Neurologic NCLEX Practice Test Part I c. give the client privacy during meals.

d. fill out the menu for the client.

7. The nurse is performing a mental status

1. If a male client experienced a examination on a male client diagnosed with
cerebrovascular accident (CVA) that damaged the subdural hematoma. This test assesses which of
hypothalamus, the nurse would anticipate that the following?
the client has problems with: a. Cerebellar function
a. body temperature control. b. Intellectual function
b. balance and equilibrium. c. Cerebral function
c. visual acuity. d. Sensory function
d. thinking and reasoning.
8. Shortly after admission to an acute care
2. A female client admitted to an acute care facility, a male client with a seizure disorder
facility after a car accident develops signs and develops status epilepticus. The physician
symptoms of increased intracranial pressure orders diazepam (Valium) 10 mg I.V. stat. How
(ICP). The client is intubated and placed on soon can the nurse administer a second dose
mechanical ventilation to help reduce ICP. To of diazepam, if needed and prescribed?
prevent a further rise in ICP caused by a. In 30 to 45 seconds
suctioning, the nurse anticipates administering b. In 10 to 15 minutes
which drug endotracheally before suctioning? c. In 30 to 45 minutes
a. phenytoin (Dilantin) d. In 1 to 2 hours
b. mannitol (Osmitrol)
c. lidocaine (Xylocaine) 9. A female client complains of periorbital
d. furosemide (Lasix) aching, tearing, blurred vision, and photophobia
in her right eye. Ophthalmologic examination
3. After striking his head on a tree while falling reveals a small, irregular, nonreactive pupil — a
from a ladder, a young man age 18 is admitted condition resulting from acute iris inflammation
to the emergency department. He’s unconscious (iritis). As part of the client’s therapeutic
and his pupils are nonreactive. Which regimen, the physician prescribes atropine sulfate
intervention would be the most dangerous for the (Atropisol), two drops of 0.5% solution in the
client? right eye twice daily. Atropine sulfate belongs to
a. Give him a barbiturate. which drug classification?
b. Place him on mechanical ventilation. a. Parasympathomimetic agent
c. Perform a lumbar puncture. b. Sympatholytic agent
d. Elevate the head of his bed. c. Adrenergic blocker
d. Cholinergic blocker
4. When obtaining the health history from a
male client with retinal detachment, the nurse 10. Emergency medical technicians transport a
expects the client to report: 27-year-old iron worker to the emergency
a. light flashes and floaters in front of the eye. department. They tell the nurse, “He fell from a
b. a recent driving accident while changing two-story building. He has a large contusion on
lanes. his left chest and a hematoma in the left parietal
c. headaches, nausea, and redness of the eyes. area. He has a compound fracture of his left
d. frequent episodes of double vision. femur and he’s comatose. We intubated him and
he’s maintaining an arterial oxygen saturation of
5. Which nursing diagnosis takes highest 92% by pulse oximeter with a manual-
priority for a client with Parkinson’s crisis? resuscitation bag.” Which intervention by the
a. Imbalanced nutrition: Less than body nurse has the highest priority?
requirements a. Assessing the left leg
b. Ineffective airway clearance b. Assessing the pupils
c. Impaired urinary elimination c. Placing the client in Trendelenburg’s position
d. Risk for injury d. Assessing level of consciousness
6. To encourage adequate nutritional intake for 11. An auto mechanic accidentally has battery
a female client with Alzheimer’s disease, the acid splashed in his eyes. His coworkers irrigate
nurse should: his eyes with water for 20 minutes, and then take
a. stay with the client and encourage him to him to the emergency department of a nearby
eat. hospital, where he receives emergency care for
b. help the client fill out his menu. corneal injury. The physician prescribes
dexamethasone (Maxidex Ophthalmic steps; with each step, the client’s feet make a
Suspension), two drops of 0.1% solution to be half circle. To document the client’s gait, the
instilled initially into the conjunctival sacs of both nurse should use which term?
eyes every hour; and polymyxin B sulfate a. Ataxic
(Neosporin Ophthalmic), 0.5% ointment to be b. Dystrophic
placed in the conjunctival sacs of both eyes every c. Helicopod
3 hours. Dexamethasone exerts its therapeutic d. Steppage
effect by:
a. increasing the exudative reaction of ocular 16. A client, age 22, is admitted with bacterial
tissue. meningitis. Which hospital room would be the
b. decreasing leukocyte infiltration at the site best choice for this client?
of ocular inflammation. a. A private room down the hall from the
c. inhibiting the action of carbonic anhydrase. nurses’ station
d. producing a miotic reaction by stimulating b. An isolation room three doors from the
and contracting the sphincter muscles of the iris. nurses’ station
c. A semiprivate room with a 32-year-old client
12. Nurse April is caring for a client who who has viral meningitis
underwent a lumbar laminectomy 2 days ago. d. A two-bed room with a client who previously
Which of the following findings should the nurse had bacterial meningitis
consider abnormal?
a. More back pain than the first postoperative 17. A physician diagnoses a client with
day myasthenia gravis, prescribing pyridostigmine
b. Paresthesia in the dermatomes near the (Mestinon), 60 mg P.O. every 3 hours. Before
wounds administering this anticholinesterase agent, the
c. Urine retention or incontinence nurse reviews the client’s history. Which
d. Temperature of 99.2° F (37.3° C) preexisting condition would contraindicate the
use of pyridostigmine?
13. After an eye examination, a male client is a. Ulcerative colitis
diagnosed with open-angle glaucoma. The b. Blood dyscrasia
physician prescribes pilocarpine ophthalmic c. Intestinal obstruction
solution (Pilocar), 0.25% gtt i, OU q.i.d. Based on d. Spinal cord injury
this prescription, the nurse should teach the
client or a family member to administer the drug 18. A female client is admitted to the facility for
by: investigation of balance and coordination
a. instilling one drop of pilocarpine 0.25% into problems, including possible Ménière’s disease.
both eyes daily. When assessing this client, the nurse expects to
b. instilling one drop of pilocarpine 0.25% into note:
both eyes four times daily. a. vertigo, tinnitus, and hearing loss.
c. instilling one drop of pilocarpine 0.25% into b. vertigo, vomiting, and nystagmus
the right eye daily. c. vertigo, pain, and hearing impairment.
d. instilling one drop of pilocarpine 0.25% into d. vertigo, blurred vision, and fever.
the left eye four times daily.
19. A male client with a conductive hearing
14. A female client who’s paralyzed on the left disorder caused by ankylosis of the stapes in the
side has been receiving physical therapy and oval window undergoes a stapedectomy to
attending teaching sessions about safety. Which remove the stapes and replace the impaired bone
behavior indicates that the client accurately with a prosthesis. After the stapedectomy, the
understands safety measures related to nurse should provide which client instruction?
paralysis? a. “Lie in bed with your head elevated, and
a. The client leaves the side rails down. refrain from blowing your nose for 24 hours.”
b. The client uses a mirror to inspect the skin. b. “Try to ambulate independently after about
c. The client repositions only after being 24 hours.”
reminded to do so. c. “Shampoo your hair every day for 10 days to
d. The client hangs the left arm over the side of help prevent ear infection.”
the wheelchair. d. “Don’t fly in an airplane, climb to high
altitudes, make sudden movements, or expose
15. A male client in the emergency department yourself to loud sounds for 30 days.”
has a suspected neurologic disorder. To assess
gait, the nurse asks the client to take a few 20. Nurse Oliver is monitoring a client for
adverse reactions to dantrolene (Dantrium).
Which adverse reaction is most common? b. Succinylcholine shouldn’t be used;
a. Excessive tearing pancuronium may be used in a lower dosage.
b. Urine retention c. Pancuronium shouldn’t be used;
c. Muscle weakness succinylcholine may be used in a lower dosage.
d. Slurred speech d. Pancuronium and succinylcholine both
require cautious administration.
21. The nurse is monitoring a male client for
adverse reactions to atropine sulfate (Atropine 26. A male client is color blind. The nurse
Care) eyedrops. Systemic absorption of atropine understands that this client has a problem with:
sulfate through the conjunctiva can cause which a. rods.
adverse reaction? b. cones.
a. Tachycardia c. lens.
b. Increased salivation d. aqueous humor.
c. Hypotension
d. Apnea 27. A female client who was trapped inside
a car for hours after a head-on collision is rushed
22. A male client is admitted with a cervical to the emergency department with multiple
spine injury sustained during a diving accident. injuries. During the neurologic examination, the
When planning this client’s care, the nurse should client responds to painful stimuli with
assign highest priority to which nursing decerebrate posturing. This finding indicates
diagnosis? damage to which part of the brain?
a. Impaired physical mobility a. Diencephalon
b. Ineffective breathing pattern b. Medulla
c. Disturbed sensory perception (tactile) c. Midbrain
d. Self-care deficient: Dressing/grooming d. Cortex

23. A male client has a history of painful, 28. The nurse is assessing a 37-year-old client
continuous muscle spasms. He has taken several diagnosed with multiple sclerosis. Which of the
skeletal muscle relaxants without experiencing following symptoms would the nurse expect to
relief. His physician prescribes diazepam find?
(Valium), 2 mg P.O. twice daily. In addition to a. Vision changes
being used to relieve painful muscle spasms, b. Absent deep tendon reflexes
diazepam also is recommended for: c. Tremors at rest
a. long-term treatment of epilepsy. d. Flaccid muscles
b. postoperative pain management of
laminectomy clients. 29. The nurse is caring for a male client
c. postoperative pain management of diagnosed with a cerebral aneurysm who reports
diskectomy clients a severe headache. Which action should the
d. treatment of spasticity associated with spinal nurse perform?
cord lesions. a. Sit with the client for a few minutes.
b. Administer an analgesic.
24. A female client who was found unconscious c. Inform the nurse manager.
at home is brought to the hospital by a rescue d. Call the physician immediately.
squad. In the intensive care unit, the nurse
checks the client’s oculocephalic (doll’s eye) 30. During recovery from a cerebrovascular
response by: accident (CVA), a female client is given nothing
a. introducing ice water into the external by mouth, to help prevent aspiration. To
auditory canal. determine when the client is ready for a liquid
b. touching the cornea with a wisp of cotton. diet, the nurse assesses the client’s swallowing
c. turning the client’s head suddenly while ability once each shift. This assessment
holding the eyelids open. evaluates:
d. shining a bright light into the pupil. a. cranial nerves I and II.
b. cranial nerves III and V.
25. While reviewing a client’s chart, the nurse c. cranial nerves VI and VIII.
notices that the female client has myasthenia d. cranial nerves IX and X.
gravis. Which of the following statements about
neuromuscular blocking agents is true for a client
with this condition?
a. The client may be less sensitive to the
effects of a neuromuscular blocking agent.
Neurologic NCLEX Practice Test Part II b. Determine whether the client is allergic to
iodine, contrast dyes, or shellfish.
c. Place a cap over the client’s head.
d. Administer a sedative as ordered.
1. A white female client is admitted to an acute
care facility with a diagnosis of cerebrovascular 7. During a routine physical examination to
accident (CVA). Her history reveals bronchial assess a male client’s deep tendon reflexes, the
asthma, exogenous obesity, and iron deficiency nurse should make sure to:
anemia. Which history finding is a risk factor for a. use the pointed end of the reflex hammer
CVA? when striking the Achilles tendon.
a. Caucasian race b. support the joint where the tendon is being
b. Female sex tested.
c. Obesity c. tap the tendon slowly and softly
d. Bronchial asthma d. hold the reflex hammer tightly.
2. The nurse is teaching a female client 8. A female client is admitted in a disoriented
with multiple sclerosis. When teaching the client and restless state after sustaining a concussion
how to reduce fatigue, the nurse should tell the during a car accident. Which nursing diagnosis
client to: takes highest priority in this client’s plan of care?
a. take a hot bath. a. Disturbed sensory perception (visual)
b. rest in an air-conditioned room b. Self-care deficient: Dressing/grooming
c. increase the dose of muscle relaxants. c. Impaired verbal communication
d. avoid naps during the day d. Risk for injury

3. A male client is having a tonic-clonic 9. A female client with amyotrophic lateral

seizures. What should the nurse do first? sclerosis (ALS) tells the nurse, “Sometimes I feel
a. Elevate the head of the bed. so frustrated. I can’t do anything without help!”
b. Restrain the client’s arms and legs. This comment best supports which nursing
c. Place a tongue blade in the client’s mouth. diagnosis?
d. Take measures to prevent injury. a. Anxiety
b. Powerlessness
4. A female client with Guillain-Barré syndrome c. Ineffective denial
has paralysis affecting the respiratory muscles d. Risk for disuse syndrome
and requires mechanical ventilation. When the
client asks the nurse about the paralysis, how 10. For a male client with suspected increased
should the nurse respond? intracranial pressure (ICP), a most appropriate
a. “You may have difficulty believing this, but respiratory goal is to:
the paralysis caused by this disease is a. prevent respiratory alkalosis.
temporary.” b. lower arterial pH.
b. “You’ll have to accept the fact that you’re c. promote carbon dioxide elimination.
permanently paralyzed. However, you won’t have d. maintain partial pressure of arterial oxygen
any sensory loss.” (PaO2) above 80 mm Hg
c. “It must be hard to accept the permanency
of your paralysis.” 11. Nurse Maureen witnesses a neighbor’s
d. “You’ll first regain use of your legs and then husband sustain a fall from the roof of his house.
your arms.” The nurse rushes to the victim and determines
the need to opens the airway in this victim by
5. The nurse is working on a surgical floor. The using which method?
nurse must logroll a male client following a: a. Flexed position
a. laminectomy. b. Head tilt-chin lift
b. thoracotomy. c. Jaw thrust maneuver
c. hemorrhoidectomy. d. Modified head tilt-chin lift
d. cystectomy.
12. The nurse is assessing the motor function
6. A female client with a suspected brain tumor of an unconscious male client. The nurse would
is scheduled for computed tomography (CT). plan to use which plan to use which of the
What should the nurse do when preparing the following to test the client’s peripheral response
client for this test? to pain?
a. Immobilize the neck before the client is a. Sternal rub
moved onto a stretcher. b. Nail bed pressure
c. Pressure on the orbital rim a. Loosening restrictive clothing
d. Squeezing of the sternocleidomastoid muscle b. Restraining the client’s limbs
c. Removing the pillow and raising padded side
13. A female client admitted to the hospital rails
with a neurological problem asks the nurse d. Positioning the client to side, if possible, with
whether magnetic resonance imaging may be the head flexed forward
done. The nurse interprets that the client may be
ineligible for this diagnostic procedure based on 19. The nurse is assigned to care for a female
the client’s history of: client with complete right-sided hemiparesis. The
a. Hypertension nurse plans care knowing that this condition:
b. Heart failure a. The client has complete bilateral paralysis of
c. Prosthetic valve replacement the arms and legs.
d. Chronic obstructive pulmonary disorder b. The client has weakness on the right side of
the body, including the face and tongue.
14. A male client is having a lumbar puncture c. The client has lost the ability to move the
performed. The nurse would plan to place the right arm but is able to walk independently.
client in which position? d. The client has lost the ability to move the
a. Side-lying, with a pillow under the hip right arm but is able to walk independently.
b. Prone, with a pillow under the abdomen
c. Prone, in slight-Trendelenburg’s position 20. The client with a brain attack (stroke) has
d. Side-lying, with the legs pulled up and head residual dysphagia. When a diet order is initiated,
bent down onto chest. the nurse avoids doing which of the following?
a. Giving the client thin liquids
15. The nurse is positioning the female client b. Thickening liquids to the consistency of
with increased intracranial pressure. Which of oatmeal
the following positions would the nurse avoid? c. Placing food on the unaffected side of the
a. Head mildline mouth
b. Head turned to the side d. Allowing plenty of time for chewing and
c. Neck in neutral position swallowing
d. Head of bed elevated 30 to 45 degrees
21. The nurse is assessing the adaptation of
16. A female client has clear fluid leaking the female client to changes in functional status
from the nose following a basilar skull fracture. after a brain attack (stroke). The nurse assesses
The nurse assesses that this is cerebrospinal fluid that the client is adapting most successfully if the
if the fluid: client:
a. Is clear and tests negative for glucose a. Gets angry with family if they interrupt a
b. Is grossly bloody in appearance and has a task
pH of 6 b. Experiences bouts of depression and
c. Clumps together on the dressing and has a irritability
pH of 7 c. Has difficulty with using modified feeding
d. Separates into concentric rings and test utensils
positive of glucose d. Consistently uses adaptive equipment in
dressing self
17. A male client with a spinal cord injury is
prone to experiencing automatic dysreflexia. The 22. Nurse Kristine is trying to communicate
nurse would avoid which of the following with a client with brain attack (stroke) and
measures to minimize the risk of recurrence? aphasia. Which of the following actions by the
a. Strict adherence to a bowel retraining nurse would be least helpful to the client?
program a. Speaking to the client at a slower rate
b. Keeping the linen wrinkle-free under the b. Allowing plenty of time for the client to
client respond
c. Preventing unnecessary pressure on the c. Completing the sentences that the client
lower limbs cannot finish
d. Limiting bladder catheterization to once d. Looking directly at the client during attempts
every 12 hours at speech

18. The nurse is caring for the male client who 23. A female client has experienced an
begins to experience seizure activity while in bed. episode of myasthenic crisis. The nurse would
Which of the following actions by the nurse would assess whether the client has
be contraindicated? precipitating factors such as:
a. Getting too little exercise active range of motion
b. Taking excess medication c. Providing information, giving positive
c. Omitting doses of medication feedback, and encouraging relaxation
d. Increasing intake of fatty foods d. Providing intravaneously administered
sedatives, reducing distractions and limiting
24. The nurse is teaching the female client visitors
with myasthenia gravis about the prevention of
myasthenic and cholinergic crises. The nurse tells 29. A male client has an impairment of cranial
the client that this is most effectively done by: nerve II. Specific to this impairment, the nurse
a. Eating large, well-balanced meals would plan to do which of the following to ensure
b. Doing muscle-strengthening exercises client to ensure client safety?
c. Doing all chores early in the day while less a. Speak loudly to the client
fatigued b. Test the temperature of the shower water
d. Taking medications on time to maintain c. Check the temperature of the food on the
therapeutic blood levels delivery tray.
d. Provide a clear path for ambulation without
25. A male client with Bell’s palsy asks the obstacles
nurse what has caused this problem. The nurse’s
response is based on an understanding that the 30. A female client has a neurological deficit
cause is: involving the limbic system. Specific to this type
a. Unknown, but possibly includes ischemia, of deficit, the nurse would document which of the
viral infection, or an autoimmune problem following information related to the client’s
b. Unknown, but possibly includes long-term behavior.
tissue malnutrition and cellular hypoxia a. Is disoriented to person, place, and time
c. Primary genetic in origin, triggered by b. Affect is flat, with periods of emotional
exposure to meningitis lability
d. Primarily genetic in origin, triggered by c. Cannot recall what was eaten for breakfast
exposure to neurotoxins today
d. Demonstrate inability to add and subtract;
26. The nurse has given the male client with does not know who is president
Bell’s palsy instructions on preserving muscle
tone in the face and preventing denervation. The
nurse determines that the client needs additional
information if the client states that he or she will:
a. Exposure to cold and drafts
b. Massage the face with a gentle upward
motion
c. Perform facial exercises
d. Wrinkle the forehead, blow out the cheeks,
and whistle

27. Female client is admitted to the hospital

with a diagnosis of Guillain-Barre syndrome. The
nurse inquires during the nursing admission
interview if the client has history of:
a. Seizures or trauma to the brain
b. Meningitis during the last 5 years
c. Back injury or trauma to the spinal cord
d. Respiratory or gastrointestinal infection
during the previous month.

28. A female client with Guillian-Barre

syndrome has ascending paralysis and is
intubated and receiving mechanical ventilation.
Which of the following strategies would the nurse
incorporate in the plan of care to help the client
cope with this illness?
a. Giving client full control over care decisions
and restricting visitors
b. Providing positive feedback and encouraging