# NCLEX-RN Neurology Practice Questions and
Answers – Edition 2024-2025
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**01.** A nurse is assessing a client with a traumatic brain injury. Which finding suggests increased
intracranial pressure (ICP)?
A) Glasgow Coma Scale score of 15
B) Pupils equal and reactive to light
C) Widening pulse pressure with bradycardia
D) Tachycardia and hypotension
🔍 RATIONALE💡-- Widening pulse pressure (increasing systolic with stable diastolic) and bradycardia
are components of Cushing’s triad, a late sign of increased ICP. A GCS of 15 is normal; equal/reactive
pupils are expected; tachycardia/hypotension are not typical of ICP.
ANSWER💫✔️-- C) Widening pulse pressure with bradycardia
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**02.** A nurse is caring for a client who has a new diagnosis of myasthenia gravis. Which medication is
used to improve muscle strength?
A) Neostigmine
B) Atropine
C) Prednisone
D) Rituximab
,🔍 RATIONALE💡-- Neostigmine (an acetylcholinesterase inhibitor) increases acetylcholine availability at
the neuromuscular junction, improving muscle strength. Prednisone and rituximab are used for
immunosuppression but not for immediate symptom improvement.
ANSWER💫✔️-- A) Neostigmine
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**03.** A nurse is assessing a client with a suspected stroke. Which finding is most indicative of a
left‑sided (middle cerebral artery) stroke?
A) Left‑sided neglect
B) Aphasia
C) Right visual field loss
D) Ataxia
🔍 RATIONALE💡-- Left hemisphere stroke often causes aphasia (language deficit). Right‑sided neglect is
seen with right hemisphere stroke. Ataxia is more common with cerebellar stroke.
ANSWER💫✔️-- B) Aphasia
---
**04.** A nurse is caring for a client with a spinal cord injury at T5 who suddenly develops a severe
headache, flushing of the face and neck, and a blood pressure of 220/110 mm Hg. What is the priority
action?
A) Administer a prescribed antihypertensive medication
B) Sit the client upright in bed
C) Check the client’s bladder for distention or catheter obstruction
D) Notify the provider immediately
,🔍 RATIONALE💡-- This is autonomic dysreflexia, a medical emergency. The first action is to place the
client in a sitting position to lower blood pressure, then identify and remove the triggering stimulus
(e.g., distended bladder).
ANSWER💫✔️-- B) Sit the client upright in bed
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**05.** A nurse is assessing a client with a head injury. The client opens eyes to painful stimuli, makes
incomprehensible sounds, and withdraws from pain. What is the Glasgow Coma Scale (GCS) score?
A) 6
B) 8
C) 10
D) 12
🔍 RATIONALE💡-- Eye opening to pain = 2; incomprehensible sounds = 2; withdrawal to pain = 4; total =
8 (severe brain injury).
ANSWER💫✔️-- B) 8
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**06.** A nurse is caring for a client with Guillain‑Barré syndrome. Which finding is most concerning?
A) Ascending weakness
B) Paresthesias in the feet
C) Respiratory distress
D) Facial droop
🔍 RATIONALE💡-- Respiratory distress indicates ascending paralysis affecting the phrenic nerve and
diaphragm, which can lead to respiratory failure. This is the most life‑threatening complication.
, ANSWER💫✔️-- C) Respiratory distress
---
**07.** A nurse is assessing a client with Parkinson’s disease. Which finding is characteristic?
A) Intention tremor
B) Resting tremor
C) Chorea
D) Flaccid paralysis
🔍 RATIONALE💡-- Parkinson’s is characterized by resting tremor (pill‑rolling), rigidity, bradykinesia, and
postural instability. Intention tremor is seen in cerebellar disorders; chorea in Huntington’s.
ANSWER💫✔️-- B) Resting tremor
---
**08.** A nurse is caring for a client with bacterial meningitis. Which finding indicates increased
intracranial pressure?
A) Sunken anterior fontanel
B) Positive Kernig’s sign
C) Bradycardia and hypertension
D) Tachycardia and hypotension
🔍 RATIONALE💡-- Cushing’s triad (bradycardia, hypertension, irregular respirations) indicates increased
ICP. Positive Kernig’s is a meningeal sign, not specific to ICP. Sunken fontanel suggests dehydration.
ANSWER💫✔️-- C) Bradycardia and hypertension
Answers – Edition 2024-2025
---
**01.** A nurse is assessing a client with a traumatic brain injury. Which finding suggests increased
intracranial pressure (ICP)?
A) Glasgow Coma Scale score of 15
B) Pupils equal and reactive to light
C) Widening pulse pressure with bradycardia
D) Tachycardia and hypotension
🔍 RATIONALE💡-- Widening pulse pressure (increasing systolic with stable diastolic) and bradycardia
are components of Cushing’s triad, a late sign of increased ICP. A GCS of 15 is normal; equal/reactive
pupils are expected; tachycardia/hypotension are not typical of ICP.
ANSWER💫✔️-- C) Widening pulse pressure with bradycardia
---
**02.** A nurse is caring for a client who has a new diagnosis of myasthenia gravis. Which medication is
used to improve muscle strength?
A) Neostigmine
B) Atropine
C) Prednisone
D) Rituximab
,🔍 RATIONALE💡-- Neostigmine (an acetylcholinesterase inhibitor) increases acetylcholine availability at
the neuromuscular junction, improving muscle strength. Prednisone and rituximab are used for
immunosuppression but not for immediate symptom improvement.
ANSWER💫✔️-- A) Neostigmine
---
**03.** A nurse is assessing a client with a suspected stroke. Which finding is most indicative of a
left‑sided (middle cerebral artery) stroke?
A) Left‑sided neglect
B) Aphasia
C) Right visual field loss
D) Ataxia
🔍 RATIONALE💡-- Left hemisphere stroke often causes aphasia (language deficit). Right‑sided neglect is
seen with right hemisphere stroke. Ataxia is more common with cerebellar stroke.
ANSWER💫✔️-- B) Aphasia
---
**04.** A nurse is caring for a client with a spinal cord injury at T5 who suddenly develops a severe
headache, flushing of the face and neck, and a blood pressure of 220/110 mm Hg. What is the priority
action?
A) Administer a prescribed antihypertensive medication
B) Sit the client upright in bed
C) Check the client’s bladder for distention or catheter obstruction
D) Notify the provider immediately
,🔍 RATIONALE💡-- This is autonomic dysreflexia, a medical emergency. The first action is to place the
client in a sitting position to lower blood pressure, then identify and remove the triggering stimulus
(e.g., distended bladder).
ANSWER💫✔️-- B) Sit the client upright in bed
---
**05.** A nurse is assessing a client with a head injury. The client opens eyes to painful stimuli, makes
incomprehensible sounds, and withdraws from pain. What is the Glasgow Coma Scale (GCS) score?
A) 6
B) 8
C) 10
D) 12
🔍 RATIONALE💡-- Eye opening to pain = 2; incomprehensible sounds = 2; withdrawal to pain = 4; total =
8 (severe brain injury).
ANSWER💫✔️-- B) 8
---
**06.** A nurse is caring for a client with Guillain‑Barré syndrome. Which finding is most concerning?
A) Ascending weakness
B) Paresthesias in the feet
C) Respiratory distress
D) Facial droop
🔍 RATIONALE💡-- Respiratory distress indicates ascending paralysis affecting the phrenic nerve and
diaphragm, which can lead to respiratory failure. This is the most life‑threatening complication.
, ANSWER💫✔️-- C) Respiratory distress
---
**07.** A nurse is assessing a client with Parkinson’s disease. Which finding is characteristic?
A) Intention tremor
B) Resting tremor
C) Chorea
D) Flaccid paralysis
🔍 RATIONALE💡-- Parkinson’s is characterized by resting tremor (pill‑rolling), rigidity, bradykinesia, and
postural instability. Intention tremor is seen in cerebellar disorders; chorea in Huntington’s.
ANSWER💫✔️-- B) Resting tremor
---
**08.** A nurse is caring for a client with bacterial meningitis. Which finding indicates increased
intracranial pressure?
A) Sunken anterior fontanel
B) Positive Kernig’s sign
C) Bradycardia and hypertension
D) Tachycardia and hypotension
🔍 RATIONALE💡-- Cushing’s triad (bradycardia, hypertension, irregular respirations) indicates increased
ICP. Positive Kernig’s is a meningeal sign, not specific to ICP. Sunken fontanel suggests dehydration.
ANSWER💫✔️-- C) Bradycardia and hypertension
