Title EVAL EXAM - NEURO (KEY).pdf ✅

TOP RANK REVIEW ACADEMY, INC. Page 1 | 4 REFRESHER PHASE EVALUATIVE EXAMINATION NEUROLOGIC NURSING NOVEMBER 2024 Philippine Nurse Licensure Examination Review 1. A patient with right-sided weakness that started 90 minutes earlier is admitted to the emergency department and all these diagnostic tests are ordered. Which test should be done first? A. Noncontrast computed tomography (CT) scan B. Electrocardiogram (ECG) C. Complete blood count (CBC) D. Chest radiograph (Chest x-ray) 2. A patient who is seen in the outpatient clinic complains of restless legs syndrome. Which of the following over-the-counter medications that the patient is taking routinely should the nurse discuss with the patient? A. multivitamin (Stresstabs) B. acetaminophen (Tylenol) C. ibuprofen (Motrin, Advil) D. diphenhydramine (Benadryl) 3. A patient has a stroke affecting the right hemisphere of the brain. Based on knowledge of the effects of right brain damage, the nurse establishes a nursing diagnosis of A. impaired physical mobility related to right hemiplegia. B. impaired verbal communication related to speech- language deficits. C. ineffective coping related to depression and distress about disability. D. risk for injury related to denial of deficits and impulsiveness. 4.The nurse identifies the nursing diagnosis of imbalanced nutrition: less than body requirements related to impaired self- feeding ability for a patient with right-sided hemiplegia. Which intervention should be included in the plan of care? A. Assist the patient to eat with the left hand. B. Provide a wide variety of food choices. C. Provide oral care before and after meals. D. Teach the patient the chin-tuck technique. 5. When a patient is experiencing a cluster headache, the nurse will plan to assess for A. nuchal rigidity. B. unilateral eyelid swelling. C. projectile vomiting. D. throbbing, bilateral facial pain. 6. A 32-year-old patient has a stroke resulting from a ruptured aneurysm and subarachnoid hemorrhage. Which intervention will be included in the care plan? A. Assisting to dangle on edge of bed and assess for dizziness B. Encouraging patient to cough and deep breathe every 4 hours C. Applying intermittent pneumatic compression stockings D. Inserting an oropharyngeal airway to prevent airway obstruction 7. A patient who has had a stroke has a new order to attempt oral feedings. The nurse should assess the gag reflex and then A. order a varied pureed diet. B. assess the patients appetite. C. offer the patient a sip of juice. D. assist the patient into a chair. 8. A patient who has right-sided weakness after a stroke is attempting to use the left hand for feeding and other activities. The patients wife insists on feeding and dressing him, telling the nurse, I just dont like to see him struggle. Which nursing diagnosis is most appropriate for the patient? A. Situational low self-esteem related to increasing dependence on others B. Interrupted family processes related to effects of illness of a family member C. Disabled family coping related to inadequate understanding by patients spouse D. Impaired nutrition: less than body requirements related to hemiplegia and aphasia 9. A patient with a history of several transient ischemic attacks (TIAs) arrives in the emergency department with hemiparesis and dysarthria that started 2 hours previously. The nurse anticipates the need to prepare the patient for A. surgical endarterectomy. B. tissue plasminogen activator (tPA) infusion. C. transluminal angioplasty. D. intravenous heparin administration. 10. Several weeks after a stroke, a patient has urinary incontinence resulting from an impaired awareness of bladder fullness. For an effective bladder training program, which nursing intervention will be best to include in the plan of care? A. Limit fluid intake to 1200 mL daily to reduce urine volume. B. Assist the patient onto the bedside commode every 2 hours. C. Perform intermittent catheterization after each voiding to check for residual urine. D. Use an external condom catheter to protect the skin and prevent embarrassment. 11. A patient is admitted to the hospital with dysphasia and right-sided weakness that resolves in a few hours. The nurse will anticipate teaching the patient about A. alteplase (tPA). B. warfarin (Coumadin). C. aspirin (Ecotrin). D. nimodipine (Nimotop). 12. A patient with a left-sided brain stroke suddenly bursts into tears when family members visit. The nurse should A. use a calm voice to ask the patient to stop the crying behavior. B. teach the family that emotional outbursts are common after strokes. C. explain to the family that depression is normal following a stroke. D. have the family members leave the patient alone for a few minutes. 13. A patient with sudden-onset right-sided weakness has a CT scan and is diagnosed with an intracerebral hemorrhage. Which information about the patient is most important to communicate to the health care provider? A. The patients speech is difficult to understand. B. The patients blood pressure is 144/90 mm Hg. C. The patient takes a diuretic because of a history of hypertension. D. The patient has atrial fibrillation and takes warfarin (Coumadin). 14. A patient has a new prescription for bromocriptine (Parlodel) to control symptoms of Parkinsons disease. Which information obtained by the nurse may indicate a need for a decrease in the dose? A. The patient has a chronic dry cough. B. The patients blood pressure is 90/46 mm Hg. C. The patient has four loose stools in a day. D. The patient develops a deep vein thrombosis. * NLE * NCLEX * HAAD * PROMETRICS * DHA * MIDWIFERY * LET * RAD TECH * CRIMINOLOGY * DENTISTRY * PHARMACY * MED TECH
TOP RANK REVIEW ACADEMY, INC. Page 2 | 4 15. A patient with a stroke has progressive development of neurologic deficits with increasing weakness and decreased level of consciousness (LOC). Which nursing diagnosis has the highest priority for the patient? A. Impaired physical mobility related to weakness B. Disturbed sensory perception related to brain injury C. Risk for impaired skin integrity related to immobility D. Risk for aspiration related to inability to protect airway 16. Which of these nursing actions included in the care of a patient who has been experiencing stroke symptoms for 60 minutes can the nurse delegate to an LPN/LVN? A. Administer the prescribed clopidogrel (Plavix). B. Assess the patients gag and cough reflexes. C. Determine when the stroke symptoms began. D. Infuse the prescribed IV metoprolol (Lopressor). 17. After receiving change-of-shift report on the following four patients, which patient should the nurse see first? A. A patient who has atrial fibrillation and a new order for warfarin (Coumadin) B. A patient who experienced a transient ischemic attack yesterday who has a dose of aspirin due C. A patient with a subarachnoid hemorrhage 2 days ago who has nimodipine (Nimotop) scheduled D. A patient with right-sided weakness who has an infusion of tPA prescribed 18. When assessing a patient with a possible stroke, the nurse finds that the patient's aphasia started 3.5 hours previously and the blood pressure is 170/92 mm Hg. Which of these orders by the health care provider should the nurse question? A. Titrate labetolol (Normodyne) drip to keep BP less than 140/90 mm Hg. B. Infuse normal saline at 75 mL/hr. C. Keep head of bed elevated at least 30 degrees. D. Administer tissue plasminogen activator (tPA) per protocol. 19. The nurse is caring for a patient with carotid artery narrowing who has just returned after having left carotid artery angioplasty and stenting. Which assessment information is of most concern to the nurse? A. The pulse rate is 104 beats/min. B. The patient has difficulty talking. C. The blood pressure is 142/88 mm Hg. D. There are fine crackles at the lung bases. 20. When caring for a patient with left-sided homonymous hemianopsia resulting from a stroke, which intervention should the nurse include in the plan of care during the acute period of the stroke? A. Apply an eye patch to the left eye. B. Approach the patient from the left side. C. Place objects needed for activities of daily living on the patients right side. D. Reassure the patient that the visual deficit will resolve as the stroke progresses. 21. A patient with left-sided hemiparesis arrives by ambulance to the emergency department. Which action should the nurse take first? A. Check the respiratory rate. B. Monitor the blood pressure. C. Send the patient for a CT scan. D. Obtain the Glasgow Coma Scale score. 22. After teaching a patient about management of migraine headaches, the nurse determines that the teaching has been effective when the patient says, A. I will take the (Topamax) as soon as any headaches start. B. I will try to lie down someplace dark and quiet when the headaches begin. C. I should avoid taking aspirin and sumatriptan (Imitrex) at the same time. D. A glass of wine might help me relax and prevent headaches from developing. 23. A patient has a tonic-clonic seizure while the nurse is in the patients room. Which action should the nurse take? A. Insert an oral airway during the seizure to maintain a patent airway. B. Restrain the patients arms and legs to prevent injury during the seizure. C. Avoid touching the patient to prevent further nervous system stimulation. D. Time and observe and record the details of the seizure and postictal state. 24. The nurse obtains all of the following information about a 65-year-old patient in the clinic. When developing a plan to decrease stroke risk, which risk factor is most important for the nurse to address? A. The patient has a daily glass of wine to relax. B. The patient is 25 pounds above the ideal weight. C. The patient works at a desk and relaxes by watching television. D. The patients blood pressure (BP) is usually about 180/90 mm Hg. 25. Following a thymectomy, a patient with myasthenia gravis receives the usual dose of pyridostigmine(Mestinon). An hour later, the patient complains of nausea and severe abdominal cramps. Which action should the nurse take first? A. Auscultate the patients bowel sounds. B. Notify the patients health care provider. C. Administer the prescribed PRN antiemetic drug. D. Give the scheduled dose of prednisone (Deltasone). 26. Which action will the nurse take when evaluating a patient who is taking phenytoin (Dilantin) for adverse effects of the medication? A. Listen to the lung sounds. B. Auscultate the bowel tones. C. Inspect the oral mucosa. D. Check pupil reaction to light. 27. A patient tells the nurse about using acetaminophen (Tylenol) several times every day for recurrent bilateral headaches. Which action will the nurse plan to take first? A. Suggest the use of biofeedback for headache control. B. Teach the patient about magnetic resonance imaging (MRI). C. Discuss the need to stop taking the acetaminophen. D. Describe the use of botulism toxin (BOTOX) for headaches. 28. A patient found in a tonic-clonic seizure reports afterward that the seizure was preceded by numbness and tingling of the arm. The nurse knows that this finding indicates what type of seizure? A. Partial B. Absence C. Myoclonic D. Atonic 29. When obtaining a health history and physical assessment for a patient with possible multiple sclerosis (MS), the nurse should A. assess for the presence of chest pain. B. inquire about any urinary tract problems. C. inspect the skin for rashes or discoloration. D. question the patient about any increase in libido. 30. Which information about a patient who is being treated with carbidopa/levodopa (Sinemet) for Parkinsons disease is most important for the nurse to report to the health care provider? A. Shuffling gait B. Uncontrolled head movement C. Tremor at rest D. Cogwheel rigidity of limbs 31. A 28-year-old woman who has multiple sclerosis (MS) asks the nurse about risks associated with pregnancy. Which response by the nurse is accurate? A. Women with MS frequently have premature labor. B. Symptoms of MS are likely to become worse during pregnancy. C. MS is associated with a slightly increased risk for congenital defects. D. MS symptoms may be worse after the pregnancy.
TOP RANK REVIEW ACADEMY, INC. Page 3 | 4 32. When the nurse is assessing a patient with myasthenia gravis, which action will be most important to take? A. Check pupillary size. B. Monitor grip strength. C. Observe respiratory effort. D. Assess level of consciousness. 33. A patient with multiple sclerosis (MS) is to begin treatment with glatiramer acetate (Copaxone). Which information will the nurse include in patient teaching? A. Recommendation to drink at least 3 to 4 L daily B. Need to avoid driving or operating heavy machinery C. How to draw up and administer injections of the medication D. Use of contraceptive methods other than oral contraceptives 34. Which information about a patient with MS indicates that the nurse should consult with the health care provider before giving the prescribed dose of fampridine (Ampyra)? A. The patient has relapsing-remitting MS. B. The patient has an increased creatinine level. C. The patient enjoys walking for relaxation. D. The patient complains of pain with neck flexion. 35. A patient with multiple sclerosis (MS) has urinary retention caused by a flaccid bladder. Which action will the nurse plan to take? A. Teach the patient how to use the Cred method. B. Decrease the patients fluid intake in the evening. C. Suggest the use of incontinence briefs for nighttime use only. D. Assist the patient to the commode every 2 hours during the day. 36. A patient with Parkinsons disease has a nursing diagnosis of impaired physical mobility related to bradykinesia. Which action will the nurse include in the plan of care? A. Instruct the patient in activities that can be done while lying or sitting. B. Have the patient take small steps in a straight line directly in front of the feet. C. Teach the patient to keep the feet in contact with the floor and slide them forward. D. Suggest that the patient rock from side to side to initiate leg movement. 37. When teaching a patient with myasthenia gravis (MG) about management of the disease, the nurse advises the patient to A. perform physically demanding activities in the morning. B. anticipate the need for weekly plasmapheresis treatments. C. do frequent weight-bearing exercise to prevent muscle atrophy. D. protect the extremities from injury due to poor sensory perception. 38. A patient with amyotrophic lateral sclerosis (ALS) is hospitalized with pneumonia. Which nursing action will be included in the plan of care? A. Assist with active range of motion. B. Observe for agitation and paranoia. C. Give muscle relaxants as needed to reduce spasms. D. Use simple words and phrases to explain procedures. 39. A 42-year-old patient who was adopted at birth is diagnosed with early Huntingtons disease (HD). When teaching the patient, spouse, and children about this disorder, the nurse will provide information about the A. use of levodopa-carbidopa (Sinemet) to help reduce HD symptoms. B. availability of genetic testing to determine the HD risk for the patients children. C. need to take prophylactic antibiotics to decrease the risk for pneumonia. D. lifestyle changes such as increased exercise that delay disease progression. 40. A patient is seen in the health clinic with symptoms of a stooped posture, shuffling gait, and pill rollingtype tremor. The nurse will anticipate teaching the patient about A. oral corticosteroids. B. the purpose of electroencephalogram (EEG) testing. C. preparation for magnetic resonance imaging (MRI). D. antiparkinsonian drugs. 41. A patient seen at the health clinic with a severe migraine headache tells the nurse about having four similar headaches in the last 3 months. Which initial action should the nurse take? A. Refer the patient for stress counseling. B. Suggest the use of muscle-relaxation techniques. C. Ask the patient to keep a headache diary. D. Teach about the effectiveness of the triptan drugs. 42. The nurse identifies the nursing diagnosis of impaired verbal communication for a patient with expressive aphasia. An appropriate nursing intervention to help the patient communicate is to A. have the patient practice facial and tongue exercises. B. develop a list of words that the patient can read and practice reciting. C. ask simple questions that the patient can answer with yes or no. D. prevent embarrassing the patient by changing the subject if the patient does not respond. 43. A hospitalized patient complains of a moderate bilateral headache that radiates from the base of the skull. Which of these prescribed PRN medications should the nurse administer initially? A. lorazepam (Ativan) B. acetaminophen (Tylenol) C. morphine sulfate (Roxanol) D. butalbital and aspirin (Fiorinal) 44. The health care provider is considering the use of sumatriptan (Imitrex) for a patient with migraine headaches. Which information obtained by the nurse is most important to report to the health care provider? A. The patient has at least 1 to 2 cups of coffee daily. B. The patient has had migraine headaches for 30 years. C. The patient has a history of a recent acute myocardial infarction. D. The patient has been taking topiramate (Topamax) for 2 months. 45. A patient who has had a subarachnoid hemorrhage is being cared for in the intensive care unit. Which information about the patient is most important to communicate to the health care provider? A. The patient complains about having a stiff neck. B. he cerebrospinal fluid (CSF) report shows red blood cells (RBCs). C. The patients blood pressure is 90/50 mm Hg. D. The patient complains of an ongoing severe headache. 46. The nurse witnesses a patient with a seizure disorder as the patient suddenly jerks the arms and legs, falls to the floor, and regains consciousness immediately. It will be most important for the nurse to A. assess the patient for a possible head injury. B. give the scheduled dose of divalproex (Depakote). C. document the timing and description of the seizure. D. notify the patients health care provider about the seizure. 47. Which of these prescribed interventions will the nurse implement first for a hospitalized patient who is experiencing continuous tonic-clonic seizures? A. Give phenytoin (Dilantin) 100 mg IV. B. Monitor level of consciousness (LOC). C. Administer lorazepam (Ativan) 4 mg IV.
TOP RANK REVIEW ACADEMY, INC. Page 4 | 4 D. Obtain computed tomography (CT) scan. 48. When the home health RN is planning care for a patient with a seizure disorder, which nursing action can be delegated to an LPN/LVN? A. Make referrals to appropriate community agencies. B. Place medications in the home medication organizer. C. Teach the patient and family how to manage seizures. D. Assess for use of medications that may precipitate seizures. 49. A patient with Parkinsons disease has decreased tongue mobility and an inability to move the facial muscles. Which nursing diagnosis is of highest priority? A. Imbalanced nutrition: less than body requirements B. Activity intolerance C. Self-care deficit: toileting D. Ineffective self-health management 50. A patient who has a history of a transient ischemic attack (TIA) has an order for aspirin 160 mg daily. When the nurse is administering the medications, the patient says, I dont need the aspirin today. I dont have any aches or pains. Which action should the nurse take? A. Document that the aspirin was refused by the patient. B. Tell the patient that the aspirin is used to prevent aches. C. Explain that the aspirin is ordered to decrease stroke risk. D. Call the health care provider to clarify the medication order.