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

SITUATION: George T. is a 74 year old construction worker. He was lifting hollow blocks when he suddenly felt an intense headache, vomiting, and photophobia. He was rushed to the ER and assessment reveals hemiplegia of the right side of his body. 29. In observing George T, the nurse should check for signs of increased intracranial pressure. Of the following combinations of symptoms the most indicative of increased intracranial pressure is: A. Slow bounding pulse, rising blood pressure, elevated temperature, stupor B. Rapid weak pulse, fall in blood pressure, low temperature, restlessness C. Weak rapid pulse, normal blood pressure, intermittent fever, lethargy D. Slow bounding pulse, fall in blood pressure, temperature below 36 C (97F), stupor 30. Since Mr. Buenaflor is unconscious, the nurse should expect him to be: I. Unable to react to painful stimuli II. Incontinent of urine and feces III. Incapable of spontaneous motion IV. Incapable of hearing A. 1 and 2 B. 2, 3 and 4 C. Except 1, 3 and 4 D. Except 1 and 2 31. George T soon regained consciousness. However, when asked about what his name was, he answered “And the lights all went out in Massachusetts.” This finding is consistent with damage to a part of: A. Cerebellum B. Cerebral Cortex C. Brainstem D. Frontal lobe 32. George T suffered from a hemorrhage stroke. His wife has been reading a lot about strokes and asks why her husband did not receive Alteplase. What is the nurse’s best response? A. “Why ask me? You’d better ask his doctor.” B. “This drug is used primarily for patients who experience an acute heart attack.” C. “Alteplase dissolves clots and may cause more bleeding into your husband’s brain.” D. “Alteplase should be given on the first three hours of stroke attack.” 33. Melissa was diagnosed with Bell’s palsy. The nurse assessing the client expects to note which of the following? I. Difficulty closing the eyelid on the affected side II. A symmetrical smile III. Paroxysms of excruciating pain in the lips and cheeks on the affected side IV. Speech difficulty A. 1, 2 and 4 B. 3 only C. 1 and 4 D. Except 1 and 4 34. What is the primary action of Decadron? A. Reduces cerebral edema B. Improves the CSF outflow C. Reduces CSF production D. Increases GFR 35. Which event may trigger pain in the patient with trigeminal neuralgia? A. Walking in the mall B. Sitting in the sun C. Eating lunch D. Sleeping 36. Guillain Barre is an autoimmune attack of the peripheral nerve myelin. The major precipitating factor or predisposing event that may lead to this syndrome is: A. Change in weather B. Exposure to allergens C. Infection D. Poor nutrition 37. Phenytoin (Dilantin) has been prescribed for a client. Based on an understanding of this medication, the nurse caring for the client should exclude: I. Administer good oral hygiene II. Dilute IV Dilantin with 5% dextrose III. Give Dilantin intravenously with PNSS IV. Maintain a Dilantin level of 30-50 ug/ml A. 1 and 2 B. 2 and 4 C. 1 only D. 3 only 38. Harry D was diagnosed with amyotrophic lateral sclerosis. An early symptom associated with this is: A. Fatigue while talking B. Change in mental status C. Numbness of the hands and feet D. Spontaneous fractures 39. Helena is a world-renowned figure skater. However, during one of her exhibition spins, she slipped on a patch of ice and hit 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. Subdural hematoma B. Subarachnoid hemorrhage C. Epidural hematoma D. Contusion 40. A 50 year old female was rushed to the ER due to a head injury and an emergency surgery was indicated. A procedure wherein a portion of the cranium is removed to relieve pressure on the brain structures by providing space for expansion is: A. Lobectomy B. Decortication C. Craniotomy D. Craniectomy 41. Mariana O is a patient diagnosed with Alzheimer’s Disease. You are her home care nurse. Her family complains about inadequate nutritional intake. You should: A. Stay with the client and encourage him to eat. B. Help the client fill out his menu. C. Give the client privacy during meals. D. Fill out the menu for the client. 42. Mary H sustained head injuries which were later found out to have caused a subdural hematomA. You are performing a mental status examination. This gives you an idea about the status of: A. Cerebellar function B. Intellectual function C. Cerebral function D. Sensory function 43. Kiera H came to the ER due to pain on A periorbital area, tearing, blurred vision, and photophobia in her right eye. A small, irregular, nonreactive pupil was seen. Atropine sulfate was prescribed. Atropine sulfate belongs to which drug classification A. Parasympathomimetic agent B. Sympatholytic agent C. Adrenergic blocker D. Cholinergic blocker 44. Nurse Yannie is caring for a client who underwent a lumbar laminectomy two (2) days ago. Which of the following findings should the nurse consider abnormal? A. More back pain than the first postoperative day. B. Paresthesia in the dermatomes near the wounds. C. Urine retention or incontinence. D. Temperature of 99.2¬∞ F (37.3¬∞ C). TOP RANK REVIEW ACADEMY, INC. Page 3 | 7