Title WORKBOOK - NEURO (KEY) ✅

COMPREHENSIVE PHASE WORKBOOK NEUROLOGIC NURSING NOVEMBER 2025 Philippine Nurse Licensure Examination Review SITUATION: A 32 year old bus driver was rushed to the ER after sustaining severe head injury following a head-on collision with a ten wheeler truck. Nurse Lea is utilizing the Glasgow Coma Scale in assessing the neurologic status of the driver. 1. Nurse Lea is assessing the motor function of the driver. She would plan to use which of the following to test the driver’s peripheral response to pain? A. Sternal rub B. Pressure on the orbital rim C. Nail bed pressure D. Squeezing the sternocleidomastoid muscle 2. In assessing eye opening, the nurse observed that the driver opens his eyes only when peripheral pain is inflicted. What score will the nurse give? A. 1 B. 2 C. 3 D. 4 3. What GCS Score would the nurse give if Juan’s eyes open in response to pain, has no verbal response, and has decerebrate posturing? A. 4 B. 5 C. 6 D. 7 4. Nurse Lea has poor understanding about the Glasgow Coma Scale scoring when she states which of the following, EXCEPT? I. GCS is not a tool for assessing a client’s response to stimuli II. GCS scores range from 3 (normal) to 15 (deep coma) III. The smaller the GCS score, the deeper the coma IV. GCS assesses 3 areas (eye opening, motor response, verbal response) A. I and II B. II and III C. II, III and IV D. III and IV Situation 2 – A 14 year old teenager was admitted due to photophobia, throbbing headache and nuchal rigidity. A history of pneumonia was elicited. Diagnosis: Bacterial Meningitis. 5. To help support the diagnosis of bacterial meningitis, the nurse looks for Brudzinski’s sign. She knows that it is present if she sees: A. Hyperextension of the neck with passive shoulder flexion B. Flexion of the legs with rebound tenderness C. Flexion of the hip and knees with passive flexion of the neck D. Hyperflexion of the neck with rebound flexion of the legs 6. 8 hours after admission, the teenager suddenly had a tonic-clonic seizure and was unconscious after. What should the nurse do FIRST? A. Check the pulse B. Administer Valium C. Place the client in a side-lying position D. Place a tongue blade in the mouth 7. A 16 year old high school student was rushed to the ER due to a head injury following a car accident. The nurse notes a clear drainage from the left ear. The nurse would suspect: A. Concussion B. Subdural hematoma C. Basilar skull fracture D. Epidural hematoma SITUATION: A farmer is being assessed in the emergency room after sustaining a fall from a coconut tree. Admission assessment reveals that he hit his head on the grounD. 8. While assessing the farmer, which of the following neurological signs is of most concern? A. Reduced sensory responses B. Flaccid paralysis C. Pupils fixed and dilated D. Diminished spinal reflexes 9. We would be able to determine that the intracranial pressure (ICP) is rising if which of the following pulse rate result in the VITAL SIGNS is noted during the course of the work shift? I. Increased temperature II. Decreased pulse III. Increased respirations IV. Decreased BP V. Decreased temperature VI. Increased pulse VII. Decreased respirations VIII. Increased BP A. 2, 4 and 6 B. 2 C. 1, 2, 7 and 8 D. 3, 4, 5 and 6 10. The farmer is drowsy and complains of chest pain. Which of the following doctor’s orders shouldn’t the nurse question? I. Elevate the head 30° II. Nitroglycerin III. Apply antibiotics ointment to abrasions IV. Codeine for pain A. 1, 2 and 3 B. 2 and 4 only C. 3 and 4 only D. 4 only 11. On the 6th hospital day, the client developed cerebral edema and is given mannitol intravenously. The nurse knows that the drug is effective with which renal result: I. Urinary output increases II. Respirations drop to 12 and become regular III. Client’s level of consciousness improves IV. Client has no seizures A. 1 and 3 B. 1 only C. 1, 2 and 3 D. All are correct 12. The physician orders hyperventilation of the mechanical ventilator in a patient with head injury suffering from increased intracranial pressure. The nurse recognizes that hyperventilation is used to: TOP RANK REVIEW ACADEMY, INC. Page 1 | 7
A. Promote cerebral vasodilation for more blood flow to the brain B. Promote respiratory alkalosis C. To control the temperature of the client and decrease metabolic demand D. To allow more oxygen delivery to the brain SITUATION: Marian R. consulted to the doctor due to muscle weakness and ptosis. She was diagnosed with myasthenia gravis. 13. Respiratory complications are common for individuals with myasthenia gravis because of: A. narrowed airways B. impaired immunity C. ineffective coughing D. viscosity of secretions 14. During her diagnostic workup, she was administered with Edrophonium HCL (Tensilon). If she really has myasthenia gravis, which of the following outcomes is expected? A. increase in symptoms B. drying of the mouth and throat C. increase in blood pressure D. increase in muscle strength 15. Marian R suddenly developed cholinergic crisis. The nurse administered an antidote. Which of the following s/sx would you expect? I. Increase urine output II. Constipation III. Increase secretions IV. Pupil dilation V. Decrease urine output VI. Salivation A. 1, 3 and 6 B. except 2 and 5 C. 2, 4 and 5 D. 1, 4 and 6 16. Marian R. had not been taking her medications regularly. She was rushed to the ER due to difficulty of breathing. If the client would undergo an arterial blood gas analysis, which of the following would be seen? A. Respiratory acidosis B. Metabolic alkalosis C. Respiratory alkalosis D. Metabolic acidosis 17. When caring for a client with myasthenia gravis, an important nursing consideration would be to A. Prevent accidents from falls as a result of vertigo B. Maintain fluid and electrolyte balance C. Control situations that could increase intracranial pressure and cerebral edema D. Assess muscle groups toward the end of the day SITUATION: Lyndon J. sought consult as his son noticed pill rolling tremors. He was diagnosed with Parkinson’s Disease. 18. In order to decrease the frequency of tremors, which of the following actions should the nurse advise the family? A. Take a warm bath B. Hold an object in that hand C. Take diazepam (Valium) as needed D. Try to rest the hand and limit holding objects 19. Lyndon J’s son asks you about how he can help his father stand from a chair. Which of the following should you advise? A. Choose clothing with several snaps and buttons to increase the benefits of physical therapy B. Use a rocking motion to get up out of chairs C. Sit in a soft reclining chair to support joints while watching television D. None of the above 20. As Lyndon J. is discharged from the hospital, the home care nurse is doing her assessment on the client’s neurological status; the nurse would find the client’s gait to be: A. Staggering and unsteady B. Moonwalking but broad-based C. Walking on tips of toes D. Shuffling and propulsive SITUATION: Anthony C. is a school principal. During the flag raising ceremony, he suddenly experienced tonic clonic seizures. He was admitted in the ward for diagnostic workup. 21. A nurse was about to measure the intake and output of the patient when Anthony C. who was sitting on a chair begins seizing. Which of the following must the nurse do first? A. Insert a rubber slippers inside his mouth B. Ease the patient to the floor C. Lift the patient and put him on bed D. Ensure patient will not fall from the chair 22. Anthony C is scheduled for CT SCAN for the next day, noon time. Which of the following is the correct preparation as instructed by the nurse? A. Shampoo hair with Head and ShouldersTM thoroughly to remove oil and dirt and dandruff B. Shave scalp and securely attach electrodes to it C. Both A and B D. All are incorrect 23. Anthony C is placed on seizure precaution. All but one is not incorrect: A. Allow him to wear his own clothing B. Obtain his oral temperature C. Encourage to perform his own personal hygiene D. Encourage him to be out of bed 24. After his episode of seizure, which of the following patient status would you expect? A. Sleeps for a period of time B. Most comfortable walking and moving about C. Becomes restless and agitated D. Saying he is thirsty and hungry 25. Before, during and after seizure, the nurse knows that the patient is placed in what position? A. Low fowler’s B. Lateral C. Modified Trendelenburg D. Supine SITUATION: Mikee is an equestrian. During one of her races, she accidentally fell sustaining a spinal cord injury. 26. Her spinal cord injury led to paraplegia. Formation of urinary calculi is a complication that may be encountered by the client with paraplegia. A factor that contributes to this condition is: A. High fluid intake B. Increased intake of calcium C. Inadequate kidney function D. Increased loss of calcium from the bones 27. Another patient with a spinal cord injury at level C3 – C4 is being cared for by the nurse. What is the priority management? A. Determine the level at which the patient has intact sensation. B. Ineffective airway clearance C. Monitor respiratory effort and oxygen saturation level. D. Assess the level at which the patient has retained mobility. 28. A 16-year old with T8 spinal cord injury is seen also by the nurse. Given the patient’s deficits, which of the following is an unrealistic statement concerning her expected outcome? A. "I know this means being on a ventilator the rest of my life." B. "I know this means using a catheter for a while." C. "I know this means my legs won't work like before." D. None of the above TOP RANK REVIEW ACADEMY, INC. Page 2 | 7