NCLEX-RN Pharmacology Neurological
System Part 1 Exam Questions with
Rationales
20 ATI & NGN-Style Practice MCQs
Question 1
Clinical Scenario
A 24-year-old woman with newly diagnosed generalized tonic-
clonic epilepsy is prescribed levetiracetam. She tells the nurse,
"I feel fine now that my seizures are controlled. I may stop
taking the medication if I don't have another seizure for a few
months." Her vital signs are stable, and laboratory results are
within normal limits.
Question Stem
Which response by the nurse is most appropriate?
A. "You may stop the medication whenever you feel seizure-
free."
B. "Skip doses if you experience mild dizziness."
,C. "Do not stop taking levetiracetam abruptly because doing so
may increase your risk of seizures."
D. "You should only take levetiracetam when you feel a seizure
coming."
Correct Answer
Correct Answer: C. Do not stop taking levetiracetam abruptly
because doing so may increase your risk of seizures.
Detailed Rationale
Levetiracetam is an antiseizure medication that reduces
abnormal neuronal activity and helps prevent seizures.
Consistent adherence is essential because sudden
discontinuation can precipitate rebound seizures or even status
epilepticus. Patients should only discontinue therapy under
healthcare provider supervision using a gradual taper. Patient
education should also include avoiding missed doses,
recognizing mood or behavioral changes, and avoiding activities
such as driving until seizure control is established.
Option A is incorrect because seizure freedom does not indicate
that epilepsy has resolved, and abrupt discontinuation increases
seizure risk. Option B is incorrect because patients should not
skip doses due to mild adverse effects without consulting the
prescriber. Mild dizziness often improves over time. Option D is
incorrect because levetiracetam is not effective as an "as-
,needed" medication; therapeutic blood concentrations require
regular scheduled dosing.
Medication adherence significantly improves seizure control
and reduces injury risk associated with breakthrough seizures.
Learning Objectives
After completing this question, the learner should be able to:
• Explain why antiseizure medications should not be
discontinued abruptly.
• Educate patients regarding medication adherence.
• Recognize appropriate patient teaching for epilepsy
management.
Medication Safety Focus
Patient Education
Question 2
Clinical Scenario
A 70-year-old man with Parkinson disease is prescribed
carbidopa/levodopa. Two weeks after therapy begins, he
reports that his hand tremor has improved but complains of
nausea and occasional dizziness when standing. Blood pressure
is 122/76 mm Hg sitting and 98/62 mm Hg standing.
, Question Stem
Which nursing intervention is the priority?
A. Advise the patient to rise slowly from sitting or lying
positions.
B. Recommend stopping the medication immediately.
C. Encourage increasing dietary protein with every medication
dose.
D. Restrict daily fluid intake.
Correct Answer
Correct Answer: A. Advise the patient to rise slowly from
sitting or lying positions.
Detailed Rationale
Carbidopa/levodopa remains the most effective treatment for
Parkinson disease by increasing dopamine availability in the
central nervous system. Orthostatic hypotension is a common
adverse effect, particularly during therapy initiation or dosage
adjustments. The priority nursing intervention is preventing falls
by teaching the patient to change positions slowly, sit briefly
before standing, and request assistance if dizziness occurs.
Adequate hydration and home safety measures further reduce
injury risk.
System Part 1 Exam Questions with
Rationales
20 ATI & NGN-Style Practice MCQs
Question 1
Clinical Scenario
A 24-year-old woman with newly diagnosed generalized tonic-
clonic epilepsy is prescribed levetiracetam. She tells the nurse,
"I feel fine now that my seizures are controlled. I may stop
taking the medication if I don't have another seizure for a few
months." Her vital signs are stable, and laboratory results are
within normal limits.
Question Stem
Which response by the nurse is most appropriate?
A. "You may stop the medication whenever you feel seizure-
free."
B. "Skip doses if you experience mild dizziness."
,C. "Do not stop taking levetiracetam abruptly because doing so
may increase your risk of seizures."
D. "You should only take levetiracetam when you feel a seizure
coming."
Correct Answer
Correct Answer: C. Do not stop taking levetiracetam abruptly
because doing so may increase your risk of seizures.
Detailed Rationale
Levetiracetam is an antiseizure medication that reduces
abnormal neuronal activity and helps prevent seizures.
Consistent adherence is essential because sudden
discontinuation can precipitate rebound seizures or even status
epilepticus. Patients should only discontinue therapy under
healthcare provider supervision using a gradual taper. Patient
education should also include avoiding missed doses,
recognizing mood or behavioral changes, and avoiding activities
such as driving until seizure control is established.
Option A is incorrect because seizure freedom does not indicate
that epilepsy has resolved, and abrupt discontinuation increases
seizure risk. Option B is incorrect because patients should not
skip doses due to mild adverse effects without consulting the
prescriber. Mild dizziness often improves over time. Option D is
incorrect because levetiracetam is not effective as an "as-
,needed" medication; therapeutic blood concentrations require
regular scheduled dosing.
Medication adherence significantly improves seizure control
and reduces injury risk associated with breakthrough seizures.
Learning Objectives
After completing this question, the learner should be able to:
• Explain why antiseizure medications should not be
discontinued abruptly.
• Educate patients regarding medication adherence.
• Recognize appropriate patient teaching for epilepsy
management.
Medication Safety Focus
Patient Education
Question 2
Clinical Scenario
A 70-year-old man with Parkinson disease is prescribed
carbidopa/levodopa. Two weeks after therapy begins, he
reports that his hand tremor has improved but complains of
nausea and occasional dizziness when standing. Blood pressure
is 122/76 mm Hg sitting and 98/62 mm Hg standing.
, Question Stem
Which nursing intervention is the priority?
A. Advise the patient to rise slowly from sitting or lying
positions.
B. Recommend stopping the medication immediately.
C. Encourage increasing dietary protein with every medication
dose.
D. Restrict daily fluid intake.
Correct Answer
Correct Answer: A. Advise the patient to rise slowly from
sitting or lying positions.
Detailed Rationale
Carbidopa/levodopa remains the most effective treatment for
Parkinson disease by increasing dopamine availability in the
central nervous system. Orthostatic hypotension is a common
adverse effect, particularly during therapy initiation or dosage
adjustments. The priority nursing intervention is preventing falls
by teaching the patient to change positions slowly, sit briefly
before standing, and request assistance if dizziness occurs.
Adequate hydration and home safety measures further reduce
injury risk.
