NSG 3250 Exam 3
Comprehensive Neurological Nursing
Care Exam 2026
SECTION 1: TRANSIENT ISCHEMIC ATTACK (TIA) AND STROKE BASICS
Question 1:
A patient presents to the emergency department with sudden onset of slurred speech and right-sided
weakness that resolved completely after 30 minutes. The nurse recognizes this as which condition?
A. Hemorrhagic stroke
B. Transient ischemic attack (TIA)
C. Ischemic stroke with permanent damage
D. Seizure activity
ANSWER: B
Rationale:
Option A is incorrect because hemorrhagic stroke involves bleeding in the brain and does not resolve
spontaneously within 30 minutes; it causes progressive symptoms.
Option B is correct because a TIA is defined as a transient episode of neurologic dysfunction due to focal
brain, spinal cord, or retinal ischemia without acute infarction, and symptoms typically resolve within 1
hour.
.
Option C is incorrect because ischemic stroke with permanent damage would not resolve completely;
there would be lasting neurological deficits.
Option D is incorrect because seizure activity typically presents with different symptoms such as
convulsions, loss of consciousness, or altered awareness, not isolated focal neurological deficits that
resolve quickly.
Question 2:
,The nurse is educating a patient who experienced a TIA about why this is considered a medical
emergency. Which statement by the nurse is most accurate?
A. "TIAs are not serious and will not affect your future health"
B. "A TIA is a warning sign that you are at high risk for a future stroke"
C. "TIAs only require monitoring and no treatment is necessary"
D. "A TIA causes permanent brain damage that needs immediate surgery"
ANSWER: B
Rationale:
Option A is incorrect because TIAs are serious medical emergencies that indicate significant risk for
future stroke.
Option B is correct because a TIA serves as a critical warning sign that the patient is at high risk for a
subsequent stroke, making it a medical emergency requiring immediate evaluation and intervention.
.
Option C is incorrect because TIAs require immediate treatment including medications, preventative
interventions, and lifestyle changes to prevent future stroke.
.
Option D is incorrect because TIAs do not cause permanent brain damage or acute infarction on
imaging; they are temporary and resolve without permanent tissue damage.
.
Question 3:
Which nursing intervention is the priority when assessing a patient who experienced a TIA?
A. Administer pain medication for headache
B. Perform a comprehensive neurological assessment
C. Schedule physical therapy consultation
D. Provide discharge teaching immediately
ANSWER: B
Rationale:
Option A is incorrect because while headache may occur, it is not the priority; assessment must come
first to establish baseline and detect any changes.
Option B is correct because performing a neurological assessment including monitoring reflexes,
posture, and neurological status is essential to establish baseline data and detect any progression or
changes.
,.
Option C is incorrect because physical therapy may be needed later, but initial assessment takes priority
to determine the patient's current status.
Option D is incorrect because discharge teaching is important but cannot be provided until after
thorough assessment and stabilization.
Question 4:
The nurse understands that the key difference between a TIA and an ischemic stroke is:
A. TIAs only affect the left side of the brain
B. TIAs show acute infarction on imaging
C. TIAs resolve without acute infarction on imaging
D. Ischemic strokes always resolve within 24 hours
ANSWER: C
Rationale:
Option A is incorrect because TIAs can affect either side of the brain depending on which blood vessel is
involved.
Option B is incorrect because TIAs are specifically defined as occurring without acute infarction on
imaging.
.
Option C is correct because a TIA is defined as focal brain, spinal cord, or retinal ischemia without acute
infarction on imaging, whereas ischemic stroke shows evidence of tissue damage.
.
Option D is incorrect because ischemic strokes do not resolve within 24 hours; they cause permanent
damage, while TIAs are the ones that resolve quickly.
Question 5:
Which medication would the nurse anticipate administering to a patient who has experienced a TIA to
prevent future stroke?
A. Antibiotics
B. Anticoagulants or antiplatelet agents
C. Diuretics
D. Bronchodilators
ANSWER: B
, Rationale:
Option A is incorrect because antibiotics are used to treat infections, not to prevent stroke.
Option B is correct because anticoagulants or antiplatelet agents are standard treatment for TIA to
prevent clot formation and reduce the risk of future stroke.
.
Option C is incorrect because diuretics are used to manage fluid balance and blood pressure but are not
the primary prevention for stroke after TIA.
Option D is incorrect because bronchodilators are used for respiratory conditions like asthma or COPD,
not for stroke prevention.
SECTION 2: LEFT BRAIN VS RIGHT BRAIN STROKE
Question 6:
A patient is admitted with a left brain stroke. Which assessment finding would the nurse expect to find?
A. Left-sided hemiplegia
B. Right-sided paralysis
C. Bilateral weakness
D. No motor deficits
ANSWER: B
Rationale:
Option A is incorrect because left brain stroke affects the right side of the body, not the left side.
Option B is correct because a stroke affecting the left hemisphere causes right side hemiplegia or
paralysis due to the crossing of motor pathways.
.
Option C is incorrect because strokes typically cause unilateral (one-sided) deficits, not bilateral
weakness.
Option D is incorrect because left brain stroke causes motor deficits on the contralateral (opposite) side
of the body.
Question 7:
The nurse is caring for a patient with a left brain stroke. Which communication strategy would be most
appropriate?
A. Speak loudly and slowly
B. Use gestures, pictures, and write things down
Comprehensive Neurological Nursing
Care Exam 2026
SECTION 1: TRANSIENT ISCHEMIC ATTACK (TIA) AND STROKE BASICS
Question 1:
A patient presents to the emergency department with sudden onset of slurred speech and right-sided
weakness that resolved completely after 30 minutes. The nurse recognizes this as which condition?
A. Hemorrhagic stroke
B. Transient ischemic attack (TIA)
C. Ischemic stroke with permanent damage
D. Seizure activity
ANSWER: B
Rationale:
Option A is incorrect because hemorrhagic stroke involves bleeding in the brain and does not resolve
spontaneously within 30 minutes; it causes progressive symptoms.
Option B is correct because a TIA is defined as a transient episode of neurologic dysfunction due to focal
brain, spinal cord, or retinal ischemia without acute infarction, and symptoms typically resolve within 1
hour.
.
Option C is incorrect because ischemic stroke with permanent damage would not resolve completely;
there would be lasting neurological deficits.
Option D is incorrect because seizure activity typically presents with different symptoms such as
convulsions, loss of consciousness, or altered awareness, not isolated focal neurological deficits that
resolve quickly.
Question 2:
,The nurse is educating a patient who experienced a TIA about why this is considered a medical
emergency. Which statement by the nurse is most accurate?
A. "TIAs are not serious and will not affect your future health"
B. "A TIA is a warning sign that you are at high risk for a future stroke"
C. "TIAs only require monitoring and no treatment is necessary"
D. "A TIA causes permanent brain damage that needs immediate surgery"
ANSWER: B
Rationale:
Option A is incorrect because TIAs are serious medical emergencies that indicate significant risk for
future stroke.
Option B is correct because a TIA serves as a critical warning sign that the patient is at high risk for a
subsequent stroke, making it a medical emergency requiring immediate evaluation and intervention.
.
Option C is incorrect because TIAs require immediate treatment including medications, preventative
interventions, and lifestyle changes to prevent future stroke.
.
Option D is incorrect because TIAs do not cause permanent brain damage or acute infarction on
imaging; they are temporary and resolve without permanent tissue damage.
.
Question 3:
Which nursing intervention is the priority when assessing a patient who experienced a TIA?
A. Administer pain medication for headache
B. Perform a comprehensive neurological assessment
C. Schedule physical therapy consultation
D. Provide discharge teaching immediately
ANSWER: B
Rationale:
Option A is incorrect because while headache may occur, it is not the priority; assessment must come
first to establish baseline and detect any changes.
Option B is correct because performing a neurological assessment including monitoring reflexes,
posture, and neurological status is essential to establish baseline data and detect any progression or
changes.
,.
Option C is incorrect because physical therapy may be needed later, but initial assessment takes priority
to determine the patient's current status.
Option D is incorrect because discharge teaching is important but cannot be provided until after
thorough assessment and stabilization.
Question 4:
The nurse understands that the key difference between a TIA and an ischemic stroke is:
A. TIAs only affect the left side of the brain
B. TIAs show acute infarction on imaging
C. TIAs resolve without acute infarction on imaging
D. Ischemic strokes always resolve within 24 hours
ANSWER: C
Rationale:
Option A is incorrect because TIAs can affect either side of the brain depending on which blood vessel is
involved.
Option B is incorrect because TIAs are specifically defined as occurring without acute infarction on
imaging.
.
Option C is correct because a TIA is defined as focal brain, spinal cord, or retinal ischemia without acute
infarction on imaging, whereas ischemic stroke shows evidence of tissue damage.
.
Option D is incorrect because ischemic strokes do not resolve within 24 hours; they cause permanent
damage, while TIAs are the ones that resolve quickly.
Question 5:
Which medication would the nurse anticipate administering to a patient who has experienced a TIA to
prevent future stroke?
A. Antibiotics
B. Anticoagulants or antiplatelet agents
C. Diuretics
D. Bronchodilators
ANSWER: B
, Rationale:
Option A is incorrect because antibiotics are used to treat infections, not to prevent stroke.
Option B is correct because anticoagulants or antiplatelet agents are standard treatment for TIA to
prevent clot formation and reduce the risk of future stroke.
.
Option C is incorrect because diuretics are used to manage fluid balance and blood pressure but are not
the primary prevention for stroke after TIA.
Option D is incorrect because bronchodilators are used for respiratory conditions like asthma or COPD,
not for stroke prevention.
SECTION 2: LEFT BRAIN VS RIGHT BRAIN STROKE
Question 6:
A patient is admitted with a left brain stroke. Which assessment finding would the nurse expect to find?
A. Left-sided hemiplegia
B. Right-sided paralysis
C. Bilateral weakness
D. No motor deficits
ANSWER: B
Rationale:
Option A is incorrect because left brain stroke affects the right side of the body, not the left side.
Option B is correct because a stroke affecting the left hemisphere causes right side hemiplegia or
paralysis due to the crossing of motor pathways.
.
Option C is incorrect because strokes typically cause unilateral (one-sided) deficits, not bilateral
weakness.
Option D is incorrect because left brain stroke causes motor deficits on the contralateral (opposite) side
of the body.
Question 7:
The nurse is caring for a patient with a left brain stroke. Which communication strategy would be most
appropriate?
A. Speak loudly and slowly
B. Use gestures, pictures, and write things down
