to perform initially?
A client is admitted to the ER for head trauma is diagnosed with an epidural hematoma. The underlying cause of epidural hematoma is usually related to which of the following conditions?

19. 'The lens is normally transparent
A patient has a question about a recent eye exam. Which of the following statements would be an accurate response to inquiry?
A client with a subarachnoid hemorrhage is prescribed a 1 -000- mg loading dose of Dilantin IV. Which consideration is most important when administering this dose?
After falling 20' - a 36-year - old man sustains a C6 fracture with spinal cord transaction. Which other findings should the nurse expect
A client has been pronounced brain dead. Which findings would the nurse assess?

20. Myoclonic Seizure
A client is at risk for increased ICP. Which of the following would be a priority for the nurse to monitor?
A patient has a question about a recent eye exam. Which of the following statements would be an accurate response to inquiry?
Sporadic jerks - usually on both sides of the body. Patients sometimes describe the jerks as brief electrical shocks. When violent - these seizures may result in dropping or involuntarily throwing objects.
A client with history of glaucoma was diagnosed by the community nurse as experiencing Visual Sensory/Perceptual Alterations R/T increased intraocular pressure. The plan of care should focus on:

21. Noxious stimuli
A patient with glaucoma has medication prescribed to decrease intraocular pressure. Which of the following medication should be questioned by the nurse?
Sudden and general loss of muscle tone - particularly in the arms and legs - which often results in a fall.
A nurse assesses a client who has episodes of autonomic dysreflexia. Which of the following conditions can cause autonomic dysreflexia?
Whiplash - shaken baby

22. 4 things that protect the brain
A patient has a question about a recent eye exam. Which of the following statements would be an accurate response to inquiry?
Meningies - csf - blood - brain barrier - skull
A 22-year - old client with quadriplegia is apprehensive and flushed - with a blood pressure of 210/100 and a heart rate of 50 bpm. Which of the following nursing interventions should be done first?
The nurse is caring for the client in the ER following a head injury. The client momentarily lost consciousness at the time of the injury and then regained it. The client now has lost consciousness again. The nurse takes quick action - knowing this i

23. Hypogeusia
A patient has a normal sensory change that results in diminished sense of taste. How would this be documented
Which of the following respiratory patterns indicate increasing ICP in the brain stem?
A client with a subarachnoid hemorrhage is prescribed a 1 -000- mg loading dose of Dilantin IV. Which consideration is most important when administering this dose?
After falling 20' - a 36-year - old man sustains a C6 fracture with spinal cord transaction. Which other findings should the nurse expect

24. The patient should be placed on droplet precautions.
Which of the following respiratory patterns indicate increasing ICP in the brain stem?
Vitals/turn freq/call light close/ ROM
Which of the following describes decerebrate posturing?
You are working in the emergency department when a college freshman is brought in by his roommate. The freshman has a severe headache - stiff neck - subjective fever and his roommate had to pull over en route to the hospital to let the patient vomit.

25. Back arched; rigid extension of all four extremities.
Head is suddenly forced to stop or start moving - or to turn rapidly.
A client has noticed a decrease in taste sensation. Which of the following cranial nerves are most likely involved
Which of the following describes decerebrate posturing?
A client arrives at the ER after slipping on a patch of ice and hitting her head. A CT scan of the head shows a collection of blood between the skull and dura mater. Which type of head injury does this finding suggest?

26. Slow - irregular respirations
A 22-year - old client with quadriplegia is apprehensive and flushed - with a blood pressure of 210/100 and a heart rate of 50 bpm. Which of the following nursing interventions should be done first?
A client with history of glaucoma was diagnosed by the community nurse as experiencing Visual Sensory/Perceptual Alterations R/T increased intraocular pressure. The plan of care should focus on:
A patient has a question about a recent eye exam. Which of the following statements would be an accurate response to inquiry?
Which of the following respiratory patterns indicate increasing ICP in the brain stem?

27. Equal pupillary constriction in response to light
You are the nurse assigned to perform an eye assessment on an 80-year - old client. Which of the following findings during the assessment is considered normal?
Repetitive - rhythmic jerks that involve both sides of the body at the same time.
A gentleman from Peru is brought by his wife to the clinic. He does not speak English and she is translating for him. You learn that he was a manganese miner for over twenty years. This gentleman is at particular risk of developing symptoms of which
A client has signs of increased ICP. Which of the following is an early indicator of deterioration in the client's condition?

28. Wrap her hands in soft 'mitten' restraints
A client who is regaining consciousness after a craniotomy becomes restless and attempts to pull out her IV line. Which nursing intervention protects the client without increasing her ICP?
You are working in the emergency department when a college freshman is brought in by his roommate. The freshman has a severe headache - stiff neck - subjective fever and his roommate had to pull over en route to the hospital to let the patient vomit.
A client receiving vent - assisted mode ventilation begins to experience cluster breathing after recent intracranial occipital bleeding. Which action would be most appropriate?
The nurse is caring for the client in the ER following a head injury. The client momentarily lost consciousness at the time of the injury and then regained it. The client now has lost consciousness again. The nurse takes quick action - knowing this i

29. Damage to cranial nerve I
A client has noticed a decrease in taste sensation. Which of the following cranial nerves are most likely involved
A 78-year - old client is admitted to the Emergency Department (ED) via emergency medical service (EMS) with complaints of severe diarrhea with resultant weakness and signs of dehydration. Discussion with the significant other reveals that the patien
A gentleman from Peru is brought by his wife to the clinic. He does not speak English and she is translating for him. You learn that he was a manganese miner for over twenty years. This gentleman is at particular risk of developing symptoms of which
Gap between the dura and the cortical surface of the brain.

30. Absence Seizure
A client with history of glaucoma was diagnosed by the community nurse as experiencing Visual Sensory/Perceptual Alterations R/T increased intraocular pressure. The plan of care should focus on:
After falling 20' - a 36-year - old man sustains a C6 fracture with spinal cord transaction. Which other findings should the nurse expect
Sudden and general loss of muscle tone - particularly in the arms and legs - which often results in a fall.
Short loss of consciousness (just a few seconds) with few or no symptoms. The patient - most often a child - typically interrupts an activity and stares blankly. These seizures begin and end abruptly and may occur several times a day. Patients are us

31. Generalized seizures
are produced by electrical impulses from throughout the entire brain
A client who is regaining consciousness after a craniotomy becomes restless and attempts to pull out her IV line. Which nursing intervention protects the client without increasing her ICP?
A client arrives at the ER after slipping on a patch of ice and hitting her head. A CT scan of the head shows a collection of blood between the skull and dura mater. Which type of head injury does this finding suggest?
A 78-year - old client is admitted to the Emergency Department (ED) via emergency medical service (EMS) with complaints of severe diarrhea with resultant weakness and signs of dehydration. Discussion with the significant other reveals that the patien

32. generalized and partial (also called local or focal)
The nurse is discussing the purpose of an electroencephalogram (EEG) with the family of a client with massive cerebral hemorrhage and loss of consciousness. It would be most accurate for the nurse to tell family members that the test measures which o
Abnormal posturing that involves rigidity - flexion of the arms - clenched fists - and extended legs.
A client arrives at the ER after slipping on a patch of ice and hitting her head. A CT scan of the head shows a collection of blood between the skull and dura mater. Which type of head injury does this finding suggest?
Seizures are divided into two broad categories:

33. Encourage the client to hyperventilate
You are the nurse assigned to perform an eye assessment on an 80-year - old client. Which of the following findings during the assessment is considered normal?
A client with a spinal cord injury is prone to experiencing autonomic dysreflexia. The nurse would avoid which of the following measures to minimize the risk of recurrence?
Which of the following nursing interventions is appropriate for a client with an ICP of 20 mm Hg?
Gap between the dura and the cortical surface of the brain.

34. Loss of lens elasticity
Which of the following clients on the rehab unit is most likely to develop autonomic dysreflexia?
Which of the following physiologic changes would be expected in a patient with presbyopia?
The nurse is evaluating neurological signs of the male client in spinal shock following spinal cord injury. Which of the following observations by the nurse indicates that spinal shock persists?
A client with head trauma develops a urine output of 300 ml/hr - dry skin - and dry mucous membranes. Which of the following nursing interventions is the most appropriate to perform initially?

35. Raise the head of the bed immediately to 90 degrees
A 22-year - old client with quadriplegia is apprehensive and flushed - with a blood pressure of 210/100 and a heart rate of 50 bpm. Which of the following nursing interventions should be done first?
A client comes into the ER after hitting his head in an MVA. He's alert and oriented. Which of the following nursing interventions should be done first?
A client with history of glaucoma was diagnosed by the community nurse as experiencing Visual Sensory/Perceptual Alterations R/T increased intraocular pressure. The plan of care should focus on:
Short loss of consciousness (just a few seconds) with few or no symptoms. The patient - most often a child - typically interrupts an activity and stares blankly. These seizures begin and end abruptly and may occur several times a day. Patients are us

36. A trauma nurse is caring for a patient that sustained trauma to the head. She notices that the patient has a 'blown pupil' (one pupil is fixed a dilated). This is caused by intracranial swelling and brain herniation. A blown pupil is caused by disrup
CN III
Which of the following respiratory patterns indicate increasing ICP in the brain stem?
A client with head trauma develops a urine output of 300 ml/hr - dry skin - and dry mucous membranes. Which of the following nursing interventions is the most appropriate to perform initially?
Sudden and general loss of muscle tone - particularly in the arms and legs - which often results in a fall.

37. Atonic Seizure
Gap between the dura and the cortical surface of the brain.
The nurse is evaluating neurological signs of the male client in spinal shock following spinal cord injury. Which of the following observations by the nurse indicates that spinal shock persists?
A client with a cervical spine injury has Gardner - Wells tongs inserted for which of the following reasons?
Sudden and general loss of muscle tone - particularly in the arms and legs - which often results in a fall.

38. Call the physician while another nurse checks the vital signs and ascertains the patient's Glasgow Coma score
A client receiving vent - assisted mode ventilation begins to experience cluster breathing after recent intracranial occipital bleeding. Which action would be most appropriate?
The nurse is discussing the purpose of an electroencephalogram (EEG) with the family of a client with massive cerebral hemorrhage and loss of consciousness. It would be most accurate for the nurse to tell family members that the test measures which o
Muscle stiffness - rigidity
You are working in the emergency department when a college freshman is brought in by his roommate. The freshman has a severe headache - stiff neck - subjective fever and his roommate had to pull over en route to the hospital to let the patient vomit.

39. 'Grand Mal' or Generalized tonic - clonic
Gap between the dura and the cortical surface of the brain.
Unconsciousness - convulsions - muscle rigidity
A client is admitted to the ER for head trauma is diagnosed with an epidural hematoma. The underlying cause of epidural hematoma is usually related to which of the following conditions?
A client with a subarachnoid hemorrhage is prescribed a 1 -000- mg loading dose of Dilantin IV. Which consideration is most important when administering this dose?

40. Dilated non reactive pupils
A client has been pronounced brain dead. Which findings would the nurse assess?
You are the nurse assigned to perform an eye assessment on an 80-year - old client. Which of the following findings during the assessment is considered normal?
Abnormal posturing that involves rigidity - flexion of the arms - clenched fists - and extended legs.
are produced (at least initially) by electrical impulses in a relatively small part of the brain.

41. Limiting bladder catherization to once every 12 hours
You are the nurse assigned to perform an eye assessment on an 80-year - old client. Which of the following findings during the assessment is considered normal?
Collision between a rapidly moving body part and a stationary object
A gentleman from Peru is brought by his wife to the clinic. He does not speak English and she is translating for him. You learn that he was a manganese miner for over twenty years. This gentleman is at particular risk of developing symptoms of which
A client with a spinal cord injury is prone to experiencing autonomic dysreflexia. The nurse would avoid which of the following measures to minimize the risk of recurrence?

42. Encouraging compliance with drug therapy to prevent loss of vision
During an episode of autonomic dysreflexia in which the client becomes hypertensive - the nurse should perform which of the following interventions?
Repetitive - rhythmic jerks that involve both sides of the body at the same time.
A client with history of glaucoma was diagnosed by the community nurse as experiencing Visual Sensory/Perceptual Alterations R/T increased intraocular pressure. The plan of care should focus on:
Which of the following physiologic changes would be expected in a patient with presbyopia?

43. Epidural hematoma
A patient has a question about a recent eye exam. Which of the following statements would be an accurate response to inquiry?
Vitals/turn freq/call light close/ ROM
The nurse is caring for the client in the ER following a head injury. The client momentarily lost consciousness at the time of the injury and then regained it. The client now has lost consciousness again. The nurse takes quick action - knowing this i
Which neurotransmitter is responsible for may of the functions of the frontal lobe?

44. deceleration injury
Collision between a rapidly moving body part and a stationary object
Which neurotransmitter is responsible for may of the functions of the frontal lobe?
Gap between the dura and the cortical surface of the brain.
Which of the following respiratory patterns indicate increasing ICP in the brain stem?

45. CN IX and CN VII
A client with a spinal cord injury is prone to experiencing autonomic dysreflexia. The nurse would avoid which of the following measures to minimize the risk of recurrence?
A client has noticed a decrease in taste sensation. Which of the following cranial nerves are most likely involved
Sporadic jerks - usually on both sides of the body. Patients sometimes describe the jerks as brief electrical shocks. When violent - these seizures may result in dropping or involuntarily throwing objects.
A patient in the hospital for observation after a presumed seizure is found thrashing about in his room. Which of the following would be an improper intervention?

46. Depressed skull fractures
Dural and arachnoid membranes and their associated blood vessels are readily torn by the impact and fractured bone fragments
A client is at risk for increased ICP. Which of the following would be a priority for the nurse to monitor?
A client comes into the ER after hitting his head in an MVA. He's alert and oriented. Which of the following nursing interventions should be done first?
High - energy transfer - such as a blow from a baseball bat

47. Subdural hemorrhage
Gap between the dura and the cortical surface of the brain.
A client with a cervical spine injury has Gardner - Wells tongs inserted for which of the following reasons?
Unconsciousness - convulsions - muscle rigidity
Blunt trauma

48. To immobilize the surgical spine
Sporadic jerks - usually on both sides of the body. Patients sometimes describe the jerks as brief electrical shocks. When violent - these seizures may result in dropping or involuntarily throwing objects.
Which of the following describes decerebrate posturing?
Which of the following respiratory patterns indicate increasing ICP in the brain stem?
A client with a cervical spine injury has Gardner - Wells tongs inserted for which of the following reasons?

49. partial seizures
A client has signs of increased ICP. Which of the following is an early indicator of deterioration in the client's condition?
Sporadic jerks - usually on both sides of the body. Patients sometimes describe the jerks as brief electrical shocks. When violent - these seizures may result in dropping or involuntarily throwing objects.
are produced (at least initially) by electrical impulses in a relatively small part of the brain.
A patient with glaucoma has medication prescribed to decrease intraocular pressure. Which of the following medication should be questioned by the nurse?

50. Tonic Seizure
The nurse is discussing the purpose of an electroencephalogram (EEG) with the family of a client with massive cerebral hemorrhage and loss of consciousness. It would be most accurate for the nurse to tell family members that the test measures which o
Blunt trauma
High - energy transfer - such as a blow from a baseball bat
Muscle stiffness - rigidity