1 The nurse is assessing the motor function of an unconscious client. The nurse should plan to use which technique to test the client’s peripheral response to pain?
1. Sternal rub
2. Nail Bed Pressure
3. Pressure on orbital rim
4. Squeezing of the sternocleidomastoid muscle
2. Nail Bed Pressure
Ans
2 The nurse is caring for the client with increased intracranial pressure. The nurse would note which trend in VS if the intracranial pressure is rising?
1. Increasing temperature, increasing pulse, increasing respirations, decreasing BP
2. Increasing temperature, decreasing pulse, decreasing respirations, increasing BP
3. Decreasing temperature, decreasing pulse, increasing respirations, decreasing BP
4. Decreasing temperature, increasing pulse, decreasing respirations, increasing BP
Ans
2. Increasing temperature, decreasing pulse, decreasing respirations, increasing BP
3 A client recovering from a head injury is participating in care. The nurse determines that the client understands measures to prevent elevations in intracranial pressure if the nurse observes the client doing the activity?
1. Blowing the nose
2. Isometric exercises
3. Coughing vigorously
4. Exhaling during repositioning
Ans
4. Exhaling during repositioning
4 A client has clear liquid leaking from the nose following a basilar skull fracture. Which findings would alert the nurse that cerebrospinal fluid is present?
1. Fluid is clear and tests negative for glucose.
2. Fluid is grossly bloody in appearance and has a pH of 6.
3. Fluid clumps together on the dressing and has a pH of 7.
4. Fluid separates into concentric rings and tests positive for glucose.
Ans
4. Fluid separates into concentric rings and tests positive for glucose.
5 A client with a spinal chord injury is prone to experiencing autonomic dysreflexia. The nurse should avoid which measure to minimize the risk of occurrence?
1. Strict adherence to a bowel retraining program
2 Keeping the linen wrinkle-free under the client
3. Preventing unnecessary pressure on the lower limbs
4. Limiting bladder catheterization to once ever 12 hours
Ans
4. Limiting bladder catheterization to once ever 12 hours
6 The nurse is evaluating the neurological signs of a client in spinal shock following spinal chord injury. Which observation indicates that spinal shock persists?
1. Hyperreflexia
2. Positive reflexes
3. Flaccid paralysis
4. Reflex emptying of the bladder
Ans
3. Flaccid paralysis
7 The nurse is caring for a client who begins to experience seizure activity while in bed. Which action by the nurse is contraindicated?
1. Loosening restrictive clothing
2. Restraining the client’s limbs
3. Removing the pillow and raising padded side rails
4. Positioning the client to the side, if possible, with the head flexed forward
Ans
2. Restraining the client’s limbs
8 The nurse has instructed the family of a client with stroke (brain attack) who has homonymous hemianopsia about measures to help the client overcome the deficit. Which statement suggests that the family understands the measures to help when caring for the client?
1. “We need to discourage him from wearing eyeglasses.”
2. “We need to place objects in his impaired field of vision.”
3. “We need to approach him from the impaired field of vision.”
4. “We need to remind him to turn his head to scan the lost visual field.”
Ans
4. “We need to remind him to turn his head to scan the lost visual field.”
9 The nurse is assessing the adaption of a client to changes in functional status after a stroke (brain attack). Which observation indicates to the nurse that the client is adapting most successfully?
1. Gets angry with the family if they interrupt a task
2. Experiences bouts of depression and irritability
3. Has difficulty with using modified feeding utensils
4. Consistently uses adaptive equipment in dressing self
Ans
4. Consistently uses adaptive equipment in dressing self
10 The nurse is teaching a client with myasthenia gravis about the prevention of myasthenic and cholinergic crises. Which client activity suggests that teaching is most effective?
1. Eating large, well-balanced meals
2. Doing muscle-strengthening exercises
3. Doing all chores early in the day while less fatigued
4. Taking medications on time to maintain therapeutic blood levels
Ans
4. Taking medications on time to maintain therapeutic blood levels
11 The nurse has given instructions to a client with Parkinson’s Disease about maintaining mobility. Which action demonstrates that the client understands the directions?
1. Sits in soft, deep chairs to promote comfort.
2. Exercises in the evening to combat fatigue.
3. Rocks back and forth to start movement with bradykinesia.
4. Buys clothes with many buttons to maintain finger dexterity.
Ans
3. Rocks back and forth to start movement with bradykinesia.
12 The nurse has given suggestions to a client with trigeminal neuralgia about strategies to minimize episodes of pain. The nurse determines that the client needs further education if the client makes which statement?
1. “I will wash my face with cotton pads.”
2. “I’ll have to start chewing on my unaffected side.”
3. “I’ll try to eat my food either very warm or very cold.”
4. “I should rinse my mouth if toothbrushing is painful.”
Ans
3. “I’ll try to eat my food either very warm or very cold.”
13 The client is admitted to the hospital with a dx of Guillian-Barre syndrome. Which past medical history finding makes the client most at risk for the disease?
1. Meningitis or encephalitis during the last 5 years
2. Seizures or trauma to the brain within the last year
3. Back injury or trauma to the spinal chord during the last 2 years
4. Respiratory or gastrointestinal infection during the previous month
Ans
4. Respiratory or gastrointestinal infection during the previous month
14 A client with Guillian-Barre syndrome has ascending paralysis and is intubated and receiving mechanical ventilation. Which strategy should the nurse incorporate in the plan of care to help the client cope with this illness?
1. Giving client full control over care decisions and restricting visitors
2. providing positive feedback and encouraging active range of motion
3. Providing information, giving positive feedback, and encouraging relaxation
4. Providing IV administered sedatives, reducing distractions, and limiting visitors
Ans
3. Providing information, giving positive feedback, and encouraging relaxation
15 A client has a neurological deficit involving the limbic system. Which assessment finding is specific to this type of deficit?
1. Is disoriented to person, place, and time
2. Affect is flat, with periods of emotional lability
3. Cannot recall what was eaten for breakfast today
4. Demonstrates inability to add and subtract; does not know who is the president of the United States.
2. Affect is flat, with periods of emotional lability
16 The nurse is evaluating the status of a client who had a craniotomy 3 days ago. Which assessment finding would indicate that the client is developing meningitis as a complication of surgery?
1. A negative Kernig sign
2. Absence of nuchal rigidity
3. A positive Brudzinski sign
4. A Glasgow Coma Scale score of 15
Ans
3. A positive Brudzinski sign
17 The nurse has completed discharge instructions for a client with application of a halo device. Which action indicates that the client needs further clarification of the instructions?
1. Uses a straw for drinking
2. Drives only during the daytime
3. Uses caution because the device alters balance
4. Washes the skin daily under the lamb’s wool liner of the vest
Ans
2. Drives only during the daytime
18 The nurse is admitting a client with Guillain-Barre syndrome to the nursing unit. The client has ascending paralysis to the level of the waist. Knowing the complications of the disorder, the nurse should bring most essential items into the client’s room?
1. Nebulizer and pulse oximeter
2. Blood pressure cuff and flashlight
3. Flashlight and incentive spirometer
4. Electrocardiographic monitoring electrodes and intubation tray
Ans
4. Electrocardiographic monitoring electrodes and intubation tray
SECTION 5
1. Which of the following neurotransmitter is known to be associated with sleep, mood and appetite?
A. Acetylcholine
B. Dopamine
C. Serotonin
D. GABA
Answer Key C
2. The neurons of motor pathway control:
A. Stress reaction
B. Organs and glands
C. Involuntary muscles
D. Voluntary muscles
Answer Key D
3. Which of the following would be active when the person is sleeping?
A. Sympathetic nervous system
B. Parasympathetic nervous system
C. Central nervous system
D. Somatic system
Answer Key D
4. The area of the brain which is involved in the understanding of meaning is:
A. Broca’s area
B. Association areas
C. Wernicke’s area
D. Motor speech area
Answer Key C
5. Which is the neurotransmitter believed to be decreased in cognitive disorders, such as Alzheimer’s disease?
A. Acetylcholine
B. Dopamine
C. Serotonin
D. GABA
Answer Key A
6. The neurotransmitter serotonin is derived from which precursor amino acid?
A. Dopamine
B. Tyrosine
C. Tryptophan
D. Glutamine
Answer Key C
7. The location of the blood-brain barrier is considered to be;
A. At the level of the brain capillaries
B. At the level of glia
C. At the level of neurons
D. At the level of dendrites
Answer Key A
8. Identify the major excitatory neurotransmitter system in the mammalian CNS.
A. Aminobutyric acid
B. Histamine
C. Substance P
D. Glutamate/aspartate
Answer Key D
9. Agents that potentiate the actions of GABA in the brain will likely have which of the following effects?
A. Elevate blood pressure
B. Provide sedation
C. Cause seizures
D. Relieve pain
Answer Key B
10. Basal ganglia or neostriatum include the following areas, EXCEPT:
A. Caudate nucleus
B. Putamen
C. Globus pallidus
D. Amygdala
Answer Key D
11. The most common cause of dementia in the general population is
A. Epilepsy
B. Vascular disease
C. Alzheimer’s disease
D. Parkinson’s disease
E. Head trauma
Answer Key C
12. Which of the following medications may retard the progress of Alzheimer’s disease deterioration?
A. Donepezil
B. L-dopa
C. Prednisone
D. Vitamin B12
Answer Key A
13. Spike-and-wave discharges in EEG record is typical of :
A. Parkinson’s disease
B. Alzheimer’s disease
C. Delirium
D. Epilepsy
Answer Key D
14. In the dementia associated with Alzheimer’s disease, the EEG will
usually show:
A. Spike-and-wave discharges
B. Periodic frontal lobe discharges
C. Focal slowing
D. Generalized background slowing
Answer Key D
15. The normal EEG rhythm of an awake adult is
A. Beta waves
B. Alpha waves
C. Delta waves
D. Theta waves.
Answer Key B
16. Parkinson’s disease, is caused by the degeneration of neurons in an
area of the brain called the:
A. substantia nigra
B. Basal ganglia
C. Cerebellum
D. Corpus callosum
Answer Key A
17. The ability to constantly change both structure and function of many cells in the brain in response to experience and trauma is termed as:
A. spasticity
B. neural plasticity.
C. arousal
D. deep lesioning
Answer Key B
18. The division of nervous system which controls the involuntary muscles, organs, and glands is:
A. Somatic nervous system
B. Autonomic nervous system
C. Central nervous system
D. The motor pathway of the CNS.
Answer Key B
19. Parasympathetic system is also called:
A. fight-or-flight system.
B. eat-drink-and-rest system
C. autonomic nervous system
D. somatic nervous system
Answer Key B
20. A condition, causing the affected person to be unable to understand or comprehend the language (poor comprehension) with intact repetition (fluent output) is termed as:
A. Broca’s aphasia
B. Global aphasia
C. Wernicke’s aphasia
D. Conduction aphasia
Answer key C
SECTION F
1. The nurse is about to administer a contrast medium to the client undergoing diagnostic testing. Which question does the nurse first ask the client?
a. “Are you in pain?”
b. “Are you taking ibuprofen daily
c. “Are you wearing any metal?”
d. “Do you know what this test is for?”
B
2. The nurse is caring for a client who is scheduled to have a transcranial Doppler (TCD). What does this diagnostic test evaluate?
a. Cerebral vasospasm
b. Cerebrospinal fluid
c. Evoked potentials
d. Intracranial pressure
A
3. Which task does the nurse plan to delegate to the unlicensed assistive personnel (UAP) caring for a group of clients in the neurosurgical unit?
a. Assist the health care provider in performing a lumbar puncture on a confused client
b. Attend to the care needs of a client who has had a transcranial Doppler study
c. Educate a client about what to expect during an electroencephalogram (EEG)
d. Prepare a client who is going to radiology for a cerebral arteriogram
B
4. Which information is most important for the nurse to communicate to the primary care provider (PCP) about a client who is scheduled for CT angiography?
a. Allergy to penicillin
b. History of bacterial meningitis
c. Poor skin turgor and dry mucous membranes
d. The client’s dose of metformin (Glucophage) held today
C
5. The nurse has just received report on a group of clients on the neurosurgical unit. Which client is the nurse’s first priority?
a. Client whose deep tendon reflexes have become hyperactive
b. Client who displays plantar flexion when the bottom of the foot is stroked
c. Client who consistently demonstrates decortication when stimulated
d. Client whose Glasgow Coma Scale (GCS) has changed from 15 to 13.
D
6. The nurse is performing a neurologic assessment on an 81-year-old client. Which physiologic change does the nurse expect to find because of the client’s age?
a. Decreased coordination
b. Increased sleeping during the night
c. Increased touch sensation
d. Nightly confusion
A
7. Which cranial nerve allows a person to feel a light breeze on the face?
a. I (olfactory)
b. III (oculomotor)
c. V (trigeminal)
d. VII (facial)
C
8. The nurse has just received report on a group of clients. Which client does the nurse assess first?
a. Client who was in a car accident and has a Glasgow Coma Scale score of 14
b. Client who had a cerebral arteriogram and has a cool, pale leg
c. Client who has a headache after undergoing a lumbar puncture
d. Client who has expressive aphasia after a left-sided stroke
B
9. The nurse has just received change-of-shift report about a group of clients on the neurosurgical unit. Which client does the nurse attend to first?
a. Adult postoperative left craniotomy client whose hand grip is weaker on the right
b. Middle-aged adult client who had a cerebral aneurysm clipping and is becoming increasingly confused
c. Older adult client who had a carotid endarterectomy and is unable to state the day of the week
d. Young adult client involved in a motor vehicle crash (MVC) who is yelling obscenities at the nursing staff
B
10. An older client presents to the clinic after a ground level fall at home. What statement by the client indicates the need for more injury prevention education?
a. “I always take my medicine as directed.”
b. “I only eat little snacks so I don’t gain weight.”
c. “I will make sure I drink enough water.”
d. “I make sure to get as much sleep as I used to.”
B
11. A client is scheduled for an electroencephalogram (EEG) in the morning. Which instruction does the nurse give the client?
a. “Do not take any sedatives 12-24 hours before the test.”
b. “Please do not have anything to eat or drink after midnight.”
c. “You may bring some music to listen to for distraction.”
d. “You will need to have someone to drive you home.”
A
12. The nurse prepares to assess a client with diabetes mellitus for sensory loss. Which equipment is the best choice for the nurse use to perform this assessment?
a. Cotton-tipped applicator
b. Glucometer
c. Hammer
d. Safety pin
A
13. The nurse is assessing a client with a neurologic condition who is reporting difficulty chewing when eating. The nurse suspects that which cranial nerve has been affected?
a. Abducens (CN VI)
b. Facial (CN VII)
c. Trigeminal (CN V)
d. Trochlear (CN IV)
C
14. Which client diagnosed with neurologic injury is typically at highest risk for depression?
a. Older man with a mild stroke
b. Older woman with a seizure
c. Young man with a spinal cord injury
d. Young woman with a minor closed head injury
C
15. A client has just returned from cerebral angiography. Which symptom does the client display that causes the nurse to act immediately?
a. Bleeding
b. Increased temperature
c. Severe headache
d. Urge to void
A
16. Which client will the neurologic unit charge nurse assign to a registered nurse who has floated from the labor/delivery unit for the shift?
a. Adult client who has just returned from having a cerebral arteriogram and needs vital sign checks every 15 minutes.
b. Older adult client who was just admitted with a stroke and needs an admission assessment.
c. Young adult client who has had a lumbar puncture and reports, “Light hurts my eyes.”
d. Middle-aged client who has a possible brain tumor and has questions about the scheduled magnetic resonance imaging.
A
17. The nurse is performing a rapid neurologic assessment on a trauma client. Which assessment findings are normal? Select all that apply.
a. Decerebrate posturing
b. Glasgow Coma Score (GCS) 15
c. Lethargy
d. Minimal response to stimulation
e. Pupil constriction to light
B, D
SECTION 6
1 The sympathetic nervous system postganglionic neuron releases what neurotransmitter?
A. Acetylcholine
B. Norepinephrine
C. Both Acetylcholine and Norepinephrine
D. Arginine
The answer is B. Norepinephrine
2 The sympathetic nervous system preganglionic neuron releases what neurotransmitter?
A. Serotonin
B. Acetylcholine
C. Norepinephrine
D. Arginine
The answer is B. Acetylcholine
3 In the sympathetic nervous system ganglia are found? Select all that apply:
A. Thoracic
B. Brain stem
C. Sacral
D. Lumbar
The answers are A and D, thoracic and Lumbar
4 In the parasympathetic nervous system the ganglia are found? Select all that apply:
A. Cervical
B. Brain Stem
C. Lumbar
D. Sacral
The answers are B and D, the brain stem and sacral
5 The postganglionic neuron releases what neurotransmitter in the parasympathetic nervous system?
A. Arginine
B. Norepinephrine
C. Dopamine
D. Acetylcholine
The answer is D. Acetylcholine
6 Select all the signs and symptoms a patient can experience with the stimulation of the sympathetic nervous system: select all that apply:
A. Tachycardia
B. Hypotension
C. Hyperglycemia
D. Dilated pupils
E. Urinary incontinence
F. Bronchodilation
G. Cold and clammy
H. Excessive salivation
I. Sweating
The answers are A, C, D, F, and I. Tachycardia, Hyperglycemia, Dilated pupils, Bronchodilation, and sweating
7 Select all the signs and symptoms a patient can experience with the stimulation of the parasympathetic nervous system: select all that apply:
A. Bradycardia
B. Dilated pupils
C. Bronchoconstriction
D. Constrict pupils
E. Bladder contraction
F. Dry mouth
G. Slow digestion
H. Hypertension
The answers are A, C, D, and E. Bradycardia, Bronchoconstriction, Constrict pupils, and Bladder contraction
8 The __________ nervous system stimulates cranial nerve __________, which is responsible for slowing the heart rate, constricting the airway, and stimulating digestion.
A. Parasympathetic, X
B. Sympathetic, V
C. Parasympathetic, III
D. Sympathetic, VII
The answer is A. Parasympathetic and X, the vagus nerve
9 A patient is started on a norepinephrine drip. What side effects can this medication cause? Select all that apply:
A. Tachycardia
B. Hypoglycemia
C. Hypertension
D. Bronchoconstriction
The answers are A and C.
10 A patient with myasthenia gravis is started on Pyridostigmine. What assessment finding demonstrates the drug is working correctly?
A. The patient experiences dilation of the pupils.
B. The patient experiences a relaxed bladder
C. The patient experiences Bronchodilation
D. The patient experiences normal muscle function in the face and eyes.
The answer is D.
11 Select the drugs below that are considered anticholinergic drugs (also called parasympatholytic)
A. Pyridostigmine
B. Atropine
C. Ipratropium
D. Propranolol
The answers are B and C, Atropine and Ipratropium are both anticholinergic drugs
12 What are some side effects of adrenergic antagonist drugs (sympatholytic): select all that apply:
A. Tachycardia
B. Bradycardia
C. Bronchoconstriction
D. Bronchodilation
The answers are B and C. Bradycardia and Cronchoconstriction
13 Select the drugs below that are considered sympathomimetic drugs:
A. Albuterol
B. Dopamine
C. Epinephrine
D. Propranolol
The answers are A, B, and C. Albuteral, Dopamine, and Epinephrine are all drugs that can mimic the sympathetic nervous system.
Please the cutoff Mark and how can I get the form