NSG 3250 Exam 3 Comprehensive Examination
Neurological Disorders - 2026 Standards
1. A patient presents to the emergency department with sudden onset of aphasia, ataxia, and visual
disturbances that resolved after 30 minutes. The nurse recognizes these symptoms as indicative of
which condition?
A. Hemorrhagic stroke
B. Transient Ischemic Attack (TIA)
C. Seizure disorder
D. Migraine headache
ANSWER: B
Rationale:
A is incorrect: Hemorrhagic stroke symptoms do not resolve on their own and typically present with
severe headache, vomiting, and decreased level of consciousness that worsens over time.
B is correct: TIA presents with stroke-like symptoms including aphasia, ataxia, headache, and visual
disturbances that resolve on their own, usually within minutes to hours. This is a WARNING SIGN that
puts the patient at higher risk for getting a stroke.
C is incorrect: Seizures typically present with altered consciousness, jerking movements, and postictal
confusion, not the specific symptoms described.
D is incorrect: While migraines can cause visual disturbances and headache, they typically don't cause
aphasia and ataxia together, and the pattern described is classic for TIA.
2. The nurse is caring for a patient with aphasia following a stroke. Which communication strategy is
MOST appropriate for the nurse to implement?
A. Speak loudly and slowly to the patient
B. Use a board to write out needs and use short, simple phrases
C. Ask multiple questions at once to maximize communication
D. Complete all sentences for the patient to save time
ANSWER: B
,Rationale:
A is incorrect: Speaking loudly is not helpful unless the patient has hearing loss. Aphasia affects language
processing, not hearing ability.
B is correct: Using a board to write out needs helps the patient communicate visually. Using short,
simple phrases that are easy to understand facilitates better communication with aphasic patients.
C is incorrect: Asking multiple questions at once overwhelms the patient with aphasia and makes it
harder for them to process and respond.
D is incorrect: Completing sentences for the patient is patronizing and doesn't give them time to express
themselves. Patients with aphasia need extra time to communicate.
3. A patient with aphasia is having difficulty expressing their needs. What is the MOST important nursing
intervention?
A. Speak only to family members who can interpret
B. Be patient and give the patient more time to explain themselves
C. Use complex medical terminology to be precise
D. Limit communication to essential information only
ANSWER: B
Rationale:
A is incorrect: The nurse should always talk directly to the patient with aphasia, not just through family
members. This respects the patient's autonomy and dignity.
B is correct: Being patient and giving the person with aphasia more time to explain themselves is
essential. They need additional time to process information and formulate responses.
C is incorrect: Complex medical terminology makes communication more difficult. Simple, clear
language should be used.
D is incorrect: While efficiency is important, limiting communication can lead to unmet needs and
frustration. The nurse should facilitate communication, not restrict it.
4. A patient has right hemianopsia following a stroke. Which nursing intervention is MOST appropriate?
A. Place all items on the patient's right side
B. Approach the patient from the right side only
C. Place the meal tray on the left side and teach the patient to scan counter-clockwise
D. Keep items in the same position to avoid confusion
ANSWER: C
Rationale:
,A is incorrect: Placing items on the right side (affected side) means the patient cannot see them. Items
should initially be placed on the unaffected side.
B is incorrect: Approaching only from the right side reinforces neglect. The nurse should approach from
both sides and teach scanning techniques.
C is correct: A patient with right hemianopsia has lost vision on the right side. The tray should be placed
on the LEFT (unaffected) side initially, and the patient should be taught to scan counter-clockwise to
compensate for the visual field deficit.
D is incorrect: While consistency helps, the patient needs to learn scanning techniques to compensate
for the visual deficit, not just rely on memorization.
5. The nurse is assessing a patient with a left hemisphere stroke. Which finding would the nurse EXPECT
to observe?
A. Unawareness of deficits and impulsive behavior
B. Depression and awareness of deficits with impaired speech
C. Spatial-perceptual problems and denial of problems
D. Left-sided neglect and impaired judgment
ANSWER: B
Rationale:
A is incorrect: Unawareness of deficits and impulsive behavior are characteristic of RIGHT hemisphere
strokes, not left.
B is correct: Left hemisphere stroke patients are typically aware of their deficits and may become
depressed. They experience significant speech impairment (aphasia) and impaired comprehension since
the left hemisphere controls language in most people.
C is incorrect: Spatial-perceptual problems and denial are associated with RIGHT hemisphere strokes.
D is incorrect: Left-sided neglect occurs with RIGHT hemisphere strokes. Left hemisphere strokes cause
right-sided deficits.
6. A patient with a right hemisphere stroke is being assessed. Which characteristic is MOST consistent
with this diagnosis?
A. Aphasia and right-sided weakness
B. Depression and slow, cautious behavior
C. Denial of deficits and left-sided weakness
D. Impaired comprehension and right visual field deficit
ANSWER: C
Rationale:
, A is incorrect: Aphasia is characteristic of LEFT hemisphere strokes. Right hemisphere strokes typically
don't cause aphasia.
B is incorrect: Depression and cautious behavior are more common with LEFT hemisphere strokes. Right
hemisphere patients tend to be impulsive.
C is correct: Right hemisphere stroke patients often have denial of deficits (anosognosia), are impulsive,
and have left-sided weakness. They may lack awareness of their condition.
D is incorrect: Impaired comprehension is associated with LEFT hemisphere strokes. Right hemisphere
strokes cause left visual field deficits, not right.
7. The nurse is caring for a patient who had a hemorrhagic stroke. Which sequela would the nurse
anticipate?
A. Flaccidity that resolves within 24 hours
B. Motor impairment determined by flaccidity initially
C. Immediate return of muscle tone
D. No motor impairment expected
ANSWER: B
Rationale:
A is incorrect: Flaccidity following a stroke does not resolve within 24 hours. It may persist and then
transition to spasticity.
B is correct: After a hemorrhagic stroke, motor impairment is initially determined by flaccidity (decrease
or absence of muscle tone in affected areas). This may later progress to spasticity.
C is incorrect: Muscle tone does not immediately return after a stroke. The initial phase is typically
flaccidity.
D is incorrect: Motor impairment is a common sequela of hemorrhagic stroke and should be expected.
8. Flaccidity following a stroke is best described as:
A. Increased muscle tone and spasticity
B. Decrease or absence of muscle tone in the affected area
C. Involuntary muscle contractions
D. Normal muscle strength
ANSWER: B
Rationale:
A is incorrect: Increased muscle tone and spasticity may develop later, but this is not flaccidity.
Neurological Disorders - 2026 Standards
1. A patient presents to the emergency department with sudden onset of aphasia, ataxia, and visual
disturbances that resolved after 30 minutes. The nurse recognizes these symptoms as indicative of
which condition?
A. Hemorrhagic stroke
B. Transient Ischemic Attack (TIA)
C. Seizure disorder
D. Migraine headache
ANSWER: B
Rationale:
A is incorrect: Hemorrhagic stroke symptoms do not resolve on their own and typically present with
severe headache, vomiting, and decreased level of consciousness that worsens over time.
B is correct: TIA presents with stroke-like symptoms including aphasia, ataxia, headache, and visual
disturbances that resolve on their own, usually within minutes to hours. This is a WARNING SIGN that
puts the patient at higher risk for getting a stroke.
C is incorrect: Seizures typically present with altered consciousness, jerking movements, and postictal
confusion, not the specific symptoms described.
D is incorrect: While migraines can cause visual disturbances and headache, they typically don't cause
aphasia and ataxia together, and the pattern described is classic for TIA.
2. The nurse is caring for a patient with aphasia following a stroke. Which communication strategy is
MOST appropriate for the nurse to implement?
A. Speak loudly and slowly to the patient
B. Use a board to write out needs and use short, simple phrases
C. Ask multiple questions at once to maximize communication
D. Complete all sentences for the patient to save time
ANSWER: B
,Rationale:
A is incorrect: Speaking loudly is not helpful unless the patient has hearing loss. Aphasia affects language
processing, not hearing ability.
B is correct: Using a board to write out needs helps the patient communicate visually. Using short,
simple phrases that are easy to understand facilitates better communication with aphasic patients.
C is incorrect: Asking multiple questions at once overwhelms the patient with aphasia and makes it
harder for them to process and respond.
D is incorrect: Completing sentences for the patient is patronizing and doesn't give them time to express
themselves. Patients with aphasia need extra time to communicate.
3. A patient with aphasia is having difficulty expressing their needs. What is the MOST important nursing
intervention?
A. Speak only to family members who can interpret
B. Be patient and give the patient more time to explain themselves
C. Use complex medical terminology to be precise
D. Limit communication to essential information only
ANSWER: B
Rationale:
A is incorrect: The nurse should always talk directly to the patient with aphasia, not just through family
members. This respects the patient's autonomy and dignity.
B is correct: Being patient and giving the person with aphasia more time to explain themselves is
essential. They need additional time to process information and formulate responses.
C is incorrect: Complex medical terminology makes communication more difficult. Simple, clear
language should be used.
D is incorrect: While efficiency is important, limiting communication can lead to unmet needs and
frustration. The nurse should facilitate communication, not restrict it.
4. A patient has right hemianopsia following a stroke. Which nursing intervention is MOST appropriate?
A. Place all items on the patient's right side
B. Approach the patient from the right side only
C. Place the meal tray on the left side and teach the patient to scan counter-clockwise
D. Keep items in the same position to avoid confusion
ANSWER: C
Rationale:
,A is incorrect: Placing items on the right side (affected side) means the patient cannot see them. Items
should initially be placed on the unaffected side.
B is incorrect: Approaching only from the right side reinforces neglect. The nurse should approach from
both sides and teach scanning techniques.
C is correct: A patient with right hemianopsia has lost vision on the right side. The tray should be placed
on the LEFT (unaffected) side initially, and the patient should be taught to scan counter-clockwise to
compensate for the visual field deficit.
D is incorrect: While consistency helps, the patient needs to learn scanning techniques to compensate
for the visual deficit, not just rely on memorization.
5. The nurse is assessing a patient with a left hemisphere stroke. Which finding would the nurse EXPECT
to observe?
A. Unawareness of deficits and impulsive behavior
B. Depression and awareness of deficits with impaired speech
C. Spatial-perceptual problems and denial of problems
D. Left-sided neglect and impaired judgment
ANSWER: B
Rationale:
A is incorrect: Unawareness of deficits and impulsive behavior are characteristic of RIGHT hemisphere
strokes, not left.
B is correct: Left hemisphere stroke patients are typically aware of their deficits and may become
depressed. They experience significant speech impairment (aphasia) and impaired comprehension since
the left hemisphere controls language in most people.
C is incorrect: Spatial-perceptual problems and denial are associated with RIGHT hemisphere strokes.
D is incorrect: Left-sided neglect occurs with RIGHT hemisphere strokes. Left hemisphere strokes cause
right-sided deficits.
6. A patient with a right hemisphere stroke is being assessed. Which characteristic is MOST consistent
with this diagnosis?
A. Aphasia and right-sided weakness
B. Depression and slow, cautious behavior
C. Denial of deficits and left-sided weakness
D. Impaired comprehension and right visual field deficit
ANSWER: C
Rationale:
, A is incorrect: Aphasia is characteristic of LEFT hemisphere strokes. Right hemisphere strokes typically
don't cause aphasia.
B is incorrect: Depression and cautious behavior are more common with LEFT hemisphere strokes. Right
hemisphere patients tend to be impulsive.
C is correct: Right hemisphere stroke patients often have denial of deficits (anosognosia), are impulsive,
and have left-sided weakness. They may lack awareness of their condition.
D is incorrect: Impaired comprehension is associated with LEFT hemisphere strokes. Right hemisphere
strokes cause left visual field deficits, not right.
7. The nurse is caring for a patient who had a hemorrhagic stroke. Which sequela would the nurse
anticipate?
A. Flaccidity that resolves within 24 hours
B. Motor impairment determined by flaccidity initially
C. Immediate return of muscle tone
D. No motor impairment expected
ANSWER: B
Rationale:
A is incorrect: Flaccidity following a stroke does not resolve within 24 hours. It may persist and then
transition to spasticity.
B is correct: After a hemorrhagic stroke, motor impairment is initially determined by flaccidity (decrease
or absence of muscle tone in affected areas). This may later progress to spasticity.
C is incorrect: Muscle tone does not immediately return after a stroke. The initial phase is typically
flaccidity.
D is incorrect: Motor impairment is a common sequela of hemorrhagic stroke and should be expected.
8. Flaccidity following a stroke is best described as:
A. Increased muscle tone and spasticity
B. Decrease or absence of muscle tone in the affected area
C. Involuntary muscle contractions
D. Normal muscle strength
ANSWER: B
Rationale:
A is incorrect: Increased muscle tone and spasticity may develop later, but this is not flaccidity.
